confused about the duodenal switch surgery

[Guest guest]

Hi all! I have been reading everything I can this week and last on the web

about duodenal switch surgery. I made an appointment with a doc in KS who

has only been doing this surgery for 4 months. Previous to his he has 20

years experience with other forms of surgery, I know stomach stapeling for

one. The more I read, the more confused I get. I read the Carnie

info and watched the surgery. When I asked the doc's nurse (not the

receptionist) if he did his open or laproscopical (?sp) she said he did his

open with the incision going vertical. She said he told her it would be

impossible to to this surgery laproscopically(sp?). I see more than one type

of surgery name/initials before the words " duodenal switch " many times. Is

there more than one kind of duodenal switch and are only some of them

" do-able " laproscopically, or is it just that he is not yet doing this

laproscopically? I am self-pay and will have to take out a heck of a loan to

get this done. It's worth it to me if I don't gain the weight back. I'm 50

years old and recently divorced. I'm not looking to wear a bikini, so the

big scar would be okay, but if it can be done the other way, what do the

scars look like, how many, how large, etc. and other than that what is

different about the surgery post op?

I know this is lots of questions, but I'm so frustrated and I want to know

all the right questions to ask when I go for my consult so I know if he's

being honest with me. Also, what is the longest any of you have personal

experience being post op from the switch and have you regained any weight?

Thanks to all !!!!!!!!!!!!!!!!!!!!!!

Ignorance is not bliss in this case.

i.e. kst1sumo@...

[Guest guest]

In a message dated 11/22/2000 11:02:54 PM Central Standard Time,

kst1sumo@... writes:

<< Hi all! I have been reading everything I can this week and last on the

web

about duodenal switch surgery. I made an appointment with a doc in KS who

has only been doing this surgery for 4 months. Previous to his he has 20

years experience with other forms of surgery, I know stomach stapeling for

one. The more I read, the more confused I get. I read the Carnie

info and watched the surgery. When I asked the doc's nurse (not the

receptionist) if he did his open or laproscopical (?sp) she said he did his

op >>

,

I may be wrong, but I think most of the docs do this surgery for a while open

before (and if) they go to doing it lap. He may be too new to the surgery to

do it lap. I had Dr. Hess (The " father " of this surgery.) and he still does

all of his open. He is an older doc (and possibly going to only do surgery

for about another year (rumor!!), and he is more comfortable doing it open.

Since this was how he was most comfortable, that is what I wanted. Also a

long time ago I made the mistake of watching a lap (not wls) on cable, and I

have not been able to get it out of my mind. My incision is where my bra

band is to the top of my belly button. In my recovery my incision healed up

very quickly. It was my insides that took a while to heal. I did have pain

and discomfort for quite some time, but it felt like it was from the cutting

on the inside and not the incision. But then again I didn't have it lap so I

don't know what I am comparing it to. I will tell you that I have a small

incisional hernia now which I think you are far less likely to get if you

have it lap.

As someone told you before, I would talk directly to the doc. The office

staff does not always know what they are talking about especially if this is

a new procedure he is doing. This may include the nurse because she is in

the office not in the operating room with him.

Dawn

Dr. Hess

4/27/00

267

11/23/00--179

Size 22 to 12

[Guest guest]

A really good site to go to for information on the DS is the DS

website. I think it is owned by Magruder.

http://www.duodenalswitch.com/

At that site there is also a list of surgeons that do the surgery.

There are asterisks by the names of the Dr.s that do it Lap.

http://www.duodenalswitch.com/Surgeons/surgeons.html

I don't know where in KS you are from but there is a Doctor in Omaha

that just started to do the DS Lap. I don't think Ms. Mgruder has

gotten to putting an asterisk by his name yet.

Dr. Ranjan Sudan

Good Luck

Happy Turkey Day

Blain

[Guest guest]

:

You needn't apologize for asking questions. We have all had lots of

them.

There are only two variations on the DS and that is in how it's done,

open or laprascopically. Some surgeons only do it open. Others do

it lap but in the case of complications may switch to open midway

through the surgery. If you have had abdominal surgery before (C-

section, hysterectomy) you may not be a good lap candidate. Whether

they do it lap or not is *not* a reflection on the skill of the

surgeon. Just thier preferred method. As someone pointed out, Dr.

Hess who invented the surgery in its current form still only does it

open. Surgeons call their surgeries different things but they are

basically all the same. Years ago surgeons did the gastric bypass

without leaving part of the duodenum or pyloric valve intact but

everything with DS after it is basically the same surgery now.

Carnie had the RNY and in interviews refers to " dumping. "

With the DS you will not have that. One of the benefits of the DS.

Every surgeon does his incisions differently. Some are vertical,

some horizontal. Some are large and some smaller. Some even do a

half moon shaped incision. If it is laproscopic it will entail 5 to

7 small cuts. If open it will be one large scar and depends on the

surgeon and on your body type as to what it will look like.

As far as weight gain after the surgery, it is practically non-

existent. After hitting your proper weight you may vary a few pounds

but there is NOT a customary weight gain as there is with some types

of surgery.

I know that reading currently about Bridget who is having such

problems at Mt. Sinai is giving you pause. Those are some of the

complications which can happen. We would be naive to think they

couldn't. But understand that sort of problem is very rare. This is

major surgery and none of us should think that problems can't occur.

They can. But the problems that can and will occur with the ongoing

years of morbid obesity outweigh (to me) the potential problems of

surgery. Go into this surgery with your eyes open but keep your eyes

on the prize. A healthy life as a normal sized person.

Regards.

