Alright folks, give it to me straight...life after DS

Everybody else has given you great responses, and mine would be the same.     I would say the only difference is that I still have some persistent deficiency problems, despite careful supplementation, particularly D and calcium absorption.    My endocrinologist still feels that they are "fixable" though, and comment just last week that he'd still rather be treating me for this than diabetes, kidney disease or hypertension!

I also am going to caution you to thoroughy discuss with this doctor that you have the consult with whether or not he truly does do the DS.   There are plenty of good docs in NYC that do, if he doesn't.  Good luck!

1. The gas. Is it as horrible as I've read about? Is it controllable (ie, will it happen when I'm doing a presentation at work?)   I'm a corporate trainer and doing lots of presentations and I can say that it rarely happens at work.   Gas is mostly created by what we eat, and what i eat in the morning and lunchtime doesn't give me gas.  My afternoon carb or sugar-laden snack gives me gas on my way home.  After eating some foods like pasta or too many homemade cookies, I can clear a room.  if I don't eat those things, no problem-o at all.

2. Do you ever have a solid BM again? I've heard that you don't (have also heard this with RNYers too)  Usually, my stools are pretty soft.  This doesn't mean diarrhea -- it's completely under control, but there's no straining necessary which is quite pleasant.  I have a giant poo of pudding like consistency lately every morning.  I mean, it's GIANT, like I want to poke this new island with a stick and look for survivors, but I usually don't go again the rest of the day.  I do realize how full of **** I really was as a pre-op.

3. What is the recovery time like? 
I was in the hospital for 4 days and took 2 months off of work.  I was very thankful the first month, and started feeling more like my usual self around 6 weeks.

4. Alcohol -- can you have it eventually?
Yes, but it's amazing how fast you get drunk, and get un-drunk.  Because the rapid weight loss i a strain on the liver, you want to wait until the weight loss stablizes before indulging.  The standard recommendataion is to wait a year.

5. Food tolerance -- sushi is my absolute fave followed by pasta and Mexican. Are all these out for good?
Pasta for me -- notsomuch -- but I did find wonderful uses for the sauces and I did find Dreamfields pasta that is low net carb and doesn't give me as bad effects as regular pasta.  I also found gnocci isn't as bad on me, either.  I eat Mexican all the time, and I never liked seafood cooked, let alone bait so I have no personal experience to share for sushi.  You may want to shy away from the rice for a while, but eat away at the bait part.

6. Post surgery vitamin deficiencies -- how serious are they? Are they easily controlled by supplements?
They can be very serious to those who aren't paying attention.  The fat-soluble vitamins are the biggest challenge, and the megadoses I'm taking of D is inching my levels along.  I've been fighting it for a couple years now, but not suffering any ill-effects yet which is my goal. 

7. At one point do you not have to worry about leaks? I am particularly concerned about this question as I believe it was a leak that killed my MIL -- she was a week out. Will I ever be able to breathe a sigh of relief that I'm "okay" and life can go on after my surgery?  If anything serious such as a leak is to occur, it will in the first two weeks, usually.

The sleeve is really a great option in the beginning, it's the long term efficacy that I questioned when I made the decision to go with the DS.  My DS journey hasn't been perfect and without speed bumps along the way, but I can promise you that I'm very happy with my surgery.  Each time I look at my size 26 pre-op pants, I know that I've taken a step in the right direction with my health.  I remember when those pants seemed to look normal sized to me...not the case anymore. 

Okay, I'll tackle your questions for you.

1.  The gas can be bad, but ONLY (please note the caps there) when I've eaten something that I already knew was going to cause me gas. You learn quickly what your triggers are;  mine are having more than 4 oz milk and white flours.  I still eat them, but ONLY when I know that I'll be at home and not around people outside of my immediate family.  I only eat white flours that are WELL worth the gas.  I don't do this often, but sometimes I find a certain food to be worth the trade off.  Each person's triggers are different, you'll learn yours if you decide to have the DS.  IT IS CONROLLABLE!!  It's all very diet related. 

