Considering DS

Ive been seeking WLS for several years now....lots of roadblocks. I have considered just about all of the surgeries I think. At this point, Im hearing more about DS. So, now I think I should take another look around and see what DS has to offer... So, any advice, etc...is needed and appreciated. I had been planning on the Sleeve but I dont want to have it done, then have to go back for the DS. I want one surgery that cures it all...lol..ok, yeh, I know WLS is not a cure-all...I was trying to be funny. All of this is overwhelming me now and Im not sure where to turn. Ive posted my problems with WLS and finding a surgeon on other boards...its also on my profile. In a nutshell - I have a BMI over 70 and 2 surgeons so far have told me to lose upwards of 50 lbs b4 they would do the surgery on me. So, I have been looking for a surgeon that wont require that weight loss. Its been hard to find. I have turned to the Mexican docs, which seem to be a good option...but I would truly rarely stay close to home. But I will go only to a surgeon who doesnt require the weight loss Anyway...Im here to learn more about the DS from those who have had it. Ive been to the website...as a nurse, I know the procedure..but as far as the aftermath, what should I expect? Is the malabsorption issue difficult? I guess thats what worries me most.

I'm pre op but I'll tell you why I'm having the DS.  I had gastric stapling and will be a revision.  I didn't want a stoma where food can get stuck, nor did I want to run the risk of ulcers later on when I may need anti-infamatory drugs.  Dumping is just not something I want to have to do...ever. The stats show that the DS offers the most weight loss and maintenance of weight loss.  Many DSers can eat just about anything after a year or more out.  They enjoy steak, chicken and even some can eat sweets.  That all depends on the individual. With a DS you have to commit to a lifetime of supplements...there are no if, and or buts about that.  You MUST or you will get very sick...remember the malabsorptive part of the surgery. Keep looking for a surgeon who will do you DS in one operation.  I think there are some out there.  Of course it may have to be open but many on this forum have had open surgeries with no problems. I wish you the best and ask any question here.  Nothing is too personal.  Oh yeah, I went to a party Thursday with a bunch of DSers...nobody smelled bad, had gas or had to run to the bathroom to poop.  Much of the printed material about bowel issues is blown out of proportion. Betty

thanks Betty. I appreciate your reply... Im gona keep looking..

Welcome Lisa!
                        I love your avatar! You have such a pretty face.
California surgeons are probably going to be your best bet. They are used to dealing with the 10% weight loss rule and California's DMHC doesn't think it is necessary. Your insurance has something to say about it, but, in CA you can fight it and win and not have to do it. Dr John Rabkin did mine and nothing was ever said about the 10%.

Thank you so much Debbie ..makes me feel good. I do actually like that pic....its just a face pic...everything below my chin, id just as soon delete though.. Im in Arkansas, so I think CA is a bit far for me to go. I dont have to worry about insurance really. I only have Medicare, which pays for DS in some states. Otherwise, Im self-pay.

Regarding Medicare- they paid for mine in Oregon at center for excellence OHSU Portland, and even if you had to travel & stay awhile wouldn't it be cheaper than self paying elsewhere?

You've come to the right place! With your BMI, I believe the DS would be the best option for you. The DS has been found to be more effective...especially with people who have a BMI over 50. Here's a link to an article about it: http://www.medicalnewstoday.com/articles/53163.php  I also think the sleeve is a good surgery; but with a BMI over 50, your chances of losing enough weight to put you out of a "morbid obesity" category is much slimmer without some malabsorption as well as Calorie restriction. I understand your concern about malabsorbtion. It's extremely important that you be consistent about taking supplements. As long as you are consistent with supplements and having your blood tested once a year, the malabsorption issue is definitely manageable. When people don't take it seriously, however, they get in trouble. The RNY also requires strict adherence to taking supplements, but unfortunately, I believe they sometimes don't take it seriously enough. Bottom line: you probably have to take supplements no matter what procedure you get. (Even procedures that don't have malabsorbtion still limit the amount of food that you eat so that you need to make sure to supplement as needed.)  Make sure you check out this website: http://duodenalswitch.com/index.html There's a list of surgeons who do the duodenal switch. This is a good list to use because the person who maintains this site makes sure that the surgeons listed on the site definitely do the DS. (Sometimes surgeons claim to do the DS, but then they try to talk you into another procedure.) This is also an excellent site to get more information about the DS.  As for whether you will be required to lose weight prior to surgery, different surgeons have different requirements. You'll have to find a surgeon and discuss it. It's always a good idea to try to lose as much weight as possible before surgery because it will help the surgeons get access to your insides...and it will help with the recovery as well. So it's a good idea to try your best. (I know it's easier said than done. ...We've all been there.) There are out-of-country options as well. Many posters on this site have had absolutely wonderful experiences with some out-of-country surgeons. I'm sure some of them can give you some recommendations. And of course, you can ask as many questions as you'd like right here. We are not shy about discussing anything here. Welcome!

Okay, I just read your profile, and I see that you DID successfully lose some weight. Congrats! I know how hard that is. I don't know what I would have done if my surgeon made me lose 50 lbs. Considering how hard you've tried, I understand why you're looking for a surgeon who doesn't require the weight loss. I definitely think you should contact some DS surgeons and see what they require.

Thank you, Dreamy.....Yes, Im beginning to really think DS is my better option, considering my current weight/BMI. I really dont want additional surgeries...except plastics ....I will have a ton of loose skin someday....i cant wait to see that lol I am going to check out that website again for the doctors. I know of a few who do it and accpet my Medicare...I will just have to find out about the weight loss issue...otherwise, I will be traveling to Mexico...it would be nice to be able to stay in the US...but I will do what I have to I guess...im sicking of being almost 400 lbs

Hi Lisa!  Good for you checking out all your options.  There just aren't that many experienced DS surgeons.  A lot of us travel for surgery.  With your BMI, the DS is your best shot at getting down to a normal weight.....and staying there.  But you will need to do your part and exercise, avoid carbs during your window.  Of course you will need supplements at least a couple times a day for the rest of your life.  That's not optional.  If you can't or won't do the supplements, please don't consider the DS any further. One day I was talking to Dr. Aniceto Baltasar in Spain and here's what he said comparing the various WLS procedures.  "I can give you a tool or I can give you a cure.  Which one do you want?" The best thing about the DS is the normalcy of post-op life.  Yes it rules your life at first but down the road it's amazingly normal. Best of luck to you whatever you choose.