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Exactly . In order for it to be truly " blind " , the patient

could not be told which surgery they'd got. And considering the risk

for marginal ulcers, narrowing of stoma's, dumping etc, one wouldnt

be safe not knowing which procedure they had. There are very

different risks and issues between the two surgeries.

I'm wondering if this wasnt an attempt to get the list in an uproar.

Unless this person can produce the details of who is doing it and

where, I consider it a prank. Meli

-- In duodenalswitch@y..., mariak415@y... wrote:

> I agree, Meli. Blind studies usually imply the use of placebos.

In

> other words, some people are treated for X and others aren't.

> There were blind studies as a part of the FDA approval for

> Meridia, Xenical, etc. to compare weight loss in one group vs. the

> other group. I think someone either misunderstood or

> misrepresented the study. This kind of " study " sounds like, if

> true, some surgeon's desperate attempt to get tenure at a

> research hospital or a poorly informed and researched grant

> proposal.

>

> Informed consent, ethics and legalities aside, I don't even see

> the need for such a " study " . If someone wants to compare RnY

> and DS, they can certainly send questionnaires out to the

> thousands of patients already being tracked by the surgeons.

> Dr. Rabkin compared RnY and DS in his own practice for a

> published paper.

>

> -maria

>

>

> > Tina, You are much less suspicious than I... I dont think this

is

> > legitimate. Either this person is being pranked or all of us

are.

> I

> > cant imagine that such a thing would be either ethical or legal.

> > JMHO,Meli

> >

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Hello ,

When I first discovered WLS, all I heard about was the RNY. I was thinking cool

finally a way to no longer be unhealthy. The more and more I read about the RNY,

the more I knew I could never do that to myself. Somehow I just felt that I

would be the one going to the emergency with either a blocked or a closed stoma

and that terrified me. Then I read about the weight regain and then I started

to think myself. This is like being on a diet. Only a hellish diet. I cant do

it. I have failed at every diet in my life I will never be succesful at this

one. I was about to unsub from the OSSG email list when someone who had a DS

posted. At first I didnt recognize the difference in surgery. But this lady was

happy. She could eat, she had no complaints no her surgery hadnt been smooth but

once she got over that rough patch Her life was great. She is now at a normal

size and she is happy. That is what I wanted for myself. I cant imagine letting

someone decide what kind of life I should lead. Because that is what is going to

happen. Someone will decided what kind of food you can have and how you relate

to that food. I have had the food issues I am trying to get past them. I just

want to be normal. I want to sit in a resteraunt concentrate on my protein and

take the rest to go and not sit at a table and have people wonder why I am not

eating. Just my .02 cents

Lisbeth

Dr. Macura

June 25, 2001

-41 lbs

aveil@... wrote: Hi all. I am new to this group. I may be offered

the chance to

paticipate in a blind research study comparing the distal RNY to the

DS. It would require that I agree to an open procedure, but also that

I would agree to having a card drawn during the procedure to

determine whether I would wake up with the RNY or the DS. I am

wondering what some of you think about this type of uncertainty. Any

constructive comments are welcome. Thanks!

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

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Being a bit too trusting has always been a problem for me. But I

can't see what the surgeon has to gain from lying about a blind

study. And you would have to be a pretty sick person to make

something like that up. So I am going to go with my gut here and

continue to believe that this is true, but that there is some

information missing. I am sure once all of the facts are presented we

will all understand this better.

- In duodenalswitch@y..., lionrampart1@y... wrote:

> Tina, You are much less suspicious than I... I dont think this is

> legitimate. Either this person is being pranked or all of us are.

I

> cant imagine that such a thing would be either ethical or legal.

> JMHO,Meli

>

>

> -- In duodenalswitch@y..., dreamweavergirlus@y... wrote:

> > There are a few facts missing here. Like do they pay for the

> > surgery? And if you were to have RNY would they leave your pyloric

> > valve in tact?

> >

> > All of this aside, I think that this study is vital to getting

> > insurers to cover DS without the " investigational crap " that they

> give

> > now. I also think that it is a great way for the world to find out

> the

> > long term benefits of DS. The more published data there is out

> there

> > the more likely that people will choose DS over RNY.

> >

> > That said, I couldn't do it not even for a lot of money. I love my

> > steak and not to be able to enjoy a good steak for atleast a year

> > would be akin to agony. Then again if you had told me pre-op that

I

> > would hate chocolate post-op I would have laughed you out of the

> room.

> >

> > my rambling 2 cents.

