10-year+ post-op BPD here, checking in

[Guest guest]

Hi, all.

I haven't read this list in a long time, so someone kindly forwarded to me

Felicia's post about her " opinions " on various wls and their outcomes.

I had the BPD (Biliopancreatic Diversion, no DS) April 17, 1991. I weighed

320 going in, and weigh about 200 today, give or take 5 lbs. I went from a

size 26/28/30 to a 14/16. I also just completed my first sprint distance

triathlon on Sunday. (My weight is higher than my size would imply because

I have a lot of muscle from my athletics.)

I received the email from Felicia Sunday night when I returned home from

the tri -- I read it to my (non-op, size 14) roommate, who said, THAT'S

WHAT YOU HAD? She couldn't believe it from Felicia's doom-and-gloom

description of post-BPD life and health. I'll respond:

> BPD: Only for those who absolutely have no other choice. This

> surgery is usually always done open, so you have those side effects,

> plus the extreme malabsorption. Yes, this surgery lets people eat

> relatively normal meals, but malabsorbs almost everything eaten except

> sugar.

This is just plain erroneous. Unbelievably WRONG. Yes, my surgery was done

open -- but that's because most BPDs (without the DS) were done in the 80s

and early 90s, before lap became an option. In fact, my surgeon

(Wittgrove) was a pioneer of lap surgery, but he hadn't started offering

lap when he did my surgery.

Another fact: many surgeons who did the BPD (which we'll call the

Scopinaro BPD for clarity's sake) now do the BPD with the DS, which we

commonly call BPD/DS. The DS is a modification to the Scopinaro

BPD. basically in the DS, the stomach is transected along the greater

curvature rather than horizonally, and the pyloric valve and a duodenal

segment are preserved. Also, there is slightly less malabsoption. In the

Scopinaro procedure, the common channel is 50cm; in the DS, the common

channel is usually 75 - 110 cm.

Both the BPD and the BPD/DS require lifetime supplementation and blood

work. When I slacked on that myself (documented on my page on the DS

website), I became severely anemic. However, only my iron and zinc levels

were off -- all my other leves were well within normal range, including

protein, calcium/PTH/alk phos, albumin, etc.)

I now take supplements designed for bariatric patients that are highly

absorbable (instead of my regular Costco-brand supplements). I get mine at

www.vita4life.net

> Supplements will be a part of daily life, forever.

True for ALL bariatric patients, of all procedures. The degree of

malabsorption will vary, but the need for supplementation won't.

> Of all of

> the post-ops I have ever seen, BPD post-ops look the worst. Usually

> they have a gray or pasty appearance. Their immune system seems shot,

> so they get huge sores on their skin if they don't take their

> supplements. Sores that don't want to heal. Sometimes their eyes are

> yellow, their skin looks jaundiced. They always seem in the process

> of losing hair. Either they have just gotten over losing, or are just

> very thin on top. I have only met one long term post-op BPD who did

> not have thin hair; thin enough to see the entire scalp. These people

> just do not look good, no matter how much they can eat.

Wow -- where do you find your post-ops? Do they supplement like their

surgeon told them to? Sounds like IF THIS IS TRUE, that your pals

desperately need help and need help fast.

But that outcome is NOT inevitable.

I don't mean to sound full of myself, but my health, fitness and vitality

have never been better. I am strong and fit and healthy. I met my personal

goals at my triathlon: to finish strong, and to finish in under two

hours. I met both and feel awesome.

I have pre- and post-op photos and my whole " story " at

www.duodenalswitch.com/Patients/Sharon/sharon.html As soon as I get my

photos back from the tri, I'll post some there. But you'll note that there

is one posted from the San Francisco Bay to Breakers footrace I did in May

(that's a 12k).

> But if you

> have an eating disorder that you cannot and/or will not face and

> overcome, the BPD might be your only chance at a relatively normal

> life.

Oh please. BPDs don't have an eating disorder more than any other wls

patient does. It's incredibly patronizing and insulting to basically imply

that we do, and that's why we chose the BPD.

For me, the choice was between the BPD and the RNY -- I chose the BPD

because the success rates of long-term health and weight loss maintenance

are MUCH better with the BPD than they are for the RNY.

