Question:
Would you choose another procedure over your DS???

I am pre-op, and believe that the DS Procedure would be the best "tool" for me. I would like comments on...the good,the bad, and the ugly. If you had to do it all over again, would this be your choice of procedure? Thank you for your honesty.    — Dee D. (posted on July 28, 2001)

July 28, 2001
Dee Dee, there are those who will shoot you down for considering the duodenal switch over the other procedures. Some honestly believe that DS is a cop out, because it is not as restrictive as the RNY. When I first strated researching WLS, I got sucked into all of the RNY hype and thought that was the ONLY way to go. Truth is, the ONLY way to go is the one that is best for you in your circumstances. In the end it is up to you and your surgeon to make that decision. Yes, RNY IS the "gold standard", the most widely practiced form of WLS, but DS is on the rise. Also, you may hear from folks who had revisions from other procedures to the DS. My stance is this, with the DS, my internal make up retains more of it's normal configuration, the pyloric valve continues to do it's job. Yes, perhaps I'll be able to eat more, and I will have to be vigilant in my steering from temptation.. but not all RNY patients dump either, so that 'failsafe' isn't always as it's expected. I wish you the very best and know that between you and your surgeon you will have the procedure that is best for you, an no one else! I'm not here to judge anyone for their choice of surgery, just to share my thoughts in answer to you question.
   — [Anonymous]

July 28, 2001
HI, I looked up both d/s and rny and thought they had good pts. I know you are wanting answers from people who had d/s and I am preop going for rny. Before you get your heartset on d/s find if there is a dr in your area that does it or see if you are willing to travel. This is the biggest reason I decided against d/s, no one here does it and the closest dr to take my ins is far away. good luck whatever you decide, and I agree with the previous poster, do what's best for you!
   — Becky K.

July 28, 2001
Dee Dee: I had laparoscopic BPD/DS on January 25, 2001 and wouldn't have made ANY OTHER CHOICE! :):) I didn't have any problems eating food, with gas/flatulence or diahhrea, so I was one of the extremely 'lucky' ones (I know it was prayer that helped:)). I am six months post-op and have lost 72 lbs. I have about 50-60 more to go to get to my idea weight of 170-180. This surgery has really changed my life. REgarding eating more --- this is compensated by the high malapsorption. So, one can eat more (I can eat pretty 'normally' and could finish most of an appetizer-sized meal at a few weeks out), BUT one is NOT absorbing all the calories. The main component that isn't absorbed are fats (this is why we must supplement with the fatty vitamins ADEK in addition to multis). Second is protein (this is why we must eat more protein than the average person to guarantee we have enough and don't become protein deficient), carbs (I think we absorb 60 pct of the carbs we eat). To me, it isn't 'cheating' at all. Sugars are still absorbed, however. This malapsorption helps to keep the weight off long term as well as get the weight down initially. :):) I enjoy food and feel FULL for the first time in what seems like forever. I am totally unable to eat as much as I did pre-op (and never WILL because my stomach will never expand back to that degree - thank GOD). I eat much less carbs than pre-op (this was my main weakness) because they fill me up so quickly. I have an occasional sugar but really don't crave chocolate or anything and really haven't been satisfied when I did eat it post-op. I mainly enjoy fruity flavors now. :) I would definately investigate this option and see whether this high-protein post-op diet would be acceptable for you (I have at least 80 gms/day). The supplements aren't really any more than a post-op RNY would take, but the health problems *could be* more severe if you don't receive proper aftercare, eat enough protein, good food and take your supplements (a complete bloodwork done every 3-6 months basically for the rest of your life to detect any minor nutritional defects and correct them early. Some may only go once a year but I'm going to be really conservative about it and go every 3-6 months and my PCP agrees with this). Another factor is you may have to educate yourself quite a bit (and even educate your PCP who will be the primary aftercare provider beyond 1 year post-op). The DS just isn't as commonly known about and many do not understand the nutritional requirements, etc. of a post-op DSer. Sorry, I don't have much of the bad or ugly to share with you because my surgery and recovery really has been remarkably smooth. However, I have known people who had or have a rough time of it (usually immediately post-op with food intolerances, diahhrea, gas or nutritional deficiencies). I would join the group [email protected] to read about others experiences. There are many pre-ops as well as post-ops there and you can get a wide variety of experiences. All the best, (Laparoscopic BPD/DS with gallbladder removal, January 25, 2001),
   — Teresa N.