> > Tina

> >

> >

> >

> > > Hi all. I am new to this group. I may be offered the chance to

> > > paticipate in a blind research study comparing the distal RNY to

> the

> > > DS. It would require that I agree to an open procedure, but also

> > that

> > > I would agree to having a card drawn during the procedure to

> > > determine whether I would wake up with the RNY or the DS. I am

> > > wondering what some of you think about this type of uncertainty.

> Any

> > > constructive comments are welcome. Thanks!

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,

It sounds like one of these Mayo clinic trials. Balssiger has

published some work on this kind of stuff. Basically he and a few

other suregons are really skeptical that the BPD/DS is better than

the RNY. Dr. Poires is among the skeptics calling for randomized

trials like the one you describe. The idea is to make sure that the

two populations studies are essentially identical so that the resutls

will not be biased.

I don't see anything unethical about this, since you have been told

about it. However, I personally would not want to be involved with

such a study. I feel strongly that the pyloric valve should be

maintained. If dumping is not a concern for you and you want to

contribute your body to science (so to speak) then go for it. It is

a personal choice. If you don't know or don't care which procedure

you want, then I guess it wouldn't matter. Most of us on this list

are stronlgy biased towards the DS (that is why we are here!).

Personally I want a surgeon who specializes in the DS and is 100%

committed to it.

Hull

> Well Folks, I knew this topic would generate some interesting

> comments. I realize now that I should have prefaced the question

with

> some other information. I may be new posting to this site, however,

I

> have been actively and passionately researching WLS for more than 1

> 1/2 years. I am an RN and I am well aware of the differences in the

> DS and the distal RNY surgeries (and the variety of other WLS that

> are available). I am also well educated on the post-op lifestyles

of

> the RNY and the DS. I have carefully chosen a surgeon who is a

leader

> in his field and who is the chief of bariatric surgery at a major

> teaching institution. Of course I would be told which surgery I had

> post-op. To not know would be unacceptable and dangerous. I gave

you

> the information that I was told by my surgeon's nurse and will get

> more details at my next appt. This may be my only opportunity to

have

> the DS because of insurance issues. I would certainly not

participate

> in anything that was a " Scam " or was " Illegal " . I do appreciate all

> comments, especially those of Lisbeth who actually

> sounded " supportive " and didn't assume I new nothing of these

> surgeries. Thanks!

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Hi :

> I have carefully chosen a surgeon who

> is a leader in his field and who is the

> chief of bariatric surgery at a major

> teaching institution.

What surgeon, and what institution?

> Of course I would be told which surgery

> I had post-op. To not know would be

> unacceptable and dangerous.

I think that the reason you received such strongly worded replies is

that to many (if not most) of the members of this list, the idea of

waking up with an RNY would be unacceptable and dangerous (to our

mental health, at LEAST).

> This may be my only opportunity to have

> the DS because of insurance issues.

That's a terrible position to be in. My heart goes out to you.

(This is probably a dumb question, but have you thought about

Medicare?)

> I do appreciate all comments, especially

> those of Lisbeth who actually sounded

> " supportive " and didn't assume I new

> nothing of these surgeries.

You sound a bit peeved at the rest of us, (at least by implication),

and I don't think that is quite fair. This group exists to help

educate people about the DS. When someone new joins up and asks a

question -- particularly one about such a strange subject -- without

indicating that s/he has any knowledge of the DS, I think it is only

normal for people in the group not to assume the person knows all

about the surgery.

As for not being supportive enough, I can only speak for myself, but

I simply will not support someone making a decision that I think is

contrary to their best interests. (If that makes me an ogre, then so

be it.) My views on the RNY are such that I am simply horrified at

the thought of going under anesthesia with a 50% chance of waking up

to find that my stomach has been mutilated so that it no longer works

correctly, and that I'll have to eat " meals " the size of my pinky for

the rest of my life.

If the DS didn't exist, then I would consider the RNY to be the best

available solution, and would thus accept that surgeons choose to

perform it and patients choose to have it.

But, IMHO, given that the DS does exist, no truly ethical surgeon

should perform the RNY unless the DS is medically contraindicated by

excessive adhesions, previous messed up WLS, etc. Also, again IMHO,

given that the DS exists, I think that any informed patient who

CHOOSES the RNY is probably somebody who should have been screened

out by the psych exam.

So, my personal advice to you, (for the very little it's worth), is

to keep looking for a way to have the DS. (Dr. Baltazar is a dang

nice bargain.)

Tom

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I think that any informed patient who

CHOOSES the RNY is probably somebody who should have been screened

out by the psych exam.

ooooo ouch!!!!

_________________________________________________________

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