Re: why all these religious wars about DS vs RnY?

[Guest guest]

Okay, Steve, I get in trouble for calling RNY patients stu***. Now you're

calling them pigs? Really, we have to stop being quite so, uh, uhm, er,

frank.

Best-

Nick in Sage

why all these religious wars about DS vs RnY?

> The postings are really occupying too much bandwidth. Who cares???

>

> I have a good friend who had the RnY last December. She has done

> quite well with it, at least so far. her courage in electing to have

> the surgery is what got me interested in WLS in the first place.

> previously, in my total ignorance, I had thought WLS was just for

> kooks, the kind of folks who experimented with drugs and voodoo.

> Then, my PCP, in desperation over my failing health, suggested

> " stomach stapling " and referred me to a surgeon who does only RnY.

> My PCP didn't know about ANY other alternatives.

>

> With reassurance from my friend who told me only the name of her

> procedure and that I could look it up in the Web, and with the push

> from my PCP, I started to do research over the Internet. I almost

> fell for the Mini-Gastric Bypass before stumbling on the Duodenal

> Switch site. Back to my friend: she didn't even know if she had

> received a proximal, medial or distal RnY!! But, she is doing OK.

> And, she's happy. And, she claims that she can eat just about

> anything that she wants to eat. She's in New England, and I have not

> had the opportunity to watch her eat to verify that claim. But,

> really, who cares? If she's happy, then that's all that counts. I'm

> happy that I found the DS and had that procedure instead of the RnY.

> But, does it really matter all that much to anybody but me? I'm

> just damned lucky that I didn't get the MGB!!!

>

> So, to reiterate, " Who cares? " If you don't like somebody's posts,

> filter them to the trash. Don't try to teach a pig to sing. You'll

> just irritate the pig, and the noise will drive everybody else crazy.

>

> --Steve

> --

>

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

>

[Guest guest]

would those be beef franks or pork franks?? <G>

~alyssa, bein' silly

Re: why all these religious wars about DS vs RnY?

> Okay, Steve, I get in trouble for calling RNY patients stu***. Now you're

> calling them pigs? Really, we have to stop being quite so, uh, uhm, er,

> frank.

[Guest guest]

Dear Steve,

My feelings exactly... Who cares. I also know RNYers (one is my

mom's friend who is 12 years post-op in perfect health and at a

perfect weight) and THEY are happy. Who am I to tell them that

they're really not? I don't waste my time trying to tell them that

my surgery is better than theirs, na, na, na, na, na....I also

educated a good friend about the DS so she could help her college age

daughter find a procedure and surgeon. The daughter went to a local

hospital and is opting for an open RNY because the doctor was " nice " ,

has no lap experience and told her open RNY is better anyway because

he can see and feel everything. Oh well, her life, her body. Your

eloquence is appreciated.

Jane J.

230/151 (-79 lbs)

Lap BPD/DS

4/26/01

> The postings are really occupying too much bandwidth. Who cares???

>

> I have a good friend who had the RnY last December. She has done

> quite well with it, at least so far. her courage in electing to

have

> the surgery is what got me interested in WLS in the first place.

> previously, in my total ignorance, I had thought WLS was just for

> kooks, the kind of folks who experimented with drugs and voodoo.

> Then, my PCP, in desperation over my failing health, suggested

> " stomach stapling " and referred me to a surgeon who does only RnY.

> My PCP didn't know about ANY other alternatives.

>

> With reassurance from my friend who told me only the name of her

> procedure and that I could look it up in the Web, and with the push

> from my PCP, I started to do research over the Internet. I almost

> fell for the Mini-Gastric Bypass before stumbling on the Duodenal

> Switch site. Back to my friend: she didn't even know if she had

> received a proximal, medial or distal RnY!! But, she is doing OK.

> And, she's happy. And, she claims that she can eat just about

> anything that she wants to eat. She's in New England, and I have

not

> had the opportunity to watch her eat to verify that claim. But,

> really, who cares? If she's happy, then that's all that counts.

I'm

> happy that I found the DS and had that procedure instead of the

RnY.

> But, does it really matter all that much to anybody but me? I'm

> just damned lucky that I didn't get the MGB!!!

>

> So, to reiterate, " Who cares? " If you don't like somebody's posts,

> filter them to the trash. Don't try to teach a pig to sing.

You'll

> just irritate the pig, and the noise will drive everybody else

crazy.