2.  Solid BM's.  Yes, I only had diarrhea for the first 3 weeks after surgery.  After that I had "pudding-like" poos, but much more on the solid side.  My Bm's range from pudding poo's to floating globs (good grief I just said globs!  TMI, sorry) When you're malabsorbing fat, solid takes on a new definition post-surgery.  But no, I do NOT have liquid diarrhea unless I've eaten something that was spoiled or if I have a stomach bug, just like pre-op.

3.  Most people take 6 weeks to really turn the corner to feeling better, I can tell you that I was feeling pretty awesome by 2 weeks out and my DS was open.  So the range is all up to each patient, I'm sure it depends on age and activitiy level.  Each person will have a different recovery.

4.  I drink about once a month now, the same as pre-op.  I'm planning to drink this weekend at the DS party I'm having at my house.   It's recommended by most surgeon's to wait a year or until your excess weight is gone.  The liver works very hard when you're losing weight quickly, and the added strain of alcohol is believed to be too taxing on the liver. 

5.  I love su****oo!  I eat it every month or two.  I try to eat it with a small amount of rice or choose rolls that are made without rice because the rice fills me up too fast to enjoy too many rolls.  That said, I can still put 10-12 rolls away, sometimes more.  I still eat mexican foods as well,I'm just careful about the white flours.  Pasta may be your biggest problem after the DS, though there are alternatives.  I eat 100% whole wheat pasta without issue, and egg noodles as well.  Others like Dreamfield's pasta and tolerate it well.  I've tasted pasta recently and you know what?  It just didn't taste as good as I remember it being.  It *is* just flour and water after all, nothing too exciting and no longer appealing to my taste buds.

6.  Supplements.  The reason we get our labs drawn is to stay on top of any deficiencies that may be happening.  I just had my 2 year labs and for the first time, I had some numbers that were going down hill.  I've done some tweaking and will be retesting in about a week.  I can FEEL that the changes I've made are making a difference, I feel like a million bucks!  I take supplements throughout the day, with each meal and at bedtime.  If I'm eating, I take vitamins.  Simple.

7.  I will defer this question to someone else, I can't remember the length of time when you're out of the woods for a leak.  I'm thinking it's just a few weeks, but I don't want to tell you wrong.  I'm so sorry about your MIL's death.  I know that has to be scary for both you and your husband.


You've been working towards surgery for awhile now it seems.  I want to point out that the surgeon you have listed under your name is not a name I've seen around here for DS surgeons.  You have to go to a surgeon that DOES the DS to get a true opinion on it.  If you go to a surgeon that doesn't do the DS, it's a rare case that they'd steer you towards the DS.  It'd be like walking into the Chevy dealer and asking the sales person if they think that maybe the Honda would be a more reliable car.  They're going to tell you anything to get you to buy the Chevy, know what I mean?  You've come this far, check out dsfacts.com for a comprehensive list of surgeons that do perform the DS.  I wouldn't even waste my time with a surgeon that doesn't do it.  It sounds like you have plenty of time to find a DS surgeon anyway while you get all of your paperwork together.  You've come this far, go to someone who performs the sleeve and the DS for a much better OVERALL picture.  You'll be glad you did!

Lori

Hello beaglemamma, first of all there are no DS surgeons in the Ct. They are in New York and most all located in Manhattan, NYC. The top 3 DS surgeons with the most experience in NY are Dr. Inabnet, Pomp and Roslin. Any of these 3, you can seek to inquire about the Duodenal Switch and interview them to see whom you feel most comfortable with and want to develop a lifelong post-op aftercare partnership with, as well.

1. The gas. Is it as horrible as I've read about? 
No, it is not horrible or gives off odor all the time. You will know what type of food or ingredient can set off your system. A DSer does not fart all day or daily. It really depends what you eat that triggers it and your body will let you know what it is, early out and even as you are further out post-op.

