Question:
How do I decide between the RNY vs. DS?
I need to lose nearly half my body wt, about 140 lbs. I'm having trouble deciding between the RNY and DS. I really want a lap procedure but fear dumping. Also, I'd like to be able to be able to eat a more normal meal so as to not be so "obvious". However, the absorption issues concern me. Can anyone tell me why they decided on one surgery over the other? — Devonne O. (posted on February 25, 2001)
February 24, 2001
Well, I am in the same situation as yourself, same amount of weight to
lose, I am 33 years old. I have chosen the DS after doing a lot of
research and weighing the pros and cons of both procedures. I did the vast
majority of my research on this very site. The "information
library" and Q and A sections archives have a TON of info for you!
Also check out the DS website, www.duodenalswitch.com. With either
procedure there is the "malabsorbtion" mechanism which will mean
that we will be taking supplements for the rest of our lives, but I feel
it's a small price to pay to be able to change my life in such a dramatic
way!! =) Check out the info here and to other links people recommend, and
keep up posted! Good luck to you.
— ChristiMNB
February 24, 2001
As a nurse, I researched the subject of WLS for many months before coming
to a decision. I also made an objective analysis of my eating lifestyle
and those factors that had contributed to or helped to create my morbid
obesity over the years. In addition to a strong genetic factor in my
family, I faced the facts that I ate too much, was a "grazer"
throughout the day, ate too fast, hardly chewed my food at all, and ate an
incredibly high fat diet. I chose a lap RNY because I wanted a surgery
which would encourage me toward a more normal and nutritionally correct
eating lifestyle...the things that our more slender friends do without
thinking: eating smaller portions, chewing thoroughly, eating more slowly,
limiting sugars and fats, and stopping when feeling full. The RNY gives me
all those things, and I have never felt "deprived". I already
suffered from Irritable Bowel Syndrome, so I clearly was not in the market
for a surgery which would increase my malabsorption problems. I do
experience "dumping" when I eat refined sugars (dessert items),
but it is not the horrible experience that many make it out to be...at
least not for me. It is an unpleasant sensation of nausea, weakness and
slighly rapid heart rate which lasts for about 20 minutes...not
life-threatening, but certainly a reminder that sugar is not a good thing
for me. I have not considered "dumping" a bad trade-off for the
125 lbs. lost over the past 11 months. Aside, from desserts, I eat
everything my friends eat, just much less of it. No one comments on the
size of my portions, and when I look at the plates of my very slender
friends, I find that we eat about the same amounts....phenomenally less
than I ate before! I felt that I needed and wanted to make constructive
changes in my life...both inside my body with the surgery, and outside with
my lifestyle. It seems to me that DS surgery is an option for those
patients who do not wish to make changes in their eating lifestyles or fear
that they cannot make lifestyle changes and would "grieve" the
loss of their favorite foods. Malabsorption becomes the major mechanism
for weight loss rather than lifestyle changes. I have "missed"
nothing, I am never hungry and have to look at the clock to remind myself
that it's time to eat, I take a multivitamin and a calcium supplement daily
and all my lab values are "picture-perfect" nearly one year
post-op. Whatever your decision, make it based on all the research
possible. That's the only way you will know that you made the decision
that was right for you. Remember, both procedures accomplish the same
goal...it's not so much which path we take, it's that we start and finish
the journey. Good luck!
— Diana T.
February 25, 2001
I will tell you my thoughts and feelings as I made my choice. I chose the
DS for many reasons. The number one reason I chose the DS was that it was
not a VBG or an RNY. I know that many people love and are very happy with
highly restrictive procedures, but for me there was little upside in those
options: I was not a slave to sugar, so I didn't feel that setting myself
up for physical discomfort (dumping) in that regard was necessary. I was
not an eater of mass quantities of food, so a high level of restriction
didn't appeal to me either. I saw lots of "pouch" issues being
discussed online; marginal ulcers, blockages, strictures and repeated
endoscopies were repellant to me. While I made bad food choices at times
(just like any other normal person), I was able to honestly assess my
eating patterns and see that my intake was not the main problem. The
problem was how my body was treating the intake. I needed the metabolism
"tweak" that the malabsorptive procedure would give
me.<br>
<br>
Years of yoyo diets and failed exercise resolutions had shown me that I
realistically wasn't going to make sustained "lifestyle" changes.