>

> --Steve

> --

[Guest guest]

I think the point being made by Nick..and why I bother to talk for

Nick I have no frigging idea because he is one of the most

intelligent, articulate, honest and accurate individuals I have ever

had the pleasure of calling friend....well that said, the rumours of

nutritional deficiencies are implied that they are NOT preventable.

As in, if you get the DS you WILL suffer from nutritional

deficiencies.

That is how it is presented, because it was presented exactly that

way to me. I had to research to discover that if I was NOT

compliant, this could be a side affect.

The same could be said that if you are a pedistrian in San Francisco,

you will get hit by a car. When indeed the accurate statement is

that if you are not diligent in San Francisco, and wait when the

light turns green, you seriously increase your risks for being hit by

a car.

I do not see one inaccurate statement made by Nick and I would stand

by what he says....but then...flock it...I love Nick!

Laughing,

Theresa

Dr. Jossart

11-19-01

Still looking for the truck that hit her last week!

> Nick: It is a fact that the malapsorption of the DS CAN CAUSE

nutritional

> deficiences. Sheesh - for someone who claims to know what they are

talking

> about, it is rather ridiculous to state that this is 'bogus

information'!!!!!

> To belittle this means putting people at possible severe risk if

they don't

> realize how crucial it is to take supplements and get protein in

DAILY. Each

> person's body adjusts differently over time and different people

may require

> a different set/strength of supplements but to say that they aren't

needed

> (which basically is what you're saying if you think that the DS

cannot cause

> nutritional deficiencies) is inaccurate.

>

> These deficiencies take time to develop and often aren't noticed

until they

> are at such a serious level as to become life-threatening and/or so

serious

> at to require intensive intervention. Knowing this fact may make

someone who

> is leary of a malapsorptive procedure choose a proximal one but it

is

> necessary for anyone having a malapsorptive surgery to realize this

and take

> care of themselves. This fact certainly does not have to interfere

with

> normal lifestyle and, as long as people are getting proper

aftercare, regular

> bloodwork, taking their supplements/protein, I really don't think

they will

> encounter any deficiencies. But, one's body needs can change and

the levels

> of nutrients (especially the malapsorbed ones like fat-soluable

vitamins and

> protein) must be monitored to maximize health and catch any dips

early.

>

> As far as stomach cancer goes, this procedure has NOT been proven

to carry

> any increased risk, although stomach surgeries in GENERAL ARE

considered a

> risk factor. I am not sure if the sleeve gastrectomy would carry a

lesser

> risk (because the lower stomach is left totally intact), but I have

read that

> any alteration of the stomach *can* increase risk. I have posted

various

> articles online, so the archives would have such things and such

references.

>

> Deadly gas? I personally haven't experienced it but for those who

have (and

> I really don't think they are lying when they relay their

experiences or are

> deliberately trying to make things sound worse than they are), I'm

sure it is

> bothersome and a major concern. I do NOT think every post-op

experiences

> this, it could very well be related to what is eaten but the

process of trial

> and error to discover what bothers the intestines can be a long and

> frustrating one.

>

> I think it is irresponsible to pre-ops to call such possible

outcomes of the

> DS surgery as 'bogus information' because it is NOT. It may not be

the

> result of the majority of surgeries but some people DO experience

it and

> struggle with it (look at Joe Frost with severe protein deficiency).

>

> 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 lbs/size sweet 16/large-MEDIUM in regular people's

clothing!

[Guest guest]

,

So then, what you are saying is that the statements Nick made are

accurate. Every single component of living can have a what if. Jim

Fixx, noted health guru and jogger died of a heart attack at a very

early age.

Every and any portion of living can and does carry inherent risks.

The bottom line is if you do the right things....such as remain

compliant with your supplementation and blood tests, you may still be

hit by a car. If you hadn't had the surgery which enabled you to

walk you would not have been hit by a car. Right?

Because a post op DSer may become too confident and stop all aspects

of compliance, then they, not the surgery, have put themselves at

risk. For the odd percentage of folks who maintain their compliance

and still have problems, one can definitely point to the DS and say

it caused it, just as the car accident victim can. It is random,

bloody, horrible bad luck but statistically possible.

I only object to the inference the doctor I met with who stated if I

were to have the DS, the following things would happen to me. All of

the issues Nick mentioned were referred to in absolutes.

