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Re: DS vs. RNY FOR DIANNE

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Hi ,

I weigh 238 and I am having DS in January. My surgeon

first asked me why I wanted this procedure. He said

that I was not that overweight. (As If) He listened

to me and agreed to do the procedure. I was approved

by my insurance in one week. I was one of the lucky

ones. Still don't know why! I was getting myself

geared for an appeal when they called and said you

have been approved. I have done alot of research. I

would not have the RNY now that I know there is

something better. We overweight people have had to

fight for alot of things. Just to be excepted...So

on. Stick to your guns and have the procedure you

want. I hope it all works out for you. Keeping my

fingers crossed.

Take Care,

BMI 41/238

AGE 39

Duodenal Switch

Dr. K

--- kdlddd1219@... wrote:

> HI DIANNE.....I AGREE WITH YOU.....MY SURGEON HAS

> ME CONFUSED. I HAVE BEEN

> TOLD BY PEOPLE THAT DS ISNT RECOMMENDED FOR PEOPLE

> OF MY SIZE...THAT I WOULD

> BE BETTER OFF WITH RNY....I WEIGH 250. PEOPLE HAVE

> BEEN TELLING ME THAT DS

> IS BETTER FOR PEOPLE WHO ARE MORE OVERWEIGHT THAT

> ME.....(SOUNDS SILLY) AND

> I KNOW MY EATING HABITS....SO I FIGURED I WAS MAKING

> SUCH A DRASTIC CHANGE,

> MIGHT AS WELL GO ALL THE WAY...LOL WHAT IS YOUR

> PERSONAL OPPINION ON THIS?

> THANKS...........LISA DUCEY

>

> JUST WAITING FOR INS. APPROVAL

>

>

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

>

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Hi -

Your weight isn't the issue. There are studies that show that the RNY isn't

as ineffective for people with a lower body mass index, which is a function

of your weight and height. That doesn't mean that an inferior lifestyle is

better for people who aren't super morbidly obese.

It is correct to say that the DS has a better track record of permanent

weight loss for the extremely morbidly obese. That doesn't mean that it

isn't good for those with a lower BMI.

If you qualify for WLS at all, why would you choose to have a surgery that

permanently gives you an eating disorder?

I would also really wonder just who these " people " are and how they are

qualified to make that pronouncement.

Best-

Nick in Sage

DS vs. RNY FOR DIANNE

> HI DIANNE.....I AGREE WITH YOU.....MY SURGEON HAS ME CONFUSED. I HAVE

BEEN

> TOLD BY PEOPLE THAT DS ISNT RECOMMENDED FOR PEOPLE OF MY SIZE...THAT I

WOULD

> BE BETTER OFF WITH RNY....I WEIGH 250. PEOPLE HAVE BEEN TELLING ME THAT

DS

> IS BETTER FOR PEOPLE WHO ARE MORE OVERWEIGHT THAT ME.....(SOUNDS SILLY)

AND

> I KNOW MY EATING HABITS....SO I FIGURED I WAS MAKING SUCH A DRASTIC

CHANGE,

> MIGHT AS WELL GO ALL THE WAY...LOL WHAT IS YOUR PERSONAL OPPINION ON THIS?

> THANKS...........LISA DUCEY

>

> JUST WAITING FOR INS. APPROVAL

>

> ----------------------------------------------------------------------

>

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I weighed 254 and I had the DS

Lisbeth

kdlddd1219@... wrote: HI DIANNE.....I AGREE WITH YOU.....MY SURGEON HAS ME

CONFUSED. I HAVE BEEN

TOLD BY PEOPLE THAT DS ISNT RECOMMENDED FOR PEOPLE OF MY SIZE...THAT I WOULD

BE BETTER OFF WITH RNY....I WEIGH 250. PEOPLE HAVE BEEN TELLING ME THAT DS

IS BETTER FOR PEOPLE WHO ARE MORE OVERWEIGHT THAT ME.....(SOUNDS SILLY) AND

I KNOW MY EATING HABITS....SO I FIGURED I WAS MAKING SUCH A DRASTIC CHANGE,

MIGHT AS WELL GO ALL THE WAY...LOL WHAT IS YOUR PERSONAL OPPINION ON THIS?

THANKS...........LISA DUCEY

JUST WAITING FOR INS. APPROVAL

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

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In a message dated 11/26/01 11:01:10 PM, duodenalswitch

writes:

<<

If you qualify for WLS at all, why would you choose to have a surgery that

permanently gives you an eating disorder?

