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Post by Gail R on Dec 19, 2013 18:59:37 GMT -5
I have to wonder if this surgery has any effect on diabetes. Perhaps none?
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Post by KathyF on Dec 19, 2013 19:57:30 GMT -5
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Post by CVHarris on Dec 19, 2013 20:08:24 GMT -5
Diana thanks for the recap. It was hard for me to catch on to exactly how the DS worked. Dr K actually gave me a wall size poster explaining the DS to me.
So saying that what do you think a Dr. Ethical requirements would be regarding the patient who comes in and is afraid to take the total DS plunge and want this safer version of the so called " DS"?
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Post by aflame on Dec 20, 2013 0:48:43 GMT -5
This may not count for much, but I have read of someone who got the SADI in Europe whose diabetes went into remission and has stayed such for at least 3 years. Their diabetes is currently in remission, though they didn't have much weight to lose.
Diana, please correct me if I am wrong, but I believe it's the SADI or the Duodenal-Jejunum Bypass (I am thinking it's the same? correct me if needed) that's being used to treat low BMI diabetics, in Europe, since it sends diabetes into remission. No long term studies have been done yet, so we don't know how effective it is for - diabetes resolution - in the long run. That it's weight loss results would not be as durable or impressive as the DS is obvious from your post and what I have read elsewhere.
The SADI/DJB was suggested to me by a well-known European surgeon of repute because he felt the DS was too 'extreme' given my lower BMI and absence of "full blown" diabetes. I know I'll get there at some point. I don't personally see a point to the "pre" part. From then on, it's just control and management. However, I discussed it with members on here, and I realized that if I were going for bariatric surgery, I might as well get it right the very first time instead of wasting time with revision. Plus, the DS, by far, has the best track record of diabetes resolution. It just wasn't worth it to me. And, I am obese anyway even if a lightweight. If I were slightly overweight or moderately overweight and diabetic, I would have opted for the SADI/DJB. It just doesn't seem to be the option for those of us that are obese.
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Post by goodkel on Dec 20, 2013 5:30:56 GMT -5
This may not count for much, but I have read of someone who got the SADI in Europe whose diabetes went into remission and has stayed such for at least 3 years. Their diabetes is currently in remission, though they didn't have much weight to lose. Diana, please correct me if I am wrong, but I believe it's the SADI or the Duodenal-Jejunum Bypass (I am thinking it's the same? correct me if needed) that's being used to treat low BMI diabetics, in Europe, since it sends diabetes into remission. No long term studies have been done yet, so we don't know how effective it is for - diabetes resolution - in the long run. That it's weight loss results would not be as durable or impressive as the DS is obvious from your post and what I have read elsewhere. The SADI/DJB was suggested to me by a well-known European surgeon of repute because he felt the DS was too 'extreme' given my lower BMI and absence of "full blown" diabetes. I know I'll get there at some point. I don't personally see a point to the "pre" part. From then on, it's just control and management. However, I discussed it with members on here, and I realized that if I were going for bariatric surgery, I might as well get it right the very first time instead of wasting time with revision. Plus, the DS, by far, has the best track record of diabetes resolution. It just wasn't worth it to me. And, I am obese anyway even if a lightweight. If I were slightly overweight or moderately overweight and diabetic, I would have opted for the SADI/DJB. It just doesn't seem to be the option for those of us that are obese. In Europe they have been doing JUST the intestinal part of the DS to cure diabetes. There have been recently a couple of surgeons in the US to do the same. US healthcare is FAR behind the rest of the first world, so this should come as no surprise. This SADI procedure, however, has no long term studies to support it and is strictly experimental. My BMI was just over the limit for weight loss surgery and I had the DS. Any surgeon who would turn you down for not being fat enough is just making excuses for his incompetence. He doesn't want to give ANYONE the DS. |
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Post by goodkel on Dec 20, 2013 5:37:39 GMT -5
Bottom line:
The SADI is not the DS.
The SADI does not malabsorb like the DS.
DS advice does not apply to the SADI.
Don't even try or you could hurt someone.
