Too Late

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I subscribed to this forum about 6 weeks ago and was denied. I

filled out the questionaire and submitted it twice. Dr Rutledge

failed to respond to me (I have had abdominal surgery so he did not

bother with me as I was a bad risk?) So, when I was denied

membership, I was shocked. But you know God is in control! I have

been researching WLS for quite some time now. A woman I that works

at the same hospital as I, had surgery with Dr Rutledge (5 other

women in upper MI, too). My PCP advised me to go to Dr Rutledge. He

gave me the information packet (has copies made of it) to make sure I

was aware of all the things that I would have to do. The funny thing

about all this is after the denial of membership and knowing that MGB

is really not an option for me because of the previous surgeries, I

started searching for a DR to do the RNY. I found a great one in

Gainsville, FL by the name of Dr P Hocking. Works for Shands

Hospital. But still researching (I am very anal about that) I came

upon a site testimony on AMOS and went to her home page:

http://www.mywls.com/ and followed a link on there about the type of

surgery she had. That link was http://duodenalswitch.com. What I

have learned there is my understanding and belief is that the DS

transects the stomach in a way that keeps the food following the

normal path down through the pyloric valve and into a portion of the

duodenum which is where some of your vitamins and minerals begin

absorption. The RNY & MGB totally bypasses the lower part of the

stomach, pyloric valve and the duodenum, leaving those parts

inactive. Therefore, I believe that you would have better

vitamin/mineral absorption from the DS. The DS does have a greater

malabsorption component where the food is not mixed with the

digestive juices from the liver and pancreas until the last 100cm

(approx.) and therefore some of the vitamins/minerals are not able to

be gleaned out of the food as well as without this component. This

portion of the DS is also an important reason why the DS surgery has

better long-term weight loss maintenence and not likely to regain.

On the other hand, in my opinion, the RNY & MGB creates an abnormal

stomach with direct connection to the intestine without a pyloric

valve and therefore has a whole slew of problems associated with that

connection, with " dumping syndrome " (Like an open drain in your sink)

being a main one that would not happen with DS. With the RNY & MGB,

food will have to be chewed extensively or it could cause blockages

and I wondered what it would be like in later life when I have false

teeth and can not chew as well. Another major problem with that

connection is a greater likelihood of ulcers, leaks and/or blockages

from scarring to the " anastomis " (sp) or connection between the

stomach pouch and intestine. Since the intestine is an alkaline

environment and the stomach is an acidic environment, the two are not

compatible without a valve separating them, thus creating a

connection that will forever be prone to problems. Since the

duodenum is bypassed, there is a problem with absorption of

vitamins/minerals that are normally absorbed in the duodenum. If the

RNY or MGB is done as a " distal " , then the intestinal bypass is

similar at the " common channel " end as the DS and so the

malabsorption is similar at that end. If the RNY or MGB is done as

a " proximal " , then very little malabsorption is created, therefore

although you will absorb more nutrients, i.e. vitamins/minerals, from

your food, you also will run the risk of less weight loss and a good

chance of long-term weight re-gain. Any surgery will require the

diligence of taking vitamins for optimum health.

For me, there was no choice, the DS was by far the better overall

surgery. I consider it to be the " cadillac " of WLS. I don't want to

worry about blockages, leaks, ulcers, dumping syndrome and the other

problems with RNY & MGB. I also don't want to every worry about re-

gaining the weight. The DS gives me the freedom to eat as a normal

person, chew as a normal person and never have to worry about eating

in public. This is all my opinion as I believe based on my research

of the surgeries.

On a final note: The 6 women in upper Michigan got help to get the

insurance approval for their surgery by the person this list hates

the most: . She had her surgery the same time as

these women. She fought the insurance companies for the right to

have this surgery. She had complications and now is against this

surgery. You can call it sour grapes or you can call it a warning.

Every surgery has the risk of complications. I am not against MGB.

I am not against RNY: I will still have it if DS is denied by my

insurance. I think Dr Rutledge has the most informative website and

without him I would not be making this great adventure.

So, in closing, thank you for inviting me to be a member of this

forum. I will be praying for all going into surgery.

Sincerely,

Viau@...