Question:
I have a BMI of 45; should I qualify for the BPD/DS?

I was thrilled when I was approved by my insurer and got a surgery date for a proximal RNY--until I saw a posting on this site about the BPD/DS (duodenal switch). The quality of life and insurance against future regaining sound so much more promising. When I asked my current doctor--a young pup a good ten years my junior--about the duodenal switch, I got a stern lecture: "It's a more radical procedure. There's a risk of death. You'll have loose, smelly stools and nutritional deficiencies. You're not fat enough to justify those risks. With diet and exercise, you should be able to reach and maintain a reasonable weight after the proximal RNY." He intends to bypass "up to" 100 cm. Well, if diet and exercise had ever worked for me, I would not be considering surgery. Risk of death? People have died after the proximal RNY as well. Nutritional deficiencies? One must take daily nutritional supplements for life after either procedure, and keeping pills down on a tiny, tender stomach with a single sip of water, as required after the RNY, sounds like a real challenge. The stools with the BPD/DS sound easier to manage than the nausea, vomiting, and flu-like symptoms the RNY can cause. From what I've read, the proximal RNY succeeds in large part by creating an aversion to food. The pleasure of eating--not bingeing, not gluttony, but normal eating--is something I am not eager to surrender. Lastly, going through all this and leveling off at 200 pounds, or regaining much of the lost weight, as many people apparently do after the proximal RNY, is a daunting possibility for me. Are surgeons who perform the duodenal switch generally willing to do so on a patient with a BMI of 45?    — Kay B. (posted on December 20, 2000)

December 20, 2000
Hi Kay, I am 5'1" and on my surgery date weighed 212. My BMI was low compared to others...when I first started doing research, it wasn't even at 40. I think the RNY is a good surgery, for those that have it. You have to remember, to each his/her own. I say "whichever surgery you choose to have is the best one for you". I had the open BPD/DS. I had my surgery on October 12, 2000. And, I have lost 46 pounds so far. I'm happy with my decision. I chose to have the bpd/ds because of some of the very reasons you've mentioned. I wanted to be able to eat, just not like I was. But, I also think..you can adapt to anything..so, if I had never been given the choice of the bpd/ds I would have went with the RNY. I take a prenatal vitamin everyday. I also take Calcium Caltrate (2 pills a day, and they are big). I have to get in (or at least my surgeon wants me to get in) 90 grams of protein a day..I make around 60 usually. I still am not getting in as much water as I should..but, I am trying. I haven't exercised at all...I have fibromyalgia..and the surgery brought on an attack. Hard to exercise with chronic muscle pain, but..I know I would feel better if I did...go figure! :-) Read everything you can, study like your life depended on it, ask advice, discard what you don't need and keep the others, and make your own decision. Because when it comes time, it is up to you and you alone. But, we will all support whatever you decide. Don't let anyone tell you any surgery is better than any other..that's your decision. As for your doctor, he/she won't be living with the choice you make, okay? If you want to email me...feel free. [email protected] Good luck and God bless~Terri
   — Terri G.

December 20, 2000
The majority of them use a BMI of 40 or greater. If you have a surgeon in mind, the best thing to do is to call his office and ask. Congratulations on your decision to have the DS!! Making that decision is a big part of the process! I've lived with the DS for over 13 months now, and you're right about so many things. I'm turning into a healthy human being with no more "problems." None. I'm healthy and I'm loveing every minute of it! To read my story, please visit <a href="http://www.mywls.com"> My Website</a>. Good luck to you!
   — [Deactivated Member]

December 20, 2000
Hope this doesn't become a DS vs RNY...that gets SO tiresome. Bottom line Kay, get the surgery that you feel is best for YOU. You'll find good/bad points and trade offs with all. Pick the one that you can live with for the rest of your life. Most post-op RNYs are fine. I've never through up or even had dry-heaves. 7 months post-op and 89 lbs gone forever. 26 lbs to goal! Good luck with whatever you decide.
   — Maxine E.

December 22, 2000
My surgeon is located in Ohio and does both RNY and BPD/DS. The choice of procedure is left up to the patient, and a BMI over 40 will qualify you for either surgery.
   — Karen F.

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