Scopinaro BPD (Long-term post-op here)

[Guest guest]

Hi, all.

I've received several emails over the past week inquiring about the

Scopinaro BPD, which I had 10.5 years ago. I'm really busy at work

right now, so my time for email is limited, so I'm replying to the

inquiries here (so everyone can see them). I'm trying to answer all

the questions I've received in one fell swoop.

I had the Scopinaro BPD April 17, 1991 with Drs. Wittgrove and

of Alvarado in San Diego. My mother had it 18 months prior (her 12-

year anniversary is this month).

If it's possible to extrapolate from our experiences and also look at

statistics as to what is likely, it's very true that the BPD is an

excellent surgery for massive weight loss and maintenance. Both of us

have excellent health and vitality. All of our co-morbidities are

gone. My mother is a healthy, active 60-year-old grandmother who is

president of her synagogue; she does water aerobics 2-3x/week. I am

32, a triathlete and a college administrator.

My thoughts about the BPD, relative to the DS:

1. Appetite/satiety -- we both note that we are often hungrier and

want to eat more than " normal " people. My theory is that we have no

pyloric valve, so nothing to regular appetite and gastric emptying.

Dr. Rabkin told me that Scopinaro BPD patients typically consume 1.5 –

3x what we ate pre-operatively, whereas BPD/DS patients will consume

about 75%.

2. I have occasional halitosis, which is more common in BPD patients

(5%) than in DS patients. Also attributable to the lack of a pylorus.

I sometimes take digestive enzymes to help further break down the

food (to prevent the odor from food putrefying in the gut). When I do

this occasionally, it's not a problem; if I do it frequently/ever

day, I can gain a few pounds). Apparently this halitosis affects

about 5% of BPD patients, according to Scopinaro's 1998 report.

3. The statistics about weight loss and maintenance are slightly

better for the DS (I think 83% average EWL for the BPD/DS to 70% for

the BPD).

4. The small remnant of the preserved duodenum in the BPD/DS MAY

result in increased micronutrient absorption of iron, calcium, B-12,

and zinc. However, all BPD and BPD/DS patients have to deal with

significant micronutrient malabsorption and must take lifelong

vitamin/mineral supplements (I prefer the ones designed for

malabsorbers by www.vita4life.net).

5. I have heard theories about the increased risk of pancreatic

cancer due to the removal of the lower half of the stomach in the BPD

instead of the removal of the stomach along the greater curvature as

in the BPD/DS. However, I have NO knowledge of any BPD patients who

have had pancreatic cancer. Granted, I know just a handful of

Scopinaro BPD patients, but this is not a concern my surgeon has for

me (us).

6. Dumping – dumping is very unusual in a BPD patient – the larger

stomach pouch does tend to digest and process food relatively well,

and rarely results in dumping sugars directly into the intestines,

which is what causes dumping (usually) in proximal RNY patients.

Proximal RNY patients typically have TINY pouches of about 1-2 ounces

initially.

7. I do not have to be careful about water consumption with meals.

8. I have never had an ulcer (nor have any of the BPD patients I know

personally). However, there is increased risk for marginal ulcer

formation at the stomach to intestine anastomosis.

In sum total, if I were shopping around for a wls today, my first

choice would be the BPD/DS. If that weren't available to me, I'd have

the BPD. I feel grateful that I was able to have it 10.5 years ago

and enjoy the past decade as a healthy, vibrant, active young adult

rather than burdended by 100-125 excess pounds.

Incidentally, when I was searching for my name, someone mentioned

they thought I'd regained 30 lbs. This is slightly off. I regained 10-

20 lbs. Then two years ago I decided to simplify my diet by

eliminating all processed foods, simple sugars, and dairy and I

quickly lost 30-40 lbs, going below the low-point achieved during

my " weight loss window of opportunity. " I've lost a total of 125 lbs.

If I eat a LOT of simple carbohydrates I can gain a few pounds, so I

try to keep my diet focused on healthier " whole " foods.

Good luck and be well,

Sharon

Sharon@...

http://www.duodenalswitch.com/Patients/Sharon/sharon.html

This summer's athletic events:

Berryessa Biathlon (1.25 mile lake swim, 20-mile bike ride)

Danskin Sprint Distance Triathlon

Lake Del Valle 2-mile aqua challenge

2001 Vineman Ironman Relay (First place winner)

Nike Sprint Triathlon