My endocrinologist discouraged the DS

Forgot to mention:  I have a genetic anemia thing going on and have had it my whole life.  It left me RIGHT AT THE BORDER of "anemic."  The DS...because, I guess, I ate/eat less...was just enought to have me dip down below that line. 

So in my case, I had spent almost 60 years being "borderline anemic."  The DS, because we finally started doing routine labs and paying attention, got me the iron I've needed forever.

Thank you for the responses.  My endocrinologist and surgeon are both professors for the medical center I'm going through.   Their specialties are obesity/bariatric surgery (surgeon)and diabetes (endo).  I think they "must" be somewhat educated.   My surgeon said he would perform the DS on me but wanted me to talk with my endocrinologist first.....she will be following up with me regularly after the surgery and he won't.   So, I don't know if he knew she would (try to) talk me out of it or if he really thinks I would be a good candidate for the surgery.   I don't have the exact numbers yet but the resident doctor assisting with my case said they've done "hundreds" of DS surgeries over the years but they are still a small percentage of overall bariatric surgeries.  

That being said, they did agree with what the dietician told me about my nutrition/vitamin supplements after surgery.  They said protein shakes are not ideal and they would want 100% of protein coming from foods after the first month.  They said calcium carbonate is what they recommend over calcium citrate because even though you absorb less of it, it is easier on your stomach and you do absorb enough to be effective.  In addition, 2 vitamins daily and a monthly Vitamin B12 shot should be all I need.  A low fat, low carb, low calorie diet would be needed for the rest of my life (as with the other surgeries).     Maybe this is why they see issues in their patients?

All of the people I personally know that have had the RNY surgery have regained a significant amount of their weight back.  I personally don't know anyone with the DS but there are a few people on this forum that have had the DS through my medical center so I'm going to try and reach them to see what their process was like.  


I also just received this email from the resident doctor working with me:
 

"With the RYGB, the average weight loss is 37% of initial body weight at 1 year.  The risk for weight regain begins at year 2, often related to non adherence to the recommended activity (150 min activity/week).  By year 10, the SOS reports (nonMayo data)  an average weight loss of 25% of initial body weight.  So they have regained about 10% of their initial body weight.  The DS the average weight loss at year 2 is 40-50% of initial body weight however the long term risk is not weight regain, those patients tend to maintain their weight loss but the array of nutritional deficiencies they often develop.  DS has a rate of reversal of 2% per year.  I personally know of two within the past 6 months that have required reversal or revision because of malnutrition."
In summary, there is about a 10% greater weight loss with DS over RYGB, but their complications are higher, sometimes requiring reversal. It is a difficult decision to make, but again, lifestyle changes are going to be the key to success regardless.

"That being said, they did agree with what the dietician told me about my nutrition/vitamin supplements after surgery.  They said protein shakes are not ideal and they would want 100% of protein coming from foods after the first month.  They said calcium carbonate is what they recommend over calcium citrate because even though you absorb less of it, it is easier on your stomach and you do absorb enough to be effective.  In addition, 2 vitamins daily and a monthly Vitamin B12 shot should be all I need.  A low fat, low carb, low calorie diet would be needed for the rest of my life (as with the other surgeries).     Maybe this is why they see issues in their patients?"

What I highlighted is indeed disturbing. No wonder some have had to be reversed or revised. No wonder they are seeing so much problems with nutritional deficiencies. That is all wrong, as I am sure you are aware. And I have never needed to use B12 shots. 

OMG, if that's what they are having their patients follow, no wonder they had to put someone on TPN. 

I think you've learned enough about the DS, that you know you need ignore most of what they tell you, right?

"...those patients tend to maintain their weight loss but the array of nutritional deficiencies they often develop.  DS has a rate of reversal of 2% per year.  I personally know of two within the past 6 months that have required reversal or revision because of malnutrition." 


My reply to that is "So what?" Worst case scenario you develop nutritional complications and they take down your DS. Best case you don't have regain, you can eat like a normal person, and you don't have stoma blockages, grehlin, etc mucking you up. And I don't think you can say in one breath they "must be educated" and then in the other breath that they are recommending such stupidity as not supplementing protein, insufficient vites, etc. Since their OWN WORDS have shown you they don't know what they are talking about, why even bother with what they have to say. 

I know personally (as in IN PERSON) about 15 DS'ers some of them long term whose labs contradict what your physician just told you. Online? Hundreds. 

Will there be people who, like Newyork***** find themselves with nutritional deficiencies even doing everything right? Yep. Will there be people who have serious bowel complications? Yep. That risk is right around 5% or so based on some of the studies (some as low as 2%). It isn't all roses. But comparing surgeries to surgeries? IF IF IF you are going to be on top of your health and your labs? No contest. Get the DS. And consider telling your endo she's a moron. (nicely). LOL

Who the heck is your surgeon?  I would be very worried about the kind of info they are giving you for the long term.  Not good at all!

My surgeon is Dr. Kendrick at Mayo Clinic.  However, he did say he'd do the DS but wanted me to see my endocrinologist first.  He's done the DS surgery many times but normally with patients with a higher BMI.     His words about the DS were, "we could certainly do that, you'd never have to worry about weight issues again.  Sometimes patients can lose too much weight and that can be a concern.  I'd be happy to do that if it's what you decide, it's a bit more complicated surgery wise but would only involve more time for me and that's fine." 

It's the endocrinologist that I'm getting a big NO from.  And she's the one I'd be following up with after surgery.  

Why would you follow up with an endocrinologist who doesn't know HOW to do DS followup and who apparently has such a horrible record that patients have to be revised after her lousy care? That's silly. Go find doctors who have a clue about the subject.

Have you been to www.dsfacts.com ?   Your docs are not quoting accurate  info. Bet they are not vetted in the DS. I see you do not have the surgeon's name by your name.

I would type more, but exhausted, it's been a busy week h ere. You better keep researching! Sorry if that sounds abrupt.... if you have researched more you would know their numbers are off. Google Dr Dougless Hess as well.

Find a vetted DS doc and consult with them and see what they say.