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I'm sorry to hear about your situation. If it were me, I would go with

the RNY without a second thought. To me it beats being this heavy. There

are many happy RNYers out there. I have a friend who started out at 400lbs.

She is thrilled with the surgery. She tells me that she doesn't feel

deprived. She gets full very quickly. She eats well with the exception of

sweets and is losing fast. Maybe Dr. Herron could do more of a distal RNY.

At least that would increase your odds of keeping it off in the long run.

Whatever you decide, I wish you luck. Keep your mind open to the different

possibilities.

Sherry

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,

What a bummer. I wonder if you suregon would consider a revised DS

with less malabsopriton. For example a longer common channel might

help aviod the diaharrea problems. Also, he could try to make the

stomic as small as possible while maintaining vagal continuity. This

would increase the restrictive part of the procedure and help

compensate. It's a long shot, but maybe he would be willing to

consider it.

If that doesn't work then you could consider the adjustable band. It

wouldn't be my first choice, but you won't get the dumping problem

and it is fairly easy to remove.

Good luck,

Hull

> Well, I spoke to Dr. Herron today and received depressing news. He

does

> not recommend ds surgery for me.

>

> About 20 yrs ago, I had surgery on my sigmoid colon for

diverticultis.

> According to the hospital report, three sections of colon was

removed.

> Bottom line is that he feels I would have a greater problem with

dirrera.

> He recommed RNY.

>

> I did lots of research regarding RNY and I dont think its for me.

Im

> not happy with the dumping, possibility of food not being chewed to

mush

> and getting stuck,also gaining my weight back. Currently, Im 420lb.

>

> The other recommendation is to find an internist, get on a diet,

exercise

> program and Xenical.

>

> I really donot want the RNY. Right now, I am do depressed. I have to

> decide soon. I am schedule to have surgery 9/7 but who knows.

>

>

>

>

>

> __________________________________________________

> FREE voicemail, email, and fax...all in one place.

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Sherry,

I spoke with after he got turned down by Dr. Herron as a candidate for

the BPD/DS procedure.

(I am also pre-op, so not very knowledgeable on a 'first-hand' basis).

is really depressed and

not at a point where he will consider the RNY due to what he feels (and

very well may be) will become

a very restrictive lifestyle. It would be really great if people with much

more knowledge than myself

and much more open to options other than BPD/DS would communicate with

. At 400 lbs., it

would be a shame to watch him do nothing versus helping him see positives

in other options.

Unfortunately, I feel about the RNY as does, but like , I too

underwent a sigmoid colectomy

and may be refused the BPD/DS and find myself in the same situation. Good

words and opinions

may save two people from doing nothing versus looking more positively at

alternatives.

Thanks,

Donna

GABS12992 (AT) Aol (DOT)

com To: duodenalswitch

cc:

08/16/2001 Subject: Re: MY

Surgery-Dont Know

02:28 PM

Please respond

to

duodenalswitch

I'm sorry to hear about your situation. If it were me, I would go

with

the RNY without a second thought. To me it beats being this heavy. There

are many happy RNYers out there. I have a friend who started out at

400lbs.

She is thrilled with the surgery. She tells me that she doesn't feel

deprived. She gets full very quickly. She eats well with the exception of

sweets and is losing fast. Maybe Dr. Herron could do more of a distal RNY.

At least that would increase your odds of keeping it off in the long run.

Whatever you decide, I wish you luck. Keep your mind open to the

different

possibilities.

