BariatricTV ForumGeneral WLS InformationDSWhy is the DS not very common?
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girlygirl1313
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« Reply #25 on: February 09, 2011, 06:44:49 AM »



Quote
The UofMN is currently doing a study with the bypass portion of RNY for the same thing.

I guess what it's going to come down to is exactly how much to bypass for highest rate of success and best long term effectiveness.  I think there also needs to be a consideration for the growing occurrences of Reactive Hypoglycemia after RNY.  I am not sure if this is in relation to gastric or intestinal bypass (or a combination of both).


Quote
There are people on OH, for example, by their own admission, believe anyone that has not had a DS has had the wrong surgery, and often tell them so. I often saw this go beyond just trying to inform someone, it included well, it was almost a mocking of those who chose a different surgery type.

Well, why don't you go over there and ask them? instead of coming onto THIS DS board and putting us on trial.  Dude, is the interwebs and it takes all types.  There are RNYrs that have ripped apart DSrs  and DSrs that rip RNYrs.  This is a select group that can be called out by name and they have been at it for a long time.  You will find more DSrs on the defensive than offensive. Usually, posts are like this on the Main Board:
DS: Hey have you heard of DS, make sure you explore your options.  You've got questions?  We've got answers and statistics, charts and current studies (May be followed by personal testimony of many DSrs)
RNY:  We don't need you here, why do you always need to talk about DS, DS people stink and poop and die of malnutrition.  I need to dump because I can't trust myself, you are all a bunch of gluttons.  My Dr said that RNY was the gold standard, what does that make the DS?  The DS is experimental.  Insurance companies will not pay for it.  My surgeon does not perform the DS and I am unwilling to drive 2 hours to get to DS surgeon.  I wanted my surgery immediately and didn't want to wait an extra 60 days for insurance approval.  You all are being paid by surgeons to spread your lies. (That's the best one)
n00b:  OMG I had no idea there was a surgery called DS, my Dr never mentioned it during the seminar.  Or my Dr said DSrs stink and poop die of malnutrition, you mean that's not true?  Why is it important that I keep my pyloric valve in tact?  What is a pyloric valve anyway?
RNY Post Op:  Nobody ever told me about different options and that makes me sad and kinda mad, wish I had known.
Bandster: I'm looking into revision and I'm glad to know this is an option thx! (proceeds to DS board for further questioning)
RNY Veteran I've regained half my weight and suffer from RH. I am sad because I never dumped and didn't know that 70% of RNYrs don't dump.  How far will I have to travel to reach the very select Dr's that dare perform this risky RNY to DS revision and how soon can they get me in, for gawd's sake!
VSG:  You know, I was looking into DS but the malabsorption scarred me.  It's good to know that I can go back for the Switch if I ever need it.

Ask DSrs about the 'over zealous' ones.  Almost every pre op DSrs was compelled by something said during a 'surgery war'. When I was in line for an RNY they made me mad as hell! Even I fought like a dog with DSrs and I hadn't even had surgery yet! I could not refute their claims as much as I wanted to and the moment I decided to go for the DS, I had a more positive outlook on WLS.

The "overzealous, preachy attitude" has been more of a service to pre-ops  than you'll ever know.
Here's a testimonial thread that's 8 pages long and spans almost 4 year so far:
http://www.obesityhelp.com/forums/DS/3484967/Who-benefited-from-DSers-posting-on-other-forums/

If you have a problem with the preachy types, skip over those posts and don't let them get to you.  The original title to this thread is:  "WHY IS THE DS NOT VERY COMMON?"  I hardly suspect it has anything to do with those who defend, educate and bring awareness of the DS to a large audience like OH, regardless of their tact or tactics.

Finally:
Quote
When did the current version of DS become "the standard"?  I ask because I keep hearing about how it's changed to become better, but also that DS has the best long-term results?  I haven't seen any specifics on this in my browsing some of the mentioned sites.

