Advice to a newbie on Biliopancreatic Diversion With Duodenal Switch

I eat ALL fats---bacon, butter, sausage, well-marbled steaks, you name it. I think that was a typo about the calcium---we all take a butt-load of calcium EVERY DAY. Carbs are the primary stink-factor for most, but *I* get some seriously bad gas if I over-indulge in onions and peppers. (I LOVE them marinated in Italian dressing, then grilled.)

1) The bowel habits, in my experience, are irregular at first, sometimes very often, sometimes stopping for a while.  Your gut has been manipulated and altered to a new configuration.  The first year after surgery is called the "maturation process".  You will have to pay attention to and learn your own body signals, as everyone is different.  It took about a week for me.

2) Again, this depends on the individual.  You can expect multiple bathroom visits to be irregular at first, but by the end of the first year, many people go about three times upon rising, and they're done for the day, unless there's a simple carb or simple sugar involved, then, you might get the trots. As for the man purse, that's your decision.  When my DS was new, I kept emergency supplies in the trunk of my car.

3) You heard right.  The smell is awful.  There is an over the counter medicine called Devrom which you can take, that effectively makers poop nearly, if not completely odorless.  I use the capsules on an as needed basis, like when visiting someone else's home, or at gatherings with a lot of people.  I don't take them daily, but some do.  That will have to be your decision.  They are not readily available in stores.  You can order them online through the manufacturer, Parthenon, or you can look on eBay, Amazon or any other online store you might know of. The chewables are banana flavored, the capsules, which I favor, are clear with powdery substance inside. You can also buy Ozium in most auto supply stores and mass merchandisers' Automotive department.  It works very well, and the original scent (dark blue can with white lettering) is actually closer to unfragranced, but it kills the smell

4) I didn't notice any difference.  If you have open surgery, you might favor one side or the other, or walk a little slumped over at first.  With lap, I don't think it's that bad.

5) "pin levels" is not a term I'm familiar with,  but  I think you mean pain levels post-op.  Frankly I had very little pain, even though my surgery was open.  My surgeon ordered a self administered morphine pump for the first two or three days post op, while I was in the hospital. 

Remember, I have based my answers on my own experience.  I am not a medical professional, but many of those have no clue when it comes to the DS. 

Keep asking questions of the vets here.  You'll get lots more information about the duodenal switch that way, and you can treat it like all information - use it, or not.  All up to you.

Hi Jason,

I'm 18 months out hopefully your experience will be as easy as I think mine was.

1)   First 6 weeks you may need to go urgently after you eat but I think only once did I have to go so quick
I didn't make it to the bathroom and I attribute that more to just recovery than anything else>

2)  I am in the 2 or 3 times a day category. This can vary depending on how I am eating. A lot of chips or
sweets can keep me on the john 5 or 6 times. 

3) It can smell bad. I would guess mine smells extra bad half the time. Usually not so bad during the day
as it is first thing in the morning. A pocket size can of deoderizer can't hurt but won't be necessary every time.
I'm a quick and multiple flush guy when I go in a public restroom. Again - some of this is avoidable with food choices
and a good pro-biotic can sometimes help.

4)  Nothing was different after I healed. I'm a side sleeper and I couldn't sleep on my side for 6 weeks after surgery.
I spent that time sleeping in a recliner although a lot of people just prop their stomach with pillows. For the first year
I heard more gurgling in my stomach than I ever did before. Just like water going through pipes but that eventually
died down and now just happens once in a while.

5)  It is major stomach surgery. I was in the hospital 3 days and took every pain med they offered. WHen I got home
I took a quarter of the dose they prescribed and was fine with that. I had no ongoing pain there was just one point between
getting up and sitting down that caused a lot of discomfort. I was off all pain meds after 2 weeks. It kind of felt like I 
remember my stomach being sore from too many situps in high school.

Keep asking questions. Research helped me avoid total panic pre-op. 

At this point I'm on a good schedule with my vitamins, BM's, and looking to lose the last 25-40 pounds.

It doesn't fix everything but it fixed a lot for me.....

Pete

1. How soon after you eat do you need to go poop? I have this image of only making it to the bathroom like 50% of the time and exploding the other 50%.

2. How many times a day will I have to go? Should I carry a man purse now with toiletries for emergencies and spare underwear?

