The Duodenal Switch – One Woman’s Journey
September 15, 2014Many of us who are bariatric patients have had a lifelong struggle with obesity. I’m no different. I had been morbidly obese for most of my life, and during a time when obesity was most often seen as a character flaw, or for a child, indictment of the parents for “allowing” their child to gain so much weight.
This might be cliché, but there were heavy people on both sides of my family. I had an aunt, my late Dad’s sister, who I’m guessing weighed at least 600 pounds. Long before all the scientific data on hereditary obesity, I already knew it as fact.
I don’t have the sad story of missing out on school milestones like proms because of my weight. In fact, I went to four. By today’s standards, I would have been a normal-sized teenager, but in my era, anything above a size nine was fat. I wore a size 13. I was not a “blob”, I was shapely, but the scale said 160 and change, and according to “the charts”, at 5-foot-3, I was morbidly obese.
Fast forward - the summer of 2008. I was 50 years old, and had lived most of my life as “the fat lady”, hearing all too often “You have such a pretty face…”. I stepped onto my doctor’s platform scale one day, during a visit and the red LED number staring back at me was 405. The scale’s weight capacity was 500.
This prompted a serious discussion between my doctor and me about weight loss surgery as an option.
I already knew I was a bad dieter, but the foods I ate were not the issue. I was a volume eater. Looking back, the types of foods I ate were no different than the average person. I just ate more of them. I also had the complication of a condition that required the use of the steroid prednisone during a disease flare up, which also helped to push my weight into the super morbid obese category. Medicines that could help reduce the flare-ups would not work for me because of the extra pounds. The weight therefore, contributed to my being disabled by my condition. I also had high blood pressure for the first time in my life, and sleep apnea, which required a CPAP machine.
I started doing research on the different weight loss surgeries, and found a top-flight bariatric surgery center in my state, St. Vincent’s Bariatric Center of Excellence. I had heard about the gastric bypass, but during my research I discovered a procedure called the Duodenal Switch. At the time, there were only 50 surgeons worldwide who performed it, but I had not yet found the doctor who would ultimately be my weight loss surgeon. As I learned more about the DS, I learned that it was both a restrictive and malabsorptive procedure, where intake is reduced as well as absorption of calories. I put that information in my mental file cabinet, for questions at the gastric bypass seminar I would attend the following month.
I attended the seminar, and after the presentation, I asked the surgeon about the Duodenal Switch, which he never mentioned. He said he didn’t do it, but his colleague, Dr. Margaret Inman, did, and I would have to attend her seminar if that’s the surgery I wanted. Though I’d made the four-hour round trip for his seminar, I signed up to come back to the DS seminar the following month.
I liked Dr. Inman right away. She was a straight-shooter, and pulled no punches about the dramatic lifestyle changes the DS would require. Further research revealed that I would be able to eat the same foods I enjoyed, with an emphasis on protein intake (meat eater!), and ultra-high vitamin doses, to make up for the malabsorption factor of the procedure.
On February 25, 2009, I was armed with the most powerful weapon to date against morbid obesity, the Duodenal Switch, also known as the Biliopancreatic Diversion with Duodenal Switch, or simply, the DS. Three-fourths of my stomach was removed, creating a tube-like, but still normally functioning stomach, with a capacity immediately post –op of 2.8 ounces. The newly reduced stomach is designed to stretch, or mature, over a year’s time to its final capacity, which is now 6-10 ounces, depending on the density of the food being eaten. The beauty of this surgery is that absorption of protein (meat, fish eggs, dairy) and complex carbs (whole grains, vegetables) are reduced to 50-60 percent.
I lost my first 200 pounds in the first year post-op. The rest came off gradually during the second year. I no longer have high blood pressure, my CPAP is gathering dust and because of the fat malabsorption, I will *never* have a cholesterol problem.
DSer’s eat for quality, not quantity. There are no “forbidden” foods with the DS, however, the body will still absorb 100 percent of any simple carbohydrates (white flour and products made with it) or simple sugars (white and brown sugar, candy, regular soda), and your body will react with gas from Hades and extra bathroom trips if they are eaten to excess. Speaking of excess, contrary to rumor, DSers don’t sit around all day gorging themselves on food. Many of us do eat small meals all day, but it’s necessary to get the calories and nutrients in. Fats are absorbed at 20 percent, which means butter, cheese and creams are now your friends, and are needed to “keep things moving”. The restriction of the stomach gets the weight off. The malabsorption of the reconfigured small intestine keeps the weight off, through reduced absorption.
The DS vitamin supplement regimen can be brutal, but is absolutely critical to maintaining health with the DS, especially vitamins A, D, E, K1 and K2, which are the fat soluble vitamins. Since the DS system is efficient at fat malabsorption, these must be taken in dry formulations.
For me, and many other DSers, calorie counting is a thing of the past! Now, the counting focuses on protein grams, ensuring that 90 to 100 grams a day are consumed.
I am so grateful for this “second chance” at a healthy life. In fact, the results of the DS inspired me to return to college to train for a new profession, even though I’m middle-aged. When I’m done, I will be a Registered Dietitian, specializing in post-op bariatric nutrition.
Photos: David Sutton/Sutton Studios
 | ABOUT THE AUTHOR Corrie Wynns, aka JazzyOne9254, is a former journalist and radio news reporter. She is currently writing a book on the Duodenal Switch for prospective patients. |
