Quote:
Originally Posted by Godsblessedme
i was wondering how everything was going Kelly. So will they do the insurance still or are you still going to be delayed for the thyroid? and will insurance cover you going out of state as well as this switch procedure? why do you want the switch and not RNY? just curious
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Thanks for asking sweetie.The thyroid is FINALLY at normal levels.I feel alot better and I think it is helping with my weight loss so far.My insurance will cover the switch if it is medically needed.There are alot of reasons I chose the switch
I made this RNY vs DS chart
RNY compared to the DS
RNY – expected weight loss
50-65% expected excess weight loss (percentage varies in opinion – this is the most commonly seen estimate)
Results may vary
Regain
Possible regain: more prevalent after 5 years
50-100% regain of weight has been recorded
Results may vary
Must follow “pouch rules” in an attempt to not regain
DS – expected weight loss
85% expected excess weight loss
Results may vary
Regain
Studies show little to no regain (20 pounds recorded)
Results may vary
Highest success rate over 10 year study (78% avg. Excess Weight Loss – EWL)
RNY – have a stoma (stomach made into a pouch – size of an egg)
Size: 2 oz
Stretch to average size of 6 oz in 2 years (possible to stretch up to 9-10 oz)
You can eat more as time goes by
Average after 1 year is 1-1.5 cups of food
No Endoscopes on blind stomach/remnant stomach that is bypassed
Doctor evaluation: cannot use an endoscope (to find ulcers and tumors)
RYGBP construction makes the large bypassed distal stomach inaccessible to standard non-invasive diagnostic modalities. Neither x-ray contrast studies nor endoscopy can assess this potentially important but hidden area.
Stoma: pouch
Should not take Nonsteroidal Anti-Inflammatory drugs (NSAID).
NSAIDs are: Advil, Alka Seltzer, Aleve, Anacin, Ascription, Aspirin, Bufferin, Coricidin, Cortisone, Dolobid, Empirin, Excedrin, Feldene, Fiorinol, Ibuprofen, Meclomen, Motrin, Nalfon, Naprosyn, Norgesic, Tolectin, Vanquish
NSAIDs are used for arthritis, bursitis, tendonitis, back pain, headaches, and general aches and pains.
Taking NSAIDs could develop into a bleeding ulcer and interfere with kidney function.
Possible Problems
Ulcers (Some doctors recommend taking prilosec for 6 months to 1/2 years in an attempt to prevent the ulcers)
Possibility of a staple line failure
Noncompliance: simply do not lose enough (even with following the rules)
Vitamin Deficiencies
Narrowing/blockage of the stoma
Vomiting if food is not properly chewed or if food is eaten to quickly
Dumping syndrome, NIPHS, Hypoglycemia
No Valve (pyloric valve that opens and closes to let food enter intestines is bypassed) which means food empties directly into the small intestines and causes dumping and/or can cause NIPHS or Hypoglycemia
Dumping: food (most commonly sugar but not necessarily “just” sugar) enters/dumps directly into small intestines and causes physical pain (some people believe this pain enforces good eating habits)
Dumping varies in degree of occurrence and discomfort
Dumping symptoms:
Nausea
Vomiting
Bloated stomach
Diarrhea
Excessive sweating
Increased bowel sounds
Dizziness
“Emotional” reactions
NIPHS (insulin over production): “the body overproduces insulin in response to food entering the intestines at a point where food would normally be more digested already - this part of the intestine is not used to coping with metabolizing glucose in the condition it arrives after RNY, and it is suspected that the intestine signals the pancreas for more insulin to aid digestion, causing a MASSIVE overproduction. The change occurs on a cellular level, hard to diagnose. Treatment: Removal of half the pancreas.”
RNY stoma that is created allows food to go straight through the stomach into the small intestine unrestricted so it does not control the flow. Because of that the body reads that it needs more insulin because the food is moving through so quickly and it thinks there's going to be a lot more food. With the DS, the normal peristalsis works because the pyloric valve is in place and can control the movement of food into the small intestines.