As of today...I have bought into the killer gas one, because no

amount of air deoderizer has killed my last contribution to the ozone

layer...laughing. However, I know I have lots of options to pursue

before I permanently concede this one!

Hugs to the other ,

Theresa

DS 11-19-01

Dr. Jossart

> Yes, being compliant goes a long, long way towards staying healthy

and NOT

> getting various nutritional deficiencies. However, there is

*still* a chance

> this could happen even if you try your best... For example, if your

health

> deteroriates or you have a condition that would interfere with your

ability

> to eat properly/often enough/etc., you *may* develop a protein

deficiency or

> other such deficiency not necessarily due to your not trying to get

the

> nutrients in. The good news is these deficiencies usually take

quite a bit

> of time to progress so it isn't like you'll get the flu and develop

severe

> problems after a few days.

>

> Also, bodies change and our needs for various supplements change

over time.

> People *may* feel that if they are eating their protein and taking

their

> vitamins they won't need regular checkups or bloodwork (and, the

bloodwork is

> a pain -- 8-10 vials or so!), especially if past labwork was good.

One may

> need more protein if one up's exercise/activity level. One may

need less of

> a certain nutrient over time.... Also, nutrients can be

within 'normal' range

> but still be declining. It is possible that one can continue

the 'old'

> pattern of protein consumption and vitamin supplements but still

develop some

> kind of deficiency and this wouldn't be detected if that person did

not have

> regular checkups, etc.

>

> For the most part, I do not think that the majority of post-ops

will develop

> serious malnutrition issues with good post-op care and attention to

protein

> and supplements. I considered this issue thoroughly because it

would mean

> that I'm totally dependent on certain things (vitamins, protein) to

ensure

> future health and I felt a little apprehensive about that.

However, the

> benefits of malapsorption and long term maintenance of weight were

> overhwhelmingly positive factors when weighed against the issue of

dependence

> on supplements.

>

> Taking my pills really doesn't phase me since I have worked it out

around

> mealtimes mainly. However, when I get really busy or am dependent

on others

> to have meals, this schedule can get out of whack (example: I

don't eat

> dinner until later and then this doesn't give me the 2-3 hours

ideally

> necessary for an empty stomach when I take my evening iron pills; I

eat

> breakfast too late and then have to fit the lunchtime pills and

meal in so

> that dinner won't be so late and hence the former scenario). I

found this

> particularly true when I was on vacation recently. My brother is a

salesman

> and doesn't eat regular meals and also has dinner quite late.

Whenever we

> waited for him my schedule was thrown off. If I stick to my pretty

regular

> 'schedule' of eating, I'm fine and all my supplements get it, get

absorbed,

> etc.

>

> I am extremely pro-DS myself and wouldn't have had any other

surgery.

> However, I think that the decision to choose the DS is a serious

one and

> malapsorption issues are a valid concern. It is not true that

people will

> just 'spontaneously' develop them but I think that long-term it

*could*

> become more difficult to maintain compliance, especially if one

feels and

> looks great (why do I need all those pills? It may start

with 'skipping' a

> dose and then doing that more frequently, etc.). I think every

post-op has

> to guard against this mentality and make sure that they do get the

bloodwork

> and follow up even if they are taking great care of themselves

otherwise.

> I think most long term post-ops DO THIS but I can see where

surgeons could

> be concerned that there could be a tendancy not to or decrease

commitment to

> certain things years down the road....

>

> 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 lbs/size sweet 16/large-MEDIUM in normal people's clothing

[Guest guest]

> ,

>

> So then, what you are saying is that the statements Nick made are

> accurate. Every single component of living can have a what if. Jim

> Fixx, noted health guru and jogger died of a heart attack at a very

> early age.

>

Theresa: I do not want to get into semantics about Nick's post. I

brought up the fact that stating that there are nutritional risks with

the DS IS a valid and true statement whereas his post seemed to

insinuate that this was merely 'hogwash'. He did not clearly state

that his beef was with those who imply that such nutritional defects

are inevitable but merely stated that making a connection about

nutritional deficiencies and DS is an inaccuracy.

I do not think the statements that Nick made are accurate. They may

have been incomplete and needed to be expanded upon and this is why I

wrote the reply to clarify that the DS DOES carry nutritional risk.

Such risks can be greatly reduced with proper aftercare and

supplementation/protein but they will ALWAYS be there. There may be

situations in one's life where one has little control over the

development of malnutrition (such as severe and prolonged illness,

etc) although it is true that keeping up with one's supplemention is

the most likely way one will avoid deficiencies as a post-op.

