Lightweights....DS v. RNY?

Just curious how many of you have had DS v. RNY?

I understand that a lot of insurance won't cover unless your BMI is over 50 and it is more malabsorptive than RNY but much better at resolving Diabetes.

 

I have been asking on the boards and decided to stick with RNY because I think there may be some deal breakers for me with DS.  I've had some people privately email me with some negative side effects.  Mostly hearing horrid gas odors and in some cases severe diarrhea and uncontrollabel "accidents".

I also understand that many more supplements are needed and I know I can commit to the RNY schedule of supplements but don't know what DS require or if I can.

I keep hearing that DS let's you eat what you want, but I don't want that lifestyle anymore.  I don't want my life to be about food bur rather my social life about being active and doing things....

 

Any thoughts?

PS - not putting anyone or any type of surgery down...just very curious....

 

Deb

We have some very successful DSers here as well as some very successful RNYers.  Both take work for the rest of your life.  WLS is a tool, not a magic pill.  DS has some great advantages but also, more malabsorption with the situations that can cause.  It also isn't covered by all insurance and shouldn't be performed by just anyone.  When I think about our successful folks who have had DS, they aren't eating anything they want.  They are being smart about what they eat but they do eat more fat than most of us RNY folks.

RNY also required vits for life and following your labs to be sure you are ok.  It is more common and easier to find someone who can do a good job with the surgery.  It also may not take a fight with your insurance company.  Most folks with RNY have their diabetes resolved. 

With either, we can be pretty darn gasy in the beginning as our new gut learns its job.  Some folks get constipated, other diarrhea.  It's a process and we get through it.

With either, as a light weight, you have a good chance of getting to a normal BMI and getting rid of co-morbidities.

Thank you for your thoughtful response.  I had asked the same questions on the DS board and I feel that some of the DSers are trying to sell  me on it or change my mind about the RNY.

 I do realize it is the effort you put into it.  I can't imagine after going through all this to sabotage your success and fail.  However, in my nutrition class there were people talking about this like it wasn't a big deal and from the way they were talking they didn't seem all that committed to the new lifestyles that will need to do.

I'm very excited about this and do look forward to being about to LIVE my life with great quality after WLS.

Deb

It does seem like this is a lot to go through to not be committed to it but folks out eat their surgery every day.  I don't think every group does a really good job educating pre-surgery about the new life.  I think it is very sad when I see folks gain back their weight. 

Hi,

I'm a lightweight and went with the DS for the malabsortion for me I just really felt like I needed the help long term. I also take NSAIDS which you can't take after having RnY and that worried me. It was harder to find a Dr to do the surgery then the RNY for sure. As far as my insurance went it didn't matter what I had they approved any surgery if you met the 35 to 40 BMI. Best of luck trying to decide I know its not easy.

Trish

My BMI is approx 40.5 -41.0. I am getting the DS on 1/24/13. I chose the DS because anatomically it made sense to me. I know plenty of rny pts...they have done wonderfully good luck to ya!

I had RNY. DS was not an option on my insurance plan. Here are my thoughts having listened carefully on the boards to both groups AND having a dear friend who had DS (earlier version that was performed i*****).

There are specific issues that could do better with DS and if I had severe arthritis (mine is mild) and a history of long-term morbid obesity, I would need anti-inflammatories and DS would be better. If I had diabetes long term, it would be better. 

I still needed the maximum weight loss because of compression fractures of my lower spine and neuropathies of both feet. Surgeon said RNY would result in the most weight loss compared to sleeve or lapband. DS was out because of insurance.

I was very proportioned for all of my life until 38 years old. I'm 5'4" and weighed about 140 then. Was 115-125 until my thirties and then gained weight gradually as I became less active and then all of a sudden I had a bad car accident and was also hit again two years later. My weight skyrocketed to 230+ pounds. Because I was managing my weight for a long time during my life, RNY seems reasonable for me to gain control again. My brain does have some wiring inside that could be woken up again and used to maintain a lighter weight. RNY is a great tool if one has the capacity to use it effectively. I think it is a good fit for me.

Now for my friend. DS saved her life. She was morbidly obese ALL her life. Her liver was failing (in lab values). She had addiction issues with alcohol for many years. I witnessed first hand food being consumed on a large scale. After her surgery and recovery, I was surprised at how much she still ate and yet remained in a small petite size. She clearly needs to eat. There is an addiction there but it is much better than alcohol (she doesn't drink now). DS in her case allows for her to meet her psychological need to eat more than what RNY would allow. She does eat healthy food but just a lot of it.

It is my opinion that if she had RNY, she would have been a failure and would have had to be converted over to a DS. As for RNY, I have seen a few failures and have read about some online. My friend with the DS struggled with a bad cabbage odor but did get it figured out and under control. I rarely even detect it anymore and if I do it is very faint. She rarely has the bathroom issues.

The decision is extremely personal as each person is unique. The more you know about others, the more you can figure out yourself and make a better decision. I was surprised at those with extensive knowledge about DS on these boards. If my friend was online in the first few years after her DS, she would have been one who would have told you straight up about the problems with it and it would have discouraged anyone. But she got it under control but it did take some time. She is an inspiration. 

I'm one that sees both sides. 

I'm nearly 6 months out from getting the DS and I've zero complications and no accidents at all. I only get and diarrhea if I have too many carbs which I generally don't - I might do this once or twice a month at the very most.

My stools are looser but definitely not diarrhea. I took a 2.5 hour flight yesterday and had absolutely zero gas/bloating issues although I seriously avoided carbs in the preceeding 24 hours. For me this is something I'm totally able to control.

Even though I'm a lightweight I know I couldn't stick to the RNY diet and given that I was self pay I was prepared to fly to another country to have a vetted DS surgeon.

Also dumping and not being able to drink with meals plus never being able to have NSAIDs were deal breakers - plus I'd already had 1 WLS the sleeve, and I wanted this to be my final WLS

Yep, if you ask this question on surgery specific boards they are going to sell you theirs. 

The DS has been a lifesaver for me--5 comorbidities going into this and 36.8BMI to start. I got to keep my pyloric valve, so no dumping and I can eat a little more--not much more. Jody and Linda, who are RNYrs, and I have gone out to eat together and we eat about the same. I do eat more fat and oils but that's about it. I don't avoid fats and oils, just can, and do, eat more natural fats and oils.

I have intentionally worked to keep my sleeve small by drinking protein shakes rather than trying to get all 120 grams of protein via dense meat and other foods. I do have to work to keep gas issues under control and I do have to supplement more than someone with the RNY. All doable and worth the pay off. Ask Jody if I'm successful controlling gas issues. lol  She is here on the LW board and we spend a lot of time together shopping and going out to eat and such.

Anyway, do some research on www.dsfacts.com and continue to ask questions. You've gotten some great feedback here. Good luck!

--gina

 

Thanks everyone. One more question. I see people who have revisions from RNY to DS? How can you do that if you don't have the pyloric valve anymore?