If I go from a VSG to a DS what are the potential side effects and changes?

I had a VSG almost a year ago.  I lost 100 pounds and really should lose at least another 100 (and I will still be a bit on the heavy side, but that's good enough for me).  The surgeon only wanted a VSG at the time - said there would be far less complications (my BMI was 66) and that after a year, maybe we would do a DS.

So, in the meantime, a social worker associated with the clinic has basically said going DS would be a very bad thing.  That loose stools and gas is so bad that people have had to quit there jobs.  Also that vitamins would cost me over $200 a month, and that I would have to be terribly compliant.

I am only losing about a pound a month right now, so it might be a good idea to do the DS.  At present, and for the last 10 or so years of my life, my biggest problem is chronic constipation.

So, basically, just how bad is life going to be after a DS?

I'm so glad you asked, because you have been terribly misinformed.

So, does Dr. Hong even do the DS?  I don't see him on the list of vetted surgeons at dsfacts.com, however there are several up and coming surgeons new to doing it that may come to the list later if their patients do well.

The social worker got 2 out of 3 facts correct.  The only truth she told you is that you have to be terribly compliant.  

If you go the route for designer bariatric vitamins, you may spend close to $200/month, but we do much better piecing together our own regimen for effectiveness as well as cost.  I spend around $40/month on my vitamins by taking advantage of  and stocking up on BOGO sales for the easy stuff I get locally.  There are a few that I get online, but you really don't have to waste your money on the bariatric specific products.

I know oodles of DSers in real life, and not one of them have ever had to quit their jobs because of gas or stools.  I have a giant poo every morning and I'm done for the day, and if I'm careful not to eat trigger foods that affect me, I have little or no gas.  I'm a corporate trainer, in front of crowds often, and never had an embarrassing moment.

Life after DS is great.  You make a routine to get your vitamins in every day and 100g of protein (food or supplements).  You're mindful of the simple carbs you consume, and the weight comes off.  I'm 7 yrs post op and have no complaints at all.

I've been living with my DS over 9 years now, and I have more trouble with constipation than I do with loose stool. I can have stinky gas if I over-indulge in certain simple carbs, but since I'm quite good at holding it, that's never been a social factor. And everyone's vitamin regime varies according to their individual lab results, but I certainly don't spend anything like $200 a month. $200 usually gets me six months' worth!

Good grief to what your social worker said. I started out with a band and revised to the DS in December. I am only a couple of months out and am probably still in the "my guts are adjusting stage" and I have yet to wonder what the big deal is all about. I suppose if you ate a bag of chips or a whole bunch of cookies or something like that you would have some bowel/gas disturbances.

I eat the same as I did with the band and have not noticed any big changes, other than the smell is a little worse. It is NOTHING that would prohibit me from working!! 

You will have to shell out money for vites and regular lab work (depending on your insurance) and that is a necessity. Mine do not cost anywhere near $200 a month, probably around $75. This is NOT optional.

As for as the ultra compliant thing. YES you will have to be that above all else. You will need to be able to explain your surgery to people in the medical community and how it is different than the RNY, take your vites DAILY, understand your labs, what levels need to be tested -- whether they are trending down or up and how and from whom to seek help from regarding any issues you may have. Basically YOU have to become very educated about the DS and be your own advocate. You cannot rely on someone else for this.

That said, I am very happy I had the DS and find compliance to not be that difficult at all.

I'm a 2 stepper (6 months out from getting switched) and I have to concur with Valerie and Ilovebeagles.  For the first few weeks you'll want to not stray too far from a bathroom (although by the time I was 2-3 weeks out I knew once my morning routine was over I was safe).

I do pay near enough $200/month for vitamins but that that's with customs and shipping which nearly doubles the cost of vites.  In the US you can generally get free shipping and no customs to pay.

I guess you may have diarrea if you eat carbs all day long, but so long as have a mainly protein diet then all's well and I really don't suffer with gas.  Vitamins are non negotiable - check out the Vitalady site as they do starter packs for DSers.

Thanks for the info!!!  I was wondering if I was crazy to be thinking about this - but obviously I'm not.  Dr. Hong works in Hamilton, Ontario and is THEE authority in Ontario.  There's not a lot of DS's done, but if it's to be done, it's him.  He also does the difficult transition cases from other surgeries.

I actually laughed when the social worker warned about loose stools, as constipation is such a big issue for me - maybe it would all balance out?

People who don't know what they are talking about should just keep their mouths shut.  My guess is that your surgeon doesn't even know how to do a DS or he would have given you one to start with to give you the best shot at achieving normal BMI.

When you find a real DS surgeon and read www.DSFacts.com you will find out the truth as well as from the vets here who know what it is like to have a DS from years of experience.

Try adding some Magnesium Oxide (capsules) to your vites.  That always works for me, along with upping fats, but you absorb fat so that isn't a good idea for you.

~Becky

Dr. Hong IS a real DS surgeon---one of only 3 or 4 in all of Canada.

First of all, great job losing 100 lbs !!!!

Many things can cause constipation. For me my hypothyroid, high protein diet, and lack of fruit and veggies are all responsible. I have had to take a cap full of Miralax daily to go at all. Since my gallbladder removal, all this has changed. I am rarely constipated. My diet now is to maintain my goal weight. More fruit, veggies, and carbs have loosened things up, no need for Miralax any more.

Gas:  Be a detective about what causes your gas reactions to what you eat. My biggest problem, gas producer was a fiber gummy with inulin. Once eliminated, rarely have any gas, even with carbs. Inulin feeds the gut bugs, good and bad ones, they produce the gas.

I have heard of many in Canada going to Dr. Hong for the D.S. Many Dr.'s here in the US have done the D.S. in 2 stages for high  BMI's, to help the fatty liver, and clear areas for better ability to do the precise surgery required for the D.S. 

Vitamins: Everyone here has given good vitamin advice. My labs are in good shape with just a few increases in single vitamins, I can find at the grocery store, or drug store. I use a multi bariatric vitamin 3 times a day, and specific additions for my low sections on my labs. i don't spend $200.00 a month, may be $50.00. Our insurance covers some pills- acid reducer, and prescriptions.

I would say the high protein diet required can be costly. Be prepared to have a few protein shakes a day to meet the protein requirements. I need over 150g protein a day. Unprocessed meat can add up, fish,  cheese,  whole cream, eggs, and Greek yogurt. Many make their own yogurt to save money. The food lasts longer, since your tummy is small. Get used to packing a few shakes a day for work, with protein snacks.

good luck with your surgery. I love my D.S., but it is not easy. Watching carbs, keeping them below 30 to lose is not easy. Analyzing how to get the scale into a down ward trend can be frustrating, even with the D.S. It is still just a tool, you have to work it, and exercise for results.

Thank you so much everyone.  You have given me some great information and I really appreciate it.