New Here...Considering DS after failed Lap-band

ElijahsMama
on 8/20/12 8:39 am
Hello all. I am new here, and newer still to the surgery called duodenal switch. This wasn't even an option when I was researching getting WLS done in 2007. I think I may have seen a brief page on it, but it was considered a radical and a very risky surgery. I was scared of by-pass at the time, because it was open...so I wasn't even entertaining the idea of something considered more "radical".
Fast forward to 2012....and I have gained all the weight I had lost and then some. I am at the highest weight I have ever been in my life. I have severe sleep apnea, and other SBO problems. I am 27 yrs old, and have a 3 yr old son. I want so desperately to get rid of the extra weight.
I see a lot of RnY patients getting revisions to the DS, so it makes me pause that perhaps getting by-pass isn't the best option either. I just want to keep the weight off. I never felt restriction with the band, and that was with more fill than the manufacturer recommended in my band. I not once felt like I was tight enough. I could eat everything, everyone else was saying got "stuck". (Yes, I know...just because I COULD eat it, doesn't mean I should have. But the point of the band is to make you feel full on smaller amounts of food, and I never felt it. I ate a band size portion, and stopped because I supposed to, not because I was full. If I was going to diet all on my own, I would never have had the surgery in the first place!)
Anyway....I have been researching the difference between the bypass and Ds and the biggest thing is with the DS there is no dumping. I like that idea very much, but then learn a side effect of this is that people may over eat carbs/sugar because they can. Sweets/carbs are my downfall. I LOVE sweets. So....how many with DS feel the carb munchies?
Next is people with DS often have fouler smelling gas and often get diarrhea a lot. What has been your experience?
My BMI is over 50, in fact it is 66, and the info I have read says that those with a very high BMI do better with DS than by-pass. Is anyone here a long term DS patient? Have you regained anything? Do you feel you made the right choice?
DS is a very complicated surgery, and not many DRs perform it. Luckily I have a surgeon very close by, who performs it, and takes my insurance. How many had to have the DS open? I am a big chicken, and don't know if I could go through the surgery if it wasn't laparoscopically done. What makes the surgeon do one way or the other? My surgeon does it both ways. (link to my surgeon http://www.obesityhelp.com/profiles/bariatric-surgeon/dr-mic hael-hill/procedures )
This is long enough...I will stop for now, lol. Thank you all for the amazing encouragment I have found so far on this site. It means so much to me. I know everyone is different, and my mileage may vary....I am trying to see averages and others experience.
Huneypie
on 8/20/12 12:33 pm - London, United Kingdom
DS on 07/24/12
Please take a look at DSfacts for more info.  This particular page compares RNY to DS http://www.dsfacts.com/Comparison-of-DS-and-RNY.html 

The DS offers you the best chance of long term success, as you lose malabsorption with RNY after ~18 months.

Carb munchies are hard, I'm only 4 weeks out so hopefully others can chime in.  Fear of gas and diarrhea are keeping me away from them to an extent (I've not tested any limits yet).

My surgery was lap and my recovery's been pretty easy.

Lowish BMI? See Lightweights Board! Lightweight Creed For more on DS see www.DSfacts.com
If you don't have peace, it isn't because someone took it from you; you gave it away. You cannot always control what happens to you, but you can control what happens in you John C Maxwell 
View more of my photos at ObesityHelp.comSleeve 2010 Dr López Corvala, Mexico. DS 2012 Dr Himpens, Belgium

I  my DS  

MsBatt
on 8/20/12 4:07 pm
The DS has been done since 1988, and that very first patient is still alive and well. (*grin*)

In the earliest years, the DS was considered riskier and more radical, and was pretty much reserved for people with a high BMI---which usually also means they're sicker and at a greater surgical risk for ANY sort of procedure. As more surgeons have learned to do the DS, and more insurance companies are covering it with the same requirements as other forms of WLS, it's become apparent that the asurgical risks are about the same for both the DS and the RNY.  (In other words, actual risk depends far more on surgeon skill and patient health than procedure type.)

Many of us find our tastes change after surgery, and we just don't like sweets like we once did. That's been true for me. And while we don't dump, we can have some distress from over-indulgence in simple carbs. But especially early out, if you're hitting your protein goals you really don't have ROOM to eat many carbs.

Malabsorption tends to cause fouler gas. This is true with both the DS and the RNY. (Go to the RNY board and search for posts about gas.) And no, the DS should never cause diarrhea---but sometimes an individual's eating habits can cause diarrhea.

There are a lot of long-term DSers out there, but mostly on other forums. OH doesn't like us very much. (*grin*) I'm 8.5 years post-op, and have had zero regain. I'm absolutely positive I made the right choice.

