I am a DS’er…that is one who has had the Duodenal Switch. I am also a lightweight. My starting BMI was 35.2. Medicare covered my DS as I WAS also an insulin pump dependent type 2 diabetic.
I had surgery on the 24th of Jan, 2011. I reached normal BMI (for a lose of 58 lbs) in August 2011. I continued to lose very slowly til I had lost another 15 lbs.
I no longer take any diabetic meds. I’ve lost 125% of my excess weight now. My current BMI is 22.3. I went from a size 3x top/18W pants to a size Small top/4 pants (sometimes a size 2).
Pre-op, I was on 11 prescription medications. I know take two and both are thyroid meds. One of those meds was for cholesterol. Now, no medications, eat all the bacon, sausage, full fat cheese/cream, butter, etc and my last cholesterol was a whooping 179!
I can take NSAIDS which those with a RNY can not take. I had GERD pre-op, it is also resolved.
IF I eat white carbs, I have smelly gas. If I don’t eat enough fat, I get constipated. I average about 100 grams of fat a day (normal people are told to keep that at about 25 grams a day)
I also know that many RNY (gastric bypass) have problems with gas/diarrhea/etc as well…as bad as those of us who have had the DS.
Why did I chose the DS:
The diet is closest to what I had been eating for a decade, high protein/low carb because of my diabetes. And while I love carbs, I love meat/veggies more.
I needed to be able to take NSAIDS after surgery. I had back surgery in 2006 and have arthritis all over.
I wanted the one that had the best resolution of co-morbids (the resolution for diabetes is 98% for the DS…and almost 40% of RNY patients develop Reactive Hypoglycemia 2-5 years out from surgery)
I wanted the one that had the least chance of regain.
Oh, and did I say, I needed to take NSAIDS??? LOL
Looking back, it was the best thing I ever did for me.
There are lots of studies as to the DS, most can be found here and here.
Another happy DSer here - I’m over 9 years out. Life with a DS is easier and more comfortable - and HAPPIER than anything I experienced before. The foods I have to avoid - to prevent gas - are primarily white flour products, and even those I can enjoy if I eat them late in the day. When I eat, I get FULL and satiated - not like the never-full feeling i had the first 50 years of my life. When I get hungry, it is almost always for the PROTEIN-containing foods I’m supposed to be eating. Because the DS causes about 80% of the fat I eat to be malabsorbed, fat is my friend - I can eat it pretty freely, which makes eating enjoyable. No fat-free ANYTHING. Butter, fatty meat, mayonnaise, eggs, cheese, BACON - these are all health foods to me. In fact, I need them to keep the internal skids greased.
With great power comes great responsiblity. I take two good sized handfuls of supplements (vitamins and minerals) daily, without fail. I do my labs (14 vials) yearly, and if I need to adjust something (usually do) I get that checked again in a few months to make sure I’m taking good care of myself. I have to eat 80-100 g of protein/day, without fail. I try to get a bit more exercise than I did when I weighted nearly 100 lbs more.
And I’m not skinny. I’m 59 years old, and decided life was more enjoyable if I was a bit heavier and not having to monitor my carb intake all the times I can live with that - and if I DO whan to lose more, I can do it like a normal person.
The DS fixed my broken metabolism. I don’t dump, I don’t have to chew my food 100 tinmes each bite, I don’t have to avoid drinking before, during and after meals. I’m pretty much normal, except my poops are bigger.
PLEASE - all of you contemplating weight loss surgery - check out the DS, including at www.weightlosssurgery.proboards.com. Best long term maintenance of weight loss, of cure of comorbidities, of ease of diet (can’t take NSAIDs with RNY) - and I’m a PhD scientist in molecular biogolgy who researched the dog poop out of bariatric surgery and have never looked back.
[QUOTE=phouka;15666481Maastricht, …Have you had to deal with any readjustments to your body image or discrepancies between what you think you look like and what you really do?
How have others reacted to your weight loss? Do you get compliments? Do you feel more attractive? Are you treated differently?[/QUOTE]
Good questions, and fun to answer. But I don’t think my answer will help you much. Questions like yours have answers that differ so much from person to person, but they do determine how happy you will be with your surgery and so they need to be adressed after surgery. That is where either therapy can be useful, or active membership of a board with people who have walked in your shoes.
First of all, it is tremendously unfair, but most people around you won’t even notice a difference untill the first 50 pounds or so have melted away. This is due to loose, elastic, concealing clothes, who didn’t show much of the weight gain, but also not of any weigth loss. And most people won’t want to buy new clothes that they are only going to wear for a couple of months or even weeks. (That is why post-ops on fora often organize clothes swaps).
Secondly, there is this thing wheb people have categorized you as “fat” or whatever they call it. And after 40 pounds many post-ops still fit that category. it isn’t untill you start approaching the “normal” sizes in stores and start to wear formfitting clothes and pay more attention to your looks, that people will start to notice and the compliments start pouring in. And change your look you will; many post ops have this whole honeymoon where they suddenly become fashionistas and have dramatic changes of hairdo, make-up etc, sometimes even plastic surgery.
Did I get compliments? Yes, lots and lots of them. But here is where my own background and hang-ups come into play.