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Post by Deleted on Dec 20, 2013 7:48:22 GMT -5
Diana, could you please talk a little bit about what "experimental" means in this context and explain the benefits of clinical trials? (I could do it, but you're much better at it than I am  .) I think it's important for folks to understand that surgical procedures are not regulated the way medications are, and that nobody is going to prevent a surgeon from doing an untested procedure. |
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Post by brooklyngirl on Dec 20, 2013 17:45:02 GMT -5
I think I read in another post something about more "experimental" procedures/versions being performed on self-pay patients? Is it more unregulated if they don't have to answer to insurance companies?
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Post by brooklyngirl on Dec 20, 2013 19:19:51 GMT -5
That's not cool
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Post by sheanie on Dec 20, 2013 23:48:40 GMT -5
I first heard of the Duodenal Switch on Oprah years ago when Dr. Oz mentioned it. I thought he said something about it curing Type 2 Diabetes, but I'm not sure. He might not even have used the DS name, he said bypassing the duodenum, I think.
When I got my DS, one of the doctors at GHP wanted me to give my brother their card because he has astronomically high cholesterol, like in the 900's. My uncles all had much higher cholesterol. Not triglycerides, but cholesterol. It was hereditary, and they all were thin, but short Frenchmen from Belgium, France. Whatever, the doctor I saw (not Foote) said they were doing surgery to correct cholesterol. My brother never went, but thinking back I wonder now if it was duodenal-related?
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Post by msbatt on Dec 20, 2013 23:51:06 GMT -5
Sheanie, haven't you noticed what fantastic cholesterol numbers most DSers have? All while pigging out on (gasp!) BACON? (*grin*)
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Post by kirstabelle on Dec 23, 2013 10:47:02 GMT -5
Same thing? www.ncbi.nlm.nih.gov/pubmed/24300921Surg Laparosc Endosc Percutan Tech. 2013 Dec;23(6):481-5. doi: 10.1097/SLE.0b013e3182950111. Novel metabolic surgery for type II diabetes mellitus: loop duodenojejunal bypass with sleeve gastrectomy. Huang CK, Goel R, Tai CM, Yen YC, Gohil VD, Chen XY. Author information Abstract A total of 22 (14F/8M) patients with a mean age of 50.3 years (range, 33 to 64 y) and a mean body mass index of 28.4 kg/m (range, 21.8 to 38.3 kg/m) underwent loop duodenojejunal bypass with sleeve gastrectomy from October 2011 to March 2012. The mean duration of onset of type 2 diabetes mellitus was 8 years (range, 1 to 20 y). All patients were on oral hypoglycemic agents; 3 (14%) patients were also using insulin. The mean preoperative glycosylated hemoglobin (HbA1c), fasting plasma sugar, and C-peptide levels dropped from 8.6% (range, 7% to 13.2%), 147 mg/dL (range, 108 to 241 mg/dL), and 2.4 ng/mL (range, 0.7 to 4.1 ng/mL) to 6.2% (range, 5.1% to 9.1%), 110 mg/dL (range, 72 to 234 mg/dL), and 1.3 ng/mL (range, 0.6 to 2.8 ng/mL) at 6 months, respectively. At 6 months, 11 (50%) patients showed type 2 diabetes mellitus remission (HbA1c<6.0%), and 20 (91%) patients achieved HbA1c<7.0% without medicine. There were no intraoperative or early postoperative complications. Loop duodenojejunal bypass with sleeve gastrectomy is safe, feasible, and shows good efficacy in terms of glycemic control in this preliminary report with short follow-up. PMID: 24300921 [PubMed - in process] |
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Post by Deleted on Dec 23, 2013 11:10:44 GMT -5
Performing a non-standard procedure on a cash-pay patient is IMNSHO one step short of criminal. (Note this is OPINION.) Surgeon wants guinea pigs for his/her variation on what's being currently done. Insurance doesn't cover these procedures, of course. Rather than go to the effort of establishing a clinical trial and DOING IT RIGHT (or, to emphasize again, what IN MY OPINION is the RIGHT WAY), the surgeon offers this option to people for cash.
Participants in studies, clinical trials, etc., that are supervised by research review boards and ethical bodies, are VOLUNTEERS. They GET SOMETHING out of the experience, whether it's a free procedure, or free aftercare, or even actual COMPENSATION for participating. To have them PAY to be guinea pigs?
