How do you like your DS? Please share your thoughts

Hi,

I have been looking into WLS for the past 10 years. 

Now I'm 37 year old after 4 kids, my weight has ballooned to a BMI of 51 ;(

My first choice of surgery was the Sleeve until now where my BMI is too high for it and my Surgeon wants me to have the DS since I also have a very large hiatal hernia. 

I am concerned about the risks of malnutrition. 

Your thoughts please? 

This may sound strange, yet I liken my DS to fire. Fire is only bad if allowed to go uncontrolled. Many good things are the result of fire & I have had many good things due to my weight loss from undergoing the DS.

Thanks for your reply, I'm having trouble understanding how the DS surgery can be uncontrolled. Can you explain that? Thanks so much! 

I was using "uncontrolled" to describe fire. Fire can be risky or safe. The DS can be dangerous or a disaster, just as fire can be safe or disastrous. I wouldn't use "uncontrolled" to describe the DS so I'm sorry for the confusion.

The DS, as well as the traditional by-pass, poses a risk for malnutrition due to the malabsorption component. Both require diligent monitoring by regular lab tests; both require some degree of supplementation also due to malabsorption. Knowing the risks helped me make the decision for the DS. Yes, it is slightly more risky than the RNY, yet for me it was significantly worth that extra risk.

I get labs done every 6 months and adjust my supplementation and diet accordingly. A case in point: I retired slightly more than a year ago. In a year, I had lost 20 pounds. All my labs results were good, so I looked at my diet. When I closely examined what had changed, I realized I wasn't *stress eating* so many carbs as I was when I was at work. By not stress eating those carbs, 20 pounds came off in a year! Plus I wasn't eating as regularly as when I was working since my routine had changed so drastically. Now with a new routine, my weight went back up 10 pounds & I am content with where it is now. 

forewarned is forearmed

saying

› said to mean that if you know about something before it happens, you can be prepared for it  

Do your research and examine yourself. Decide what is best for you. I knew the risks as well as my strengths/weaknesses and was prepared to take those risks. I am 7 years out and wouldn't change a thing.

The DS requires a good deal of care and feeding, much like a toddler.  It can get very cranky if you give it something like carbs or sugar or wheat. The gas can be horrific. It can be the sweetest thing because you'll lose the excess weight and people will notice. The DS can be very different for each of us, so you have to find what works best for you. What works for me is staying low carb, continue to use protein shakes instead of food a lot, taking vitamins according to Vitalady and adjusting those when my labs come in, and being very aware I'll need a private place every morning to clear my system out....lots of air freshener. 

--gina

Fifteen years ago, at the age of 50, and with a BMI of 60, the DS was the best option for me to lose the excess weight and keep it off.  I was essentially housebound, barely able to walk, required oxygen, had hypertension, diabetes, asthma, and sleep apnea.  The surgery gave me back my mobility, eliminated serious comorbidities, and most likely saved my life.  I have had some complications over the years, but I have no regrets.

My sister had a different procedure the same year, and has also lost and kept off her excess weight.  She has fewer nutritional deficiencies than I do, and when they arise they are more easily remedied with supplements.  However, some of her comorbidities did not resolve completely with that surgery, and she has to diet to maintain her weight loss.   In comparing her experience to mine, here is what I like about the DS:  No dumping syndrome.  I have a functioning stomach, not a pouch, so food does not get "stuck."  I can drink with my meals. I can eat relatively normally; I don't worry about restricting any foods other than carbohydrates.  

Speaking strictly for myself, troublesome things I encounter include: malabsorption of necessary medications, difficulty maintaining iron levels, hair loss, overall dryness (skin, mucous membranes) due to not absorbing fats, and slightly increased flatulence.

It is true that malnutrition can occur, and that is why if you decide on the DS you must be willing make a firm commitment to taking supplements, eating low carb and high protein, and having periodic blood work for the rest of your life. 

Best of luck in your WLS journey.

You are so very fortunate to have a surgeon who discussed different options with you in stead of just doing whatever was easiest and leaving you to work with an operation that probably wasn't the best choice for you.

The DS has the best statistics of any bariatric surgery for percentage excess weight loss, for maintaining that weight loss, and for resolution of almost all comorbidities. It also has other advantages over gastric bypass (things you probably considered when you were thinking sleeve) including no dumping, being able to drink with meals, being able to take NSAIDs, which are contraindicated with gastric bypass for the rest of your life, and the most normal post-op diet. The DS works well for anyone who qualifies medically for bariatric surgery but is especiallly valuable for people with higher bmi's - though bmi is only one consideration.

