[Bumble_Leigh_Bee]

I saw the surgeon yesterday and he recommended the Biliopancreatic Diversion with the Duodenal Switch for me as opposed to Roux en Y Gastric Bypass.

I'm scared to death about this but at the same time I have been doing my research about both...and there seems to be a better long term success rate for the switch. And there seems to be a lot of propaganda on both sides about which one runs the higher risk for malnutrition. I'm really concerned about my health and I want to make the healthiest decision when it comes to my WLS.

Is there anyone here that has had the switch that can help me with some questions? My surgeon wouldn't answer anything in definite...and he left both my boyfriend and I very confused about which would be right for me.

Help help please!

[Perfesser]

If your surgeon is talking about a switch, he must be comfortable with it. Doctors seldom do things that would cost them a patient's life. There's way too much paperwork, and it lowers their success rates!

So he is presenting to you two effective courses of action. I would ask him about his experience level with both, what patients have been experiencing as far as health, weight loss, adverse effects, deaths, etc. Any surgeon who won't talk about that is someone you need to think twice about why not!!

I chose one way for myself. My wife chose the same way. You only get one chance at this, (unless you started with a band! ) Do your research, and don't be too quick to trust the negatives you will come across. There are some in the bariatric world who'll go after you if you question their wisdom or dare to ask something they're not saying. You need to talk with honest folks who have had the procedure some time ago about their experiences. (You'll find a lot here about RNY, for example. We don't hide anything, you get it all, good, bad, and ugly!)

Good luck as you investigate. If it gets so close that you can't really figure out which is the better for you, maybe it doesn't matter! Arm yourself with knowledge about the long-term results, because if you live through it, you'll be a long-termer someday yourself!!

CT

[DocSanae]

Talk about timing.
http://www.renewedreflections.com/fo...-the-site.html

[bela]

I thought about the DS but the surgeon I chose didn't do it. He said it will work for many people (as well as the RNY and lapband do too) but he believes that the fact of not having any dumping effect and a greater "need" of fat due to the design of the malabsorption can end up as a patient eating very unhealthy even though they lose weight. He said he believes in WLS surgery as a way to help people get in control of eating little and healthy as opposed to just losing weight. He showed me statistics of DS being a bit (not much really) more effective on people with BMI over 50 (not my case anyway) and even told me he had colleagues who did DS and he could refer me to them in case I really decided for the DS. In the end I opted to do the RNY with him.

Do your research to see what's best for you.

[luckylocke]

my doc gave me the same advice as Gordinha (over 50 bmi and a referral if I wanted)

[judijo]

I asked for DS and was told my BMI was not high enough (It was 43, I think). DS was discussed in the pre-op classes my medical group required I take and that was the only reason I pondered it.

Why did I want it? I am very structured in med-taking and I NEVER miss a supplement, and that is mandatory with DS because if the malabsorption issues that go with it.

Also (Doc, correct me if I am wrong here) I could take NSAIDS after DS, and that is the ONLY thing that I regret with my decision to have RNY. I am in constant pain from shoulder strain and repetitive movement. Ibuprofin was my best friend pre-op and I miss it immensely. I HATE waking up in pain during the night, or worse, dreaming of being in pain. .

My 2 cents...your mileage may vary.

[DocSanae]

Originally Posted by judijo

Also (Doc, correct me if I am wrong here) I could take NSAIDS after DS, and that is the ONLY thing that I regret with my decision to have RNY.

One of the side effects of NSAIDs is stomach ulcer. Period. Doesn't matter if you have a normal stomach or a small pouch. It's actually strongly recommended as one of the medications to avoid if you have a history of ulcer or surgery. Period.
The reason it's strongly recommended that RNY post ops avoid NSAIDs totally is because if you get an ulcer in the small pouch, the symptoms can be more serious because even if it's a small ulcer, the proportionate area is going to be large in comparison to an ulcer of the same size in the normal stomach.
So, even though the DS generally leaves a larger pouch than RNY, it's still better to avoid NSAIDs to avoid trouble, because stomachs that have been cut up and have staple lines (which means you have raw edges in a sense) can be more vulnerable than an intact stomach.

[shasha]

I would definetly do your research. And also check to see if your insurance covers the DS. I know mine only would cover lap band or RY. Best of luck with any decision you choose. It's your choice. Hang in there

[sue4491]

Originally Posted by Bumble_Leigh_Bee

I saw the surgeon yesterday and he recommended the Biliopancreatic Diversion with the Duodenal Switch for me as opposed to Roux en Y Gastric Bypass. I'm scared to death about this but at the same time I have been doing my research about both...and there seems to be a better long term success rate for the switch. And there seems to be a lot of propaganda on both sides about which one runs the higher risk for malnutrition. I'm really concerned about my health and I want to make the healthiest decision when it comes to my WLS. Help help please!

A couple of caveats - less than 25 percent of surgeons advocate the DS/BPD because they feel the end result is not worth the risks involved - many feel there is a greater danger of not only vitamin deficiency with the DS/BPD but also protein deficiency as well on the long term.

Dr Wes Clarke (one of Carnie Wilson's doctors) said he had done 400 BPD's (the intestinal bypass part of the DS/BPD) and stopped doing them because of long term nutritional deficiencies. Here is an article he wrote for me in answer to questions about why he prefers the RNY.

RNY VS DS/BPD by Weslie Clark, MD

Also one of the surgeons who does do the DS/BPD tells his patients that pretty soon after surgery, 50 percent of them will require iron infusions.

Seems the RNY is the "gold standard" because it offers a safer journey with a good weight loss.

To note, because much of the stomach is removed in the DS/BPD, it is not reversible should a problem arise. All they can do is lengthen the part of small bowel still connected.

Advocates of the DS/BPD say the long term weight loss is better. There really aren't any definitive studies in this area but if you lurk the DS/BPD lists, you hear of plenty of weight re-gain, slow loss etc.

Dr Terry Simpson did a study comparing his DS/BPD patients weight loss with the lap band patients of Dr Ortiz at the 3 month point and found the surprising result that the weight loss in the two groups was pretty much the same. Soon after, Dr Simpson decided to specialize in the lap band.

Hope this helps - good luck on your weight loss journey!

[Bumble_Leigh_Bee]

Thank you so much for all of your help, guys! I really really appreciate it! It's going to be a difficult decision for me but I am going to choose what's the best for me in the long run. I am giving the BDS some serious thought as my surgeon did recommend it and I am trying to trust him as much as I can. Thanks again for all of your input!