3. I was told that when you do go #2 it smells god awful. Will I need to tart being extra conscious of this start looking for water sanitizers to mask the smell?

4. Will I feel any different; meaning will i notice my plumbing has been rewired and it makes me lean to the right or walk different or anything like that?

5. What can I expect for pin levels right after the surgery and how long did they typically last

I will have many more questions as these are answered but honestly I just want to know what I am getting myself in to from those who have already gone through it. Any advice will be incredibly helpful. I ask with love and respect and fear.

Okay, while I was on just liquids after my surgery, it was liquid in, liquid out and very quick sometimes. ONCE I started soft food, AND my vitamins, things firmed up. I go first thing in the morning and depending on what I am eating is directly related to how bad it smells. Carbs make me smell worse than protein or fat. But my typical day is once first thing in the morning and MAYBE 1-2 other times during the day.

My husband and I (both DS'ers and both heading into 4 years out) do not carry extra stuff at all. The ONLY thing I MIGHT have in my purse are wipes due to my husband's (LONG before the DS) history of anal fissures. So, no, no "man purse"

It CAN smell awful but it also depends on what you eat. Carbs, sugar alcohols (esp those ending in itol) are the worst offenders. But then again, **** smells.

LOL, honestly other than having your guts TALK a bit more, I felt no different. Mine has a voice of it's own if I feed it tomato juice...good God almighty, it can be loud...BUT no, you won't feel different ONCE you are healed.

Pin??? You meant Pain??? That is individual. I've had other surgeries that hurt far more. What is true for me will not be true of others. But TYPICALLY you will feel like the DS Welcome Wagon which is an 18 wheeler hit you, backs up and hits you again. But once you get past the first week or so, most of us are fine...tired still but fine.

I am coming up on 4 years out and would do it every year if I HAD TO...best thing I ever did.

Hi Jason, I know its been a few days and you have received some great responses. I thought maybe I could help as well. I am about 4.5 months out now. 

1. How soon after you eat do you need to go poop? I have this image of only making it to the bathroom like 50% of the time and exploding the other 50%.

Ah exploding. This actually has happened to me - BUT - it was not necessarily related to my surgery. I got an infection, was given amoxocillian, got C-Diff, and that led to EXPLOSIVE problems. There was A LOT of urgency and I had C-Diff for about 6 weeks. 

Since getting better though, I find that I poop in the morning and in the afternoon. I was a 2 BM a day prior to surgery and that hasn't really changed. I have noticed that if I go in the morning it's typically about an hour after getting up and moving, and its just like before surgery - Meaning I'm not running to the bathroom.

2. How many times a day will I have to go? Should I carry a man purse now with toiletries for emergencies and spare underwear?

Again, after I got over C-Diff I didn't have any need to carry extra supplies. I did however discreetly carry a hospital pair of disposable underwear in my purse for a while in case I needed it, but I never did.

3. I was told that when you do go #2 it smells god awful. Will I need to tart being extra conscious of this start looking for water sanitizers to mask the smell?

My husband and I get a kick out of the fact that my poop smells worse than his now. I call it "protein poop" because it really does smell different than before surgery. I don't care how it smells, at home my husband can get over it - thats why there are fans. And when i'm in public I'm not really going #2 - see above.

Now, if I was super conscious about it, I might get some devrom or poopori, but I'm not. 

4. Will I feel any different; meaning will i notice my plumbing has been rewired and it makes me lean to the right or walk different or anything like that?

Nope, not at all :) No one will know but you, and your Dr, and after you die if they do a full autopsy. 

5. What can I expect for pin levels right after the surgery and how long did they typically last

This questions is really going to be dependent on you. I was in the hospital overnight. I did not have a pain pump as I have seen others had. I got pain meds ever 4 hrs. I wanted out of the hospital and wanted to get home! When I got home I managed the pain with liquid percocet and oxycodone and then nothing. After a week I stopped all pain meds. Now, I still hurt. I tried to describe it to a few people, and the best description I could come up with was "It feels like parts of my insides have been rubbed up against a cheese grater". It is manageable pain, but it is not pleasant. I also couldn't sleep on my stomach for about 3 to 4 weeks, which was hard since I typically sleep on my stomach. 

Feel free to ask me any questions. I'm an open book. Best of luck to you :)