Sherry

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,

Have you talked to any other doctors about it ? I know Dr Herron can

be a tad more conservative than others, although his concerns are

justified. I was just thinking that if you have someone who measured

the bowels when the did surgery and did a proportional split, it

maybe possible. Now, if your bowel length is extremely short or you

don't have much of your duodenum left, it may not be possible. This

is one of those 50/50 split questions where some people say the would

rather get nothing than get an RNY and others say they would rather

get an RNY than nothing. Since yours isn't a case of insurance,

convenience and it's due to the fact that you may PHYSICALLY not be

able to get a DS, it puts a different spin on things in my book. As

long as I was physically able to have the DS, I would choose the DS

over any other procedure, even if it meant saving up and going to Dr

Baltasar in Spain. If I couldn't physically have the DS, I would

definitely consider the distal RNY as the long term weight loss and

maintenence is comparable to the BPD/DS. Most doctors only do a

proximal or medial RNY, but why go through surgery and risk gaining

back a large amount of weight or not losing it just because the

surgery you picked wasn't as effective as others ? At your weight,

any doc should be able to see that the distal RNY would be

appropriate in order to achieve maximum weight loss. There are some

people that are very happy with the RNY and some not. The main thing

you need to know is that with the distal RNY you will need to

increase your protein and supplements as you don't have a portion of

duodenum attached. You may or may not have the dumping syndrome and

even if you have it in the beginning, it may not last over time.

While your stomach won't always been the size of a shot glass like it

starts out, I don't know what size it eventually becomes. If you

choose to do this, you need to make sure you make a fully informed

decision. While the DS is more..user friendly, I would say..if it

was the distal RNY or yo-yo dieting and constant back pain, swollen

ankles, chest pain, etc I would choose the distal RNY, but you would

have to make that decision.

Good luck with your decision! *hugs*

Anita

Pre-op in Denver

> Well, I spoke to Dr. Herron today and received depressing news. He

does not recommend ds surgery for me.

>

> About 20 yrs ago, I had surgery on my sigmoid colon for

diverticultis.

> According to the hospital report, three sections of colon was

removed.

> Bottom line is that he feels I would have a greater problem with

dirrera.

> He recommend RNY.

>

> I did lots of research regarding RNY and I dont think its for me.

Im

> not happy with the dumping, possibility of food not being chewed to

mush

> and getting stuck,also gaining my weight back. Currently, Im 420lb.

>

> The other recommendation is to find an internist, get on a diet,

exercise

> program and Xenical.

>

> I really donot want the RNY. Right now, I am do depressed. I have to

> decide soon. I am schedule to have surgery 9/7 but who knows.

>

>

>

>

>

> __________________________________________________

> FREE voicemail, email, and fax...all in one place.

> Sign Up Now! http://www.onebox.com

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In a message dated 8/16/01 2:58:27 PM, duodenalswitch writes:

<< bout 20 yrs ago, I had surgery on my sigmoid colon for diverticultis.

According to the hospital report, three sections of colon was removed.

Bottom line is that he feels I would have a greater problem with dirrera.

He recommed RNY.

I did lots of research regarding RNY and I dont think its for me. Im

not happy with the dumping, possibility of food not being chewed to mush

and getting stuck,also gaining my weight back. Currently, Im 420lb.

The other recommendation is to find an internist, get on a diet, exercise

program and Xenical.

>>

: So sorry to hear about the surgeon's opinion regarding the DS. One

other option you MAy look into (and I don't want to get flamed here by

anti-banders) is the lap band. It has just been approved by the FDA and Dr.

Ren (at NYU) is one of the surgeons who performs it in NYC. I think that, in

comparision to the RNY, it is superior and much less invasive. At least you

can look into this option/possibility? I think that it might be a better

choice than Xenical or other medications.....

Dr. Ren has a decent website, but I don't know the address offhand..... She

is a surgeon at NYU Medical Center...

all the best,

lap ds with gallbladder removal

January 25, 2001

Dr. Gagner/Mt. Sinai/NYC

six months post-op and still feelin' fabu! :)

pre-op: 307 lbs/bmi 45

now: 230 (looks like this plateau is stickin' around!)

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In a message dated 8/16/01 2:58:27 PM, duodenalswitch writes:

<< Unfortunately, I feel about the RNY as does, but like , I too

underwent a sigmoid colectomy

and may be refused the BPD/DS and find myself in the same situation. Good

words and opinions

may save two people from doing nothing versus looking more positively at

alternatives.

>>

Donna: You guys were both at Mt.

Sinai today? I had an appt with Dr. Herron this afternoon at 3:00 and there

was NO ONE around, man! LOL

Perhaps you mean you spoke with him on the phone... sorry I missed you, .

