Lets discuss the duodenal Switch!
Ms. Cal Culator
on 8/17/10 12:52 am, edited 8/17/10 12:53 am - Tuvalu
on 8/17/10 12:52 am, edited 8/17/10 12:53 am - Tuvalu
On August 16, 2010 at 5:12 PM Pacific Time, Ladytazz wrote:
I choose the DS in 2002 because I heard it had more success in keeping weight off then the RNY. I am one of those that didn't change my habits and although I lost 120 lbs total I regained 100 lbs. I blame no one but myself. I also found the diarrhea a lot worse then I expected. I recently had my common channel lengthened (yeh, no more diarrhea and gas) and my stomach made smaller because I found that by nearly 8 years out I could eat as much as I did pre op.
I'm not trying to talk anyone out of the surgery, just that I wish I had used the tool more wisely. At the time I got it it was touted as a miracle surgery that allowed you to eat as much as you wanted. Or maybe that is just what I choose to hear. I remember when I had a stall I was advised to eat a Krispy Kreme donut and people posting recipies of Krispy Kreme bread pudding. I did lose weight for the first 2 years and then I started regaining about 10 to 15 lbs a year.
I also know other DSers that have had regain after several years. It is a good surgery for those who can live with the diarrhea and follow the guidlines. Not everyone I know that had the DS had as severe diarrhea as I did. My surgeon said that some people just have a bad reaction to the malabsorption.
"It is a good surgery for those who can live with the diarrhea and follow the guidlines."
I'm very bad at following guidelines and I don't "live with diarrhea."
But with ANY wls, you can "eat yourself sick," usually on a day-to-day or meal-to-meal basis:
•With the band, It can be lettuce or celery or bread or raisins (my experience) that can clog up the esophagus and cause you to barf...right then, right there, in the middle of the restaurant.
•With the RnY, you can (although not everyone does) eat yourself into a dumping episode.
•With the VSG--I did not have this and don't know any VSG people IRL, so I'm going by what I've read here--there can be a steep learning curve in figuring out how much you can eat without overdoing it and barfing it all up.
•With the DS--It has even more YMMV going on than the RnY and the sleeve, and that leads to a lot of confusion. There IS a steep learning curve here, too. But you have to figure out each step for yourself...as people do with the other surgeries.
I have IRL RnY friends who--if you feed then a couple of drinks--will confess that they have "planned dumps." They KNOW that a couple of Krispy Kremes will cause a dumping episode, but they want them anyway. So they put on their jammies, crawl into bed, grab a cold towel and wastebasket in case, and eat the donuts. They don't do it often. But they have done it.
I'm sure that if I ate a couple of Crispy Cremes, I would swell up to the point that I'd look eight months pregnant (not an attractive look for a 63-year-old), my gut would make noises you could hear--really--from across the room, and I might--I don't know for sure because I've never eaten two KS--have the runs. Maybe.
In my life, my D'S diarrhea episodes are due to antibiotics. I have almost non-stop UTIs and I am on antibiotics more than I am off of them. Probiotics help a lot...but it takes some time to figure out how much I need relative to which antibiotic I'm taking. THAT'S a pain.
MY take on the DS-diarrhea thing is that it is far more controllable than barfing incidents with the band or than (for some) dumping incidents with RnY. But that's just my experience.
I'm not trying to talk anyone out of the surgery, just that I wish I had used the tool more wisely. At the time I got it it was touted as a miracle surgery that allowed you to eat as much as you wanted. Or maybe that is just what I choose to hear. I remember when I had a stall I was advised to eat a Krispy Kreme donut and people posting recipies of Krispy Kreme bread pudding. I did lose weight for the first 2 years and then I started regaining about 10 to 15 lbs a year.
I also know other DSers that have had regain after several years. It is a good surgery for those who can live with the diarrhea and follow the guidlines. Not everyone I know that had the DS had as severe diarrhea as I did. My surgeon said that some people just have a bad reaction to the malabsorption.
"It is a good surgery for those who can live with the diarrhea and follow the guidlines."
I'm very bad at following guidelines and I don't "live with diarrhea."
But with ANY wls, you can "eat yourself sick," usually on a day-to-day or meal-to-meal basis:
•With the band, It can be lettuce or celery or bread or raisins (my experience) that can clog up the esophagus and cause you to barf...right then, right there, in the middle of the restaurant.
•With the RnY, you can (although not everyone does) eat yourself into a dumping episode.
•With the VSG--I did not have this and don't know any VSG people IRL, so I'm going by what I've read here--there can be a steep learning curve in figuring out how much you can eat without overdoing it and barfing it all up.
•With the DS--It has even more YMMV going on than the RnY and the sleeve, and that leads to a lot of confusion. There IS a steep learning curve here, too. But you have to figure out each step for yourself...as people do with the other surgeries.