To me, my posts which are meant to clarify certain things about

malnutrition and DS are not to be taken as a battle of wills between

Nick and I... Why are you insisting that any response I have to Nick

is either totally agreeing with him or totally disagreeing with him?

I thought his post needed clarification and did NOT want preops to

downplay the importance of nutritional risks with the DS surgery.

Let's not make my feeling the need for additional information and

clarification an issue of contention.

If you do feel the need to discuss this further for any reason, please

privately e-mail me about it. I really don't think that it adds

anything to the list to keep insisting that I agree with Nick or

not... I thought I was adding clarification to his posts where things

weren't clear to me. IF Nick has problems with any responses I've

made, he's welcome to e-mail me as well. So far, I haven't heard

anything from him. I don't think he needs people to 'stick up for

him' on this list -- He is totally able to express himself and does so

often! LOL

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

n

[Guest guest]

,

This is the statement that Nick made:

" Comments the like of which state that the DS causes malnutrition,

fatal gas

attacks, stomach cancer, etc., can't be allowed to pass unnoticed.

The same

is true for comments which unrealistically tout the superiority of

the RNY. "

I responded to your statement which I feel is innacurate:

" Sheesh - for someone who claims to know what they are talking

about, it is rather ridiculous to state that this is 'bogus

information'!!!!! "

That you amend your arguement to read that the DS carries nutritional

risk and that you were merely further clarifing what should have been

said in the first place was not what I was responding to.

There is a world of difference between " causes " and " carries the risk

of " .

I believe this is what I wanted so clearly to be understood and is

well within the charter of this board. I did not want that one

statement to go unaddressed, because, in my opinion, it attacted the

source instead of the content and by inference could ultimately

damage a valuable resource to this board. And, my apologies for

giving the impression that I wanted you to either totally agree or

disagree with Nick.

In the future, if you would prefer to take a discussion off line with

me, I am more than willing to do so, if instead of posting your

reponse on the board, you respond to me initially offline! I believe

that is fair and then noone feels that they are playing " my last word

stands " .

Thanks for listening,

Theresa

11-19-01

Dr. Jossart

in regards to the following statement that Nick made which was:

> Theresa: I do not want to get into semantics about Nick's post. I

> brought up the fact that stating that there are nutritional risks

with

> the DS IS a valid and true statement whereas his post seemed to

> insinuate that this was merely 'hogwash'. He did not clearly state

> that his beef was with those who imply that such nutritional

defects

> are inevitable but merely stated that making a connection about

> nutritional deficiencies and DS is an inaccuracy.

>

> I do not think the statements that Nick made are accurate. They

may

> have been incomplete and needed to be expanded upon and this is why

I

> wrote the reply to clarify that the DS DOES carry nutritional

risk.

> Such risks can be greatly reduced with proper aftercare and

> supplementation/protein but they will ALWAYS be there. There may

be

> situations in one's life where one has little control over the

> development of malnutrition (such as severe and prolonged illness,

> etc) although it is true that keeping up with one's supplemention

is

> the most likely way one will avoid deficiencies as a post-op.

>

> To me, my posts which are meant to clarify certain things about

> malnutrition and DS are not to be taken as a battle of wills

between

> Nick and I... Why are you insisting that any response I have to

Nick

> is either totally agreeing with him or totally disagreeing with

him?

> I thought his post needed clarification and did NOT want preops to

> downplay the importance of nutritional risks with the DS surgery.

> Let's not make my feeling the need for additional information and

> clarification an issue of contention.

>

> If you do feel the need to discuss this further for any reason,

please

> privately e-mail me about it. I really don't think that it adds

> anything to the list to keep insisting that I agree with Nick or

> not... I thought I was adding clarification to his posts where

things

> weren't clear to me. IF Nick has problems with any responses I've

> made, he's welcome to e-mail me as well. So far, I haven't heard

> anything from him. I don't think he needs people to 'stick up for

> him' on this list -- He is totally able to express himself and does

so

> often! LOL

>

>

> 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

> n

[Guest guest]

,

I agree to disagree. Since I am not up to going through this

sentence by sentence, and since my intent was to support a basic

component of DS and not get into a debate about the merits of Nick, I

will drop it now. Sorry, too preop and too much nausea for me to

respond to this one intelligently. Perhap, manana.