Welp, a couple of view points.  The first of which is that the modern has DS is actually the updated BPD with now having the addition of a DS.  This BPD/DS modern day hybrid is what is know now as just the "DS"

 But even with the modern day DS (like the RNY) different surgeons have different theories on what sizes, lengths will yield the best outcome.  Some doctors use a standard that is the same for all patients no matter their weight or intestinal length.  For example, my Dr gives everyone a 5oz stomach and 100cm common channel.  Some surgeons give a smaller stomach, 2-3oz say, with a slightly long 125cm CC.  Doctors used to give shorter CCs (50-75) to those that had a lot of weight to lose.  Studies found no significant difference with the shorter channel other than the possibility of having increased potty issues.  At 100-125CC the potty issue is essentially little to nill.  I also can not find a difference between one who has a 2 oz stomach as opposed to a 5oz stomach.  There is yet another method, the "Hess Method"  that a few surgeons subscribe to. It's strange math so I 'll just rob this quote:

"Hess Method

You will often hear Duodenal Switch procedure patients using the term "Hess Method" [1] when discussing common channel length. Dr. Hess calculated the length of the alimentary limb by multiplying the total small bowel length by 40%. The remaining 60% of intestine carries the digestive juices through the biliopancreatic limb. The length of the common channel is approximately 10% of the total length of the small bowel. "Hess Method" refers to following Dr. Hess's calculation for determining the limb lengths and common channel length but often other factors are taken into consideration; like the patient's age, weight, BMI and goals. Each patient has a different length of common channel and alimentary loop designed to achieve the best results."



~GG
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« Reply #26 on: February 09, 2011, 07:53:48 AM »

Please do not turn this into a flame fest people!! If it continues, I will take down this post. 

Remember...the rule on BTV is EVERY Surgery has it's value and NO surgery is better then the other because we choose our surgeries for very personal reasons.

If we can't play by those rules, then we won't play at all. Simple fact.

Toni
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girlygirl1313
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« Reply #27 on: February 09, 2011, 08:04:43 AM »

Then I'm done here.  I continue can't be lead on by accusations by the almighty McNee.  He can have his forum back.

Yes this is a GBCF spiel.

Peace
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Jenna Lynn
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« Reply #28 on: February 09, 2011, 08:42:40 AM »

The DS as it is currently performed has been around since 1988.

I think there are two different issues in question, and I'd appreciate some clarification from the mods. There is saying that a surgery is generally "better" and then there is saying that a surgery is generally "more effective". The first is a subjective generalization, the second is objective. I would hope that we are permitted to discuss relevant statistics and scientific studies here, as long as they are not being presented as a value judgement.

Just because the DS is the most effective WLS, doesn't mean it's the right choice for everyone. But on the other hand, just because the DS isn't right for everyone, that doesn't negate the demonstrable facts about its effectiveness, percentage of EWL, etc.
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« Reply #29 on: February 09, 2011, 09:27:27 AM »

I'm the mod so you can direct your questions to me.

The simple truth is this forum is about support for ALL surgery types. We embrace the term freaks because quite frankly, a lot of us have felt the pain of not "fitting" in.  We like being who we are which is different. We embrace the fact that we are all different, have different emotions, reasons for being obese, different life experiences and have chosen different surgeries.

By being freaks, we are embracing our differences.

The whole DS is better thing......isn't what we are about. It goes against the whole "WE love our differences". It's once again trying to push us into a singular surgery, and once again we are being told that we made a bad decision,  because statistics claim it's more effective.

It's not that we don't believe you, or your statitics. It's that we are embracing our differences and NO ONE THING is better then the others here on this forum. Hell...we dont' even say we are a better forum or support group then others. We say you MUST find your type of support where you can.

We don't allow flaming here. That's why i sent the message below. Please notice that I didn't direct it at anyone. Just a subtle reminder to all that it's not allowed.

It really is about a philosphy that most of us embrace here. Not about surgery type.  We are freaks and proud of our differences here.

If you don't like that philosphy, or can't get around the simple fact that we don't do the whole "my surgery is better then your surgery thing" here, then this is obviously not the place for  you. 


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Jenna Lynn
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« Reply #30 on: February 09, 2011, 10:13:22 AM »

Toni, I am not remotely about "my surgery is better than yours". I have zero interest in flaming or making anyone who already had surgery feel badly about their choice. I'm also not looking to trot out statistics at every turn.

But it is important to me to be able to be truthful with newbies and pre-ops so they can make the most informed decision. If someone came on here with a 60 BMI and was researching surgery, I would want to point them to the studies showing the failure rate of RNY for those with a BMI over 50 as compared to the DS.  If a pre-op was diabetic and deciding, I'd want to point them to the studies showing superior resolution of diabetes with the DS.