No. Effing. WAY.
It's apparently legal for surgeons to work this way. That doesn't make it right.
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Post by Deleted on Dec 28, 2013 20:04:51 GMT -5
Can this procedure be revised easily to a full DS?
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Post by msbatt on Dec 28, 2013 21:07:42 GMT -5
Easily? NO. Possible? Yes, but at more risk than a 'virgin' DS. Malpractice, IMNOHO.
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Post by Deleted on Jan 13, 2014 18:00:33 GMT -5
Where is the original post?
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Post by curlygirlny on Jan 18, 2014 12:04:40 GMT -5
Any more people had this surgery?
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Post by goodkel on Jan 21, 2014 2:56:35 GMT -5
Where is the original post? Someone cared so little about the time, thought and effort of everyone who chose to reply to this thread that they deleted the post and wasted all of it. I am terribly sorry about that and you can trust that I have done everything that I can to prevent it from happening again. |
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Post by fallds on Jan 21, 2014 15:15:03 GMT -5
I just talked to my doc today at my 3 month post op appt. I had a SADI DS. My stomach capacity is called a French 50 ?? And my common channel is 220 cm. Does anyone know much about this and what it means?
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Post by deedee484 on Jan 21, 2014 15:38:54 GMT -5
sorry I can't help but I'm sure others will! I just sent for my post-op report today so I'm really curious to see it! Up till now I didn't WANT to see it...too much too soon....but now I'm ready! ha ha Hope you get some answers soon!
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Post by curlygirlny on Jan 21, 2014 17:25:05 GMT -5
I just talked to my doc today at my 3 month post op appt. I had a SADI DS. My stomach capacity is called a French 50 ?? And my common channel is 220 cm. Does anyone know much about this and what it means? I know most of what you're talking about. The current sleeve (vsg) which I have is about 32-36 in size. That's just the amount held. The SADI I believe is a single asmosis (spell check) while the DS is a double cut. It's a new technique that I was and still am researching. The problem I hear is the fact bile might come back up but I don't know if that's true so I can't comment. Only a true person who has had this can comment with their personal experience. Common channel is where you absorb your nutrients in lay mans terms. Longer channel less malabsorption but more absorption if nutrients. If you google everything separately you can get an idea of the meaning. In short if you are losing slow it's because in comparison your channel is longer and stomach is bigger than a DS. Either way I personally think any bypass is better than none some DS'ers will disagree. I've been called a fool to consider the SADI. Also if you are a lightweight that can be why your sizes are bigger. |
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Post by brooklyngirl on Jan 22, 2014 6:18:27 GMT -5
I just talked to my doc today at my 3 month post op appt. I had a SADI DS. My stomach capacity is called a French 50 ?? And my common channel is 220 cm. Does anyone know much about this and what it means? CiJi, I'm just curious, were you self-pay and did you know going in that the dr was doing the SADI? |
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Post by fallds on Jan 23, 2014 10:56:52 GMT -5
I was not self pay...my insurance covered 100% up to $50,000 on the procedure. My doc had explained what he was going to do so I was aware of it. I didn't realize it was called a SADI or what that meant. I guess what I was not aware of is that there were other ways to do it. I (foolishly) assumed a DS was a DS. I work with 2 women who have had the same procedure from the same surgeon and they are doing great so I didn't ask too many questions. My surgery and the whole process only took leading up to it with testing, sleep studies, nutrition counseling...all of it...only lasted 3 months. It was sort of a whirlwind just getting it all done and the nerves and the fear and excitement. Honestly, I wasn't asking about too many specifics of the procedure. I spent my time trying to get specifics on what I needed to know once I was home. My doc says he does the SADI because if need be, it's easier to revise and just as effective. I personally have not had any issues with the bile back up that some have talked about. So far, so good. But i'm very early out. I just hope my common channel being 220 cm doesn't keep me from losing all I want to lose. At 3 months out I have lost 37% of my excess weight. I guess that is pretty good progress. Hopefully I can make my goal and having this longer common channel will help prevent severe deficiencies.
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