BPD

[hopeful77]

Has anyone had the BPD without the Switch. I was told by a doctor that I could either have the DS or the BPD, but he was leaning more towards the BPD because he said my insurance would cover it. I have read some very negative things about the BPD and would like to talk to someone who either has firsthand knowledge or is very knowledgeable about BPDs. Any help please.

[Deleted]

Why BPD instead of DS?

[msbatt]

Who's the surgeon? Frankly, I'd think your insurance would be far more likely to cover the DS than the BPD.

[larra]

Diana is right. I won't review the anatomy here as she already did a great job, but will repeat that the BPD is considered outmoded and rarely, if eve, covered by insurance in the USA.

So I reviewed your posts and recalled that you are seeking revising from RNY, and I think that's where the confusion and problem is. What the surgeon is probably proposing is not a true BPD ( I hope not for the reasons already stated) but something like an ERNY, where you keep the pouch with all its problems and get a much shorter common channel, as was done with the old, outdated BPD. While there are some people who do ok with this, in general it's a bad idea. You get all the pouch problems and specific vitamin and mineral malabsorption of your RNY, and add to that the vitamin and mineral malabsorption of the DS. We have seen people get into big time trouble with this combination and need further revision.

I have no idea what surgeon you have seen, but would strongly advise you to get a second opinion from someone who does real RNY to DS revisions. Going from RNY to BPD would require putting your stomach back together JUST AS IS YOU WERE GETTING A TRUE DS. And you would lose your pylorus forever.

Keep looking for the right surgeon.

Larra

[hopeful77]

I was in the hospital room getting an endoscopy and he came in and said, "So do you remember what options we discussed?" and I said, the jejunostomy or the DS. I then told him that I did not understand what a jejunostomy was and he said it is the Bileopancreatic Diversion. At that time, I understood what he was talking about and I said, "It is BPD without the Switch and he said exactly. I told him that I did not want the BPD and would have to think about it and he said, "There is nothing to think about." At that moment, I knew that I would not be having surgery with him. I do not want to mention his name because he is a highly regarded surgeon, but do understand that I will not be going to him for my surgery because it seems that he did not want to discuss my concerns such as losing my pyloric valve and experiencing extreme vitamin deficiencies. I know for a fact that I want to revise to a DS and am currently seeking other options. I also thought about Vanguri in Baltimore.

[Deleted]

How did he describe his proposed surgical changes to your stomach? I'm still scratching my head over whether he meant a true Scopinaro procedure. A few surgeons are doing a somewhat different type of intestinal bypass, but still using the subtotal vertical gastrectomy for the stomach.

I can certainly understand your unwillingness to use him simply because he didn't give time or credence to your concerns. I hate it when docs act like that and generally fire them.

[hopeful77]

That's the problem; he did not thoroughly explain. He just did a motion with his hands to show me how he was going to switch my intestines. I think I will stick with Greenbaum.

[Deleted]

Oy, how obnoxious!!

[aa]

I second Diana's post.

[hopeful77]

He was just not the right surgeon for me so I have since moved on.

[larra]

Good decision. Anytime you feel pressured, or that your questions and concerns are not being addressed or (as it appears in this case) not even being respected, it's time to depart.
If the doctor had provided you will specific reasons why the DS was not possible for you, or why he recommended BPD, and also gone over all your options, I would feel differently about it. Not every RNY can be converted to a DS. But that discussion didn't happen.
It's also not a great idea to present a patient with surgical options while they are just coming out from sedation and not fully able to make informed decision, but in your case you did just fine in spite of that.

Larra

[aa]

Glad to hear it.