DS math
OK, I just wanted to clear a few things up here. First, regarding the gas issue. It is not a DS or an RNY issue. It is an issue in any bypass surgery that occurs from bacterial build up in the bypassed limb of the intestines. There have been plenty of RNY patients on here that have had bouts with gas and there have been pleanty DS patients who have had bouts with gas.
The distal RNY and the DS are nearly identical from the stomach down. Gas occurs in all patients whose bypassed limb is greater than 150 cm. This is both DS and distal RNYs. Some proximal RNYs have reported this problem on this forum as well. The gas is caused by over consumption of carbs. When the carbs get down into your intestines they 'ferment' and produce gas that builds up in the digestive tract. This gas is your usual bad smelling gas that everyone wls or non wls has. The very bad (foul) smelling gas occurs when bad bacteria build up in the bypassed limb. This can and does occur with both RNY and DS. The longer your bypassed limb is the greater the chance of this occuring. My DS was very short (150 cm) as I have always been very active and my surgeon said he tried to err on the side of less malabsorbative component. I rarely get gas unless I drink a ton of non diet sodas in one day (5-7) which I try to avoid as much as possible, if I eat too much white bread (which I rarely do), or if I eat a ton of pretzels or cookies. I usually do not have the very bad gas some described.
There are several ways both RNY and DS ers can avoid bacterial overgrowth. Taking probiotics such as Danactive, Yo+, etc. Regular yogurt will work well in this area as well. Digestive enzymes are available from most health food stores and are widely aclaimed in both wls patients and non op people as well. Lastly, and this one is NOT ENDORSED BY ME, NOT ADVICE BY ME, but is something I have found works very well at correcting digestive problems (both pre and post wls) and that is every now and then (1-2 times a year), I get very drunk from hard liquor. NOT throwing up drunk, but enough that I feel it the next day. What this does is kill both the healthy and bad bacteria in your intestines, bypass limb and all. Then after you have spent the next day rehydrating yourself (water, gatorade, and most of all pedialite) then eat 2-3 yogurts or drink a few probiotic yogurt drinks (best) and you will be amazed at how well your digestive system works for several months following. Again, that one is off the books, outside of what anyone would call sound medical advice and your doctor would probably fall over if you told him you did that. I did however, learn about this off the record from a med school buddy I used to drink with back in college... I digress..,
I do not eat like Diana. I could, of all the fat we intake we absorb very very little of it. We do not absorb it's calories, we do not absorb it in the form of cholesterol or triglycerides into our bloodstream. I personally take in about 50% protein 30% fat and 20% carbs. The reason the fat % is so high is because it is a great way to boost your protein intake by including some dairy into the diet. The reason I choose not to consume it as 50% of my diet is because it causes some diarhea and gas if I consume too much. Distal RNYs have noted this occurance on these very boards as well. People with a bypassed limb greater than 100 cm can all develop loose stools from a very high fat concentration in much the way people on Xenical experience loose stools (I was and have spoken to many people who were put on that before wls was sought after as an option and most wls center's appeal forms have a section for reporting past use of these types of drugs). Whatever the case I eat high protein, low fat, low sodium, low carb.
Tonight for my aniversary I made my wife and I each a 18oz Ribeye steak and I grilled a 3/4 pound alaskan king crab leg (yes, one partial leg was 3/4 pound and had soooo much meat), I had asparagus as a side and she had french fries (I also rarely eat starches as they tend to make me gassy or uncomfortable...but then again I didn't like fries etc pre wls). I ate about half to two thirds of the steak and I will probably save the rest for breakfast tomorrow. I also had sauteed mushrooms and onions to go with it. A rough guess on that would be 80ish grams of protein and less than 20% fat and virtually no carbs (cept for the coca cola). I have RNY friends who have had steak with us so I am not saying that the DS allowed me to have this dinner, plenty of RNYers can eat dinners like this as well, though most would stick to arouns 4-6 oz of steak and 8oz crablegs. Most RNYers I have been to red lobster with substitute tobasco sauce for butter on their crab legs as they also get diarhea from eating liquid fat.
I may be an oddball, but I only eat 1 to 2 times a day. I try to eat breakfast but don't always manage to. I almost always have a big dinner. This is much the way I used to eat pre wls. Some DSers eat as much as 4000 calories a day. Some like myself eat about 2500. There was a time about 8 months post surgery where I had to take in about 3000 cals or I dropped weight too fast, but at 2500, I hold weight nicely and bounce in weight slightly from 170-180 lbs in any given month. I am largely muscle so my surgeon set my goal at 165 pounds even though it isn't the low end of a healthy BMI. Durring the summer, I was frequently under goal, but over the past 3 months I have hovered nicely around 170. When I cut out the regular sodas I almost always drop down to 162-165 and stay there untill I add in the sodas again... Coca Cola is definitely a major vice for me these days (I have had 6-7 today as I only got about 3 hours of sleep last night... and yes, I know it is extremely bad for me). One of the reasons an RNY probably wouldn't have worked for me is because I probably would have done things against the doctors recomendations that would have allowed me to circumvent the procedure.
Ah well, if your surgery works for you then you chose the right one. As a DSer, I would never want to see DS posts exclusively on the DS forum. My wife found a DS post here 6 days before I was scheduled for my RNY and I will forever be grateful to whomever made that post as I lack the disicipline to use the RNY tool correctly, again this is my shortcoming, not a fault with the RNY surgery. To my DS brothers and sisters though, I would caution how you phrase the articles. There are a couple of them that would have turned me off on the DS pre surgery and that should not be the goal. To be honest, the bickering and cat fights and poor attitudes are one of the reasons I left OH and tried to go it alone for over a year. THERE IS NO SUCH THING AS A "BETTER" SURGERY. There are amazing success stories with every mainstream type of surgery.
Last thing, and this may help some of our RNY friends see where we are coming from: many of us were decieved, lied to, or harassed by the RNY centers we went to first upon telling them we were interested in the DS. I would venture to guess (from reading the posts bios etc) that was the case with as many as 75% of us. It left an indellible impression on many of us that 'they' were trying to keep us from the truth. Many DSers feel that if they don't preach it to the masses people won't know about that option and to a large extent, they are correct. One thing us DSers need to remember about those RNY centers that alienated us in the first place...'They' went out of their way to run down the DS and say it was an inferior surgery and that made us mad and made us need to tell the truth about the DS on this forum, but seriously, lets tell the truth with out running down the RNY surgery itself, because that is no different than what 'they' did. The biggest reason I chose my surgeon wasn't because he did the DS (because when I initially met with him I was still unsure which surgery I was going to have); I chose him because he discussed the advantages and disadvantages of ALL the surgeries without disparaging a single one of them. I agree that we must continue to pay it forward, but do so with respect.
I will be posting a very long list of questions you should ask yourself and try and honestly answer if you are looking into surgeries. Depending on how you answer them you may find that one surgery might fit you better than another. This is the best way I can think of to pay it forward.
Thaks for posting the math, I love seeing things concretely like that. While I've already had my RNY and am very happy with it, I do like being knowledgeable about other surgeries in case anyone asks me questions. One thing I've wondered, about both the RNY and DS, is how much variation there is between people on malabsorbtion. Do all DSers malabsorb at the same rate, and same question on proximal RNY and distal RNY. It stands to reason that there could be considerable variation between same surgeries and different people. And for that point, how exactly is malabsorbtion measured?? LOL, I love knowing how things work and would love to hear your or anyone's opinions on that.
Debbi
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