Looking for advice on DS

Hi! I'm 27 (28 in March) and female. I had VSG at 23. I was 430 and I'm 5'8. A year after surgery I had lost 135 lbs and was in the high 200's for the first time since I was 13. Then my boyfriend moved in with me and had no job (I'm a college student and in an intensive psychiatric program so I have Medicaid and food stamps) I went from being able to afford my healthy proteins, to buying junk because $194 to feed 2 people a month doesn't exactly allow for healthy options. I slowly started back with bad habits and now 5 years later I'm 425 lbs. I recently went for a colonoscopy a week ago and what should've been a 25 minute procedure took them over an hour. This led them to refer me to their WL surgeon for the DS. Before a week ago I had never heard of this procedure and being that I'm a future teacher, I've been researching obsessively because I want to be successful this time around. With my VSG I lost A LOT of hair, even taking my vitamins religiously. Does this procedure come with a lot of hair loss as well? My appointment to meet my surgeon is Feb 24th. He accepts my Medicaid but I'm scared they won't let me have a second surgery, even though I have high blood pressure that's so bad I take 2 meds a day and it's still high (I've had high blood pressure since 5th grade so it's something I've lived with for a while and was temporarily off for 2 years after my VSG) I'm looking for any tips, advice or questions I should ask my surgeon when I meet with him in 2 weeks. From my research I've read about waiting 15 minutes after drinking to eat and 45 minutes after eating to drink. Is this correct? I've recently been starting to do this now, so that I have that healthy habit developed well before surgery. Has anyone had to get their vitamins in a shot form? What's the typical first year of vitamins look like until you get your labs back? With my Merakey/ACT team for my mental health, I get labs done every six months, so I know I can keep up with doing labs for this once a year. I just feel down that I failed my first attempt that if I can get the DS, I will fail again, so I'm really trying to learn as much as possible so I can better educate myself and prepare for it so that I can be successful. I'm still young, I have an amazing man who loves me for me and I really want to start a family with him some day and I feel like this is my last chance to get to be my healthiest self so I can live out my dreams. Any and all advice would be greatly appreciated!

I can't answer some of these since I had RNY, not DS, but since the hair loss is due to the trauma to your body from the surgery plus the rapid weight loss plus the low amount of calories you're taking in those first few months (although this last factor may be different with DS), I would imagine there's a good chance this could happen again. But...for most people, it does grow back. I considered it a small price to pay for finally getting all my excess weight off - and keeping it off.

Keep on researching. You have a lot to learn. First of all the waiting to eat and drink thing is for RNY patients. They have a pouch. Dsers have a fully functioning stomach. You may find it easier to get your protein in at first if you restrict yourself but it is not necessary long term.

Next, no you can't get your supplements in a shot. You have to take the pills. Lots of them. And they are not cheap and are usually not covered by insurance. You can count on spending at least 1K per year on supplements and at least in the beginning, protein drinks. Our protein requirements are real. Without a proper diet, you will die. Your needs have to come first. You can't do without your supplements and protein to support an unemployed BF. Doing things like this is a recipe for disaster for a DSer. You have to be in a place where you come first and you are willing to do what you have to do to survive and thrive. If you can't do this, the DS is not for you. I know this sounds harsh but you need to hear the unvarnished truth.

Kids... Forget that for now. Many of us do 2 types of BC. You will be told, no kids till the weight is gone and you are at least 2/3 years postop with NO problems. And pregnancy is considered high risk for most of us. And you will need a lot of monitoring. You will have to be very careful to avoid pregnancy for years.

The VSG is just another diet with a smaller stomach. The DS is much more powerful because it adds in malabsorbtion. This is the combination that lets us take the weight off and keep it off. It works better than anything else you could possibly do to control your weight. It has the best results long term. But the rules are not optional. You can't just not do it whenever you are having a bad day!

Make sure you know about the surgery variants. There is the standard DS, 2 anastomosis, and the SADI/Loop. Since you have a lot of weight to lose, I would encourage you to get a standard DS from a real DS surgeon. Does your sleeve need to be redone? Find out. What will your Common Chanel be? In your position, I would opt for as short as they are willing to go. Shorter means more malabsorbtion more sustained weight loss, and more chances for deficiencies as well.

You know you. Do a lot of thinking and reading about this.

I appreciate what you had to say and find it very helpful. I know kids are off the table for years, that's why I want to get it sooner rather than later. I've talked to my ACT team to see if there are any programs for cheaper bariatric supplements (they have a lot of resources and often find things I never knew existed) but if they can't find anything my dad and boyfriend have stepped up and said they would cover the cost because they understand the importance of them. I've been on mental health medicine since I was 14 and I've been on blood pressure medicine since 5th grade so I'm very compliant and understand the importance of life saving medicine. I also already get labs done twice a year, so getting even more done doesn't bother me and is something I know I can handle. As for the boyfriend moving in and feeding him, I was in college on grants living in an apartment where I could have someone live with me for free. I wanted him to go to university with me instead of our crappy community college, which meant he had to leave his job. I was younger, caring and didn't put myself first but I've learned from that experience and I've already expressed to him that if we ever live together again, I can't be there to support him because I need my protein first and foremost and he was more than understanding. When I was scoped they said my first surgery was messed up and that's why they referred me to a surgeon, so I think I will need to be re sleeved. Do you know what's the shortest CC they normally allow? This has all been really helpful and has brought up questions that I will be asking my surgeon when I meet with him! Thank you so much.

so much this. Please take Patty words as a complete truth.

