Had Sleeve, now having Duodenal Switch, need some advice

I started out at 450 lbs and had Gastric Sleeve surgery 5 months ago. i have lost 102 lbs so far (counting the pre-surgery weight loss). Things have gone very well and I haven't had any problems other than the fullness feeling in the chest if I overeat (if that's what you want to call it because I barely eat anything now) and occassional stomach cramps. No vomiting and not much diarrhea either.

My surgeon wants to go a step further and perform a duodenal switch down the road. I was wondering if anyone who has had this procedure can give me details and experiences. I have read it is a much more invasive surgery, takes alot longer and that the recovery and after life regimen can be more difficult. Although I am ready and kind of excited now for surgery now that i have survived the Sleeve procedure but since it is somewhat new I would appreciate any advice, reassurances or even warnings you can offer.

Thanks.

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I would see how far the VSG can take you before adding the switch. 5 months in my opinion is way too early to make that call. Keep following your plan and see how much you can lose. I would wait until year 2 or 3 to reevaluate.

Keep up the good work!!

Same here, although you didn't say how much weight you want to lose.  At the rate you are going, you could lose another 100 lbs. before your first year out is up.  

Like Laura in Texas - I suggest wait and see.  I don;t know if your feeling full in the chest is a problem - if it is address it in it's own right. 

But for weight loss, see how far the VSG takes you.  Your surgeon seems to suspect that you will not lose it all and/or have difficulty keeping it off - your high starting weight makes that a possibility, and the DS is the strongest (and possibly riskiest) type of WLS but it has the best long term weight loss.  My reseach is that VSG to DS can be done laparoscopically, RNY to DS is usually an open and more complicated operation.

Most of us could not find a surgeon with experience to do a DS.  How many DS surgeries has he already done - I would look for someone who has already done over 100.  That is how many bypasses it takes for a surgeon to get good (if - post WLS complications low), and I would think that it takes at least 100 to get good with the DS.  If less than 100 - he is a newbie.

I started out at 449 lbs, so I understand where you started from.  I would wait and see how much weight you can lose before you commit to another surgery.   Although I haven't lost all the weight I'd like to lose, I would not go back for the DS at this point, even at two years post surgery.

Certainly don't want to hijack this post but Geek, but for my own learning, I'd love to hear more about your thinking around revising VSG to DS for people with higher starting weights?  In your opinion, under what cir****tances does it make sense?  Or maybe it doesn't make sense at all because doing it later lessens the effect?  

It's a personal decision with many factors to consider.  For me, I do not want some of the issues that DS can bring, specifically with the potential for BM problems and odors.  I have a resected colon (colon cancer surgery in 2007) and I do not want to tax it anymore than necessary.  I didn't want the RNY either for the permanent issues with malabsorption of vitamins and supplements which is also a concern with the DS.

I also think that many people who have serious eating disorders (and I include myself) may feel that the DS will still allow you to eat a lot of food - it's a "Get Out of Jail Free" mindset.  I knew that I had to change my way of thinking about food, and the DS would probably make me feel like I could play the food roulette wheel.  

I do not begrudge or judge anyone on their choice of surgery.  I think the DS is a great surgery for many people.  Just not for me.  And I live in SoCal where one of the best DS surgeon operates.  It's not a matter of limited choices.  It's just not a road I wish to take.   

You've made really good progress in such a short amount of time. I agree with the others & would take a wait an see b4 revising to another surgery. I also was at a high starting weight & I chose the vsg & am very happy with my choice.

Hi 

I think you can do it without putting your self through more surgeries because complications usually goes up when you take more than one surgery (that what was I told) while you can achieve your gall in a year or two, i wouls like to advice you to hang on there, be patient and take it slow but steddy to reach your gall