July 28, 2001
I had the DS almost 2 years ago. I know they say it's a "tool" but to me, it is a miracle! I know longer have to think about food. Before surgery, I was constantly thinking aobut food, wheather it was my "diet" food or my "junk" food, I was constantly thinking about it. I no longer do that. I no longer worry about food. I eat what I want. I take my daily multivitamin & viactiv and that's it. This is the first time in my life where I lost my weight and have kept it off for 2 years ( and I dieted for 30 years). Not gaining the weight back was my priority for having the DS. I would have traveled around the world to have this procedure if I had to (luckily I didn't have to :>0). For ME, it was the only way to go and I look forward to the next 30 years EXPERIENCING life, instead of watching it go by. Good luck to you! http://www.mywls.com
   — [Deactivated Member]

July 28, 2001
Hi Dee Dee, I would do this again in a heartbeat and I was saying that right after surgery. I had originally thought I wanted the RNY but a week after my consult my surgeon called and felt for me I would do best with DS. He had me investigate and then choose(for me the RNY was potentially life threatening due to prior surgery for acid reflux). ANyway, I'm soooooo glad he suggested it. I love it and all that comes with it. I don't have bouts with gas/diarrhea or anything. I only experience acne like I was in the 7th grade again. Those raging hormones! I can eat what I want, when I want and yes, I need to be careful. Sometimes I wonder if he removed any of my stomach at all. I don't eat much sugar and try to get as much protein as possible. I take 1 flintstone vit. 3x day, 1 ADEK 3x day and 1 Calcium 3x day. What is difficult about that is beyond me. I'm still waiting for my first set of labs to come back but trust me I will be dilligent about the numbers and all. I decided before this surgery to take a proactive stance and know everything I need to know and not rely on my PCP. It's my job to educate him for me to get the best care possible. If you are considering this surgery than make sure you do the research-if you decide this isn't for you than do the research and best of luck in whatever you choose. I personally am thrilled. I'm down 55 lbs,26 1/2" in just under 4 months!!!!
   — Linda M.

July 29, 2001
7-29-01 Yes I would have the DS again without hesitation. I have learned so much more about all types of WLS available. In the 18 months since my DS I have met with many people who have had all the different types of operations. And the long and short of it is that after a person gets beyond the emotional, stressful preop and early post op periods, the reality of the long term results will kick in. That is to say that problems I thought to be asociated with the RNY, like dumping and never eating chocolate and eating an ounce of food for a meal just was not the case in the long run for most people. Just like severe diarrhea and odors with the DS were not a problem long term for most people, either. My biggest struggle is with the mental obsession with food and with the DS I am able to eat larger portions and this is creating a vicious circle for me. If I am honest with myself I think I wanted to believe that I would still be able to eat food after the DS and that is what made it appealing and now I see that that is the negative for me because even though I don't eat the massive quantities like before I still eat way too much and most of that is because of the mental food addiction. No operation will work on your head but I sure wish I could say I wasn't hungry or forget to eat. I know from talking to any WLS patient that anything should work if you stay in control, eat appropriately, it's just some work differently. If the bottom line is to loose weight, any operation will do the trick. The DS has fewer upper gastrointestinal problems but potentially more lower GI problems. The RNY is just the opposite. I am dealing with frequent diarrhea and loose stools and they do smell, but it is a situation I cope with and have resigned myself to. Just like any other chronic condition, I have adjusted and let me tell you that even though there are some days where I have 8 to 10 bowel movements a day and lots of gas, (I was up 3 times during the night last night) the fact that I can get there quickly, fit into the stall if at a public restroom, and clean my own butt without a sling rag or drip dry is worth it all. Like the old diet saying goes, "Nothing tastes as good as being thin feels." I project this onto my situation and say that "Nothing is too difficult or objectionable a side effect as weighing 375 pounds" Have confidence in the DS as a wonderful operation and the RNY is great, too. Keep the bottom line in focus and remember to consider all the options including distance and finances, too. You will undoubtedly find people who have had absolutely no problems at all with gas, diarrhea, frequency, or odors, (the vast majority of DS people are like this) and yet there are many of us who do have these side effects, are not making excuses for them, like "Everyone poops, right?" yes, but a dozen times a day?or "Doesn't everyone's smell?"yes, but like the building is on fire with tear gas? or, "It's not a problem for me if I don't eat certain foods." Ahh, sounds like dietary modifications by any other name... My point is to be realistic, listen to everyone's experiences and decide for yourself what risks are acceptable to you. So if you think that you could be a person like me with the lower GI challenges (so PC) and you think you can't manage that, than the DS or a Distal RNY is not for you even though most people do not have that problem. Same with the dumping after a RNY, most people ease up on sugar restrictions after a period of time but if you think you couldn't handle it if you were one of the people who didn't change and truly could never eat chocolate again, well, the RNY may not have that risk as acceptable for you and go with the DS. The more you read about people's experiences the more you will be able to make up your own mind. I have found that many people with problems are not writing in as are long term post ops, either, but I checked in today and hope my answer will help you to consider. But again, having this surgery was the best thing I ever did and I feel like a human being (and am being treat like one, too) for the first time in 30 years. I am 18 months post op Lap BPD-DS and have lost 210 pounds.
   — Fran B.