Why I chose the DS ... please research ALL your options!

My surgeon explained DS as the preferable WLS. But pointed out that most insurance companies don't like to cover the costs. So I didn't really even consider it.

I had a VBG (an old stomach-stapling) in 1987 ... lost about 130 pounds, and over the course of the following 20 years, gained every bit back. I was revised to a DS in early May. I'm just about four months out, and have lost 79 pounds, including the 20 I lost pre-op.

I have tried to be visible on the revision board, because it seems that RNY is heavily represented here, but not so much the DS. Each time I post responses within a top-level topic, I end up with PMs asking me for additional information. So, I thought I'd just toss a top-level post out, myself.

So, a random bunch of facts about my experiences with the DS, so far.

Statistically speaking, the DS has the best short- AND long-term excess weight loss for revision patients. Our metabolisms are pretty much *shot* after a WLS, and losing additional weight is difficult. The DS provides a powerful tool to help you reach and maintain your goal. The DS also has the highest co-morbidity resolution statistics, and in my opinion the best post-op quality of life.

Carbs *can* be eaten with the DS, but you really want to avoid them during the first 18 months. We absorb all the carbs we consume ... about 50% of the protein ... and about 20% of the fat. Our diet consists mostly of protein and fats (think shrimp dripping in butter, or a bacon and bacon and cheese and bacon sandwich ). It's NOT a bad way to eat.

Some people (myself included) will get gas and dh if we eat too many carbs. Some folks have no problem with them at all. Some folks start out not being able to eat them, and then later *can*. The same can be said for products made with white flour. I can only eat whole wheat bread, and try to find the low-carb stuff, if I can.

Because I retain the use of my pylorus, I don't have the sugar-dumping issues that some RNY folks do. It's not a free reign to eat carbs, but I don't obsess about the carbs, either. I find I have lost my craving for simple carbs - I will snag a bite-sized snickers at work every couple of weeks and routinely toss half of it. Complex carbs are a little different, for me. My dad's amazing corn on the cob is ripe, and I am NOT holding back!! :) I just drench it in butter, and I'm good to go!

So much of my stomach was removed (and along with it, the hormone ghrelin) that there are days I seriously don't feel like eating, and it's an  effort to *make* myself eat. I find the more I eat, the more I lose, which is a fairly common comment on the DS board. The thought is your body feels "at ease" letting fat go if it doesn't feel as if it's in starvation mode. I don't know if that's true or not... I just know that there are days I don't want to eat, and days I want to eat from the second my feet hit the floor until I go to bed at night... and that usually the "eating days" are followed by a good weight loss. On the "eating" days, I make sure I have lots of high protein snacks around... jerky, pistachios, flour-less peanut butter cookies, cheese. On the eating days, I just.... eat. This is one of the essential reasons I chose the DS - I did NOT want to feel deprived. I did NOT want to eat on small plates to try to fool myself into thinking I was eating a normal portion. I wanted to fully *participate* in the very human, very communal act of eating a meal with friends.

I can drink with my meals. I can take anti-inflammatories, because I'm at no higher risk for ulcers than the a normie. I have to be ultra-careful about my protein intake (90-100 grams a day, so I'll absorb at least 45g), and I never, ever ever miss taking my vitamins. No excuses, no exceptions. It's essential I have lab work done every six months (more often if there's a downward trend). It's very difficult for me to recover from a low level of D, A, E and K ... the fat-soluble vitamins. I buy specific vitamin types (not oil-based gel caps, for one) to give me the highest chance to absorb these vitamins. Tank on D and you invite all KINDS of issues, including osteoporosis.

The DS is *not* for the faint-hearted or the semi-committed. That's why so many of the DSers seem so... militant. They're a hard-core group, because they see this great surgery and know that so many people *aren't* offered the option for no other reason than because their surgeon doesn't perform it. Worse, the doctors that don't perform it will give outdated or plain *false* information on the DS to avoid losing your business.

I did an inordinate amount of research prior to deciding on the DS for my revision, including attending about six or seven DS-specific support group meetings in the Seattle area. I found this to be an invaluable component of my research, because I got to talk face-to-face with folks living with the surgery. But ... and this is important .. I would never have even heard about the DS, had it not been for this site. And ONLY because I witnessed a "surgery war" did I even know to click on Duodenal Switch in the forum menu.

I traveled from Seattle to NJ to have my revision, because I felt strongly enough about having the DS. It ended up costing me much, much more out-of-pocket than it would have had I stayed local and been revised to an RNY. It wasn't a snap decision, and it wasn't a frivolous one.

There aren't a lot of DS revisionist surgeons around. And you want to be CAREFUL to choose a surgeon that not only is versed in DS but ALSO versed in revisions. It's a tricky surgery because they're stapling over tissue that's already been stapled before, and there is a higher risk of leaks due to decreased blood flow. But there has been a high degree of success in excess weight loss in revision patients that have chosen the DS, and I'm on my way to being one of those success stories.

I welcome PMs if anyone has questions. I'm going to list several links, below. The first two are DS-specific Web sites that are a *wealth* of information at your fingertips. The third is a link to my surgeon's Web site page, which lists some FAQs about revision surgery.

The third link is a not-too-terribly organized list of DS surgeons that do and don't perform revisions to the DS. The list is months old, and I know that some of the information is out of date, but it was a good starting point for me when I was in research mode.

If you're on this board, it means that you probably had one WLS that has failed you. If you're at all like me, your next surgery will be your last, regardless of how successful or unsuccessful it is. You owe it to yourself to research ALL your options, not just those options that your financially-motivated surgeon is presenting.

And no matter what you choose, I wish you all the luck in the world.

xoxoxo

Kathy

http://www.dsfacts.com/

 

http://duodenalswitch.com/

 

http://www.duodenalswitchdoc.com/revisional-bariatric-surger y.html

 

http://www.obesityhelp.com/forums/ds/3808137/List-of-DS-Surg eons-Performing-Not-Performing-Revisions/

Contraindications
Though less often encountered in the morbidly obese patient, we consider a strict vegan lifestyle to be a contraindication to the performance of a DS. Patients must be willing to eat a significantly high proportion of their calories in the form of protein of high biological value to avoid hypoproteinemia.

http://bariatrictimes.com/2009/06/18/the-duodenal-switch-rev isited/

I would think being a vegetarian with a DS is doable, but you'd most likely need to supplement with protein drinks of some sort. Many of the non-veggie DSers (myself included) do. But as a vegetarian, you're probably more versed than most about non-meat sources of protein: cheese, nuts, legumes, etc.