Kristina R.
Some Reasons Why I chose the DS as opposed to the RNY
(from Lola)
It never ceases to amaze me that one persons reason for getting a particular surgery, is another persons reason to NOT get that surgery.
RNY - I got the surgery so I'd dump and the fear of that would keep me away from sugar.
DS - I got the surgery so that I wouldn't dump.
RNY - I needed the restriction to correct my relationship with food.
DS - I didn't want the restriction because I want to enjoy my relationship with food.
RNY - I wanted/needed to change my eating habits.
DS - I've dieted my whole life -- I want to quit dieting.
RNY - I'm sick of dieting and failing.
DS - I'm sick of dieting and failing.
RNY - I want a tool that I can work.
DS - I want a surgery that does the work.
RNY - I didn't want to be able to cheat the surgery.
DS - I want to be able to 'cheat' from time to time.
RNY - I want to be healthy.
DS - I want to be healthy.
RNY - I didn't want someone cutting off my stomach.
DS - I don't want a blind stomach.
RNY - I don't want to have to eat massive amounts of food.
DS - I want to be able to eat what I want.
RNY - I needed to change my habits.
DS - I've been trying to change my habits my whole life!
RNY - I never want to eat sugar or fat again!
DS - I don't want sugar and fat to be 'off-limits'.
The best choice is an informed choice!
RNY compared to the DS ... This excellent comparison was composed by Hayley F.
RNY – expected weight loss
* 50-65% expected excess weight loss (percentage varies in opinion – this is the most commonly seen estimate)
~ Results may vary
* Regain
~ Possible regain: 50% of weight after 5 years
~ 100% regain of weight has been recorded
~ Must follow “pouch rules” in an attempt to not regain
~ RNY must exercise and diet to maintain weight loss after 5 years
DS – expected weight loss
* 85% expected excess weight loss
~ Results may vary
* Regain
~ Studies show little to no regain
~ 20 lb gain from lowest weight has been recorded
~ Highest success rate over 10 year study (78% avg. Excess Weight Loss – EWL)
RNY – have a stoma (stomach made into a pouch – size of an egg)
* Size: 2 oz
~ Stretch to average size of 6 oz in 2 years (possible to stretch up to 9-10 oz)
~ You can eat more as time goes by
~ Average after 1 year is 1-1.5 cups of food
* Stoma: blind pouch
~ Doctor evaluation: cannot use an endoscope (to find ulcers and tumors)
~ Cannot take Nonsteroidal Anti-Inflammatory drugs (NSAID).
* NSAIDs are: Advil, Alka Seltzer, Aleve, Anacin, Ascriptin, Aspirin, Bufferin, Coricidin, Cortisone, Dolobid, Empirin, Excedrin, Feldene, Fiorinol, Ibuprofen, Meclomen, Motrin, Nalfon, Naprosyn, Norgesic, Tolectin, Vanquish
~ NSAIDs are used for arthritis, bursitis, tendonitis, back pain, headaches, and general aches and pains. This could develop into a bleeding ulcer and interfere with kidney function.
* Possible Problems
~ Ulcers (Doctor’s recommend taking prilosec for 1-2 years in an attempt to prevent the ulcers)
~ Possibility of a staple line failure
~ Noncompliance: simply do not lose enough (even with following the rules)
~ Vitamin Deficiencies
~ Narrowing/blockage of the stoma
~ Vomiting if food is not properly chewed or if food is eaten to quickly
~ Dumping syndrome and NIPHS/Hypoglycemia
+ No Valves (pyloric valve that opens and closes to let food enter intestines is bypassed) which means food empties directly into the small intestines and causes dumping and NIPHS/Hypoglycemia
* Dumping: food (most commonly sugar but not necessarily “just” sugar) enters/dumps directly into small intestines and causes physical pain (some people believe this pain enforces good eating habits)
~ Dumping varies in degree of occurrence and discomfort
~ Dumping symptoms:
+ Nausea
+ Vomiting
+ Bloated stomach
+ Diarrhea
+ Excessive sweating
+ Increased bowel sounds
+ Dizziness
+ “Emotional” reactions
* NIPHS (insulin over production): “the body overproduces insulin in response to food entering the intestines at a point where food would normally be more digested already - this part of the intestine is not used to coping with metabolizing glucose in the condition it arrives after RNY, and it is suspected that the intestine signals the pancreas for more insulin to aid digestion, causing a MASSIVE overproduction. The change occurs on a cellular level, hard to diagnose. Treatment: Removal of half the pancreas.”