".... You can count on spending at least 1K per year on supplements and at least in the beginning, protein drinks. Our protein requirements are real. Without a proper diet, you will die. Your needs have to come first. You can't do without your supplements and protein to support an unemployed BF. Doing things like this is a recipe for disaster for a DSer. You have to be in a place where you come first and you are willing to do what you have to do to survive and thrive. If you can't do this, the DS is not for you. I know this sounds harsh but you need to hear the unvarnished truth.

Kids... Forget that for now. Many of us do 2 types of BC. You will be told, no kids till the weight is gone and you are at least 2/3 years postop with NO problems. And pregnancy is considered high risk for most of us. And you will need a lot of monitoring. You will have to be very careful to avoid pregnancy for years.

The VSG is just another diet with a smaller stomach. The DS is much more powerful because it adds in malabsorbtion. This is the combination that lets us take the weight off and keep it off. It works better than anything else you could possibly do to control your weight. It has the best results long term. But the rules are not optional. You can't just not do it whenever you are having a bad day!...)

Way too many people died or became incapacitated by not following the DS rules. One how many? even one would be too many. There are some that ignored their health, thinking they can take care of that later, only to realized that some damage due to inadequate nutrition can be permanent. As in, it cant be reversed once the person has time and money to start taking care of themselves.

Also, some people who don't fallow a proper eating post op DS can also gain weight and on top of that deal with a very unpleasant gastro-digestive issues, like really bad diarrheas, excessive gas, really nasty excessive gas (often due to too much sugar of carbs consumption), up to really bad BO.

Why were you ever allowed someone to move in with when he could not even contribute to the food? that s clearly taking advantage of you and the situation. I hope you learned from that.

Being a teacher, and having a really bad gastro-intestines' issues (because you would decide to grab some junk food) may not be the best combination. Just think about that for a minute. Kids can be really cruel.

I am not saying you shouldn't have DS, but when you decide you have it - please make sure you are really ready for it.

Thank you so much for replying and reiterating what she had to say! I agree, one person who dies is one too many. About the boyfriend, I don't think he was taking advantage of me because I asked him to move in. He has a severe learning disability and he lost his financial aid due to his dad getting back pay from the VA (which I didn't think they could count that as income but they did). It was either him go to a community college that didn't care about him, or live with me and stay in the program he was in where he got the care and attention he needed while paying for school from his savings. He now works and only has a semester left of school and we plan on getting married. I think it was more me placing his needs above my own, which is something I refuse to do again because it started me on a bad path. Until that point I was doing really good, I rarely touched carbs and just got my protein in first and foremost. My boyfriends mom is a nurse and a health coach and she offered to teach me how to meal prep and cook healthy before surgery so that I can start preparing for the future. You're right though, kids can be mean which is another reason I want the weight off and feel that as I'm older and lived through one that I've learned my lesson from the last and can truly commit this time and be successful. You've given me a lot to think about though. Thank you so much!

I'm almost 18 years post-op with the DS. Patty was real close and I'll add a few more observations. First everyone one of us is different even though we all had the same procedure. Each surgeon is different. Most of what you read online will apply for the first 3-5 years. For example, drinking before and after you eat. At 18 years post-op I drink with meals, before and after (well sometimes after I have to be careful).

Will you lose you hair - maybe yes and maybe no. I did but it grew back. With the ups and downs, I wouldn't change a thing.

Honestly it's all about learning how your body handles your new normal - everything will change, and I mean everything. Once you accept the change and embrace it, it becomes your new normal. For example, I know exactly how much protein I need in a given day. At the beginning, I had to learn everything, but once you learn it, it doesn't become a challenge anymore. I used to weigh and measure everything I ate. Don't have to do that anymore because I learned.

I probably spend more than $1k per year on supplements. Over the years my foods have changed from "quantity' to "quality", which costs more because I deserve it. I've had issues with iron deficiency anemia and osteopirosis since my DS. Insurance covers some, but not all. Just something I have to deal with and you may have to as well.

The good news is that I have know quite a few DSers who have gone on to have successful pregnancies and healthy children.

In general, make sure you're happy with the surgeon you select. Learn everything you can and be diligent.

You've gotten many great answers here from the best... I just want to add to the mental health issues. I had been on SR Wellbutrin for years. After DS, I rapidly had withdrawals due to malabsorption abs had to switch to IR. Be cautious and research how each med is effected by DS, especially any long acting.