I hadn’t been fat all my life: I had an average weight, untill I got depressed about eight years ago, got pregnant a few times as well, and gained 50 pounds in four years. Now, at 143 pounds and a weight loss of 88 pounds, I’m back at the weight I had when I was 22 years old. I would have been glad to get back to my pre-depression weight, but I didn’t have much say in the matter, 143 pounds is just where I ended up.
So the compliments did’t feel good. I felt I had solved an embarrassing problem, no more. Frankly all the compliments made me shamefully aware of how many people had actually noticed I had been so fat.
Also, I felt I did not deserve compliments on the end result. I felt like I had, well perhaps not cheated, but certainly had cut a major corner. I would have appreciated compliments on my decision process and my courage, far more then on the end result, as that was mostly my real contribution. For the rest I could only credit my genes and my surgeon.
Also, I am sort of spoilt when it comes to being told I’m pretty. I know I was pretty before I got fat, localized sort of pretty when I was fat, and pretty now. But being pretty, for me, is the bare minimum. Because I have all these character flaws to make up for, you see? But I do see it helps me professionally. Feelign confident helps.
Besides, I married so my weight loss doesn’t help me finding or keeping love. My husband likes my new body (he marreid me when I was just mildly overweight), but he didn’t mind the old one, either. Not much has changed romantically, and our time together is still limited by our preschooler and both of our internet addictions.
About the DS: Most post-ops become big fans of the surgery they had. On the boards, you have MGB fans, sleeve fans, DS-afficionados, and people who are in love with their sleeve surgery. Not the lap band, though; the lap band has lost its fanbase, and with good reason.
Anyway, every fan group will downplay the side effects of their own surgery and play up the side effects of another. It is just what we do to reconcile ourselves with our new situation, and you will do it too, whatever you choose That is why the best thing, objectively, is to go to a surgeon who is equally good in all the surgeries you are interested in, be honest with him about your eating habits and preferences, and then let him recommend a surgery.
And 6penningtons, while you may fear failure, (and that is good, it will keep you motivated to do every thing right !) remember that your odds are very, very good. the MGB and the RNY have, in many large scale studies, a patient satisfaction rate of about 95%. And that includes patients who, unlike you, were far less healthy going in to surgery, patients who didn’t have the mental capacity to read up on their surgery beforehand and somewhat knew what they went into and what they themselves should do to make it a success. And patients who had to go with an inexperienced surgeon. You don’t have those disadvantages. That puts you ahead of the curve. Your odds tell me you’re going to be fine.
In order to get a FAIR assessment of the DS, you need to see a surgeon who DOES the DS and not one who thinks they know what it is. Many surgeons think it is the Scopinaro BPD which is actually a Dsital RNY. I had the Hess Method which is the BPD WITH DS.
If you really have a Scopinaro BPD, you have a very large pouch, distal RNY. It looks like this:
Notice that it looks like a very large pouch and is missing the pyloric valve.
A true DS (sometimes called a BPD with DS/duodenal switch) looks like this:
Notice that the stomach, while thinner, is still intact AT both ends like a normal stomach is suppose to be.
Surgeons who do NOT do the DS will not give you the straight dope!
Check with Dr. Kemmeter (in Michigan) who is a vetted DS surgeon. Lightweights CAN successfully handle a DS. The DS is NOT just for heavyweights…a surgeon who says that is trying to scare you into not choosing the best surgery for you regardless of which one it is.
You als can get information on the site with articles from professional medical publications, pubmed.org. Here’s a search resultfor the comparison between gastric bypass (I heaped in RnY and MGB together) and the DS.
I have some (without clothes, I resemble a sharpei!) But it’s not bad when dressed.
As to doing anything about it…no, and not gonna since plastics are not in the budget. And plastics are self pay. Skin removal (NOT plastics cause it just removes the excess skin) has to be medically necessary and THAT is very hard to prove.
But then again, my excess is not bad, just a bit wrinkly. I am 58 and I’ll never look like a 20 year old…I look age appropriate.
Simple Lictus, loose skin is a problem for many people after bariatric surgery. It is hard to get objective numbers; only part of the post-ops will get plastic surgery. The rest may want to, but can’t afford it, or they may feel they look fine. Or look fine, as long as they are dressed.
My estimated guess is that about 30-40 percent of people are somewhat to really bothered by their loose skin afterward. In some, the loose skin isn’'t so bad, due to age, genetics, other factors or just dumb luck. That is me. In others, there is some loose skin, but they just don’t mind that much, like **southernlady **.
Insurance pays only if you rate as a four on the Pittsburgh Rating Scale (google it: medical pictures of nude women with varying degrees of skin folds). All other cases, it is pay for your own surgery, or get used to it.
Be careful: don’t take any vitamine supplements IF you are going to have your blood tested and IF you normally don’t take supplements. If you take vitamine supplements before testing, they may obscure your real, pre-op blood values.
Otherwise, once you have been tested for basline bloodwork, it is a good idea to take a (non-bariatric) multivitamine supplement in the weeks before surgery. It is good to have some stores of the good stuff in your body.