I would look into the adjustable lap band --- Dr. Ren is one of the surgeons

here in NYC that is performing it laparoscopically... And, Lennox Hill has a

surgeon (can't remember her name) that performs it. Mt. Sinai was involved

in the FDA tests strangely enough but I don't know anyone who has had it

performed there. I think in general the surgeons at Mt. Sinai are pretty

'anti-band'.

Check out Dr. Ren's website and read more on this procedure - I think it is

definately superior to the RNY and it provides an overall better standard of

post-op life compared to the RNY. :):) There's hope yet!

all the best,

lap ds with gallbladder removal

January 25, 2001

Dr. Gagner/Mt. Sinai/NYC

six months post-op and still feelin' fabu! :)

pre0p: 307 lbs/bmi 45

now: 230 (this damn plateau is here for a bit longer)

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Why can he do the sleeve gastrectomy and do a proximal switch!?

You'll get the benefits of the 'intact' stomach and the decreased

chance of diarhea?

It's kind of a hybrid--ask?

Pammi

> Well, I spoke to Dr. Herron today and received depressing news. He

does

> not recommend ds surgery for me.

>

> About 20 yrs ago, I had surgery on my sigmoid colon for

diverticultis.

> According to the hospital report, three sections of colon was

removed.

> Bottom line is that he feels I would have a greater problem with

dirrera.

> He recommed RNY.

>

> I did lots of research regarding RNY and I dont think its for me.

Im

> not happy with the dumping, possibility of food not being chewed to

mush

> and getting stuck,also gaining my weight back. Currently, Im 420lb.

>

> The other recommendation is to find an internist, get on a diet,

exercise

> program and Xenical.

>

> I really donot want the RNY. Right now, I am do depressed. I have to

> decide soon. I am schedule to have surgery 9/7 but who knows.

>

>

>

>

>

> __________________________________________________

> FREE voicemail, email, and fax...all in one place.

> Sign Up Now! http://www.onebox.com

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In a message dated 8/16/01 6:35:06 PM, duodenalswitch writes:

<< The problem, he said, is in the long term. The restrictive procedures

like the lap-band have not been as successful in the long term,

primarily because they do not have the malabsorptive element that

restricts the potential of regaining the lost weight. He described it

by saying that the lap-band requires a high level of patient

compliance to make it work.

>>

I think this is definately true, but from what Dr. Ren was saying tonight (I

went to NYU for what I thought was a post-op DS meeting but turns out that it

was a post-op lapband meeting LOL, the lower success rate (long term

maintenance, etc.) mainly is due to patient non-compliance AND/OR little

surgeon aftercare.

The lapband can be adjusted and may need 'tweaking' for life. That's a

downer. I mean, if you gain some weight, it may need to be 'adjusted' or

'tightened'. REgular aftercare is required to maintain it. But, the same

can be said for the DS. the surgery itself won't need adjustment (in most

cases) but people have to get regular labwork done and may have to adjust

their vitamin supplementation...

I totally agree that it wouldn't be my first choice but I'd take it over the

permanance of the RNY... What if the RNY really doesn't work for you? What

if you do suffer after it and can't stand the lifestyle? You can get it

'reversed' but OUCH! There's no guarantee that a stomach that was cut that

way will be fully functional again... At least with the lapband if you suffer

afterwards or want it removed at some point in the future this is possible!

all the best,

lap ds with gallbladder removal

January 25, 2001

Dr. Gagner/Mt. Sinai/NYC

six months post-op and still feelin' fabu! :)

pre-op: 307 lbs/bmi 45

now: 230

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Hi :

> About 20 yrs ago, I had surgery on

> my sigmoid colon for diverticultis.

> According to the hospital report,

> three sections of colon was removed.

> Bottom line is that he feels I would

> have a greater problem with dirrera.

> He recommed RNY.

GET A SECOND OPINION!

The sigmoid colon is the almost last, (prior to the rectum), section

of the LARGE intestine. The DS rearranges your SMALL intestine, but

leaves your large intestine alone. Therefore, to my non-medical

mind, it just doesn't make sense to say that you'd have a greater

problem with diarrhea after the DS unless you already have a problem

with diarrhea. Do you?