Thanks,

Theresa

Dr. Jossart

11-19-01

>

> In a message dated 11/27/01 5:28:21 PM, duodenalswitch@y... writes:

>

> << I believe this is what I wanted so clearly to be understood and

is

> well within the charter of this board. I did not want that one

> statement to go unaddressed, because, in my opinion, it attacted

the

> source instead of the content and by inference could ultimately

> damage a valuable resource to this board. And, my apologies for

> giving the impression that I wanted you to either totally agree or

> disagree with Nick.>>>>>

>

>

> Theresa -- Nick talked about how such things he mentioned were

inaccurate

> (bogus) in the statement FOLLOWING the one you mentioned. Quote

the entire

> source, not just one paragraph. And, THAT'S what I had a problem

with -- and

> I do believe the term 'bogus' was used to refer to such

statements. His

> stating that things such as mention of stomach cancer and the fact

that DS

> causes malnutrition (it CAN! Can't say that is bogus

information!!!) are

> irrelevant or not accurate points about the negative aspects of the

DS

> surgery is what I was picking up on and trying to correct. I can't

believe

> that someone who DOES CLAIM to know so much can even state that

malnutrition

> is not a real and valid issue or concern with the Ds surgery.

>

> I do NOT think I'm attacking the source but expressing extreme

surprise that

> he could make such a comment. It's rather amazing that Nick

himself *can be*

> so contentious and insulting to people at times and you will

totally

> disregard this -- but if I mention that I can't believe he would be

so bold

> as to claim that DS malapsorption is bogus (with some sarcasm that

he employs

> so frequently) you will state that I am tarnishing his reputation

as a

> valuable DS source!!!

>

> Needless to say, we will definately agree to disagree on this ad

infinatum.

> I am sorry that you took such offense at my attempt to clarify a

statement

> made that I thought was misleading. Now, If I had said 'Nick, you

stupid!

> How can you say that?' I definately would have been guilty of name-

calling

> and trying to say that Nick's opinion and comments weren't of value

> (something I do believe he has said about those who chose RNY).

Instead, I

> said -- how can such an intelligent person say something

likethis????? I

> think these are two different statements altogether but obviously

you

> consider them to be synonymous.

>

>

> <<<<In the future, if you would prefer to take a discussion off

line with

> me, I am more than willing to do so, if instead of posting your

> reponse on the board, you respond to me initially offline! I

believe

> that is fair and then noone feels that they are playing " my last

word

> stands " .>>>>>

>

> Why would I have to initially post to you offline? Good Lord!

When I first

> responded to you I never anticipated this kind of ongoing dialogue

about

> something which to me seemed minor at first but apparently is

something more

> judging by what you are saying. I think your concern is much

deeper than a

> disagreement about my attempt to clarify the importance of

malapsorption and

> the fact that I considered his statements downplaying it. This is

why I

> strongly suggest that you take it to that level offline because it

doesn't

> involve anyone else on the list, but you and I.

>

> I'm saying that this is not something that I think should go on the

list when

> it is apparently a disagreement about Nick (not about what has been

said

> necessarily). For whatever reason, you feel I personally 'attacked

him'

> because I expressed surprise that he could make a certain

statement.

>

> To clarify: My purpose was NOT to invalidate Nick's experience in

the least.

> I merely used a bit of sarcasm (which he dishes out an awful lot)

to say

> that I couldn't believe he would downplay such an important fact

about the

> surgery. If that was NOT his intent, then I think he should have

clarified

> his meaning by calling concerns over malnutrition issues 'bogus'.

I would

> have acknowledged that I misunderstood his intent. That would have

been it.

>

> However, it seems that you are insinuating that I have some other

purpose to

> my post and that I want to tarnish Nick's reputation or something.

I think

> that Nick can definately damage himself with nasty comments to

others, by

> name-calling (saying those who get the RNY are 'stupid) and

whatnot... but my

> being surprised by his disregard for a technical aspect of the

surgery that

> is a well known fact (not bogus) is not going to invalidate him as

a member

> of the board, imho.

>

> I think Nick has a lot to contribute to the boards and is a valid

member,

> even if I totally disagree with the way he expresses himself at

times.

> Perhaps THIS is the crux of the issue you are bringing up --- and

this would

> involve Nick and my past history of posting, etc. and I don't think

it really

> has to do with the post at hand per se.

>

> 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 lbs (plateau! Yuck)/size sweet 16