>>

this is an excellent point, Nick ---- It's like switching one disorder for

another and it's supposed to be a GOOD tradeoff because the new regime forces

one to 'eat better', etc?

all the best,

lap ds with gallbladder removal

January 25, 2001

Dr. Gagner/Mt. Sinai/NYC

10 months post-op and still feelin fabu

preop: 307 lbs/bmi 45

now: 204 (yikes!)/size sweet 16/large-MEDIUM in normal people's clothing

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Eating disorder...yes, that's exactly what the whole " dumping "

syndrom sounds like. Which makes me wonder if rny patients suffer

from same type of problems seen with bulimia?

I've not seen anything on this, just wondering...

Gil

Dr. Keshishian

11/8 - 264 lbs

11/26 - 240 lbs

> Hi -

>

> Your weight isn't the issue. There are studies that show that the

RNY isn't

> as ineffective for people with a lower body mass index, which is a

function

> of your weight and height. That doesn't mean that an inferior

lifestyle is

> better for people who aren't super morbidly obese.

>

> It is correct to say that the DS has a better track record of

permanent

> weight loss for the extremely morbidly obese. That doesn't mean

that it

> isn't good for those with a lower BMI.

>

> If you qualify for WLS at all, why would you choose to have a

surgery that

> permanently gives you an eating disorder?

>

> I would also really wonder just who these " people " are and how they

are

> qualified to make that pronouncement.

>

> Best-

>

> Nick in Sage

>

> DS vs. RNY FOR DIANNE

>

>

> > HI DIANNE.....I AGREE WITH YOU.....MY SURGEON HAS ME CONFUSED.

I HAVE

> BEEN

> > TOLD BY PEOPLE THAT DS ISNT RECOMMENDED FOR PEOPLE OF MY

SIZE...THAT I

> WOULD

> > BE BETTER OFF WITH RNY....I WEIGH 250. PEOPLE HAVE BEEN TELLING

ME THAT

> DS

> > IS BETTER FOR PEOPLE WHO ARE MORE OVERWEIGHT THAT ME.....(SOUNDS

SILLY)

> AND

> > I KNOW MY EATING HABITS....SO I FIGURED I WAS MAKING SUCH A

DRASTIC

> CHANGE,

> > MIGHT AS WELL GO ALL THE WAY...LOL WHAT IS YOUR PERSONAL OPPINION

ON THIS?

> > THANKS...........LISA DUCEY

> >

> > JUST WAITING FOR INS. APPROVAL

> >

> > ------------------------------------------------------------------

----

> >

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FWIW, I'm 225, and I've never once been told that the DS isn't recommended

for people of " my " size. I can't imagine why the DS would be less

effective -- if anything, it'd be more effective because my guess is that I

need the malabsorptive part of the surgery more than the gastric reduction

(although that helps, too!!).

~alyssa

bmi: 45

DS vs. RNY FOR DIANNE

> HI DIANNE.....I AGREE WITH YOU.....MY SURGEON HAS ME CONFUSED. I HAVE

BEEN

> TOLD BY PEOPLE THAT DS ISNT RECOMMENDED FOR PEOPLE OF MY SIZE...THAT I

WOULD

> BE BETTER OFF WITH RNY....I WEIGH 250. PEOPLE HAVE BEEN TELLING ME THAT

DS

> IS BETTER FOR PEOPLE WHO ARE MORE OVERWEIGHT THAT ME.....(SOUNDS SILLY)

AND

> I KNOW MY EATING HABITS....SO I FIGURED I WAS MAKING SUCH A DRASTIC

CHANGE,

> MIGHT AS WELL GO ALL THE WAY...LOL WHAT IS YOUR PERSONAL OPPINION ON THIS?

> THANKS...........LISA DUCEY

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In a message dated 11/29/01 1:20:55 AM, duodenalswitch writes:

<< FWIW, I'm 225, and I've never once been told that the DS isn't recommended

for people of " my " size. I can't imagine why the DS would be less

effective -- if anything, it'd be more effective because my guess is that I

need the malabsorptive part of the surgery more than the gastric reduction

(although that helps, too!!).

>>

Alyssa: I think the imaginary 'cutoff' is below 45 bmi, actually. Not that

those with a bmi under that CANNOT get the DS but I think *many* (although

not all) surgeons will opt for the RNY and/or recommend that over the DS

(that is, unless the patient him/herself already has knowledge and starts out

pro-DS).

I had a starting bmi of 45 and I didn't have any problems getting the DS.

