Hello

[DSRIGGS]

Do you have sleep apnea, high cholesterol or high blood pressure?

Here is the basic scoop on WLS:

The Band should be outlawed because it is dangerous and doesn't work for 95% of people.

The RnY works for a couple years and the people gain the weight back. It is well documented.

The sleeve is a restrictive only surgery so you will have to diet the rest of you too life to maintain any weight-loss. If we could diet effectively we wouldn't need WLS. Most of us had a metabolic issue. Your sleeve will stretch back out..not to full stomach size but I can easily eat a 10 oz steak, baked potato with butter and sour cream, and some veggies and bread...I am 22 months post DS and eat probably 4,000 calories a day.

The DS provides the restriction of the sleeve for initial weight loss combined with the malabsorbtion from the switch. The switch keeps the weight off because after a while you can eat a lot more than it takes to maintain weight-loss from restriction only. Additionally with the DS diabetes, high blood pressure, high cholesterol all go bye bye.

Again, please read up on all the surgeries and research them all. In the end you will come to a decision that is right for you.

 

[duh_Mom]

Hi Nancy and welcome! you are in the correct place for education and support. read - search - read some more. No matter what you decide it is life changing. Like Scott, I would suggest you avoid the lapland - i was the proud owner of one for 8 years - it does offer restriction - however, I did not lose weight - 24 pre op and 20 post op. Just had it removed - along with "extensive" adhesions it provided to my guts - including attaching to my liver. Converted to a DS but my words of wisdom end there as I am so very new. Just read, read, read so you can make an informed decision.

 

[Tulipgirlaz]

Jsriggs, where did you find your material on the rny about regaining weight back? I am a surgical assistant and couldn't get approved for the duodenal switch due to not having any severe comorbitities.
I research very well and have never come across what you are claiming.
Would love to read it . thank you,
Tulipgirl

 

[DSRIGGS]

From these boards and the numerous people who had revisions because the rny didn't work. I also have a friend who weighed almost 700 pounds before surgery. He got down to 250 and today weighs at least 500 pounds.. Probably closer to 600

 

[southernlady]

Jsriggs, where did you find your material on the rny about regaining weight back? I am a surgical assistant and couldn't get approved for the duodenal switch due to not having any severe comorbitities.
I research very well and have never come across what you are claiming.
Would love to read it . thank you,
Tulipgirl

Tulipgirl, I hope you bet the odds for the RNY...

As to studies: https://scholar.google.com/scholar?...a=X&ei=5nCYVYicKIj7tQWfr4XQCg&ved=0CBwQgQMwAA

But mostly what Scott (DSRiggs said), from the shear number of RNY'er seeking revisions or are just miserable because they either didn't lose enough weight or regained after.

 

[DSRIGGS]

And I hope you do well too

 

[Tulipgirlaz]

And I hope you do well too

Thank you I hope I do too.......

 

[Larra]

@Tulipgirlaz the DS is considered a standard of care bariatric operation for anyone who meets the usual criteria of medical necessity, not just those with a higher bmi or with serious comorbidities. If you are interested in the DS - and I hope you are - you should get your hands on your EOC (evidence of coverage - a lengthy document and not just a summary) and see exactly what your policy covers AND what, if any appeals rights you have. And don't trust some low level insurance company employee to interpret your policy over the phone. Read it yourself.

the DS has the best statistics of any standard of care bariatric surgery for percentage excess weight loss, for MAINTAINING that weight loss, and for resolution of almost all comorbidities. It's the maintenance piece where RNY does poorly, as weight regain is a major problem after the initial honeymoon phase. We are seeing more and more people seeking revisions, and there would IMHO be more still if they knew it were possible and/or had insurance coverage for it. What happens a lot is that people are ashamed that they have failed yet again and just give up. After all, almost anyone who has become MO has lots of experience with failure, though in other aspects of our lives we may be very successful.
the usual definition of "success" in the world of bariatric surgery is losing and keeping off 50%, yes, just 50% of your excess weight. Even with the bar set low (again my personal opinion) the usual failure rate cited for RNY is 30%. And a lot of people fall into the 50 - 60% excess weight loss range. Personally I would not have considered myself successful if that was my result. You may feel differently, I'm not trying to tell you how you should feel or what your personal goals should be.

In addition, with RNY NSAIDs are contraindicated for the rest of your life. With the DS we can take them (in correct doses, of course). NSAIDs are one of the most commonly prescribed and used classes of drugs in the USA. Not being able to take them for life is a big deal. We also don't have to worry about dumping, or a laundry list of foods that you are never supposed to eat again, ever. It's a much more normal diet and way of life.

Your choice of operation is about far more than your bmi or comorbidities. Keep on researching. the most important research, again just my personal opinion, is of yourself. Take a good, hard, honest look at yourself and determine realistically what diet and lifestyle you can sustain for the rest of your life. Go to a local support group, if one is available to you, and talk with people with RNY. Not just the fresh post-ops, but people who have lived with it for awhile. See what they have to do to keep the weight off, and whether or not they are struggling. that was very educational for me.

And incidentally, the surgeon you have listed is not someone I would go to for a DS. He might be ok for other operations, I couldn't say.