~ RNY stoma that is created allows food to go straight through the stomach into the small intestine unrestricted so it does not control the flow. Because of that the body reads that it needs more insulin because the food is moving through so quickly and it thinks there's going to be a lot more food. With the DS, the normal peristalsis works because the pyloric valve is in place and can control the movement of food into the small intestines.
~ NIPHS/Hypoglycemia is deadly if not corrected
DS – whole stomach (size of banana)
* “Whole working stomach” - meaning the stomach’s outer curvature is removed as opposed to making a pouch/stoma.
~ Part of the stomach removed is where most of the hormone called Grehlin is produced.
~ Grehlin gives the sensation of hunger so by removing most of that section of the stomach a DSer is not as hungry as before.
* Whole working stomach: no blind stomach. Endoscope can be used.
* Can take NSAIDs
* Do not need to take Prilosec to prevent ulcers.
* Valves are in tack: no Dumping Syndrome or NIPHS
RNY – Eating
* Recommended to chew food to liquid (most important early out)
~ Foods need to be thoroughly chewed to prevent blockage (the hole/path leaving the stomach and into the intestine is the size of an eraser).
~ To get food unstuck, patients drink meat tenderizer mixed with water.
* 64 oz of water
~ Stop drinking within 15-30 minutes of a meal
~ Do not begin drinking after a meal for 1-1.5 hours
~ Not encouraged to use a straw (pushes food too quickly through the stomach and can cause gas/discomfort)
* Low carbohydrates (carbohydrates can slow weight loss)
~ Avoid sugars (to prevent dumping syndrome and slowed weight loss and/or weight gain)
* Low fat
~ Foods high in fat can also cause Dumping Syndrome
* Eat protein first
~ 60g of protein a day
* Water Loading
~ 15 minutes before the next meal, drink as much as possible as fast as possible.
~ Water loading will not work if you haven’t been drinking over the last few hours.
~ You can water load at any time 2-3 hours before your next meal if you get hungry, which will cause a strong feeling of fullness.
DS – Eating
* 80-100g of protein
~ DS patients can on average eat more food than any other type of weight loss surgery.
* 64 oz of water
~ Can drink with meals
~ Can use a straw
* Low carbohydrates (carbohydrates can slow the weight loss)
~ No dumping syndrome from eating sugar
* Eat high in fat
~ DS only absorbs 20% of fat (do not need to eat low fat)
+ If a taco has 20g of fat, a DSer only absorbs 4g while a person without surgery or RNY absorbs ALL 20g.
+ When experiencing a “stall” (slowed weight loss/plateau) a DS patient commonly increases fat consumption
RNY – Possible Issues
* Vitamin deficiencies: Must follow a vitamin regime for the rest of your life
~ Common vitamin deficiencies found in vitamins B12, iron, and zinc
~ Calcium must be supplemented for the rest of your life
* Bathroom issues
~ Gas
~ Constipation
* Reversible procedure (Reversals of any surgery is very complicated)
~ Revision often performed instead of reversal
DS – Possible Issues
* Vitamin deficiencies: Must follow a vitamin regime for the rest of your life
~ Common vitamin deficiencies found in vitamins A, D, and iron
~ “Water soluble”/ “water miscible” / “dry” vitamins absorb best (in other words get vitamins that are not fat/oil based)
~ Calcium must be supplemented for the rest of your life
* Bathroom issues
~ Gas
~ Loose stool (Most common in the first few weeks of surgery. Food related)
* Reversible procedure
~ The intestinal bypass is reversible for those having malabsorptive complications
+ revision: lengthening common channel
~ Stomach is obviously not reversible (part of stomach was removed)
RNY - Diabetes
* 85% cure rate
~ RNY does not cure diabetes but puts it in remission.
~ Can come back in two or three years--even if the
patient maintains most of their weight loss.
~ Even a small weight gain long-term can cause a diabetes
relapse.
DS – Diabetes
* 98 % cure rate for type II diabetes.
DS – Myth or Fact
The DS is only recommended for the super morbid obese (BMI over 60) = Myth / Not True
* To be eligble for ANY type of weight loss surgery, a person has to be 100 lbs. over weight or have a body mass index (BMI) of 40 or more.