Is it controllable (ie, will it happen when I'm doing a presentation at work?)
It is very controllable and doesn't happen that it comes out and you can't do anything about it. It is just a fart like any other times in your life and any other person in this earth. If you have an urge to pass gas, you can hold it in or excuse yourself for a sec, but of all the presentations I have given, I never once had to do that or felt I needed to pass gas during those momennts. It is not something that a DSer is feeling they need to pass gas all day. You will know what causes you gas and avoid it during that time period you are at work.

2. Do you ever have a solid BM again? I've heard that you don't (have also heard this with RNYers too)
Yes, I have solid bowel movement all the time, no****ery or liquid bowel movements, even if I eat a high fat intake for the day, it just makes it more smoother and more volume. My BM are just softer and have never been hard or like a rock that I have to strain or push hard since I had my DS.

3. What is the recovery time like? 
Everyone is different according to their health and healing process. On average, its takes about 4-8 weeks to recover, some can recover in 2 weeks and more power to them. It took me 18 weeks. Most of my problem during my surgical recovery was I had no energy and just wanted to sleep all day long. It happens. I also had post-op surgical pain that lasted 28 days and that is rare. It is also based on your insides. I did have previous surgery and had lots of adhesion and scars that had me in surgery for 5 hours. Once I was past the 5th month post-op, I regain my energy and moved on. This can happen with RnY and VSG as well, even other types of non-WLS surgeries. Everyone is different.

4. Alcohol -- can you have it eventually?
I did not touch alcohol until I was over a year out post-op. I only had sips as my limit. I avoid drinking alcohol because it deplete the nutrients (vitamins and minerals) you work so hard to have in your system. Drinking alcohol is very limited in my world because I do not want any of my nutrients depleted from my system. 

5. Food tolerance -- sushi is my absolute fave followed by pasta and Mexican. Are all these out for good?
I eat sushi all the time, my fav is California rolls and I can eat 3 of them. I can eat Chinese food too, but had issues with it my first year. After 16 months, I can eat Chinese food, but still limited to the amount I can have. I still get cramps if I eat more than 3 tsp of fried rice and can only eat 3 General Tso chicken, but all the veggies in it. I can eat pasta with no problems and Mexican food. I eat rice, not daily or every week, but every once and a while during the month, especially with Cuban style black bean stew. RnYer find it difficult to eat rice with their stoma adn most avoid it. But, DSer can eat rice because we have a fully functional stomach with a pyloric value to help it stay in there and churn to break it down and absorb nutrients from the food we eat. RnYers can't have that process or absorb any nutrients in their stoma.

6. Post surgery vitamin deficiencies -- how serious are they?
Depends on the indivudual and how compliant they are and if they are taking the correct supplements, amount of dosage and tweaking their regime as needed. A DSer has to be viligant to check their bloodwork and based their daily suplement intake according to it and to also maintain their health. One of the greatest concern with DSers is calcium that we malabsorb at a high rate and have to keep that in check, along with vitamin D and PTH. We malabsorb fatty vitamins such as vitamin A, D, E and K and need to have those in check. I do not take vitamin A supplement because my A level is high and am able to abosrb vitamin A from the food I eat. Each DSer is different and their daily supplement is based on their individual needs and bloodwork to what is needed. You have to check your bloodwork and sometimes, more than required. As DSer, eventhough we malabsorb calories and fats in out intestines, we are able to able aborb nutrients in our stomach and proximal duodenum as some in our limbs. It really depends on the DSer, their malabsorption level that is based on the length of their common channel and limbs.

Are they easily controlled by supplements?
Yes, if you know what you need to take and how much, but it takes a lot of tweaking and that can be a lifetime. Some have stubborn low ranges and/or deficiencies and required therapy for it such as taking more supplements or even have infusion.

7. At one point do you not have to worry about leaks? I am particularly concerned about this question as I believe it was a leak that killed my MIL -- she was a week out.
I had my leak test done while I was still in surgery. Ask your DS surgeon regarding this and when do they do a leak test, what are signs and how can you determine if you have a leak.