That is what I consider support for newbies and pre-ops. Getting the facts out there and helping newbies and pre-ops make the best, most-informed choice for themselves.  What I'm asking is whether that sort of dialogue is welcome here, particularly on the "DS board". 

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Maria C
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« Reply #31 on: February 09, 2011, 11:07:25 AM »

Toni all the DSers were doing here was answering questions and showing facts. I do not see how that is rude? or a reason to take down a very informative thread. It makes me feel as a pre op that i cant come here to discuss my DS things.
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« Reply #32 on: February 09, 2011, 11:47:03 AM »

I agree and if you want to give statistic and all...That's great and even welcome. Answer all the questions you want with your knowledge and experiences.

All We and by we I mean I, am asking is that you don't use the terms "DS is better then (enter surgery here)".

It's a very simple request.

I also ask that you don't flame other surgeries. Also a simple request.

Don't know why people are having such an issue with such a  simple request.

I guess my attitude is if you TRULY feel your surgery is the best, then there is no reason to bash and flame other surgeries.






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kj80230
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« Reply #33 on: February 09, 2011, 01:26:13 PM »

Toni,
  I don't see where a DSer said the DS is BETTER than any other surgery. McNee asked a question as to when it became better and I think GG did an excellent job trying to give information with out disparaging any other surgery. I agree with Jenna and you, statistics alone do not make one surgery superior to the other. There are several reasons that someone may not WANT a DS and they may be successful at many other surgeries.

I guess, I am struggling with the fact that this was supposed to be a conversation on why the DS is not very common and not why the OH board has surgery wars.

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« Reply #34 on: February 09, 2011, 02:35:41 PM »

The OH board has surgery wars because they allow it. I won't.  If that makes me or this board unpopular...so be it.

Please Discuss away why the DS isn't the common. Please answer people's questions regarding your surgery.

BTW

I never called anyone rude, I never accused anyone specifically of flaming. I just reminded you guys of the rules. I didn't pull the post, simply reminded people particpating that if this was to turn into a flame fest, and in my opinion, it was heading in the direction, that I would. 

Call it a preemptive strike.

If I seem a little strong here, it's because I am extremely protective of keeping this site flame free!  Those of us who used to be on OH can understand why.

I believe eveyone is entitled to thier opinion but they aren't entitled to hurting someone else with it.
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shepkatt
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« Reply #35 on: February 09, 2011, 03:08:41 PM »

I really didn't see anything flamey about any of it..   Definitely don't want any of our threads to turn into OH, though.. most of us fled from there because of all the bad vibes.

I think the discussions around the DS are awesome.  

And really.. these 'my surgery is better than your surgery' discussions aren't unique to the DSrs.. I have seen plenty of RnYrs do it to the Lapbanders too..   So our dislike of that isn't limited to one group but to the whole idea of that..   

We are all FREAKS..  or FREAKS to be.. all with the common bond of obesity..  Info/Facts and Stats can be shared without dukin' it out.. 

Like I said.. I didn't really see anything 'flamey' but I might have missed it.

Keep it coming folks.
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kj80230
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« Reply #36 on: February 09, 2011, 04:27:28 PM »

I didn't see anything flaming either and it just sucks to invited to share information and then threatened when we do.

 I understand and agree with your desire not to have this turn into a "my surgery is better than your surgery" or to encourage or allow surgery wars.  I just kind of felt like perhaps you were a little sensitive and it came off as though you expect all DSers to act like McNee mentioned, over-zealous. Trust me, some of us can get our point across as to why we made the decision to have a DS with out putting anyone else down. I just hope that since we were invited her to participate that we will be allowed to do that without having our motives questioned.  I thought this would be a clean start but it appears that you cannot look past the impression that some DSers have made on OH.

Everyone chooses the surgery that is right for them and part of that is getting all the information and making a decision for your self. I hope that DSers will be allowed to share our knowledge and not have our intent questioned every time we make a post.  My intent is to help get people the information that they need in order to make their own decision with no malice or judgement on the final outcome. I don't think I am better than anyone else and while I could have been successful with other surgeries, I chose to have the DS. If anyone wants to know the reasons for that decision, I am totally open to sharing. 

