Calling all DSers! Your input is needed. Please reply ASAP!

Dear DSers,

I'm a 37 BMI with mild hypertension and cholesterol.  Other than that I'm in pretty good shape for a 285 pound (I'm 6'3") 51-year-old.

I had a sleeve 5 years ago which is somewhat stretched.  I only came down from 320 to 260 and have regained 25 pounds. My insurance (Kaiser So Cal) is offering to revise me to an RNY.  Kaiser won't cover a DS (unless, I suppose, I go through a fight, but I'm not sure if I would be approved in the end because of my relatively low BMI).

I can get a DS (and/or sleeve adjustment) in Mexico with Dr. Ungson, however.

I don’t know what to do.  I’ve read hundreds of posts.  For the most part, people GENERALLY seem pleased with the RNY, but more pleased with the DS. There are, however, always exceptions.

I have some questions for all of you and I would love as many honest opinions as possible, whatever they might be:

1. My major concern is LONG-TERM results/safety. If I weren’t heavy I think I could make it to my late 80s, as most men in my family have. Has anyone (especially early DSers) been suffering from malnutrition, or other complications?  And, if so, how likely do you think it is?
2. Does everyone need to take vitamins 5 times a day?  Or is 2-3 times more the norm?
3. Other than the first few months, how bad are the bathroom issues? How many times a day do you go?  How bad, really, is the smell?  Are your stools usually firm or more often diarrhea?  Any accidents?
4. Any other advice based on my situation?

I will sincerely appreciate hearing your experience.

In unity, Mark

I am an "early DSer" so I can't tell you about long term results for me yet. (actually had SADI though, so not a true DS). however i'm a mid-20's female and i have lost 105 pounds in 6 months!

• i've only had one set of labs done after surgery so far, but in 3 months my vitamin A level went down 20 points to a deficient state, so now I get to play catch-up
• my biggest issue/complication is vomiting. as i pay attention to the rules with the timing of what I'm eating and drinking, I've done better. however, sometimes it seems there is no rhyme or reason to why i'm vomiting. other times, i know exactly what the offending food was but it takes several hours to resolve. Today I tried some pork from a Pho resturant. finished eating at 1240....unable to get fluids down again until 1840. 
• i try to follow my surgeon's vitamin plan that includes vitamins 4 times a day
• I have more of a problem with constipation than diarrhea. however, I do not have a "true DS" so I have a longer common channel to begin with...and I take iron supplements that contributes to having constipation. I do occasionally have diarrhea, it seems to be in the morning right after taking my morning vitamins. no accidents, but the kind where I need to squeeze the cheeks and get to the bathroom within a few minutes.

Thank you for sharing.  If you don't mind, let me ask you point blank:  Any regrets?  Would you do it again?  And why did you choose the SADI over the DS (no judgement - strictly curious ?

I'm a DS vet of 10 years come this Halloween and my only complication was a ventral hernia my second post-op year.   I've had some low nutrient  levels early out that I addressed with a vengence, but never suffered any effects of malnutrition.  I was taking vitamins orally 4x a day for many years, but this year I've switched to patches and take only calcium citrate once daily (4 pills) along with my patch.  I'm getting bloodwork done next month to see how they're doing for me, but my hair and nails are showing their approval for some time now.

I have a BM once a day, first thing in the morning.  Consistency is loose but totally in control (unlike diarrhea).  I've not had any accidents since my first year or so when I was learning how my body reacts to certain foods.  It took years to figure out that straight milk and onions are the devil in my life (while other dairy and onion powder are just fine).

I have seen many over the years appeal Kaiser and win to get the DS over RNY, so if it's something you really want, you may be able to get it covered.  Otherwise, Dr. Ungson is a wise choice.  My other recommendation is to learn all you can about nutrition, because we are definitely not cut from the same mold.  Some need much more than I ever had.  Never trust anyone from the doc's office when they say that "your results are fine".  They rarely compare to your last bloodwork to look for any downward trending.  You need to do this yourself.  Nutritionists are useless to us as well, for they think the same RNY regimen is sufficient, or some designer bariatric vitamin with DS dosage will work (don't fall for that either). 

Thank you, Valerie.

As a DS vet, I really appreciate hearing your experience.  Since you're still active on this board after 10 years, I imagine you have also heard the experience of many, many, many other DS vets.  

Regarding post-op complications, nutritional and bowel issues, would you say overall that your experience is typical for a long-term DS vet?

As a matter of fact, I'm quite the norm, especially with the bowels.  Like I said earlier, our nutritional needs differ greatly.  Some take extra calcium or A&D (3x more than my megadoses were).  Some need extra iron, but I never did after my first 6 mos.  That's why its important to pay special attention and understand those factors yourself.  Don't hesitate to ask the vets for help with labs, either.

Thank you again, Valerie.  I'm relieved to hear it.  I'm sure I will have no problems complying with the vitamins and labs.  On that kind of thing, I'm very organized and disciplined.  Now, put a pint of Ben & Jerry's in front of me and I go temporarily insane. As Louis CK says, "the meal isn't over when I'm full; the meal is over when I hate myself."

One more question: What have you heard from DS vets that are also seniors (or close to it)?  I'd be curious if any of them had problems rooted in the DS.  Your body can put up with a lot when you're younger, but, as you age, it's not as resilient as it used to be. I'm wondering if anything about the DS may not reveal itself until you get in your 60s, 70S and 80s...

Thoughts? 

Hi Valerie.  You mention in your post about asking the vets for help with labs.  I'd like to get some feedback about what I need to change to get things back in line.  Could you direct me to the best place to post my labs?

Also, I'd like to bookmark certain threads, but can't seem to find how to do it.  Can you help?

Thank you.

I haven't been online in forever but I popped in to check out the old ds site. I'm glad to see you Valerie. When I decided to get the ds 6 years ago, you were one of if not the first person to respond to me when I needed to make the decision. Many have come and gone and I'm happy to see your still here giving your honest perspective. I want you to know you have a special place in my heart. Op it is worth the fight living a ds life is remarkable 189 lbs off and Staying off. Sad to see many Rny's I knew of who had surgery before and after me fail. Oh and I had twins after my surgery and here I am no pregnancy weight people can't believe I have 3 kids.

How did those patch vitamin results go?