Will I ever be able to breathe a sigh of relief that I'm "okay" and life can go on after my surgery?
First year was a very challenging journey for me. I did not have any risks or complications based on my DS, just a lot of food intolerances that eventually all went away by the time I was 12 months post-op. I was just a very slow healer within.

For me personally, after a year, everything was good. At almost 3 years post-op, I live and feel as though I never had WLS. I eat normal food (just smaller portions) with no restrictions or have to avoid anything. I do moderate certain things based on ingredients, but not deal that I can't have it for life or I get sick from it that I need to lay down and get over it. I am not a person who eat high fat food normally, but when I feel like, I have that fried chicken or green salad that has ham, egg and cheese, with some crumbled bacon in it. The DS is a non-dramatic and non-punitive way of life. You just go on as you normally do, with focus on your protein quota, make sure you stay well hydrated and take your required supplement to maintain your health and check your bloodwork in intervals to make sure you are ok.

1. The gas. Is it as horrible as I've read about? Is it controllable (ie, will it happen when I'm doing a presentation at work?) Gas has not been a problem for me. It is TOTALLY controllable by what you eat. What seems to set me off is sugar alcohols, fruit, and grains.

2. Do you ever have a solid BM again? I've heard that you don't (have also heard this with RNYers too) When I have my morning BM, it appears "fluffy" and different than pre-op. I will say that BM's are much easier than they were pre-op. I would not want to go back to straining for a BM. I would like to add that I have yet to experience a BM emergency and that I can count on going each morning twice--about 10 minutes a part.

3. What is the recovery time like? I had a tougher recovery than some. I had had 4 previous abdominal surgeries ( 3 C-sections and a hysterectomy.) I would say that the recovery time for the DS was less intense than the C-sections or hysterectomy. For me, the toughest part of recovery was eating and relearning how to eat.

4. Alcohol -- can you have it eventually? Yes

5. Food tolerance -- sushi is my absolute fave followed by pasta and Mexican. Are all these out for good? I have a tiny stomach and I cannot tolerate rice--fills me up too fast. So now, I eat sushimi instead of traditional rolls. I have recently found a restaurant that uses thin slices of cucumber instead of rice in their rolls--they were amazing! I am not a pasta fan but many people enjoy eating Dreamfields pasta. I am in Texas and Mexican food is a staple of my diet. In fact, the guacamole, sour cream, and tons of cheese are health foods for us. I do not eat the rice--per earlier comment--or tortillas, for the same reason. However, many people enjoy low-carb tortillas after the DS--my 2 oz. tummy just cannot handle all the bread yet.

6. Post surgery vitamin deficiencies -- how serious are they? Are they easily controlled by supplements? Any surgery that has malabsorbtion contains a risk of vitamin deficiencies. Except for rare instances, taking multivitamins, calcium, and the specific vitamins that you need based on blood work is all you need to do to keep yourself healthy. In fact, I would like to add that I have not been sick since my DS, thanks to the vitamins that I take. I decided that taking vitamins and keeping track of my blood work was a small price to pay to remove: diabetes, high blood pressure, sleep apnea, high cholesterol, and obesity from my life forever. ALL of which are excellent now.

7. At one point do you not have to worry about leaks? I am particularly concerned about this question as I believe it was a leak that killed my MIL -- she was a week out. Will I ever be able to breathe a sigh of relief that I'm "okay" and life can go on after my surgery? I think leaks are of biggest concern right after surgery. Many doctors do leak tests at the time of surgery or within the first day.


I would like to add that Dr. Bell does not do the DS. He may not be the right person to ask about which surgery will work best for you. Very few surgeons are altruistic enough to send patients to another doctor to do a surgery that they are not capable of doing themselves. In fact, many of the WLS surgeons who do not do the DS are the ones who perpetrate DS myths in order to promote the surgeries that they are capable of doing--I liken it to bullies who make fun of others in order to feel better about themselves. The best option is to speak to a surgeon who does all of the surgeries.

Thank you, thank, you, THANK YOU everyone for your thoughtful replies. There's a lot of reassuring information in these posts! It is much appreciated.