I hope we can all get along as this sounds like a great site.
Thanks, Kj
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shepkatt
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« Reply #37 on: February 09, 2011, 05:10:02 PM »

Toni has had some bad experiences on other forums.. and since this is our forum we definitely don't want to do any replays of that stuff.  And I don't think she was pointing fingers at anyone specifically re: flaming..  When we first launched this forum we made a lot of the same statements back at that time just to set expectations.  Expectations set.. Done.. Lets move on.. shall we?  :-)
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« Reply #38 on: February 09, 2011, 05:47:40 PM »

As usual Lynnda... Well said.

  Maybe just maybe I should avoid the forum this "time of the month". I tend to be a little over sensitive.  I'm gonna go eat some chocolate now and maybe all will be right in my world. Roll Eyes

I apologize if I offended anyone. Didn't mean too. Like Lynnda said, just trying to manage expectations.

Toni
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Maria C
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« Reply #39 on: February 09, 2011, 05:52:21 PM »



I apologize if I offended anyone. Didn't mean too.

Toni

Thank you Toni. Smiley I personally was a little shocked when I read your post. I have a lot of respect for what you and Lynnda do for the bariatric community.
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southernlady
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« Reply #40 on: February 09, 2011, 09:55:35 PM »

There is one statistic under represented and it's popping up more and more. I was origiginally scheduled for a RNY and flamed by many of those same people on OH but I hung in there. I kept reading. But I read more than just the DS board, I read the Main board, and all the other ones I could.

My original surgeon would not do a DS on me as I am a LW (pulled into his office at 35.2 BMI) and he said he only did 50 and above. What I did not know was his partner did do LW's. Had I known, I would have started with him first.

But after a couple of months of lurking and doing my own research, I came to the conclusion I needed a new surgeon. One willing to handle a LW DS. So I went hunting.

Now there were two reasons I did that. One, I have to have celebrex for spinal arthritis. Right now I am coping but miserable. Normally on celebrex, my pain level is a 2/3, right now, it's 4+. A RNY would rule that out. And I was already taking the alternatives with the celebrex. My insurance company approved the surgery but not my out of state surgeon so I had to find an in state surgeon...turns out the only one willing to do a LW was my original surgeon's partner. I was working on my third appeal to the insurance company when they agreed to let me switch.



Second reason is Reactive Hypoglycemia. I have type II diabetes and have RH within it already. I did not need to aggrevate the situation with adding that to my plate. And more and more threads were popping up on OH about that issue.


After doing research on many aspects of both, the DS is better not just for resolving diabetes but for keeping it away from your door down the road. I spent much time over on the RNY board and time after time, I saw threads about hypoglycemia. So I looked it up on my favorite diabetes format, the endocrinologists that TREAT diabetes.

    Here is what I found:
    Endocrine News http://www.endo-society.org/endo_news/2009/upload/Endocrine-News-February-2009-part-I-of-IV.pdf
   
Quote
Patients who undergo Roux-en-Y gastric bypass surgery (RYGBP) experience many benefits such as dramatic weight loss and type 2 diabetes remission. Yet, they also face a risk for developing severe postprandial hypoglycemia due to gastric dumping.

    Researchers have observed elevated levels of the incretin glucagon-like peptide 1(GLP-1) postsurgery, which has been linked to increased β-cell proliferation and differentiation. A research team led by Josep Vidal, M.D., Ph.D., at the Hospital
    Clínic Universitari in Barcelona, Spain, investigated whether a rise in this hormone could over time cause this severe setback.

    The team divided 24 women into three groups according to time after RYGBP (9–15 mo, 21–30 mo, and > 30 mo). Controls were 8 additional normal weight and 8 morbidly obese women. The subjects fasted overnight and ate a standardized test meal the following day. Blood samples to measure GLP-1, immunoreactive insulin, plasma glucose, and glucagon were taken beforeeating and 10, 30, 60, 90, and 120 minutes after the meal. The patients also underwent an intravenous glucose tolerance test to look for insulin secretion and insulin sensitivity and used a continuous glucose monitoring system to record their postprandial glucose profiles.