I refused to put on the rose-colored glasses again. The surgery is too big
and the stakes too high for me to try to fool myself in that regard. I have
never liked exercise, even at my lower weights, and my years of yoyo
dieting had screwed my metabolism completely. I couldn't lose weight
without sustaining an intolerably low caloric intake.<br>
<br>
I didn't want to choose a surgery that would require me to make
"lifestyle" changes. I'm not saying that I was stubbornly
unwilling to do my part. I'm saying that I wanted a surgery that would work
for me moreso than a surgery that I would have to work for. Subtle but
significant distinction.<br>
<br>
Given all of that, and all the research I had done and reading of clinical
reports, I decided that a mostly restrictive surgery would not make me
happy, nor would it give me the long-term results I wanted. All of the
choices require lifelong vitamin compliance and aftercare, so that was not
a deal-breaker for me. The DS surgery has the best percentage of excess
weight loss over the long-term, with the fewest restrictions on types and
amounts of food. There are no ongoing "pouch" issues with which
to contend. As long as I get my annual bloodwork and stay religious with my
daily multivitamin and calcium, I will stay healthy. To me, that's a
miniscule price to pay for a real chance at normal.<br>
<br>
I'm 16 months post-op and have gone from 299 to 161 and still losing (but
tapering off slowly now). I truly eat what I want, when I want, and treats
included. My bloodwork has been consistently good, and my overall health
and well-being are phenomenal. I love being unrestricted and feeling
utterly normal.
— mmagruder
February 25, 2001
The main reason I chose the DS over the RNY, having thoroughly investigated
them both is that the RNY creates an abnormally functioning stomach, for no
good reason as far as I can tell. The loss of the pyloric valve is
unecessary. I even asked the RNY doc if he could do the RNY and do the DS
version of the stomach. He said he WOULD not, and refused to offer any
reason why except that "We don't do that here." that told me
they were way too interested in the assembly line approach to the surgery.
My stomach was reduced from one that could hold upwards of 1.5 GALLONS of
food, to one that feels full with about 1.5 cups. My food selections were
pretty good before hand, it just took a huge volume for me to feel full.
Now, I eat pretty much the same things I ate before: Egg McMuffin and nurse
a large ice tea for breakfast, 8oz yogurt or a banana about 10:30, soup and
salad(with dressing!) or a tuna sandwich (before I used to eat 3-5
sandwiches) for lunch, 1/5 cups of baby carrots for a snack, a 4 inch
square of lasagna for dinner, 2-3 cups of watermelon (before I would eat
about 1/4-1/3 of a melon), or a cup of frozen yogurt or a couple of cookies
and milk before I go to bed. Obviously I vary the vegies, sometimes make
my own scrambled egg omelette, etc., but for the most part that is what
satisfies me. I am 9 months post op and have lost 142 pounds. I will put
up a new picture when I hit the 150# lost mark. Good Luck to you!
— merri B.
February 25, 2001
I started out at 280 pounds 13 months ago and had open RNY
surgery. I am down 130 pounds so far and still losing slowly.
I don't know alot about the DS, but for me, the RNY is perfect.
I eat around 1-1/2 cups of food at a sitting, and I eat
normally (it doesn't take me 45 minutes to eat). Quite honestly,
I DON'T want to eat the way I ate before- even if I don't absorb it.
I was out of control and I didn't like the amounts I ate- there was
nothing normal about those portions. I think the amount I eat NOW
is normal for me:) I know the dumping and food restrictions sound scary,
but
they don't last forever (even if some AMOS members think
they should). I didn't have this surgery to keep me in bondage
to food, I had it to free myself from it. I can and do eat sweets
occasionally,
high fat foods, and carbs. None of them do I eat in large amounts,
or often, but I will eat if I have a craving (especially
during that time of month). The surgery is a great tool
for me. Good Luck in whatever you decide!
— M B.
February 25, 2001
This is an easy one for me to answer for two reasons: #1 There are no
doctors in our area doing the DS. #2 Sugar and sweets were one of my BIG
problems and I needed something to force myself to give them up. Just the
threat of dumping has kept me away from most sugar. That doesn't mean that
I don't have any at all, it just means that now I eat ONE Girl Scout cookie
instead of a BOX of Girl Scout cookies! As far as eating a normal meal, I
eat the same thing as the rest of my family just in smaller portions. Good
luck with your decision.
— georgiacarol
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