6penningtons, did your Mexico doc ask for a psychological evaluation? My doc did (a short evaluation, though, right after my talk with him) just to make sure that I didn’'t suffer from bulimia (uncontrollable eating binges) and that I was (sort of) a sane person, psychologically, who (sort of) knew what she was going in to.
Any tricks on reducing the extent to which one indulges in carbs, especially sugar? The most effective and simplest one is: “Don’t have it around the house” but aside from that?
Have you found convenient ways to get all your vitamins and minerals when on a diet? I have no problem getting enough protein.
Exercise: Any tips on doing it sooner than tomorrow, ever tomorrow?
Sugar…read Potatoes, not prozac. And Allan Carr’s book, The Easy Way To Stop Smoking. Even, or especially if you’re not a smoker. Carr’s book is the best book I know about addiction. And Potatoes Not Prozac is the best book I’ve encountered about sugar as an addiction. Both together help me to see sugar as an addiction, and an addiction that I have a lot to gain by giving up.
Vitamins and minerals on a diet? I have never dieted, so I can’'t help you there. After my surgery, I now eat healty, and I take vitamine supplements to compensate for my newly les efficient metabolism.
Exercise? I can’t give you tips you won’t find anywhere else. My own secret is to arrange my life so that going everywhere on my bike is more efficient then using the car. And by having a ratty heavy old bike.
I do think that giving up sugar can make many people less tired IF their tiredness is related to fluctuating blood sugar levels. To find out if that applies to you, you could borrow or buy a simple blood sugar measuring kit through your doc, of just buy one in the medical drugstore.
For me, carbs have a consequence…belly bloat and severe GAS…paint peeling. As long as I stay away from simple carbs and keep the rest of mine about 100 grams (I count ALL carbs NOT net carbs), I’m fine.
I don’t diet but I do take a slew of vitamins. Those of us who have had a malabsorptive procedure need even more than average. Example, the normal vit D range is 35-100. D is a fat soluble vitamin and the prescription D is oil based which goes right thru someone who malabsorbs. We don’t get to use the D we take. So taking a dry form is best. There is only ONE company (BioTech) that makes D3 in a high enough quantity to even budge most of us. And I take 50K daily (yes, 50K) along with an extra 50K two to three times a week to keep my levels around 100.
Iron, we don’t absorb the iron found in most multivitamins…that is the Ferrous Sulfate kind. Cabonyl or heme is much easier to absorb.
A bariatric vitamin even with high AEDK usually doesn’t even have iron listed in their ingredients. I know Bariatric Advantage High AEDK doesn’t. I’ve used that one before I moved to a regimen recommended by Vitalady
I had WLS to STOP dieting. That’s why I chose the DS…I don’t have to diet.
And ANOTHER happy DSer here! I’ll be 9 years out come December, and I couldn’t be happier with my choice. Today I have eaten: a hamburger steak with sauteed peppers and onions, with a couple of tomatoes on the side for breakfast, for lunch I had (2) salmon croquettes with fried potatoes and cole slaw, a afternoon snack of string cheese and nuts, and I’m planning a steak, salad, and baked potato for dinner. And I’m sure that before I go to bed tonight I’ll have an ‘indulgent’ snack.
And eating like this, I’m maintaining a loss of 170+ pounds! Like Southernlady, I was tired of dieting.
Ruby, how are you? It’s been three years since your surgery? And 6penningtons, if you can give an update, I would be very much interested in how you are these three years later.
My doctor thinks me quite the freak for halving my weight and keeping it off, I am near 3 years maintaining now after two years losing via calorie counting. She says 5-10% for the formerly morbidly obese at 5 years. I have read that a number of those who lost a lot of weight via our Biggest Loser TV program opted for bariatric surgery to help them keep the weight off and that makes sense to me, the surgery is easier, safer and less of a mindfuck if you have already changed your ways. I still have to pay more attention than I’d like as someone who would rather eat pizza than broccoli.
Living in a smaller body is a very hard transition to make, I had reasons for building a shield of fat and sedating/comforting myself with food that didn’t go away with the weight. I understand why so many put it back on if there is not some physical limitation, morbid obesity is a head issue much more than a body one.
My doctor is female, young and thin. She doesn’t seem to care or understand a 60 year old battling losing weight, trying to diet but having no success. I have tried to find other doctors but they don’t have openings for a new patient. I’m 240, 5"8 and in a lot of physical pain. I have tried to lose weight and succeeded many times, but this is the most I have EVER weighed and it’s so hard. I’m now diagnosed as pre-diabetic. Open to any help I can get. Believe me I know how as I’ve been dealing with weightloss for almost 50 years
Bethandgino, what is your BMI? If it is over 30, I recommend you read this book first. If you still think surgery is for you, then make an account at this site and find a well recommended doc near you.
Or you could do what 6penningtons did in this thread and go the Mexico route.
Or go to one of the top docs in the US for the kin dof surgery I had, dr Rutledge.
But I do see it helps me professionally. Feelign confident helps.
That is why the best thing, objectively, is to go to a surgeon who is equally good in all the surgeries you are interested in, be honest with him about your eating habits and preferences, and then let him recommend a surgery.