    In an upcoming article in The Journal of Clinical Endocrinology & Metabolism,* the researchers report that although GLP-1 rose steadily after RYGBP, it did not eventually cause inappropriate insulin secretion. Additionally, their data did not reflect a link between asymptomatic postprandial hypoglycemia in the RYGBP-operated women and an unsuitable relationship between β-cell function and insulin sensitivity. The researchers called for further studies to examine why some patients develop severe postprandial hypoglycemia.

While that article says there wasn’t enough evidence at this time, it did give me pause in that they are even considering the issue.

Then there was a blog article from the EndocrineToday that intrigued me:

Hypoglycemia after Roux-en-Y surgery for weight reduction
Posted by Michael Kleerekoper, MD, MACE April 7, 2009 11:26 AM
Endocrine Today Blog http://www.endocrinetoday.com/blogs.aspx

   
Quote
Seven years ago, my patient had a Roux-en-Y procedure to fight her obesity, and the result was just what she wanted — substantial weight reduction and “no more diabetes” as she reported with a huge smile. Her weight had been stable for a few years, and she was comfortable with it. Four months before her office visit, and for reasons she could not explain, she felt the need to go on a weight-reduction diet during which she lost 12 lb. Two months before she was referred to me, she began to experience episodic hypoglycemia. In her early post-surgery period, she had experienced very typical “dumping syndrome” symptoms, but they had finally cleared and the recent episodes of hypoglycemia seemed quite different.

    At 10 p.m. one evening, she felt weak and her capillary blood glucose was 50 mg/dL. This was several hours after dinner. Over the next several weeks, she had a CBG of 53 at 7:45 p.m., 59 at 10:30 p.m., 45 at 3:30 p.m., and most worryingly to her, she woke at 1 a.m. one night feeling very unwell and disoriented, and her CBG was 45 mg/dL. She never experienced fasting hypoglycemia.

    Physical examination was essentially normal aside from a suggestion of hyper-pigmentation of her abdominal scar and palmar creases. Pulse and blood pressure were normal as were visual fields and the thyroid examination. Her laboratory findings were also all normal, including electrolytes, fasting blood glucose of (89), insulin, C-peptide, cortisol and adrenocorticotropic hormone.

    The history had many characteristics of the dumping syndrome, but several pieces of information did not quite fit. Dumping syndrome is not uncommon in the early months after a Roux-en-Y procedure, but patients generally adapt well by taking frequent very small meals, and over time, the syndrome seems to resolve. Additionally, why did the hypoglycemia occur only several hours after a meal and not sooner? She tried several approaches to changing her eating habits, but these episodes persisted.

    I discussed this case with my colleague Dr. Anu Puttagunta, who had cared for a patient with much the same history. This late (post-weight-reduction surgery ) and delayed (post-meal) hypoglycemia has been reported,1, 2 but the mechanism remains elusive as far as I could tell from my reading. The articles reported that some patients did respond to frequent small meals that had little carbohydrate while others only responded when the diet change was accompanied by acarbose.

    In some patients, it appears that acarbose alone was sufficient. Dr. Puttagunta’s patient did well with diet modification plus acarbose, so I have begun that same therapy on my patient. She had found those same articles on her own, had modified her diet and had no subsequent episodes of hypoglycemia, but that was not reassuring to her because they were so episodic. When adding the acarbose it was important to remind her to take the tablet (I started with 25 mg three times per day) as soon as she takes her first bite of food. I will report her progress after a few months.

    1: Kellogg TA. Surg Obes Relat Dis. 2008;4:492-499. PMID: 18656831.
    2: Moreira RO. Obes Surg. 2008;18:1618-1621. PMID: 18566871.

But was was the final straw that pushed me into the DS camp were the guidelines published for the Endocrine Society in March 2009.
Evaluation and Management of Adult Hypoglycemic Disorders: http://www.endo-society.org/guidelines/final/upload/FINAL-Standalone-Hypo-Guideline.pdf
An Endocrine Society Clinical Practice Guideline
First published in the Journal of Clinical Endocrinology & Metabolism, March 2009, 94(3): 709-728
Quote
Hypoglycemia can occur as a result of hyperinsulinism in the absence of previous gastric surgery or after Roux-en-Y gastric bypass for obesity. (pg8)

