New to board - considering DS over RY bypass

[jojo99]

Hi!  I have just found this board and I can not tell you how incredibly useful I have found it.  I have been on the fence between the DS and RY since learning of all the options.  I am incredibly fortunate that I live in Durham and have access to Dr. Sudan at Duke who I read has rave reviews.

My biggest reservation with the DS has been the potential nightmare of running to the bathroom every 5 minutes - or worse, running to the bathroom and not making it.  If there is anyone who could comment on that, I would really appreciate it.

I was also concerned at first with the seemingly overwhelming number of vitamins and supplements needed with the DS.  But when I looked at a list a RY person provided, it seemed fairly extensive as well.  If the DS provides a better outcome long term, I'm beginning to think the difference between 25 pills a day and 20 pills a day is a moot point.

If I could, this is the jist of what I have learned:
DS - high protein, medium to high fat diet with complex carbs added in, occasional sweets appear ok depending on how you manage sugar  - the one thing I am unclear on is the role fruits play in the diet; it also seems you can eat at a more normal pace - sort of snacking all day and sipping and drinking water all day

RY - I think I read something about not being able to drink with meals, having to drink a certain amount of time before eating, then after eating, etc.  It sounded much more regimented, but I could be misunderstanding.  I'm not sure of the role of fats in this diet either, although I know it is high protein.

DS - excellent treatment for diabetes

RY - good for diabetes but not as good as DS

DS - more weight loss and more likely to keep it off because of continued mal-absorption component.

RY - successful but more likely to gain some weight back

DS and RY - risk of malnutrition so daily vitamins and supplements are life long

DS and RY - risk of bowels twisting, blockage, in the future

Are there any other significant things I should consider?

For the record, I am 40 years old, 5 feet tall and weigh 250lbs - my BMI is 48.  I have recently drifted in the the diabetes range with my A1C and it continues to drift upward.  I have extremely high blood pressure if not on medication (it was recently 225/115).  My cholesterol is also high.  I also have sleep apena and a newly acquired CPAP machine.  I have come to a point where I no longer feel well.  I am utterly exhausted all the time and I could easily sleep 12-16 hours a day.  I feel I am failing my husband (I sleep most of the day) and my children (I don't feel like doing things and sleep Saturdays away when we could be out doing fun things.)  They are 7.5 years old.  I feel like I am missing out on so much.  I have very flat feet and terrible ankles so walking and exercising are tough for me right now.  It's hard for me to take walks with the girls or run around in the yard.  I'm a front porch parent - and I hate it.

If anyone could comment on the bowel issues or give me any other thoughts to ponder on the RY vs DS, I would be so grateful.

Thanks!

[caprice]

Welcome!
I can comment on my experience, anyway... I had the DS in October of 2007 and am grateful for it every day.
Early out, fat consumption might cause looser poop, but after several months, the fat didn't seem to cause that so much.
The rule I try to follow is to eat my protein first (fat is attached to the protein many times, which is fine). Any carbs I try to hold off on until I have gotten in the meat.
I do take supplements - Dry D3, calcium, A, some other odds and ends... I've given up on iron, and just get infusions when I need them. A good relationship with a medical professional who will help you keep your labs in a "good place" is a must. Tracking your labs your own self is a good practice, too, as that will allow you to see trends, before you absolutely tank on something.
Pooping..... Immediately after surgery, it's a free-for-all, that is, some people will be in the bathroom several times a day, some just a couple. I have been constipated one time since my surgery, but for others, that's the norm, and they do what they can to get things to loosen up. For several years after surgery, I pooped first thing in the morning, then (with rare exceptions) was done for that day. Lately, it' been morning, then late afternoon, when I get home from work. Part of that may be that I'm letting too many carbs sneak in to my diet, but it's starting to annoy me, so I've added probiotics (just yesterday, actually) and will dial back the carbs, and we'll see what happens. There are a few exceptions, but, for most of us, this is very manageable.
Bowel twisting, blockage.... I think that's gonna be the same with either surgery because you're going to be losing a bunch of weight, stuff will be shifting around, it's abdominal surgery either way. "You spins the wheel and takes yer chances" is pretty much how I figure it. I did experience severe abdominal pain at around 4 years out, and the thing that got my butt to the ER was the fear of intestinal blockage. It wasn't, it was pancreatitis, so, still a good thing that I went, but I DON'T want blockage or kinks and have part of my intestine die. I would like to keep everything I have left, thankyouverymuch.
Diabetes.... there is no guarantee with either surgery, but the DS does have better statistics (for type 2, not 1)
An important negative to be aware of with the RNY, and I don't think I saw it in your post, is Reactive Hypoglycemia. Not with the majority, but it happens often enough that even I am aware of it. Not trying to bash any surgeries, but it would be a real bitch to have to deal with that, too. So you want to be aware of it, at least.
Hope this wasn't too long-winded, and that I provided helpful information on something, at the minimum, another point of view.
Again, welcome, and I hope you get the info you're looking for.
Wishing you a successful, event-free journey.