* BMI’s under 40 have also been approved (usually require a comorbidy/health problem - an example is sleep apnea).
The DS is “experimental and investigational” = Myth / Not True
* Medicare approves the DS
* Many insurance companies are starting to cover the DS.
* DS has been performed since the 1970s
DSer will have a problem when they become old = Not True
* We wont need to eat as much when we are older b/c our bodies will adapt
* The little hair-like villa located in the intestines grows longer to adjust to the new digestive system (grows longer to increase absorbtion).
DSer’s gas stink = true
* The gas does smell. (This is true for the DS and RNY)
* There are products called air fresheners that a person can use.
DSers may need to wear a diaper = Myth / Not True
* That is silly
Skin color turns yellow or pallor = Myth / Not True
* Patients who follow their regular vitamin regime (keep up with blood work) do not turn pallor
* If someone looks pallor, they could have a vitamin deficiency. This applies to any type of weight loss surgery.
* Vitamins and blood work must be monitored for life. For both RNY and the DS.
DSers will have a heart attack from all the fatty food they eat = Myth / Not True
* Cholesterol levels lower after having the DS.
* 80% of the fatty food is not absorbed – the fatty food is healthier to eat as a DSer than a person without surgery.
* If a taco has 20g of fat, a DSer only absorbs 4g while a person without surgery or a person with the RNY will absorb ALL 20g. Good meal for the DSer.
Dsers don’t need to exercise = Myth / Not true
* DSer’s are aware of the benefits of exercise (body and soul).
* Exercise helps in losing weight and maintaining goal weight
Not every surgery will be right for everyone. Not every surgery will be covered by insurance. Good luck to everyone and thank you for reading my comparison chart. Hayley F.
Okay, so here's my story....
I've been fat for as long as I can remember... God I hate that word "FAT" it just sounds so awful... Anyways...
I was born in CT and lived there untill I was 12. I'm biracial, my mom is white (hungarian irish and german) and my dad is black. Both of them have been overweight since about their 30's (but they both struggled with it before that). I was within my weight range, but on the high end. Unfortuneately, all the kids I went to school with were skinny, so even though I wasn't technically overweight, I still got teased mercilessy. My nickname in 2nd grade was "blubberina" it still makes me cry to think of that. When I was 12 my dad got transferred to FL, and we uprooted our lives and moved down there to the Tampa Bay area. It was at this point my weight started to creep up and up. by the time i was 14 i was over 200, over 250 by 16. I never really figured out if the weight gain was due to me hitting puberty, or the turmoil in our family at that point, they kinda coincided. I was still teased mercilessly, now not just about my weight, but my racial background as well. There were a lot more black kids in florida, but although I tended to hang out with them more, I never really fit into any one group. by the time I hit 10th grade I was miserable. I had broken several chairs at school, in the middle of the cafeteria, which of course just gave the kids there more of an opportunity to tease me.
In my desperation to fit in with someone, anyone, I gave away the only thing it seemed anyone ever wanted from me... I lost my virginity at 14 and by the time I left school, I was widely known as the "loose" girl (although I was called much worse) Since I never wanted to be a high school dropout I got my GED right away and went to college. Though my grades in High school were terrible, my scores on the entrance exams were extremely high. In college, I was at least able to blend into the background a lot more. I no longer got teased (not to my face anyway) I just got ignored, which was fine with me. Unfortunately due to my "loose" morals and overly trusting nature, I fell in with some people who were not very good for me. At that age it was hard for me to understand that a guy could want to have sex with me without actually wanting me. So I ended up with quite a few jerks, and was even raped at the age of 16 by my boyfriend (who was by the way 10 years older than me)
I had my heart broken more times than I could count and still went back for more cause I hated being alone.
by 18 I was up to 300lbs. I had been with a guy on and off for a few years and at 19 I got pregnant from him. We have not had a civil conversation since. I had my daughter at 20. My pregnancy was uncomfortable and miserable because of my weight. I had horrible heartburn throughout and was unable to eat. I actually ended up losing weight LOL. I was in labor for 39 hours. I had to be induced. apparently my hormones were messed up from having poly-cystic ovarian syndrome(did not find that out till several years later though) that my body was unable to go into labor on its own. Anyhow... I had my daughter and she was incredible. She was so beautiful, even all wrinkled and purple when she first came out lol like an 8lb raisin! Things for the next few years were not too bad, I got my Associates degree at 22 and a second one at 23. I majored in sign language interpreting, but I was unable to pass my state certification test because my signs were " too large" kinda hard to sign in a small space when you wrigh 330lbs. I went to the University of South Florida to pursue my BA in Psychology.