I have IRL RnY friends who--if you feed then a couple of drinks--will confess that they have "planned dumps." They KNOW that a couple of Krispy Kremes will cause a dumping episode, but they want them anyway. So they put on their jammies, crawl into bed, grab a cold towel and wastebasket in case, and eat the donuts. They don't do it often. But they have done it.
I'm sure that if I ate a couple of Crispy Cremes, I would swell up to the point that I'd look eight months pregnant (not an attractive look for a 63-year-old), my gut would make noises you could hear--really--from across the room, and I might--I don't know for sure because I've never eaten two KS--have the runs. Maybe.
In my life, my D'S diarrhea episodes are due to antibiotics. I have almost non-stop UTIs and I am on antibiotics more than I am off of them. Probiotics help a lot...but it takes some time to figure out how much I need relative to which antibiotic I'm taking. THAT'S a pain.
MY take on the DS-diarrhea thing is that it is far more controllable than barfing incidents with the band or than (for some) dumping incidents with RnY. But that's just my experience.
Everyone is different and I am aware that not everyone with the DS gets diarrhea. I have friends that have the DS who have problems with constipation. I was told that some people had a bad reaction and that seemed to be me. No matter what I ate I had it. I tried every probiotic and antibiotic I could find. I had some relief with the antibiotics but it always came back. Believe me, I would never had had major, open surgery if there were another solution. But I am glad I did. As I said, my story is not common by any means and most people I know who had the DS are very happy with it. I wi**** would have worked out for me. I just wanted to give another point of view.
WLS 10/28/2002 Revision 7/23/2010
High Weight (2002) 240 Revision Weight (2010) 220 Current Weight 115.
Your bowel issues were a direct result of what you put in your mouth.
I can easily give myself diarrhea by eating what I should not eat. So I choose not to eat that stuff.
Most people with the DS have problems with constipation not diahrrea.
Are you saying you gained 100 lbs by gaining 10-15 lbs a year? So it took you 5-10 years to regain that?
What is your weight status today?
I can easily give myself diarrhea by eating what I should not eat. So I choose not to eat that stuff.
Most people with the DS have problems with constipation not diahrrea.
Are you saying you gained 100 lbs by gaining 10-15 lbs a year? So it took you 5-10 years to regain that?
What is your weight status today?
I actually went on a strict diet for 6 months to see if that would help and it did a little, if only the quanity but I still had the diarrhea. That was bad enough but I was also having "accidents", sometimes in public. Talk about humiliating. I had to keep a change of clothes with me.
I started out at 240, lost down to 120 at 2 years and ended up this year at 220. The last fews years it was coming on faster. It was nearly 8 years since my surgery. Since my revision I have lost, unofficially, about 30 lbs. I only officially count weigh ins at the doctors but my home scale seems pretty accurate, so I am about 190 lbs now.
I started out at 240, lost down to 120 at 2 years and ended up this year at 220. The last fews years it was coming on faster. It was nearly 8 years since my surgery. Since my revision I have lost, unofficially, about 30 lbs. I only officially count weigh ins at the doctors but my home scale seems pretty accurate, so I am about 190 lbs now.
WLS 10/28/2002 Revision 7/23/2010
High Weight (2002) 240 Revision Weight (2010) 220 Current Weight 115.
I'm really sorry. It sounds like your surgeon did not give you a correct DS.
Do you have a pouch now? From the same surgeon?
I know that we see 10 times more complaints of constipation than we do diarrhea. Were you taking the vitamins that tend to cause constipation? Calcium and iron?
I hope you have cured your diarrhea and accidents.
Do you have a pouch now? From the same surgeon?
I know that we see 10 times more complaints of constipation than we do diarrhea. Were you taking the vitamins that tend to cause constipation? Calcium and iron?
I hope you have cured your diarrhea and accidents.
I do have a pouch now, from the same surgeon. This is the third time Dr. Deveney performed surgery on me and I have no complaints, really. Now I find he may have done the DS incorrectly which is very upsetting but I can't change the past. I never had constipation in my 8 years until after my revision. I am grateful that I have no more diarrhea. I was good at taking my supplements and my labs were generally good except a problem I had once with Vit D, which I corrected. Believe me, I wish I didn't have the diarrhea. It wasn't just that but I also had terrible fatigue which I think was from constantly going to the bathroom. I couldn't even count the number of times I went a day. I have heard of that happening to some other patients but most of them seemed fine. I don't want it to seem like I am putting down the surgery. It was my first choice. I guess I just picked the wrong surgeon to do it. For anyone who is considering having the surgery make sure you have a top notch surgeon. This is your life and you have to live with the results.
WLS 10/28/2002 Revision 7/23/2010
High Weight (2002) 240 Revision Weight (2010) 220 Current Weight 115.