[OnMyWay2Thin]

Caprice summarized everything great, as usual. I'm slightly different in that I've never had a problem with bowel movements being too loose. I veer in the opposite direction towards constipation and find myself taking two Colace, two magnesium oxide, and two magnesium citrate just to try and combat this problem. That being said, this seems to work well for me, allows me to go once a day, and the only thing I'm now worried about is too much magnesium in my lab tests. I should really look this up because I would hate to be trying to hard to do things right only to make things bad with two much magnesium.

As far as the DS goes, this is the best choice I ever made. I had a lapband before and my quality of life was horrible. Vomiting, sick feeling, lack of ability to eat, and feeling lousy were normal things in my typical lapband day. Now I feel great and feel like I can eat all day long (the right things, I never go over the carbs indicated and munch on protein-filled items.) I now feel wonderfully healthy and it's typical to have even strangers ask me how I stay so fit. Forget those people that know me, they are astounded by the outcome and often don't recognize me! I have 14 pounds to go until goal.

Getting used to all the supplements was a little challenging but I now set my phone alarm for every two hours and usually have all my vitamins, minerals, and prescriptions (potassium, thyroid medication, and omeprazole) in by about 1 or 2. I take four doses a day.

My diabetes was out of control, that was one of my reason for wanting this. It is now perfect, between 80 and 93 each day. My insurance company just turned down my diabetes supplies because they say I no longer have it. I guess that's a good thing! My blood pressure was also getting high and I was about to be on medication, that's completely normal now. Most importantly, I feel good about myself, I feel pretty, I feel healthy!

Good luck with your decision, it is a good one but it sounds like you are doing your research. The best of luck to you!

Kelly

[bboop]

Let me tell you about the bathroom...the other two posters have covered the DS surgery and the results really well.

At first you will be running to the potty. This is normal. After surgery you will be on a liquid diet...liquid in - liquid out. So be prepared. Soon you will move to more solid food, but it's really mush...that too can cause irregular and frequent bowel movements. Finally when you are able to eat solid food, it won't be much food to begin with, you will begin to have more control over your bowel movements. Eventually you will have regular bowel movements sometimes once a day sometimes twice, and on some occasions three times...if you have been ingesting too many carbs. I usually go twice in the mornings...and then I'm done for the day.

When I did my research, I chose the DS because it provided the best result with the least harmful side effects. For me the choice was simple.

Welcome to the forum and come back and ask questions. That's what we are here for.

[jpcello]

If 12 people reply regarding their bathroom habits, you will get 12 different stories. Everyone is different. Bathroom issues are generally directly related to what you put in. High carbs will cause major bathroom issues.

In my opinion (and that's all this is) the DS is the best surgery for long-term success. It's the malabsorption that will give you the greatest chance of keeping the weight off long term. There are people who have the RNY and are successful, just as there are some people with the DS who are not successful. It's all about how you use the tool, because that's what the surgery is.

I'm 12 years post-op and I love my DS. I take my vitamins every day. I get labs done once a year. I eat large amounts of protein. I drink the right amount of water. Other than that, I don't really think about the DS. I've been lucky to have never had any obstruction issues, but the risk is always there.

[PeteA]

I'm almost 2 years post-op. There can be some challenging BM's but after the first month I never had it come on me so quick that I couldn't get to the bathroom. As time goes on you get a good feel between what you are eating and the likelyhood that you will need to find a bathroom quickly. While there are a few horror stories I think the majority of people settle like me, I tend to have one or 2 BM's in the morning and then I'm done. If I know I need to leave early I do get up early to give my body time to get started and do my business before hitting the car. I've started swimming early in the morning and if I do't go before I leave it isn't a problem.

Diabetes in remission from day 1 after the surgery. Doesn't always happen that way but I was happy it did for me.

I was overwhelmed with the vitamin schedule but now it is just part of my day. I take about 30 pills a day and set up my vitamin organizers 2 months at a time.

Protein first as far as eating goes but I am currently looking at making protein a little less of my daily total since I'm near my maintenance weight and I seem to tolerate pretty much everything well.

Love my DS. Good luck on your decision. Whatever you choose just work with it, not against it. That's the important thing.

Pete

[jojo99]

Thank you all for the replies. I am feeling much less concerned about the bathroom issues. Especially since I realized today (as I went urgently twice in an hour) that I ALREADY have bathroom issues. I have to go within 30 minutes of eating and several times a day with various urgency and "consistency". It can't really be worse than that.

This forum is a wealth of knowledge and I'm going to have my husband start reading so he can be prepared as well.

Thanks everyone...

[goodkel]

It takes awhile (months) to fully heal and during that time, the earlier out you are the more sensitive and urgent your bowels will be. After that it depends on carbs and what foods to which you may have developed intolerance.

You've received some excellent replies and I can't add much more than to say:

Welcome! I'm glad you found us.

Kelly

[teetster]

Hi Jojo99, just wanted to say how lucky you are to live so closely to Dr. Sudan!! He was my surgeon, and I live almost 4 hours away. He has lots of patients that travel a good distance just to see him.

In full disclosure, I did have some pretty bad complications, but know that I would have had them regardless of my choice of surgeon. Dr. Sudan saved my life.

I wish you the best of luck, you are already off to a great start just by picking Duke and Dr. Sudan!!