By this time I was over 350, though I'm not sure how far over since my doctor's scale didn't go up that far. I had 4 PCPs in 2 years, and they all said the same thing "gee Kristina, you really need to lose some weight!" I had one Dr tell me that because of my weight and the tendonitis in my ankle I would be in a wheel chair by the time I was 30. No one had any suggestions other than "eat healthy and exercise" Oh my god!!! Why didn't I think of that????? It still amazes me how much of the medical community is completely retarded when it comes to morbidly obese and super morbidly obese patients. Do they think that we really want to hurt everywhere and not be able to breathe when we go up the stairs? Like we haven't tried every diet on the planet, no matter what effect it may have on our health?
Anyways, when I turned about 25, I met a girl online who told me I was really pretty and I should try modeling. I was intrigued at who would want a model who was 5'4" and 370lbs, so I took her information and went to this website. I won't say the name of the site here, but it is an adult site devoted to BBW. I figured what the hell and took a few pics using the timer on my digital camera and sent them in. within a month I had my own site and even a paying member. I got emails every day telling me how sexy and beautiful i was, but i never ever believed it. It was still uncomfortable for me to get naked in front of anyone else (weird considering I had put my privates on display on the net) I hated looking at my own pics even if was to decide what pics to send to the webmaster to put on the site. After awhile, I hooked up with another girl in my area and she took some pics for me and helped me become a bit more comfortable with my body. I still hated the way I looked but at least i could believe there were people out there that thought I looked good (even if I thought they were nuts) BTW if you want to see any of the PG pics I have them posted on my myspace page, myspace.combbwhottiejazz. There are some of them that even i think are pretty (mostly the ones that are neck up)
About 2 years ago, my parents moved to VT. a year later, I followed, i hated being so far away from my mom. I've been here for a year, and things have never been better. My daughter is truly blossoming in school. she is a little bit heavy, but she is extrememly active, which I never was. I have a job that i love, and I live with my parents at the moment, but I will by buying my own home relatively soon. We're even getting a puppy this weekend! I am even taking Tae Kwon Do several times a week. My daughter has been doing it for over a year, and her master finally convinced me to take a class. I was so embarassed, I hate doing anything even remotely physical in front of anyone else, but everyone was really supportive and it turns out that I am very flexible and stronger than i thought, and I am doing very well.
Anyhow, here is why I am HERE... I was diagnosed with type 2 diabetes earlier this year. My PCP here (who is wonderful by the way) suggested WLS to me after (yet another) failed Weight Watchers attempt. i had done some research on it in the past and it was such a scary thing, but the idea of having diabetes really made me think about it seriously. At first what I wanted was a lap-band, it seemed the least dangerous and least invasive procedeure. doing some more research, i found out that since my BMI is so high the surgery is not even possible (the max BMI that the local surgeon reccomends for lab band is 45 I'd have to lose 100lbs to get there) Plus the fact that the success rate is generally about 50% of EWL which just wasn't good enough for me. I learned some more about the RNY but I was really hesitant to do that for many reasons. First of all, I can't take most narcotic pain meds. With an RNY I couldn't take any NSAIDS, something I rely on on a daily basis for my TMJ (something that would not go away after weight loss) Then there was the whole idea of dumping. I am a chef and the idea of not even being able to taste the stuff I cook without fear of becoming violently ill was upsetting. Finally, I had read some stats about RNY patients with a higher starting BMI regaining a lot of weightat about the 2 year mark. It just didn't seem worth it to me to have such a major surgery then still regain the weight. I mean I know there are plenty of RNY success stories out there, but I didn't want to be one of the failures!
I joined OH not too long ago, and I learned about the DS procedeure. I thought it was too good to be true, but as I read more and more success stories I became more and more convinced that this was the right thing for me. I searched around untill I found an experienced surgeon not too far away. There are no surgeons in VT who do this procedeure, so I am going to NY with Dr Roslin. I have my surgical consult at the end of November and if all goes well with insurance I should be switched by March of 08!! I am very excited, and so glad to have found OH and all the amazing people on it!!!!!!!!!
