Need help. Have Lapband, considering sleeve or DS

Hello everyone...I'm new to the group and I need some opinions based on your experience.

I had a lap band placed in 2008. No critical problems, just either too tight or too lose, could never dial it in. Lost about 40 lbs and regained it all plus a little for good measure. I'm male, 54, 5'11 and 265. BMI is roughly 36.5. I have sleep apnea so insurance isn't an issue.

I saw my DR, and he recommends DS after band removal, done with two surgeries, and he suggested keeping the common channel a little longer than normal because I'm not too big...lol.

I've reviewed all the information and perused the forums. I am hung up with the issue of having malabsorbtion of vitamins/minerals for life. I heard that after about 5 years the data on both merged,as the calorie malabsorbtions returns almost to normal with DS, but the vitamin malabsorbtion remains for life. I know with the sleeve vitamins are a must too....I am just worried about the nutritional malabsorbtion and possible diarrhea issues with the DS...and is it too drastic for my size.

I guess th question is R U willing 2 take vites every single day 4 life ?

Its really NOT a jail sentence.... just what U HAVE 2 do following a DS or an RNY .

????

I?ll also dare say that most surgeons ? measurements ? for the ? correct ? surgery r WAY off.

Because they?re thinking about the likelihood of you surviving the surgery statistically.... whereas you?re trying to achieve a ? normal ? weight beauty of course and long term health.

Their idea about goal weight and yours may literally differ 50 lbs or more.

I certainly am able to commit to vitamins for either sleeve or ds...I'm just concerned that there may be other issue such as diarrhea, or many bowl movements per day etc

Please continue your research. I am 18 years following a full DS and I still experience significant malabsorption. Everyone is different so you're never going to hear two stories that are the same. If you do decide on the DS and do it in two parts, you can see if maybe the sleeve alone will work for you. Remember the sleeve is just another restrictive surgery.

There's a version of the DS called the SADI, which I think is what they call what you're describing - a longer common channel. Just remember that as malabsorption disappears, so does your ability to keep the weight off. At 18 years post-op I do not diet at all. I eat normally for someone who has a DS. Capacity-wise, I feel I have the capacity of a "normal" person - definitely not what I ate pre-op but more than post-op.

I eat a very high protein diet, eat full fat everything, drink lots of water, take all my vitamins, and watch my carbs. Carbs, for me, is where I lose and gain weight, period. Too many carbs, I gain weight (and deal with other DS-related issues - gas, bloating, loose stood, etc.), but I do love my sweets. However, if I don't eat enough carbs, I lose weight. Sometimes I simply don't want to lose weight - yes I can say that at this point in my life :) The main thing I've learned in almost 20 years is to listen to my body and eat appropriately for me.

I get labs done once a year. I take the full complement of vitamins and supplements to maintain "normal" ranges. I have a great primary doctor (after years of shopping around). I have osteoporosis so I'm currently being treated with Prolia. I've also battled iron deficiency anemia almost since the beginning. Again, working with my doctors, I'm able to maintain a normal iron/ferritin with diligence, regular testing, and periodic infusions.

Good luck with your research.

DS seems a bit extreme for someone with a BMI of 36, but then, I'm not your doctor, so...

diarrhea isn't that common with a sleeve (i.e., if you have it as a standalone surgery). Most people with sleeve (or RNY) have the opposite problem - constipation. Diarrhea IS more common with DS, but I think there are ways they can control that (the DS'ers here would know - I don't since I didn't have DS)

No one can predict how your body will respond to the surgery. They can share their experiences, but cannot guarantee what your experince will be.

I have always considered the worst case scenario and then planned for how I would deal with it. If I can see myself managing that scenario, then I usually will go ahead with the action. If I do not experience the worst outcome, I consider that a bonus.

I have been on this site since 2003. At one time, there were a lot of people with DS. There were DS'ers who lived with chronic diarrhea. They made many, many bathroom trips a day and some wore diapers. Some people ate enormous quantities of food and had to purchase better toilets to handle their waste.

I remember people who had problems at work because they kept the office restrooms smelling so bad. Some had constant farting that they described as able to clear the room and strip off the wallpaper.

My sister is an attorney. She had someone who wanted to sue their surgeon because after weight loss surgery no one wanted to work in the same office with them and they were forced to work from home. I do not know which procedure that person had and my sister did not take their case. That person could not stop passing very smelly gas.

I also remember people becoming extremely ill because they would not take their supplements.

With DS, you have fat malabsorption for life. If you eat carbs, you will absorb the carbs.

With RNY you have calorie malabsorption for a few years, but it is mostly gone by the end of year three.

With both, you have vitamin malabsorption for life.

You are right to have concerns about your body after any weight loss surgery.

I had RNY in 2007. I no longer absorb oral iron and get infusions. I am always dealing with diarrhea or constipation issues. I almost never had any issues like that before surgery. RNY resulted in weight loss as well as health issues.

For me, the potential risks of DS would not be something I would risk with a 36.5 BMI. The DS at one time was only used for people with BMI over 50.

You already know that lapband did not work for you and a sleeve is basically a more convenient lapband. It gives you only restriction and every calorie you consume is absorbed. You control your weight by controlling your food intake.

RNY gave me malabsorption that made it easy to lose my weight. After RNY malabsorption ended, I control my weight with diet and exercise.

I have had times when I ate more than I burned and gained ten, twenty, and even thirty pounds over my goal weight. I was not doing anything like eating big meals, but was snacking and eating things with too much fat and sugar.

I have always gone back to counting calories or Weigh****cher points, exercising more, and getting the weight back off. For me, the surgery took it off and dieting keeps it off.

I had the RNY in 2001, I have never had any malabsorption problems whatsoever. I think if you believe the worst you can bring on the worst to yourself. I had the surgery in 2001 and have been maintaining weight loss for life. Now that I'm over 50, I have to be careful to eat less than when I was in my 40's and my bloodwork has been great every year of my life for over 20+ years now.

Sorry to sound so dumb but what does DS stand for?

Duodenal switch