    Some persons who have undergone Roux-en-Y gastric bypass for obesity have endogenous hyperinsulinemic hypoglycemia most often due to pancreatic islet nesidioblastosis, but occasionally due to an insulinoma (48–50). With nesidioblastosis, spells of neuroglycopenia usually occur in the postprandial period and develop many months after bariatric surgery. Spells of neuroglycopenia that occur in the fasting state soon after bariatric surgery are more likely due to a preexisting insulinoma (51). The predominance of women with post-gastric-bypass hypoglycemia may reflect the gender imbalance of bariatric surgery. The precise mechanisms of hypoglycemia remain to be determined (52–54). The incidence of this disorder is unknown, but at the Mayo Clinic the number of cases exceeds, by a considerable degree, that of insulinoma. Partial pancreatectomy is recommended for nesidioblastosis in patients who do not respond to dietary or medical (e.g. an a-glucosidase inhibitor, diazoxide, octreotide) treatments. (pg11)

I checked the document for any mention of the DS and there weren’t any but there were the two references to the RNY.

I have reactive hypoglycemia within my diabetes already. I don’t need a surgery that will make that worse.

All the browbeating, “yelling”, sniping, etc in my other posts discussing my options and TRYING to figure out what to do for ME, did not carry the weight as much as those articles and clinical guidelines did.

My insurance company approved the surgery but not my out of state surgeon so I had to find an in state surgeon...turns out the only one willing to do a LW was my original surgeon's partner. I was working on my third appeal to the insurance company when they agreed to let me switch.

Liz
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« Reply #41 on: February 09, 2011, 10:15:35 PM »



I apologize if I offended anyone. Didn't mean too.

Toni

Thank you Toni. Smiley I personally was a little shocked when I read your post. I have a lot of respect for what you and Lynnda do for the bariatric community.


Just like everyone else going through life... I have off days..today is one of those days. Unfortunately, not only does our metabolism slow to a crawl as we get older, but  PMS ramps up into over drive.

Poor mike...he's still praying that we institute some type of menstrual hut that he can ban me to.

Mark you calendars people. 28 days from now, I should be banned from the forum for a few days.

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« Reply #42 on: February 09, 2011, 10:35:22 PM »

I have administered a medicinal dose of dark chocolate to Toni and put her to bed. If you have any other problems with her in the next 4 to 5 days let me know. I'll apply another Dark Chocolate medicinal tongue wrap and she'll be right as rain.

Now it's off to Home Depot for some lumber to start on the backyard menstrual hut.

Cary on citizens, nothing more to see here!

Mike
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Who is just as observant, and dashingly good looking, as his wife is.
shepkatt
Honey Badger don't give a sh*t
Administrator
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Surgery Date: 11/17/2003
Surgery Type: RNY
Posts: 3189


WLS ain't for wussies


« Reply #43 on: February 10, 2011, 07:15:30 AM »

Liz - Excellent post.  I have heard a lot about Reactive Hypoglycemia in RnY patients as of late.. Melting Momma first brought it to the attention of most of us in the WLS forums.  That certainly wasn't anything that was discussed over 7 years ago when I had my surgery but is defintely a factor to take into consideration now.  That coupled with your need to take NSAIDs for pain management would rule out the RnY for you no question.

Why did you decide on the DS vs the Sleeve?  The success rates?  Or was the switch just a better match for you and your lifestyle?

Thank you so much for posting this info..  You are correct that this side effect of RnY is popping up more and more and people should be aware of it when doing their research.

edited to changed sleeve to switch.. DOH
« Last Edit: February 10, 2011, 07:24:09 AM by shepkatt » Logged

I enjoy fine chocolate.. cheese and being on time.  I am Switzerland!
shepkatt
Honey Badger don't give a sh*t
Administrator
Grand Poohbah of Freaks
*****
Surgery Date: 11/17/2003
Surgery Type: RNY
Posts: 3189


WLS ain't for wussies


« Reply #44 on: February 10, 2011, 07:18:23 AM »



I apologize if I offended anyone. Didn't mean too.

Toni

Thank you Toni. Smiley I personally was a little shocked when I read your post. I have a lot of respect for what you and Lynnda do for the bariatric community.


Just like everyone else going through life... I have off days..today is one of those days. Unfortunately, not only does our metabolism slow to a crawl as we get older, but  PMS ramps up into over drive.

Poor mike...he's still praying that we institute some type of menstrual hut that he can ban me to.

Mark you calendars people. 28 days from now, I should be banned from the forum for a few days.