 

[southernlady]

@Larra, she's post op...

 

[Larra]

@southernlady yeah, I figured that out after I posted. I was confused because the OP is pre-op and considering options. Feel free to delete if you want, whatever is appropriate. And I do hope she will be happy and successful with the option she has chosen.

 

[southernlady]

@southernlady yeah, I figured that out after I posted. I was confused because the OP is pre-op and considering options. Feel free to delete if you want, whatever is appropriate. And I do hope she will be happy and successful with the option she has chosen.

No, I'll leave it. May help others in their decision process.

 

[Larra]

I was thinking the same thing. That's the only reason I didn't delete it when I realized my mistake.

 

[Nancy Roberts]

@Tulipgirlaz the DS is considered a standard of care bariatric operation for anyone who meets the usual criteria of medical necessity, not just those with a higher bmi or with serious comorbidities. If you are interested in the DS - and I hope you are - you should get your hands on your EOC (evidence of coverage - a lengthy document and not just a summary) and see exactly what your policy covers AND what, if any appeals rights you have. And don't trust some low level insurance company employee to interpret your policy over the phone. Read it yourself.

the DS has the best statistics of any standard of care bariatric surgery for percentage excess weight loss, for MAINTAINING that weight loss, and for resolution of almost all comorbidities. It's the maintenance piece where RNY does poorly, as weight regain is a major problem after the initial honeymoon phase. We are seeing more and more people seeking revisions, and there would IMHO be more still if they knew it were possible and/or had insurance coverage for it. What happens a lot is that people are ashamed that they have failed yet again and just give up. After all, almost anyone who has become MO has lots of experience with failure, though in other aspects of our lives we may be very successful.
the usual definition of "success" in the world of bariatric surgery is losing and keeping off 50%, yes, just 50% of your excess weight. Even with the bar set low (again my personal opinion) the usual failure rate cited for RNY is 30%. And a lot of people fall into the 50 - 60% excess weight loss range. Personally I would not have considered myself successful if that was my result. You may feel differently, I'm not trying to tell you how you should feel or what your personal goals should be.

In addition, with RNY NSAIDs are contraindicated for the rest of your life. With the DS we can take them (in correct doses, of course). NSAIDs are one of the most commonly prescribed and used classes of drugs in the USA. Not being able to take them for life is a big deal. We also don't have to worry about dumping, or a laundry list of foods that you are never supposed to eat again, ever. It's a much more normal diet and way of life.

Your choice of operation is about far more than your bmi or comorbidities. Keep on researching. the most important research, again just my personal opinion, is of yourself. Take a good, hard, honest look at yourself and determine realistically what diet and lifestyle you can sustain for the rest of your life. Go to a local support group, if one is available to you, and talk with people with RNY. Not just the fresh post-ops, but people who have lived with it for awhile. See what they have to do to keep the weight off, and whether or not they are struggling. that was very educational for me.

And incidentally, the surgeon you have listed is not someone I would go to for a DS. He might be ok for other operations, I couldn't say.

Hi Larra,
What is dumping? What does that mean. I am reading your post and I want to understand what you are talking about. Is there any restrictions of foods with DS?
Thanks Nancy

 

[DSRIGGS]

dump·ing syn·drome
noun
MEDICINE

1. a group of symptoms, including weakness, abdominal discomfort, and sometimes abnormally rapid bowel evacuation, occurring after meals in some patients who have undergone gastric surgery.

Doesn't happen with the DS but a common, but not always, side effect of Gasric Bypass. The food gets into system too fast, is basically the issue...and it is typically from carbs from what I have been told

 

[Larra]

@Nancy Roberts No one is really sure what percentage of people with gastric bypass experience dumping. I've seen statistics from 30% to 70%, which is such a wide range that my conclusion is that no one knows for sure. It can occur with either carbs or fatty foods, and different foods affect different people. For some people even a very small amount can cause dumping, for others, they learn how much they can tolerate and try to stay below their personal limit.
Dumping can occur with any stomach surgery but is common (see numbers above) with gastric bypass and rare with DS. It is sometimes billed as a weight loss tool, but in reality is just a potentially very nasty side effect of gastric bypass. The symptoms can include both vomiting and diarrhea, sweating, palpitations, and feeling faint or weak. There is no evidence to show that it helps with weight loss. Some people with really severe dumping even dump with foods that would seem to be healthy choices, perhaps because, as @Scott mentioned, it's related to food passing rapidly from the RNY pouch directly into the small intestine. But that's much less common.
Getting back to your other question, there are no foods that are forever off limits with the DS. We do need to emphasize protein because we absorb about 40-60% of the protein we consume, and your body needs protein. Since we only absorb about 20% of the fat we consume, we can eat fat freely, which means we aren't limited to lean forms of protein or fat-free cooking methods. This allows for a much more normal diet. We do absorb carbs well so we need to limit them, esp during the weight loss phase. And if you do have the DS, you will learn that certain foods can cause gas and/or diarrhea, so you will learn what to avoid, or perhaps only eat those foods in smaller amounts or when you are going to be at home. But there is no list of forbidden foods.