My DS was done open, but again, that was 8.5 years ago. Very few are done open these days, but even if the surgeon you choose prefers to do it open, don't let that be a deal-breaker for you. My open DS wasn't really any more painful than my lap hernia repair.

However---I'm not familiar with your surgeon as a DS surgeon. Might want to research him VERY throughly. The DS does require a lot more 'practice' than do other forms of WLS.
smileyjamie72
on 8/20/12 3:49 pm - Palmer, AK

I am an RNY to DS revision.

With RNY, I suffered from foul smelling gas and diarrhea.

Now, with the DS, I have foul smelling gas, and NO diarrhea.


Do NOT believe all of the myths of the gas/diarrhea with the DS!!!!
Lots of people who have the DS suffer with constipation issues.


Foul smelling gas..... that can mostly be controlled with what you put in your mouth (Carbs).  But since your intestines have been rearranged wwith the RNY and DS, your gas is going to smell.  Period.


RNY 2/26/2002                           DS 12/29/2011
HW 317                                     SW 263 BMI 45.1
SW 298                                     CW 192 BMI 32.9~60% EWL
LW 151 in 2003  
TT 4/9/2003

Normal BMI 24.8 is my GOAL!!!

 

 

 


 

 

 

GBP (RNY) 2/26/02 298 lbs, TT 4/9/03 151 lbs, DS 12/29/11
HW 317 SW 263 BMI 45.1/CW 192 BMI 32.9/GW 145 ~ Normal BMI 24.8
**Revision Journey started 3/2009 Approved 12/12/11**

JazzyOne9254
on 8/21/12 1:53 pm

Everybody's gas smells...DSer's just get a more pungent form post-op!

                                                          

HW 405/SW 397/CW 138/GW 160  Do the research!  Check the stats!
The DS is *THE* solution to Severe Morbid Obesity!

    

ElijahsMama
on 8/20/12 9:08 am, edited 8/20/12 9:17 am
OK...I have more questions...I hope I am not annoying anyone. Here is the list of questions I came up while reading through posts, and readinf dsfacts.com.

J-tube? How common is it?
What are dry vitamins?? How hard are they to find? How much do you spend a month on vitamins?
Protein SHakes? Does anyone just do generic protein powder? Or is there a better and more special protein powder for DS patients.
How have your taste buds changed since surgery? Crave more salty? More sweet? EVeryone different?
Post-op for RnY different than post-op for DS? How?
Pre-op vitamin regimen?
Anyone *****grets having the DS surgery?
Anyone have fidelis(insurance) and have the DS covered? Was it a fight to get it covered?
How do you know your surgeon is vetted?
Sandra C.
on 8/20/12 9:12 pm - Kalamazoo, MI
 Welcome to the D.S. forum !!!

Asking lots of questions is the best way to see if this surgery is a good match for you. I'm sure many others are at the same stage as you choosing surgeries. They will be watching your questions and answers for ideas too. Dont hesitate to ask anything here, we are all used to the most personal types of inquires.

I'll address some of your questions and let others more qualified answer the rest. First of all finding the most qualified surgeon is your top priority. Your life is on the table, in their hands. The surgeons here on the OH list who do the D.S. have good track records for successful D.S.es. There are less than 50 across the country who offer the D.S., thats why most people must travel to have the top docs. Visit several surgeons intro meetings to meet them, ask questions like how many D.S.es have they done, open and lap. Some will switch you to the other surgeries at the last min with excuses why its not good for you. They may say you need it in 2 parts-- the vertical sleeve gastrectomy being the first part. They may never offer you the second part- the D.S. malabsorbtion. Two part D.S.es are never as successful getting all the weight off as the virgin D.S. in one surgery. My insurance- BCBS of Mi would only pay for one WLS in a lifetime. That was my incentive to have the best most successful surgery the first time. Dont forget the D.S. preserves the pylorus for digestion, unlike any other possible WLS. I have my own system working like always, and the ability to take NSAIDS, not possible with a pouch. I sure need it with my aging aches and pains of arthritis.

I'm so happy I had the D.S. At one year out I am maintaining my goal weight within a 5 lb range up and down, doing great at maintaining now for 4 months. I reached my goal in 8 months. I do have a few sweet and carb cravings still, but dont like the heavy flavors either too salty or too sweet. If i do eat carbs, they fill me up way too fast making my stomach feel too full and uncomfortable. I know my surgeon is known for small sleeves, fine by me, I'll have less chance of regain. I can eat any kind of food, at any restaurant with out anyone knowing I have had surgery. No dumping, no upper or lower  GI upset. Minimal gas, so used to it now I dont even give it a thought. I am usually constipated same as pre surgery. I use Miralax in a drink rather than eating fats like a lot of D.S.ers. I just dont like fat. Tonight we all ate at Olive Garden, I had a little of everything, less than 1/4 serving of each- meat, pasta, salad w/ tomatoes and olives, cheese cake. Even though I feel like I ate the whole dinner, I always take home a box full. Our fridge is always packed with restaurant carry out boxes !! Eating a wide variety of foods is very healthy. I do use protein shakes to insure I get enough daily protein- 80-120g a day. D.S. Facts really explaines it all. 