Joe Frost, old gentleman, not old fart

Pre-op, San , TX

60 years old, BMI 48

Dr. Welker, Surgery Scheduled 11/29/00

http://www.duodenalswitch.com/Patients/Joe/joe.html

> Hi all! I have been reading everything I can this week and last on

the web

> about duodenal switch surgery. I made an appointment with a doc in

KS who

> has only been doing this surgery for 4 months. Previous to his he

has 20

> years experience with other forms of surgery, I know stomach

stapeling for

> one. The more I read, the more confused I get. I read the Carnie

> info and watched the surgery. When I asked the doc's nurse (not

the

> receptionist) if he did his open or laproscopical (?sp) she said he

did his

> open with the incision going vertical. She said he told her it

would be

> impossible to to this surgery laproscopically(sp?). I see more

than one type

> of surgery name/initials before the words " duodenal switch " many

times. Is

> there more than one kind of duodenal switch and are only some of

them

> " do-able " laproscopically, or is it just that he is not yet doing

this

> laproscopically? I am self-pay and will have to take out a heck of

a loan to

> get this done. It's worth it to me if I don't gain the weight

back. I'm 50

> years old and recently divorced. I'm not looking to wear a bikini,

so the

> big scar would be okay, but if it can be done the other way, what

do the

> scars look like, how many, how large, etc. and other than that what

is

> different about the surgery post op?

> I know this is lots of questions, but I'm so frustrated and I want

to know

> all the right questions to ask when I go for my consult so I know

if he's

> being honest with me. Also, what is the longest any of you have

personal

> experience being post op from the switch and have you regained any

weight?

> Thanks to all !!!!!!!!!!!!!!!!!!!!!!

> Ignorance is not bliss in this case.

> i.e. kst1sumo@a...

[Guest guest]

Hi , I agree...there is a tremendous amount to learn - and this is too big a deal to go into without having all th available info. Heve you been to the DS Website? www.duodenalswitch.com ? THere is a ton of great info there. under procedure you'll see the difference between theDS and the RNY - under the links you'll find much more info - its enough to keep you busy for a week - because you're gotta go slow. When you start to get overwhelmed check out some of those patient pages and they will pump you back up!!!

If you are self pay you might be interested in checking out Br. Baltazar in Spain ( might not be spelled right)- he is very reasonably priced - 10,500 for surgery and hospitalization for up to 9 days. Lots of list members have gone that route and are very satisfied. I think that Dr. Maguire also has a special self-pay rate - its quite a bit higher than Dr. B but better than the regulat rate. Dr . Dennis in Marietta GA is also making some special arrangements for self pay patients - but I think it still runs 22-25,000

I'm still a pre-op, so I can't answer your other questions - I didn't even talk about your doc's experience - if he's done 20 then he has done 12 or 15 more than Dr. , had he has us lined up waiting impatiently. I don't think that 20 is a bad number....

HAng in there ...keep reading and you'll be an old pro in no time at all. Hope you had a happy Thanksgiving... W

Pre -op Dr.

Denied on 10/26 and fighting mad!!! - Prudential POS

5'5'' 301 - BMI 51

Mire fuera de Prudencial, está muy enojado....

[Guest guest]

,,,one moe thing and then I promise i'll shut up...THere are 3 different incisions that I know about used in open DS surgery. Some do it with a vertical incision, some use a horizontal and some use a wavy horizontal one - which is supposed to be less likely to open. Dr. B in Spain does it horizontal and then when the does a Tummy tuck later (if you need or want one) he incorperates it into the TT - look at the patient pages - some brave people have given us wonderful pictures - Kris is a Dr.B patient...i can't think of any others. Bye...again....

W

Pre -op Dr.

Denied on 10/26 and fighting mad!!! - Prudential POS

5'5'' 301 - BMI 51

Mire fuera de Prudencial, está muy enojado....

[Guest guest]

Joe, it looks like you have answered my questions. Same surgery called by

two different names apparently, depending on what that particular doc calls

it. One says Distal Gastric Bypass with Duodenal Switch and one says

Biliopancreatic Diversion with Duodenal Switch.

Of course, no one wants complications. My biggest worry is financial. My

BMI is only 36. I'm don't want to wait another 10 years as I slowly fight

and win only to loose again and hit a BMI of 50 before someone finally says

ok, we'll pay for it. With my current BMI, insurance is out. (and if anyone

is wondering, yes, sick & desperate person that I am, I actually

contemplated gaining another 50 pounds on purpose to see if insurance would

pay. Luckily, I can't go there on purpose!) So, now, I am considering

getting a loan at the bank to pay for my surgery, as this is not spare change

laying around in my piggy bank or other purse (wish it was). I have been

quoted $4,000 for the surgeon and $7,000 for 3 days hospital stay. I

understand this is not considered high, but rather low. Although I work a

lot of hours, I am considered a part time employee at this time. I have

insurance because I pay for it myself. As a part time employee, if I do not

work, I do not get paid. 4 weeks off work means a month with no paycheck.

All of this I could handle with the loan. I won't be working full time until

next summer. Here's the kicker I worry about: if I have complications and

have to stay in the hospital an extended amount of time, how the heck will I

ever pay for it?!! It could go into many more thousand!! That is, of

course, a rhetorical question. How many years will it take me to pay it off,

thus using up money I should be putting back for my retirement. (I spent

most of my retirement money to get a small house after my recent divorce). I

know so many of you have gone through so much more than me. I am such a

lucky person. I always have been. I hope I don't sound like I'm whining.

I'm just trying to think of what all could go wrong and weigh out the

options. There's no question for me that having the surgery is worth the

physical risks. Guess if I decide to go for it I'll just have to trust it

over to a power bigger than me.

I have been to the duodenal switch web site, but the info I've gotten in the

past 24 hours from pre and post patients has been clairfying for me.

Thanks again.