Short term results with sleeve are good, or at least about the same as gastric bypass, though not as good as with the DS. What really counts, though, is long term results, and we are learning more all the time about inadequate weight loss AND weight regain with both these operations. We are seeing more and more people seeking revisions a few years down the line when the weight comes back on despite their best efforts.

As far as nutrition goes, there are excellent long term studies that show that with proper education and compliance, nutritional problems are not common at all with the DS. In other words, if you make the commitment to taking the right vitamins and minerals daily in the right doses, and eating plenty of protein, and checking labs to make sure your levels are ok, for life, chances are you will do just fine. If you fail to do this, you can and will get into nutritional trouble. But it's largely up to you.

Larra

Seven and a half years ago I had my first WLS.  I decided on the RNY.  I did lose half my body of weight with it, but it was sure a lot of exercise... especially at the end in wanting to get to MY goal.  Over the years I was gaining bit by bit back.  I had to go back to dieting, and diet pills.  I injured by body with my excess exercise so I wasn't exercising as much.  Over the past 7 1/2 years, I gained back 65 lbs. I felt like I failed WLS too.  Then, I went and had an UGI done and found out that the Stoma (connection between pouch and intestine) was open... stretched out... something... and I had no retention in my pouch.   I found that there was 40% RNY that have revisions (not sure where I read/heard that). 

Two weeks ago I had a revision to the DS.  I am very happy to have made this decision and should have made it to begin with.  I am now grateful to be able to take NSAIDS (Aleve, Ibuprofen, Advil, etc). I was in the hospital 2xs for a bleeding ulcer with the RNY.  I am happy to not have the dumping "geez, I want to die" feeling when I have had too much sugar.   

I am just learning about the DS diet... really in the dark, as I am still in full liquid phase.  I am just pleased to be here with this surgery that I wish I did to begin with.

BUT... that was my Choice... you do what is best for you.  Do you need NSAIDs a lot?  Try not drinking during a meal and at least 30 mins after a meal.  

I wish the best for you! 

So glad you picked a surgeon who knows about the DS. So many bariatric surgeons just talk RNY or some may still slay Lapband, which is not done by many surgeons anymore (bad surgery). As the others have said, the DS will give you more for the buck, better kept off weight, loss of more co-morbidities, , weight kept off better or at least easier to take back off if one just follows basics. Yeah, there could be other issues with flatulence, more stool than you know what to deal with (that would most likely be from ingesting carbs), IBS problems. Now at 6 years out, I do enjoy more carbs (sugar and chip things). From early out till around year 3 or 4, keep carbs to a minimum. I never say don't eat any, do not deprive yourself, and then may over indulge. But you do have to look at every surgery the surgeon offers and see what fits your lifestyle and that of your family. I originally had the gastric bypass and that also is a "bad surgery" in my opinion though I knew a few who have kept it off for over 7years, and now they have finally started gaining so you see that is where the DS comes in. Lay off carbs, eat more protein, drink lots and lots of water, and yes include fats to help the poop and everything work. No other surgery has this option to just go back to basics and the weight will fall right off. It is up to you what works for you.

I love my DS.  I just knew that I would get around a sleeve, a RNY, a Lapband, etc.  And the DS does cut your stomach in half - and sure enough, I stretched mine out.  And I eat carbs when I shouldn't.  I'm not good with diet or portion control.  But the malabsorbtion keeps working and there is no way I can eat around that part.  80% of the work is done for me.

Do I worry about deficiencies?  No because I stay on top of it.  I take my vitamins every day religiously.  I enjoy making up my daily batches and creating huge gallon bags of pills I take daily.  I'm in tune with vitamin brands and where to shop for them.  I enjoy this part of it.

I get my lab work done at least once a year.  Usually twice a year.  My numbers are good.  I map my results for every test on a sheet.  When I see a number drifting down, I increase supplements to stop that trend.  I'm good at this part.

It takes commitment for the rest of your life.  You have to take suppliments and stay on top of the labs.  If you don't, it becomes "a raging fire" that someone else mentioned - very dangerous and a bear to dig out of. 

I'm so grateful I got it done.  I no longer have diabetes or sleep apnea.