> You really can eat more than a post-op RNY should ever be able

> to eat.

" should " ?

It's absolutely true that BPD patients eat more than RNYs (duh). It's also

quite likely that we eat more than we did pre-operatively. I've heard

estimates that the figure varies from 1.5 to 3 times what we ate

pre-operatively. I think that the " Switch " is a super enhancement, since

it maintains the pyloric valve and a more " naturally " shaped stomach. I

rarely reach a " Normal " satiety after eating, and I believe that's because

of my lack of a pylorus.

But, whatever -- I'm healthy and fit and strong and it's not THAT big a

deal. Just an observation.

> You can eat sweets and junk food, you can eat and drink

> together with ease. You will be like a relatively normal person in

> those aspects.

You can eat whatever you want and still maintain weight loss -- that's

mostly true.

But we can't eat whatever we want AND BE HEALTHY -- that is true, and

often understated. We still need healthy nutritious food, JUST LIKE NORMAL

PEOPLE. Because we are normal, just surgically enhanced.

> But I have never seen a BPD who got to goal, despite

> all of the malabsorption. So is it worth it? For some, yes, because

> it is their only chance. Most of the BPD's I've seen are still obese,

> if not MO. Most look very ragged and sickly. But they are alive,

> versus being dead if they'd done nothing. I would say that the distal

> RNY would be better for these people, but some just can't seem to

> address or overcome their eating disorder, and they could easily kill

> themselves with the small pouch of the RNY, whereas the BPD allows

> them to eat more, and even binge in a small way.

Goal?

Those of us who opted for the BPD wanted a surgery that would work. I was

only 22 years old (barely) when I had my surgery and I had been dieting

from the time I was five years old (or possibly younger -- that's my first

recorded diet).

I am still a big girl -- but my size doesn't interfere with my quality of

life, and certainly not with my health. I'm healthier than most of my thin

friends, and finished the triathlon ahead of them.

But enough of the eating disorder crap. I don't need YOU to pretend to

psychoanalyze ME.

> The gas and BM's are

> usually out of this world. They can clear a room, some say.

ANY malabsorptive procedure will result in rotting food and malodorous gas

and bowel movements. The trick is to learn how to control it, either with

an air cleaner, an air sprintzer deodorizer, or Devrom tablets.

felicia: no post-op had to be as unhealthy as you describe your BPD

post-op pals to be -- they should get to an experienced doctor pronto and

find out what their deficiencies are and address them.

THe BPD is not a death sentence nor does it mean an inevitable unhealthy

outcome.

And I am NOT unique. My mother had the BPD 12 years ago this OCtober, and

a cousin of mine had it 9 years ago. All of us are doing fabulously well.

Sharon

sharon@...

[Guest guest]

Sharon--

I checked out your page as you suggested and you look great--I envy that

athletic glow. Now...for a perhaps awkward question. When you said you'd

addressed niggling health concerns you included hallitosis. How does one

address that? My concern as a pre-op is that if the stuff coming out of one

end of the body smells worse, then perhaps breath will be affected as well.

Does Devrom help, or is there some other supplement?

Best,

Belinda

[Guest guest]

Hi, Belinda.

Thanks for the compliments -- I am LOVING being an athlete and fit and

strong and HEALTHY.

The halitosis is something that still challenges me. According to

Scopinaro, about 5% of BPDs are afflicted with it. But I've only heard

of ONE BPD/DS with it. I think the reason for the problem is that the

Scopinaro BPDs don't have the pyloric valve to keep digestive malodors

in their place. An issue for *me* is that I never know nwhen it's

happening unless someone tells me. How many people do you know who

want to tell someone they have bad breath?

I recently started taking Devrom (as recommended by Dr. Rabkin) --

we'll see how that helps.

Truly, as someone looking into the DS, I wouldn't worry about it.

Good luck and be well,

Sharon

> Sharon--

> I checked out your page as you suggested and you look great--I envy

that

> athletic glow. Now...for a perhaps awkward question. When you said

you'd

> addressed niggling health concerns you included hallitosis. How

does one

> address that? My concern as a pre-op is that if the stuff coming

out of one

> end of the body smells worse, then perhaps breath will be affected

as well.

> Does Devrom help, or is there some other supplement?

>

> Best,

> Belinda