I checked the list of DS surgeons that was posted and I was surprised that Dr Bell wasn't on the list. His profile indicates he does DS and I went through his reviews and there was at least 1 DS patient. Is it perhaps that he hasn't done enough of them to make the DS surgeons list? I know he does the sleeve for sure (which is how I found out about him). I'll make some calls to the ones in NY that were recommended here.

For me, there is no question that it's either between the sleeve or DS. Thank you all, again, for giving me such great information. I posted last night and this morning I had an overwhelming response. This forum is great!!!

Oh sure, he probably does the DS (insert sarcastic snort here). I would scratch the surface deeper and ask questions like:

http://www.dsfacts.com/Questions-To-Ask-Your-Surgeon.html

That should help separate the wheat from the **** so to speak.

The lists there and at www.duodenalswitch.com have been vetted and each doc there has done a large number of DSes successfully.

Best of luck to you, no matter what you decide!

Nicolle

ETA: sarcasm. I think there ARE some lesser-known DS surgeons out there who are doing the good work but simply have NOT done enough DSes to "qualify" for the vetted lists. Most of the clowns I see mentioned on OH, particularly the main board, are NOT those guys.

Nicolle, I went with a friernd of mine to a bariatric surgeon whose office say he does the DS. I told her he doesn't do the DS, she insisted he does because the office said so. I went with her to the consult and asked him if he does the DS, he said he does something similar to it. I asked him to explain what exactly he does and to please go in in anatomical details. It turns out he does the extended Roux-en-Y that is NOTHING to the physiology of the duodenum switch digestive mechanism or the way I malabsorb. I told him that is an ERNY or even a distal RnY, not DS, technically or in surgically.

I also told him there is no part you can say is like a DS, not even the intestinal portion and especially the digestion is not even the same or the malabsorption. yes we have common limbs, but intestinal part that processes does not have the duodenum divided in half and the small intestines divided in 2 to make 2 separate limbs one for food the other for the digestive juices. You do not get that with the ERNY or distal RnY and both limbs alimentary and bioliopancreatic are both 100% functional to process the food  in one limb and and the other with some of the nutrients. So, to inservice his office that you do not do the DS and only various form of RNY procedures. 

Don't get me started on those surgeons who say they do the DS and the patient wakes up with just a VSG and a lame excuse. One of my friend has a bariatric surgeon sued for it and malapractice. There was no health or complication to her life that he could not complete the DS on her and it seems this is happening more and more now. If a surgeon only does the VSG, he is NOT a DS surgeon, not even technically.

Yeah, my post should have included the phrase "sarcastic snort" or something. I know what you mean!

I will edit the above post to reflect my derision!

Nicolle

Most of my answers are the same as the rest, but I'll answer anyway!

The gas. Is it as horrible as I've read about? Is it controllable (ie, will it happen when I'm doing a presentation at work?) 
 - I have virtually no gas, ever.  I had issues after about a year out, and did a round of Flagyl and have been fine since.  I will occassionally find a food that hits me wrong, but not necessarily the same food - I think it depends on what I've eat (or not eaten) with it.  But it's rare and very controllable (not like I have the walking farts or anything).

Do you ever have a solid BM again? I've heard that you don't (have also heard this with RNYers too)
 - Mine varies from pudding to semi-firm (usually similar to toothpaste?)

What is the recovery time like?
 - I felt like death warmed over for a couple weeks, and worn out for a couple more weeks, but I was pretty self-sufficient and moving around when I came home from the hospital.

Alcohol -- can you have it eventually?
 - yep, you've already been given the 'wait' advice

Food tolerance -- sushi is my absolute fave followed by pasta and Mexican. Are all these out for good?
 - I have none specific.  Some whey or some ice creams (not all) make me poop more, but nothing uncontrollable.

Post surgery vitamin deficiencies -- how serious are they? Are they easily controlled by supplements?
  - Mine are all within 'normal' range, but not as high as I'd like . . . still tweaking based on my regular labs.

At one point do you not have to worry about leaks? 
 - My surgeon did the leak test while I was still in surgery and opened up.