DS Opinion

Hello,

I'm presently on the list for a DS. Had the sleeve done in December 2018, but at a plateau, this is why doctors are suggesting DS. Worried about the side effects of the surgery (i.e. malabsorption, vitamin deficiency, and other worrisome effects. Has anyone experienced major bad side effects? Anyone have any opinions or thoughts. Thank you. Look I forward to hearing from people.

plateaus are normal. How much have you lost?

Is it really a plateau or any you eating st a maintenance level instead of a loss level? How many calories a day and what does a typical days menu look like for you?

The good news about the side effects is that they are controllable.

Stinky gas and loose stools - controlled by what you eat. Simple carbs, lactose (for some) and other random individual foods (onions for me) cause this. Avoid them and you don't have it. Take probiotics and the smell is about 80% reduced.

Vitamin deficiency - this is hard because we want to trust docs, however the docs really have no clue. They are notorious for giving bad advice - even nutritionists like to bundle us into one WLS file and our needs are very different. Find the Vitalady schedule and start there. I cannot think of anyone who went deficient following that regimen and you adjust dosages as labs dictate. Also learn how to read your labs and take control yourself.

This is the first I've heard about Onions (and I know it's very dependent on the individual) and IDK how I feel about it. Onions are in 90% of everything I eat/make!

No question that this is a major change to your digestion and it will affect the rest of your life. Your concerns:

malabsorption. If you have the DS you are going to malabsorb many nutrients, such as protein, fa****er, vitamins, minerals etc. You will perfectly absorb sugar. Malabsorption is one of the key reasons DS works. Its your responsibility to eat a diet high in protein, relatively low in carbs, and healthy in other nutrients to counteract some of the malabsorption. Some people have encountered bad surgeons and have had greater problems with getting enough nutrition than most, but it does happen.

vitamin deficiency. You are committing yourself to a lifetime of blood tests, at least annually and more often for some people. You will have probably have deficiencies that can be corrected by changing your doses in most cases. You are responsible for studying what vitamins and minerals you will need, because most nutritionists aren't very good when it comes to this surgery. The blood tests will pick up what you need to change. Most people have to tweak their doses over time. Those that stop doing blood tests and taking daily vitamins get into trouble.

other worrisome effects. For the first year or so I felt like my gut was ruling my life. If I made bad food choices, I paid for it in putrid gas, stinking poop and urgent diarrhea and multiple daily poops. I tested the limits sometimes and paid for it. Now, I know the limits, my gut is more accepting of food adventures and those problems are much less frequent. Something that I didn't appreciate starting out was that the cost of groceries would be higher because carbs are cheaper than protein, multiple daily vitamins are a new monthly expense for our budget, and health insurance copays and deductibles can add up for 20+ blood tests and doctors visits and infusions. The good news was that I was hired for a much better job with better benefits because I wasn't morbidly obese!

Don't take this surgery lightly. It's a lifetime decision. I had worsening diabetes and arthritis and that was the tipping point for doing it. Losing diabetes for me was worth every little post-op aggravation.

You are not alone. We see new people with VSG or even gastric bypass looking into revising to the DS all the time. It has the best statistics of any bariatric surgery not just for percentage excess weight loss, but also for maintaining that weight loss and for permanent resolution of almost all comorbidities.

Yes, it comes with side effects, but malabsorption isn't a side effect. It's how the surgery is intended to work, and it does work. It allows for a diet that requires sufficient protein and allows you to eat fat freely, though you do still have to watch carbs. As others have stated, there is a both an adjustment of your guts and also a learning process necessary for success, but that success is there for you if you want it.

Deficiencies can be avoided if you eat adequate protein and take your vitamins and minerals faithfully. This is a commitment that you make to and for yourself, and it's a life time commitment. Most (not all!) of the people who get into nutritional trouble are the ones who decide they are special and slack off on the supplementation. You will need to be well informed and follow your labs, but really, it's all doable.

Larra

I'm always reluctant to post on this topic but maybe it's helpful for you. I had the exact same concerns as you especially with the malnutrition and side effects like gas. I was worried the DS might be overkill since my BMI was around 40, not 50+. I was ok with the vsg but worried about regain. Also my surgeon was moving cross country.

In the end, I was referred to a dr at Lennox Hill in NY that specializes in DS but also does a variation called a Sadi DS. He sold my on the longer common channel and lower surgical risk. There are also fewer vitamins needed and less risk of malabsorption.

I had this done 5 years ago and lost every once of fat, had some minimal regain which I needed. I'm generally very lean and healthy today. I would suggest researching this, but only use a surgeon that has experience with whatever procedure you decide on.

My vitamins are limited to about 6 pills in the morning. Flatulance is not an issue if you stay away from certain foods. For me it's too much dairy. I can eat anything and not gain weight which was also important to me.

Your 5 year results are very promising. I'm watching these hybrids closely, hoping they will one day replace the RNY and the torture they put themselves through.

My only issue with the hybrids are some of the surgeons representing them as DS to the patient and the insurance companies, putting the patient at risk of their fraud. I only know of one that got theirs revised to a DS.

Yeah, I'm somewhat of the opinion that all surgeries are a bit extreme but necessary, given the food industry and work life balance is stacked heavily against us. My opinion is limited to my experience with the SADi DS, although I was a week away from the Hess DS when my original surgeon dropped a last second bomb that he was moving across the country in a couple of weeks and no one else knew how to do the DS. I switched to Lenox Hill after that which has a much better wls program.

I understand people's skepticism about the SADi DS and all other procedures really, but I jumped into the deep end of the pool and it's the real deal for me. When I look at the pros and cons of each surgery, I have a hard time understanding why anyone wouldn't do the same.

The trepidation is two-fold:

First, there is a lack of data. With so many revisions with other procedures, people are more mindful nowadays to research prior to jumping in with both feet. The SADI is very new so that long-term success data is unavailable. It took the DS 20 years before it was even approved to be covered by insurance.

Second, was some shady acts by unscrupulous surgeons in the first years. They sold the SADI as a traditional DS to the patient and the insurance company. I know of one patient that this happened to and she had to get a revision and discovered that her DS was not a DS at all. This is what gives the most skepticism, I think.