> The other recommendation is to find an

> internist, get on a diet, exercise

> program and Xenical.

Yeah right. And someday monkeys will fly out of my butt!

Let's be real here . If an exercise program (plus or minus the

latest fad drug) would solve the problem, you wouldn't weigh 420

pounds, and you wouldn't be seeking bariatric surgery. Am I right?

Tom

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I think the Dr. over at Lenox Hospital is Dr. Leitman but I am not sure.

Lisbeth

Dr. Macura

June 25, 2001

I would look into the adjustable lap band --- Dr. Ren is one of the surgeons

here in NYC that is performing it laparoscopically... And, Lennox Hill has a

surgeon (can't remember her name) that performs it. Mt. Sinai was involved

in the FDA tests strangely enough but I don't know anyone who has had it

performed there. I think in general the surgeons at Mt. Sinai are pretty

'anti-band'.

Check out Dr. Ren's website and read more on this procedure - I think it is

definately superior to the RNY and it provides an overall better standard of

post-op life compared to the RNY. :):) There's hope yet!

all the best,

lap ds with gallbladder removal

January 25, 2001

Dr. Gagner/Mt. Sinai/NYC

six months post-op and still feelin' fabu! :)

pre0p: 307 lbs/bmi 45

now: 230 (this damn plateau is here for a bit longer)

----------------------------------------------------------------------

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In a message dated 8/18/01 8:18:37 PM Eastern Daylight Time,

pensiondude@... writes:

> 1..Does anyone know about Dr Jersy Macura ?He the Director of Bariatric

> Surgery at Staten Island University Hospital. Trying to get appt with

> him.

>

He is my surgeon. I am going in for a DS on Thursday. He has two

associates. Dr. Nicastro and Dr. McMullen. I believe Dr. Macura did 165

surgeries last year (DS and RNY) and 140 something the year before that. He

has been doing surgeries much longer but don't know how many he did. I have

learned that his RNY's are distal and he seems to be very fond of the DS.

Surgery is done out of Staten Island University Hospital and they do have a

bariatric unit. Dr. Macura only does open surgeries. He has an excellent

after care program. On Mondays, there are nutrition support meetings and on

Tuesdays, there is psych meetings for post ops only to help us deal with food

issues, new found attention, etc. I've heard that Dr. M is getting about 12

new patients a week which is phenomenal. You must fit the criteria and and

meet with the nutritionist first. She will give you a list of all the

testing that needs to be done. It is your responsibility to make sure they

have copies of everything. After all the tests are back, you will get a

consult appointment. From there, they will submit for approval and once you

have approval, they will give you a surgery date. Hope this info helped.

Good luck .

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I would like to thank everyone for there support especially Donna who

listened to me when I called.

I went to my PCP and he contacted Dr Herron. They spoke for about 15

min. Dr herron will not do DS surgery on patients who underwent surgery

for a sigmoid colectomy. In my case, I have about 10 in removed. Bottom

line is that he feels I would have a greater problem with diarrhea.

He says that normal DOS patients go 4 to six times a day. I my case I

would be living on the bowl.

I did have a done a few month ago, I was fine. The PC said he will

contact the and discuss the test and how much skimmed was there.

I told the PC that I was against having the ANY done. He recommended

to get a second opinion but to keep an open mind on the RNY procedure.

With all the research I did on RNY, my mind is closed. DS is the way

I want to go.

I have 2 questions...

1..Does anyone know about Dr Jersy Macura ?He the Director of Bariatric

Surgery at Staten Island University Hospital. Trying to get appt with

him.

2..Smelly question, after surgery what is the average number of BM's

you may have. Is it diarrhea and when does it / doesnt it stop.

I have not had any problems with BM's since my sigmoid colectomy.

I dont know if doctor's or nurses are members of this room, if so I would

like to here from you directly.

Again, thank you.

pensiondude@... - email

x4399 - voicemail/fax

__________________________________________________

FREE voicemail, email, and fax...all in one place.

Sign Up Now! http://www.onebox.com

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I would like to thank everyone for there support especially Donna who

listened to me when I called.