The D.S. is very helpful  for WL along with making good high protein  food choices, hydrating with at least 64 oz fluid a day, and vitamins and supplements. It wont do all the work for you, you have to make the right decisions about choices constantly. Low carb, about 50g or less usually is advised durring the active weight loss phase. I tried to keep carbs at 20-30 untill goal. Carbs will slow or hault WL. Good to know in case you wondered how to stop the WL with malabsorbtion. I'm having fun eating all those usually forbiden foods, within reason of course. ;-)   ( along with a high protein meal).

Best wishes with your WLS search !!!

View more of my photos at ObesityHelp.com

Duodenal Switch- lap
Dr. Paul. Kemmeter Grand Rapids, Mi.
Dr. John  Renucci, Plastics, Body contouring,Grand Rapids, Mi.
Start 255/ Surgery wt 235/ Current wt. 117

BMI-20, 135 lbs lost, 5'3"

   

Huneypie
on 8/21/12 2:18 am - London, United Kingdom
DS on 07/24/12
You can get a 90 starter pack of vitamins from Vitalady for sub $350 inc free S&H here http://www.vitalady.com/cgi-bin/commerce.cgi?multiadd=action &msku0=1930X90DS&mqty0=1&msku1=1999XDS&mqty1=1 

Pre-op I just took a multi vitamin and had a 100g of protein, your surgeon may have different requirements though.

I don't thinkg I got a J-tube so can't help there.

Vetted surgeons are listed here  http://www.dsfacts.com/duodenal-switch-surgeons.html 

Lowish BMI? See Lightweights Board! Lightweight Creed For more on DS see www.DSfacts.com
If you don't have peace, it isn't because someone took it from you; you gave it away. You cannot always control what happens to you, but you can control what happens in you John C Maxwell 
View more of my photos at ObesityHelp.comSleeve 2010 Dr López Corvala, Mexico. DS 2012 Dr Himpens, Belgium

I  my DS  

route66hello
on 8/21/12 3:14 am - Half Moon Bay, CA
DS on 03/15/12
Hello,

I am a RNY Gastric Bypass revision to DS. I had the J tubes with both surgeries. They usual come out with 10 days as long as there are not complications. I had to have an open revision so the recovery was quite different.

The vitiams are not hard to find. There are several online sites which sell all you need. www.vitalady.com is a site to check out. There are lots of vitiams post-op that you need to move toward taking.

You want to look at the dsfacts site since there are only very few vetted surgeons for revision surgeries. You might want to tell use where you live. I used Dr. John Rabkin who is in San Francisco.  His site is http://www.paclap.com/ and has a lot of great information. His practice it totally setup for people to travel to him.

Best of luck! Terri

MsBatt
on 8/21/12 9:38 am
I did not have a J-tube.

'Dry' vitamins are water-miscible (dissolves in water) forms of the fat-soluble vitamins A, D, E, and K. They're not usually found on the shelf at Wal-Mart, but they're easily bought on-line. Just how much YOU will need to spend per month on vitamins is going to depend on exactly what YOUR body needs, and you won't know that until you've had some lab work done. *I* spend about $40 a month, some people spend a lot more.

I don't do protein shakes, but I have no trouble eating 125-150 grams of protein from food daily.

Yes, my tastes have changed. AS I said earlier, I don't crave sweets like I did pre-op, but I do crave things like pickles---and bacon! (*grin*) I eat---no, I CRAVE---things now that I wouldn't touch pre-op, like cole slaw,  deviled eggs, and tuna salad.

Well, I've never had an RNY, but certainly everything I've read about post-op lifestyle tells me there's a BIG difference.

Sadly, no, I didn't take vitamins pre-op, and I wish I had. It's always a good idea to push vitamins into the optimal levels pre-op, and to push protein as well.

There's a list of 'vetted' surgeons at www.dsfacts.com This is not actually some sort of formal accreditation---it's simply the accumulated wisdom and experience of many, many DS vets. It's not fool-proof---new surgeons get added to the list when they have done enough procedures with an acceptable rate of good, successful outcomes, and surgeons get removed if they start messing up. Think of it like the BBB, except that you have to get positive input to get on the list.
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