We filmed last night and I was telling Toni that when I read her post about "taking down this tread" it reminded me of my mom when she would say something like "you children behave or I will turn this car around so fast it will make your heads spin"..   

She agreed she might have.. um... overreacted a bit.. 

Keep the chocolate coming, Mike.. :-)
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I enjoy fine chocolate.. cheese and being on time.  I am Switzerland!
southernlady
Fresh Freak
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Surgery Date: Jan 24, 2011
Surgery Type: Doudenal Switch
From:: Eastern Tennessee
Posts: 17



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« Reply #45 on: February 10, 2011, 07:26:40 AM »

Quote
Why did you decide on the DS vs the Sleeve?  The success rates?  Or was the sleeve just a better match for you and your lifestyle?

Unfortunately the VSG (sleeve) was not an option for me, I am a Medicare/Medicare Advantage patient. And under the rules in 2010 when I was getting approval, it was not even on the table. However, I also need the malabsorbtion for my diabetes, my cholesterol, etc. So of the three that were available to me, the DS was my best option.

Had I not needed the malabsortion of the DS, I would have loved the sleeve, LOL.

Liz
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shepkatt
Honey Badger don't give a sh*t
Administrator
Grand Poohbah of Freaks
*****
Surgery Date: 11/17/2003
Surgery Type: RNY
Posts: 3189


WLS ain't for wussies


« Reply #46 on: February 10, 2011, 07:39:27 AM »

Thanks for the information.. The type of research you did is exactly what everyone should be doing..   Surgery is a big deal and everyone needs to find the right surgery for their lifestyle/health challenges.

How are you doing?  Looks like you just got switched recently.. Surviving those horrid first few months after surgery okay?
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I enjoy fine chocolate.. cheese and being on time.  I am Switzerland!
southernlady
Fresh Freak
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Surgery Date: Jan 24, 2011
Surgery Type: Doudenal Switch
From:: Eastern Tennessee
Posts: 17



WWW
« Reply #47 on: February 10, 2011, 08:01:01 AM »

I'm doing great, down 15 lbs, eating soft foods, getting all my vitamins in per vitalady's plan...will adjust those once I have my first set of labs.

My husband is also a Ds'er, he had his on the 16th of Dec so he's only 5 weeks ahead of me. Both of us are lightweights. He's hit his first stall tho (we knew it would happen so no posting of "why am I not losing weight?"), he's down 40 lbs. And why do men lose faster than women?Huh

Anyway, yes, I am doing very well but this wasn't my first major surgery and it wasn't my worse. (that honor belongs to my back surgery).

One other thing I would like to say, I believe that the RNY has also changed some over the years. Didn't they use to handle the pouch differently? If I remember my research correctly, it's also not the same surgery now that it was when it started (and I don't mean open versus lap, either).  So time changes all surgeries, they get better so long term results may skew the statistics on any of that.

Liz
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baka
Mr. Wizard of Protein
Grand Poohbah of Freaks
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Surgery Date: 07-27-09
Surgery Type: RNY
From:: Surf City, CA
Posts: 4930


Tuo Ku Zi, Fang Pi


« Reply #48 on: February 10, 2011, 09:54:30 AM »

Unfortunately the VSG (sleeve) was not an option for me, I am a Medicare/Medicare Advantage patient. And under the rules in 2010 when I was getting approval, it was not even on the table.

This is the thing that drives me crazy - Not having procedures we need/want covered by our insurance unless we fight like a rabid dog

I dunno about killing all the lawyers first..... Insurance twerps are right up there!

Ian
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Fear Can Hold You Prisoner - Hope Can Set You Free!
southernlady
Fresh Freak
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Surgery Date: Jan 24, 2011
Surgery Type: Doudenal Switch
From:: Eastern Tennessee
Posts: 17



WWW
« Reply #49 on: February 10, 2011, 10:08:55 AM »

This is the thing that drives me crazy - Not having procedures we need/want covered by our insurance unless we fight like a rabid dog

I dunno about killing all the lawyers first..... Insurance twerps are right up there!

Ian

You know tho, had all four been available, given MY circumstances, I still would have gone with the DS. Like I said, I needed the malabsorption. So it really was a non-issue for me that it wasn't offered. For many, yes it is an issue.
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