I went to my PCP and he contacted Dr Herron. They spoke for about 15

min. Dr herron will not do DS surgery on patients who underwent surgery

for a sigmoid colectomy. In my case, I have about 10 in removed. Bottom

line is that he feels I would have a greater problem with diarrhea.

He says that normal DOS patients go 4 to six times a day. I my case I

would be living on the bowl.

I did have a done a few month ago, I was fine. The PC said he will

contact the and discuss the test and how much skimmed was there.

I told the PC that I was against having the ANY done. He recommended

to get a second opinion but to keep an open mind on the RNY procedure.

With all the research I did on RNY, my mind is closed. DS is the way

I want to go.

I have 2 questions...

1..Does anyone know about Dr Jersy Macura ?He the Director of Bariatric

Surgery at Staten Island University Hospital. Trying to get appt with

him.

2..Smelly question, after surgery what is the average number of BM's

you may have. Is it diarrhea and when does it / doesnt it stop.

I have not had any problems with BM's since my sigmoid colectomy.

I dont know if doctor's or nurses are members of this room, if so I would

like to here from you directly.

Again, thank you.

pensiondude@... - email

x4399 - voicemail/fax

__________________________________________________

FREE voicemail, email, and fax...all in one place.

Sign Up Now! http://www.onebox.com

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> 2..Smelly question, after surgery what is the average number of BM's

> you may have. Is it diarrhea and when does it / doesnt it stop.

, my normal routine is to have one or two BMs in the morning within

30 minutes of awakening. Usually that is it for the day, unless I'm

eating a lot, in which case I might have another BM in the evening. I

don't get diarrhea any more now than I did as a pre-op (seldom). My

normal stool now is softer than pre-op, and can be smellier, but not

always, and it's never so bad that a spritz of run-of-the-mill (Glade

Potpourri is what I have in the bathroom right now, I think) can't

eradicate. I am 22 months post-op now. Early post-op, I did go through

an adjustment phase where the BMs were looser and less predictable and

smellier. Things have progressively improved; at this point my gut is

well-adapted and is not problematic at all. Hope this helps!

M.

---

in Valrico, FL, age 39

Starting weight 299, now 156

Starting BMI 49.7, now 26.0

Lap DGB/DS by Dr. Rabkin 10-19-99

http://www.duodenalswitch.com

Direct replies: mailto:melanie@...

_________________________________________________________

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Hello ,

Dr. Macura performed my surgery. He has a practice in both Brooklyn and Staten

Island I have been to both office but I primarily go to the SI office. Dr.

Macura only performs the DS open. He feels comfortable performing surgery with

the old feel and touch method. His patients run the entire spectrum from " light

weights " like me to the Super MO. I had the oppurtunity to meet the mother of

one of his Super MO patients she told me her son weighed 600+ pounds pre-op that

his surgery was without complications and her son has lost over 200+ lbs. Dr.

Macura really stresses his support group meetings and feels that patients with

support do better with weight loss. Dr. Macura is reserved but when you speak to

him he is super attentive and answers questions even the ones you dont ask. All

in all my experience with Dr. Macura has been very positive. Dr. McMullen is

also very attentive and very patient. Dr. Nicastro assisted Dr. Macura with my

surgeon.

Hmmmm bm's well right after surgery I stayed very close to the bathroom. About

the 5th week out it tapered to what it has been since then which is once in the

morning sometimes maybe 2 times (very infrequently its 2 times and very rarely I

may have another bm at night. I had IBS before surgery so I was very concerned

about having the DS procedure. But so far it has not been a problem.

Lisbeth

Dr. Macura

June 25, 2001

1..Does anyone know about Dr Jersy Macura ?He the Director of Bariatric

Surgery at Staten Island University Hospital. Trying to get appt with

him.

2..Smelly question, after surgery what is the average number of BM's

you may have. Is it diarrhea and when does it / doesnt it stop.

I have not had any problems with BM's since my sigmoid colectomy.

I dont know if doctor's or nurses are members of this room, if so I would

like to here from you directly.

Again, thank you.

pensiondude@... - email

x4399 - voicemail/fax

__________________________________________________

FREE voicemail, email, and fax...all in one place.

Sign Up Now! http://www.onebox.com

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