Then again, I chose Dr. Gagner (who is pretty pro-DS) and I went into my

initial consult wanting the DS and being prepared to fight for it (which I

didn't have to do). However, another lady who had an appointment on the same

date had a lower bmi (of 43 or something) and Gagner recommended she get the

RNY... I've heard this occuring pretty frequently (at least more frequently

with those in the mid 40's and above). Those that I have known with lower

bmis than mine who had the DS started out stating they wanted the DS, not

letting the surgeon choose or suggest which surgery was best. :):)

I think the idea that the DS is 'better' or 'more effective' for those with

higher bmis is an outdated one but I think it still exists unfortunately in

the medical community. I totally agree with you that people with lower bmi's

can also benefit from the surgery - especially the long term weight

maintenance. I felt I had the surgery at the perfect time for me -- I think

if I had a higher bmi I *could have* faced a higher rate of complications and

I hadn't yet developed serious co-morbidities...

all the best,

lap ds with gallbladder removal

january 25, 2001

Dr. Gagner/Mt. Sinai/NYC

10 months post-op and still feelin' fabu

preop: 307 lbs/bmi 45

now: 203 lbs/size sweet 16

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<< I totally agree with you, but my slant on the current medical

establishment thinking is that the DS brings along

compliance-malabsorption (and, unfortunately, as-yet unresolved liver

complication issues that should have been debunked years ago, but

still linger on like a DS's BM odors) concerns. Therefore, since the

establishment regards the RnY as less risky (as well as easier and

more profitable), only the super MO would get referred for the DS.

For the just plain MO, who presumably are less at risk from their

excess weight, the RnY, being a presumptively less risky procedure,

would be indicated.

Make any sense (from the point of view of a poorly-informed doc)?

>>

Oh, yeah -- I totally understand where the medical establishment is coming

from -- they want to suggest the less 'risky' surgery for those at 'least

risk' (or perceived to be at less risk due to lower bmi). However, this

attitude that the DS really only benefits those at higher bmis is changing.

I think a few years ago, Dr. Gagner would have been more hesitant to

recommend the DS for someone with my bmi (45) but now he will.

Even if the RNY is a less risky procedure (and, we're talking about the

proximal here, I'm sure) due to less malapsorption -- It is such a violation

of the natural order of things and presents such a restrictive post-op eating

lifestyle that I'm really surprised anyone would not give the DS more serious

consideration (and, I'm referring to both patients and surgeons who recommend

the surgery). And, the entire attitude of not even defining the difference

between a proximal and distal RNY if it were the 'same surgery' blows my

mind.... The surgeons will accept the malnutrition issues that come with a

Distal RNY in a heartbeat if the patient is considered 'heavy' enough for a

distal procedure but will not even educate themselves or patients about the

DS option...

all the best,

lap ds with gallbladder removal

January 25, 2001

Dr. Gagner/Mt. Sinai/NYC

10 months post-op and still feelin' fabu

preop: 307 lbs/bmi45

now: 201 lbs (maybe over this plateau? I did have a crispy creme donut

today! LOL)/size sweet 16

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,

I totally agree with you, but my slant on the current medical

establishment thinking is that the DS brings along

compliance-malabsorption (and, unfortunately, as-yet unresolved liver

complication issues that should have been debunked years ago, but

still linger on like a DS's BM odors) concerns. Therefore, since the

establishment regards the RnY as less risky (as well as easier and

more profitable), only the super MO would get referred for the DS.

For the just plain MO, who presumably are less at risk from their

excess weight, the RnY, being a presumptively less risky procedure,

would be indicated.

Make any sense (from the point of view of a poorly-informed doc)?

--Steve

At 10:06 AM -0500 11/29/01, ruisha@... wrote:

>I... another lady who had an appointment on the same

>date had a lower bmi (of 43 or something) and Gagner recommended she get the

>RNY... I've heard this occuring pretty frequently (at least more frequently

>with those in the mid 40's and above). Those that I have known with lower

>bmis than mine who had the DS started out stating they wanted the DS, not

>letting the surgeon choose or suggest which surgery was best. :):)

>

>I think the idea that the DS is 'better' or 'more effective' for those with

>higher bmis is an outdated one but I think it still exists unfortunately in

>the medical community.

--

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In a message dated 11/29/01 1:31:42 PM, duodenalswitch writes:

<< My BMI is 41 my PCP told me that they might not do the

DS on me because he said my BMI was to low. He said

that they generally liked them to be 45 or above. But

he wrote me a letter for the surgeon recommending me

for it anyway. My surgery is in January. My surgeon

did ask me why I wanted to have the surgery as I was

not that overweight. I explaned why I wanted it and

asked him alot of questions. He could see I was

serious about this procedure and he agreed to do it.

So stick with what you want. Good Luck!