NIPHS, Hypoglycemia is deadly if not corrected
DS – whole stomach (size of banana)
“Whole working stomach” - meaning the stomach’s outer curvature is removed as opposed to making a pouch/stoma.
Part of the stomach removed is where most of the hormone called Grehlin is produced.
Grehlin gives the sensation of hunger so by removing most of that section of the stomach a DSer is not as hungry as before.
Whole working stomach: no blind stomach. Endoscope can be used.
Can take NSAIDs
Do not need to take Prilosec to prevent ulcers.
Valves are in tack: no Dumping Syndrome or NIPHS
RNY – Eating
Eat protein first
60g of protein a day
Recommended to chew food to liquid consistency (pureed, soft, thoroughly chewed)
This is more important for people early out (new pouch stomach will stretch out with time).
Food is thoroughly chewed to prevent blockage (the hole/path leaving the stomach and into the intestine is roughly the size of a dime).
To get food unstuck, patients drink meat tenderizer mixed with water.
Low carbohydrates
Carbohydrates can slow weight loss and lead to possible regain
Avoid sugars in particular (to prevent dumping syndrome)
Low fat
Foods high in fat may cause Dumping Syndrome
Fatty foods can lead to slow weight loss or possible regain
64 oz of water
Stop drinking within 15-30 minutes of a meal
Do not begin drinking after a meal for 1-1.5 hours
Some doctors do not encourage the use of a straw (pushes food too quickly through the stomach and can cause gas/discomfort)
Water Loading
15 minutes before the next meal, drink as much as possible as fast as possible.
Water loading will not work if you haven’t been drinking over the last few hours.
You can water load at any time 2-3 hours before your next meal if you get hungry, which will cause a strong feeling of fullness.
Disclaimer: this is a practice some people use to feel “full” and lose weight. Not a requirement.
DS – Eating
Eat protein first
80-100g of protein
DS patients can on average eat more food than any other type of weight loss surgery.
Low carbohydrates
Carbohydrates can slow the weight loss and lead to possible regain
No dumping syndrome from eating sugar (or fat)
Eat high in fat
DS only absorb 20% of fat (do not need to eat low fat)
If a taco has 20g of fat, a DSer only absorbs 4g while a person without surgery or RNY absorbs ALL 20g. (this is just an example, measuring absorption is not an exact science)
When experiencing a “stall” (slowed weight loss/plateau) a DS patient commonly increases fat consumption to resolve
64 oz of water
Can drink with meals
Can use a straw
RNY – Possible Issues
Vitamin deficiencies: Must follow a vitamin regime for the rest of your life
Common vitamin deficiencies found in vitamins B12, iron, and zinc
Calcium must be supplemented for the rest of your life
Bathroom issues
Gas
Constipation
Dumping in the form of loose stools
Reversible procedure (Reversals of any surgery is very complicated)
Revision often performed instead of reversal
Revising to a different type of surgery is possible.
DS – Possible Issues
Vitamin deficiencies: Must follow a vitamin regime for the rest of your life
Common vitamin deficiencies found in vitamins A, D, and iron
“Water soluble”/ “water miscible” / “dry” vitamins absorb best (in other words get vitamins that are not fat/oil based)
Calcium must be supplemented for the rest of your life
Bathroom issues
Gas
Loose stool (Most common in the first few weeks of surgery. Generally food related)
Reversible procedure
The intestinal bypass is reversible for those having absorption complications
revision: lengthening common channel (to stop losing weight and/or to absorb vitamins)
Stomach is obviously not reversible (part of stomach was removed)
RNY - Diabetes
85% cure rate
RNY can put diabetes in remission.
Diabetes may come back in two or three years--even if the
patient maintains most of their weight loss.
Even a small amount of weight gain, long-term, can cause a diabetes
relapse.
DS – Diabetes
98 % cure rate for type II diabetes
I have lost and gained weight so many times that I think the smaller stomach with more malabsorbtion will be the right thing for me.I am sure of it infact.I am also what they call super morbidly obese.This surgery is reccomended for people who are.
Kelly's story
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good for you i know you cant wait to get that date now
/CW-181/GW-140
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