to ds or not to ds?

Insurance is requiring 6 months supervised diet and I'm about to lose my ins so looking at self pay which means no longer limited to just the sleeve. I have heard DS requires expensive vitamins and other nutritional requirements. Exactly how much hassle is all of this for you guys? I hate taking pills when I'm not good about taking them on time every day. while I can do a morning dose I am pretty much guaranteed to forget to do anything in the afternoon or evening. Looking to go to Dr Ortiz in mx as he did my band in 2007 (removed in 2012). Current bmi 43 plus sleep apnea. 

If you are not totally committed to taking the required vitamins for the rest of your life, then DS is not for you.  You will become malnourished and you will die without proper supplementation.  My Dr. explained that with other surgeries, it takes longer to reach that state but that with a DS procedure you can become severely malnourished in a month if you don't take your vitamins.  I'm still pre-op and what I am doing is going ahead and starting a vitamin regimen (it's good for you even if you don't have WLS) so that I get into the habit of taking them while I don't have to worry about malnutrition.  You should consider doing the same to make sure that you can commit to a vitamin program before going through with a DS procedure.  

Good idea to try before I buy so to speak. Exactly what would the daily regimen entail?

Roseygirl,

If you want a surgery that is better forgiving, because how challenging it is for you to change your habits DS is a good suggestion.  But I must alarm you, for me, perhaps not for all...because remember DS affects people differently.  But the DS in many ocassions FORCE you to behave, or you will regret the reprcauious.  For instant, I do not eat high carb meals, like corn bread, or large meals before I go on dates because I do not want gas.  I do not eat ice cream because I was lactose intolerant before the surgery, and if I eat milk products now...buyers beaware of being uncomfortable, gas, bloated, and sometimes diaherrea.

I must take my vitamins or my body will instantly start telling me something is going on...well it tells me, some people do not get warning signs.  If I do not take enough vitamin K, my fingers start to go numb, if I do not take enough calicuim my teeth look yucky gray and ginivitities kicks in. And the list goes on if I do not take my vitamins/supplements.  It is very important and should not be taken litely, plus it is definitely costly....any where from $100 - $150 per month.  However, like most humans we are good for adapting to are situation.  Right now I am trying to get a hold of stomach noises in this quiet office, however others do not have this problem...and its based on what I eat SOMETIMES.   

However I look marvelous darlin, and people THINK just how I look that I am an expert in this area because I look so good.  Now that can be annoying because I do not tell strangers about my business.

Ty sunshine. I feel that I probably need the help of the ds but what you are describing with vitamins is alarming. I think I may lean towards the sleeve and then judge layer of I need the added help from the switch. I appreciate your candid feedback. 

The sleeve is restrictive only, just like the band.  If the band didn't do it for you, it's likely you won't be happy with the longterm results of the sleeve either.  For longterm success, you have to accept you will be on a starvation diet for pretty much the rest of your life.  You know the drill.  Around 800 cal per day, low fat, low cal, low carb.  Plus since the diet isn't normal you need to take supplements anyway.

The proximal RNY combines restriction with a little malabsorbtion.  Our bodies adapt the best they can and by the time you are about 2 years postop the malabsorbtion is pretty much gone.  This is why some people have problems with regain.  Again, supplements are required.

The DS combines malabsorbtion and restriction.  We have so much malabsorbtion the body can never completely adapt.  Hence, the DS has the best stats of any WLS for longterm loss.  Our bodies also adapt as best they can.  This is one of the reasons we stop losing.  Once we reach that point the bounceback happens.  We usually gain a little back and then settle into our new normal.  This is why I always tell people to go 10% under goal in anticipation of the bounceback.  We have to supplement a lot and have labs done at least yearly.  Our postop diet is the most 'normal' of any of the procedures and eventually you can eat a normal meal.  We eat high fat, high protein, and low carb.  Protein and supplements are not negotiable.  If you are not willing to do this, the DS is not for you.

I don't believe your doc does the DS.  The only one I know of right now in MX is Ungson and he is excellent.

 Do you lose weight now when you diet and follow a plan? Only you can decide if you will lose weight simply by eating less, or if your body needs a metabolic boost to see results.  The DS give you a lot of freedom and the absolute best results for weight loss and maintained than any other surgery.  With that comes the price of taking charge of your nutritional health.  You need to learn more than the surgeon and nutritionist knows about what a DSer needs to keep healthy.  It doesn't have to be terribly expensive to take supplements (I spend around $40/month), but if you cannot commit to staying on a schedule of taking the vitamins, it can cause permanent damage and even kill you, so if you don't think you can take pills on a schedule, then don't get the DS OR the RNY.  Good results don't matter if you're dead.

Hi Val!  Could you please share how your vitamins are $40 per month, and where you shop?  I bought the 3 month package from vitalady and spent $350 (I did buy the prepackaged ones, so I don't mess it up) and those were a little more expensive.  TY!

My 2 cents, got for the DS. I too had a lap band and decided to go for the surest thing this time around.     We need to make changes with all surgeries if we want to be successful , right?    Make this the change you make , take your supplements. I do not believe in the I CAN'T, it is more like I DO NOT WANT TO. Vitamins are not expensive once  you do the math ( less then 50 dlls a month)  but taking them is important.  Just as I plan what you I will eat daily I plan to take my vitamins daily. Have a plan and follow it. Sleeve patients need to take supplements too, you know this right? Not as imperative but important for long term health too.  You brush your teeth several times a day, you bath daily, it will just become part of your routine.

 I did not do well with the band I did not want to have to do through a 3rd surgery, spend the money, lose another year of my life struggling to lose weight so  I went to MX for my DS.   

As everyone else has said, the vitamin and protein requirements of the DS are not negotiable. They are crucial for maintaining good nutritional health, and the requirements continue for the rest of your life. However, that doesn't mean that it's difficult. It's just a matter of knowing what you need, establishing a daily routine, and then DOING IT. Anyone who isn't willing to make this committment should not have the DS. Same goes for gastric bypass, though the vitamins involved are different and there are less of them. But the bottom line is the same: if you don't take the necessary vitamins and supplements, very bad things happen. they may happen more slowly with gastric bypass, but they still happen.

I've been taking those vitamins now for over 8 years. I knew about this committment before my DS and I accepted it. I am aware that there are some people who just will not take vitamins. This is something I don't understand, but it's real, and those people should not have any operation that will include malabsorption.

Having said that, you are already unhappy with your band or we wouldn't be having this conversation (don't feel too bad, the band has crappy results and a high rate of reoperation) and as Patty said, the sleeve is also a restrictive operation, so it is not likely that you would do well longterm with the sleeve either. That leaves you with operations that include malabsorption, which means you will need to be very serious about your vitamins. So do some soul searching, and be honest with yourself about whether or not you are willing and able to make that committment. If not, you are probably better off remaining as you are.

One last thing - I have never heard of your surgeon as someone who offers the DS, and that's in 9 years here and other websites dedicated to the DS. The only DS surgeon in Mexico most of us here would recommend is Dr. Ungson. He is very experienced with the DS, and his hospital also gets good reviews.

Larra