>>

: See what Dr. K says... I don't know about his practice, but I've

known at least 2-3 people with bmis lower than 45 who have had the DS

performed at Mt. Sinai AND NYU... So, some surgeons are open to this... I

think the patient has to intiate their desire to have the ds and show they

have knowledge of it and then the surgeon will feel more comfortable

performing it in their particular case...

However, there *may be* some surgeons who have a kind of 'rule' in which

those under a certain bmi are not to be recommended for the DS...

all the best,

lap ds with gallbladder removal

January 25, 2001

Dr. Gagner/Mt. Sinai/NYC

10 months post-op and still feelin' fabu

preop: 307 lbs/bmi 45

now: 201 lbs/size sweet 16

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Hello here,

My BMI is 41 my PCP told me that they might not do the

DS on me because he said my BMI was to low. He said

that they generally liked them to be 45 or above. But

he wrote me a letter for the surgeon recommending me

for it anyway. My surgery is in January. My surgeon

did ask me why I wanted to have the surgery as I was

not that overweight. I explaned why I wanted it and

asked him alot of questions. He could see I was

serious about this procedure and he agreed to do it.

So stick with what you want. Good Luck!

M.

pre-op 01/09/02

BMI 41/ 238 lbs

AGE 39

Dr. K

--- ruisha@... wrote:

>

> In a message dated 11/29/01 1:20:55 AM,

> duodenalswitch writes:

>

> << FWIW, I'm 225, and I've never once been told that

> the DS isn't recommended

>

> for people of " my " size. I can't imagine why the DS

> would be less

>

> effective -- if anything, it'd be more effective

> because my guess is that I

>

> need the malabsorptive part of the surgery more than

> the gastric reduction

>

> (although that helps, too!!).

>

> >>

>

> Alyssa: I think the imaginary 'cutoff' is below 45

> bmi, actually. Not that

> those with a bmi under that CANNOT get the DS but I

> think *many* (although

> not all) surgeons will opt for the RNY and/or

> recommend that over the DS

> (that is, unless the patient him/herself already has

> knowledge and starts out

> pro-DS).

>

> I had a starting bmi of 45 and I didn't have any

> problems getting the DS.

> Then again, I chose Dr. Gagner (who is pretty

> pro-DS) and I went into my

> initial consult wanting the DS and being prepared to

> fight for it (which I

> didn't have to do). However, another lady who had

> an appointment on the same

> date had a lower bmi (of 43 or something) and Gagner

> recommended she get the

> RNY... I've heard this occuring pretty frequently

> (at least more frequently

> with those in the mid 40's and above). Those that I

> have known with lower

> bmis than mine who had the DS started out stating

> they wanted the DS, not

> letting the surgeon choose or suggest which surgery

> was best. :):)

>

> I think the idea that the DS is 'better' or 'more

> effective' for those with

> higher bmis is an outdated one but I think it still

> exists unfortunately in

> the medical community. I totally agree with you

> that people with lower bmi's

> can also benefit from the surgery - especially the

> long term weight

> maintenance. I felt I had the surgery at the

> perfect time for me -- I think

> if I had a higher bmi I *could have* faced a higher

> rate of complications and

> I hadn't yet developed serious co-morbidities...

>

> all the best,

>

> lap ds with gallbladder removal

> january 25, 2001

> Dr. Gagner/Mt. Sinai/NYC

>

> 10 months post-op and still feelin' fabu

>

> preop: 307 lbs/bmi 45

> now: 203 lbs/size sweet 16

>

>

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

>

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In a message dated 11/29/01 5:33:49 PM Eastern Standard Time,

duodenalswitch writes:

<< I don't know about his practice, but I've

known at least 2-3 people with bmis lower than 45 who have had the DS

performed at Mt. Sinai AND NYU... So, some surgeons are open to this... I

think the patient has to intiate their desire to have the ds and show they

have knowledge of it and then the surgeon will feel more comfortable

performing it in their particular case... >>

I think I read in Dr. Hess' medical literature (not the brochure) that he

*used* to only do the DS for those with high BMIs but then found that it

worked just as well for those who did not have high BMIs. I have a 46, which

believe me, is higher than I would like, and he is doing the DS for me. He

did say " oh you aren't that big "

though ! I think thats the first time I heard that from a Dr.! LOL

Carole

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,

This surgery is superior no matter what your BMI. Mine was 42.3, and

3 weeks postop it was 39. So, 10 pounds should make the difference

if you get the surgery? I don't think so!! Keep asking for what you

want.