I hope you are doing better now. And thank you for paying it forward and reminding folks of how important it is to have an experienced and successful surgeon do this procedure.
I don't know how you got talked into getting a pouch as I can't possibly see how that would affect your diarrhea.
You may now have a similar situation to what VitaLady has. Malabsorption that requires high protein and a pouch that limits the amount of protein that you can eat. That would be awful. I guess you must drink a LOT LOT LOT of protein shakes?
I don't know how you got talked into getting a pouch as I can't possibly see how that would affect your diarrhea.
You may now have a similar situation to what VitaLady has. Malabsorption that requires high protein and a pouch that limits the amount of protein that you can eat. That would be awful. I guess you must drink a LOT LOT LOT of protein shakes?
My common channel was lengthened to 200 I believe so I still have the DS configuration with a longer common channel. The diarrhea is gone thank God so for me it was worth it. I feel 100 times better. To tell you the truth I didn't care about the stomach but I was afraid to keep gaining weight so I decided to allow my stomach to be made smaller. I didn't get a resleeve because frankly I figured I had already stretched it out and could see doing that again. I never really felt much restriction anyway and always felt like I could eat too much. Since my main problem has always been that I eat too much I hope that having a smaller stomach would solve that. So far I do like being satisfied with the small amounts I am eating. I am good with my supplements and my labs have always been within normal ranges, except a problem with vit D that I corrected pretty quickly. I'm not doing great with protein, about 80 grams a day. Hopefully I will do better as I can eat more. I hate protein drinks so I only have one a day. Before I got all my protein from food with no problems.
WLS 10/28/2002 Revision 7/23/2010
High Weight (2002) 240 Revision Weight (2010) 220 Current Weight 115.
StacysMom
on 8/17/10 2:21 pm
on 8/17/10 2:21 pm
It sounds as though your surgeon made the sleeve too big to begin with. Did you know that they can make the sleeve in several different sizes? He probably gave you the largest one!
You don't have a "smaller stomach" like you think (and said above) -- you now have a "pouch", which operates in an entirely different manner.
I hate to tell you with, but the pouches always stretch out. So, do the stomas. There are even two endoscopic surgeries developed to correct this very problem, but they don't work (Stomaphyx & ROSE). Your food used to enter your intestines though your natural pyloric valve, not an artificially made stoma, Now that valve is out of the equation and when the stoma stretches out (as they all do), food will start going right through you and the feeling of fullness will be lost. You may be looking for a revision again (maybe even to the DS with a smaller sleeve this time).
Be sure and follow your pouch rules so that you don't stretch it out. You have no idea how many people I have read about who started gaining back all or part of their weight only a few years out from a VIRGIN RNY!! And, I've been reading these boards for over 3 years!
And, BTW, you don't have the DS configuration any more. You have the configuration of an ERNY. You can look up the difference online. There are diagrams. If I understand you correctly, what you have is a sleeve that has a pouch cut out of it, with the remainder of the sleeve free-floating inside your body - like the "blind" stomach of the RNY. Your pyloric valve is floating there along with it and your intestines are now attached to the pouch and food enters this new configuration via the man-made stoma, not your naturally occurring pyloric valve.
I have heard that the surgeon you used, unfortunately is not one of the vetted surgeons mentioned on the DS websites, so your original DS surgery was probably not done correctly in the first place. I hope this new surgery works for you.
You don't have a "smaller stomach" like you think (and said above) -- you now have a "pouch", which operates in an entirely different manner.
I hate to tell you with, but the pouches always stretch out. So, do the stomas. There are even two endoscopic surgeries developed to correct this very problem, but they don't work (Stomaphyx & ROSE). Your food used to enter your intestines though your natural pyloric valve, not an artificially made stoma, Now that valve is out of the equation and when the stoma stretches out (as they all do), food will start going right through you and the feeling of fullness will be lost. You may be looking for a revision again (maybe even to the DS with a smaller sleeve this time).
Be sure and follow your pouch rules so that you don't stretch it out. You have no idea how many people I have read about who started gaining back all or part of their weight only a few years out from a VIRGIN RNY!! And, I've been reading these boards for over 3 years!
And, BTW, you don't have the DS configuration any more. You have the configuration of an ERNY. You can look up the difference online. There are diagrams. If I understand you correctly, what you have is a sleeve that has a pouch cut out of it, with the remainder of the sleeve free-floating inside your body - like the "blind" stomach of the RNY. Your pyloric valve is floating there along with it and your intestines are now attached to the pouch and food enters this new configuration via the man-made stoma, not your naturally occurring pyloric valve.
I have heard that the surgeon you used, unfortunately is not one of the vetted surgeons mentioned on the DS websites, so your original DS surgery was probably not done correctly in the first place. I hope this new surgery works for you.
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