Doctor has proposed Duodenal Switch

How old are you now if you don't mind me asking? I am wondering how it will be as I get older etc with the malabsorption and food etc. I had DS on 9-28-16. Thank you.

If I had to label my "history," I might use the word "abysmal," as well.... I can regain weight in an amount that (I consider) is extreme. 24 months ago I lost 110 lbs...in the past 12 months I've gained 100 back. That, in reality, is why the DS seems the most appealing surgery to me. I know I can lose the weight, I know I can incorporate lifestyle changes for those year(s) when everything is "easy" and weight is just sliding off. But, when motivation wears thin and the going starts getting tough -- I'd love a "tool" (the weight loss surgery) that is the most effective in helping me keep the weight off, long term.

Amanda - another thing to point out about the DS is your commitment to vitamins and labs (for the rest of your life). Because of the malabsorption, vitamins are of higher importance than most of the other WLS options. It is an expense you have to be willing to accept and agree to.

The bathroom issues your PA mentioned can be true - it's all about what goes in must come out (so to speak). For me personally I spend a good amount of time in the bathroom in the morning - but I'm also drinking coffee while I let my body wake up. People have mentioned just one or two bowel movements a day - I definitely have more than that. Is it stinky? Yup it sure can be but I believe most people's poop stinks. Again, it's all about food choices.

During the losing phase, it's really not that much of an issue because you're focused primarily on protein. Once you start introducing more carbs to your diet, things will change. Again, it's all about food choices.

Many people will talk about protein supplements. I only used supplements until I was finally able to eat my protein. I never wanted to rely on supplements so I get 100% of my protein from food. But I'm also 14 years post-op. Speaking of 14 years post-op, I'm still within 10 pounds of my goal weight. I reached goal within about 14 months (175 pounds lost) and have been able to maintain it simply because of the DS. I focus on protein (making sure I get a minimum of 125 grams of protein a day), but other wise much eat what I want. Nothing is really off limits but my choices are healthier (that's one of the lessons learned - learning how to eat).

Good luck with your decision.

Yes!! Thank you for saying this! I'd read about it on other threads in this DS forum, and it was something both the physician and the PA specifically brought up -- the lifetime commitment to vitamins and labs. I asked the PA if their office would see me for the rest of my life for the labs and monitoring and she said ideally, yes... But it sounded like, or at least made me think, that I need to be prepared to be responsible for those labs wherever I end up 5, 10, 20 years down the road. Thank you for bringing up the food choices and protein intake (and I agree -- when I'm able after surgery, I definitely want my protein intake to come from real food, not just powder/liquid supplements -- though I understand those are important and in some cases critical...) And yes, haha -- I think all poop stinks too!

Have you continued with a specific bariatric multivitamin the entire 14 years since your surgery?

Today there are no 'bariatric' vitamins that are good enough for us. You need to be assertive, learn, and become your own advocate. When you start learning, it seems overwhelming but down the road it becomes automatic. And yes, you need to learn to be responsible for all of this yourself. There are very few docs and NUTS who understand our needs.

I take them morning and evening and I use 2 7 day organizers. When I travel I use snack size zip lock bags. I order most of mine when they go on sale from Amazon or Puritan. Costs around $400 per year. I am a good shopper. Always remember, when in doubt, just take the pills.

If your doc is selling vites, that's because it's an extra revenue stream for the practice. Not necessarily because they are good for you!!! Always follow the money.

Yes! While this is part of what's intimidated me early on while researching/learning about the DS, I realize it's quite critical -- learning what I need (i.e. vitamin and lab-wise, especially) and being prepared to advocate for that for myself. I have a very ordinary trust in my doctor, that he is keeping all of those bases covered for me, as long as I keep showing up to my appointments. But -- yes. That is a responsibility I will need to, in the short and long term, shoulder much of myself, as well. (And yes -- both the doctor and the nutritionist offered a line of "bariatric vitamins and supplements" [powders, pills, drinks, bars, you name it]), which I am sure are great (if you can afford it in the long term)...but I also need the multivitamin/supplements that work for me and I can keep up with, financially. $400, $500 a year on multivitamins as a result of having the DS sounds reasonable to me. $200, $300 per month...I would not be able to do.

Amanda - when I had my DS my surgeon (Hazim Elariny) sold a vitamin called Vita-4-Life. It was supposed to be a one-stop shop. Take 12 per day (4 three times a day) and that's it. Well not everyone absorbs the same so of course I started having issues with low labs on some and high labs on others (for example by B12 was crazy high and still is even though I haven't taken any B12 for years). After a couple of years on V4L, I switched to Vitalady (a company in Oregon started by a husband and wife RNY team). They were great until recently (within the last year) when I started have problems getting some of my vitamins. I now get everything either from Costco/BJ's and Amazon. It's much easier now to get dry vitamins (DSers can't take any oil-based vitamins - must be in dry form, particular ADEK).

I'm not going to lie - I had major issues with iron. When I had my DS I was pre-menopausal and the combination of not absorbing oral iron and having fairly heavy periods, I became severely anemic. I still deal with it but now that I'm post-menopausal, a series of iron infusions ever few years is all I need to keep my iron normal.

I also have severe osteoporosis. When I had my DS 14 years ago my bone density was normal. I take massive amounts of calcium and Vit D, but obviously not enough.

It is what it is - I wouldn't change a thing. I don't take any prescriptions - no high blood pressure, no diabetes, nothing. All I take are vitamins and omeprezole (for heartburn). I'm good with that :)

Janet, I was wondering how the Iron is absorbed with the DS because I am feeling more and more tired, so I upped my oral Iron, labs in a month so I''ll see how it is, but what else could it be other than the Iron? I take nascobal for vit b 12 nasally, so I am just trying to get my old strength or some of it back.. I don't eat enough either. 9-28-16 DS Ty

Cindy - I simply don't absorb the oral iron, no matter how much I take. Also iron and calcium tend to cancel each other out so many people separate the two. I'm fortunately have a hematologist who understands malabsorption. I've had issues with my ferritin pretty much since my DS.

Keep a close eye on your ferritin. Research "iron deficiency anemia" and see if you have any other symptoms - I did once I saw what they were (my symptoms were very pale skin, always exhausted, restless leg syndrome, bad PICA - I chewed ice). Also if you are still pre-menopausal, that means you're also bleeding once a month so also losing blood/iron. For me, fortunately menopause helped with my iron as well :)

I just recently went through two iron infusions (one week apart) with a new drug that is designed specifically for people who can't/don't absorb oral iron -- Injectafer. My ferritin went from 13 to 329! I hope this will keep me within range for 3-4 years. I've just accepted the fact that I'll probably need infusions every 3-5 years.

If you're already deficient IMHO no amount of oral iron will get you back on track. You'll need infusions.

Thank you for the advice -- those are all good things to consider. I am 37 and have never had iron deficiencies so I don't think I'm going into this with that stacked against me -- all of my labs are normal, except that I am Vitamin D deficient (living in the Buffalo NY region will do that to you!). So that's something for me to keep in mind as I start vitamin/supplements post-surgery. And to keep an eye on calcium. Thank you!!