Pammi

> >

> > In a message dated 11/29/01 1:20:55 AM,

> > duodenalswitch@y... writes:

> >

> > << FWIW, I'm 225, and I've never once been told that

> > the DS isn't recommended

> >

> > for people of " my " size. I can't imagine why the DS

> > would be less

> >

> > effective -- if anything, it'd be more effective

> > because my guess is that I

> >

> > need the malabsorptive part of the surgery more than

> > the gastric reduction

> >

> > (although that helps, too!!).

> >

> > >>

> >

> > Alyssa: I think the imaginary 'cutoff' is below 45

> > bmi, actually. Not that

> > those with a bmi under that CANNOT get the DS but I

> > think *many* (although

> > not all) surgeons will opt for the RNY and/or

> > recommend that over the DS

> > (that is, unless the patient him/herself already has

> > knowledge and starts out

> > pro-DS).

> >

> > I had a starting bmi of 45 and I didn't have any

> > problems getting the DS.

> > Then again, I chose Dr. Gagner (who is pretty

> > pro-DS) and I went into my

> > initial consult wanting the DS and being prepared to

> > fight for it (which I

> > didn't have to do). However, another lady who had

> > an appointment on the same

> > date had a lower bmi (of 43 or something) and Gagner

> > recommended she get the

> > RNY... I've heard this occuring pretty frequently

> > (at least more frequently

> > with those in the mid 40's and above). Those that I

> > have known with lower

> > bmis than mine who had the DS started out stating

> > they wanted the DS, not

> > letting the surgeon choose or suggest which surgery

> > was best. :):)

> >

> > I think the idea that the DS is 'better' or 'more

> > effective' for those with

> > higher bmis is an outdated one but I think it still

> > exists unfortunately in

> > the medical community. I totally agree with you

> > that people with lower bmi's

> > can also benefit from the surgery - especially the

> > long term weight

> > maintenance. I felt I had the surgery at the

> > perfect time for me -- I think

> > if I had a higher bmi I *could have* faced a higher

> > rate of complications and

> > I hadn't yet developed serious co-morbidities...

> >

> > all the best,

> >

> > lap ds with gallbladder removal

> > january 25, 2001

> > Dr. Gagner/Mt. Sinai/NYC

> >

> > 10 months post-op and still feelin' fabu

> >

> > preop: 307 lbs/bmi 45

> > now: 203 lbs/size sweet 16

> >

> >

> --------------------------------------------------------------------

--

> >

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Carole,

My doctor told me the same thing. My BMI is 40 and has been up to 45

and I was heading back up there rapidly with only having one workable

knee. I about fell down laughing, when he said that as I can

remember ever single nickname I have had since I was 8 years

old...Tubby Shultz, Chorizo...(my lovely aunties name for me) Tons of

Fun....as well as just the plain cruel ones! Because of all the side

affects from my knee replacement, and the meds I have been on for the

past year and couple of months, Dr. Jossart said that a lot of

patients talk to him about the surgery being pretty drastic at their

point in life, and he wishes they could see the future and realize

how much more risky and complex it is when they wait until the point

that they are diabetic, can't walk like me, hypertensive, etc!

My God, if only folks could be given this option younger and pre

falling apart stage...my only regret...is that I have spent over half

my life miserable and unhealthy, but oh boy, the second half of my

life will be so grand!!!

Hugs,

Theresa

DS 11-19-01

Dr. Jossart

-13#s

Who has found that she spends a great deal of time crying over every

reference to Sept. 11, commercials for Dumbo, Burger King

commercials, and Rain. Shrugs....while being happy as hell!

> In a message dated 11/29/01 5:33:49 PM Eastern Standard Time,

> duodenalswitch@y... writes:

>

> << I don't know about his practice, but I've

> known at least 2-3 people with bmis lower than 45 who have had the

DS

> performed at Mt. Sinai AND NYU... So, some surgeons are open to

this... I

> think the patient has to intiate their desire to have the ds and

show they

> have knowledge of it and then the surgeon will feel more

comfortable

> performing it in their particular case... >>

>

> I think I read in Dr. Hess' medical literature (not the brochure)

that he

> *used* to only do the DS for those with high BMIs but then found

that it

> worked just as well for those who did not have high BMIs. I have a

46, which

> believe me, is higher than I would like, and he is doing the DS for

me. He

> did say " oh you aren't that big "

> though ! I think thats the first time I heard that from a Dr.! LOL

> Carole

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Thanks! I'll be there!

Ford

Re: DS vs. RNY FOR DIANNE

Hey Ford,

FYI, the next support meeting is on Tuesday, December 4th at Fairfax

Hospital.

Michele

> Hey, Steve? When is the next support meeting with Dr E?

>

> Ford

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

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