Weight Loss Surgery - anybody know someone who had the Duodenal Switch?




goincrazyinky
11-16-2008, 09:15 AM
I am 130 lbs overweight. I had the RNY surgery in 2001, gained it all back. This new surgery says you can eat what you want and still lose 85% of all your excess weight and keep it off even 5 years later. I am looking for anybody who had it and to tell me if you know something bad about it. I can't find one bad thing about it from anybody, anywhere on the web. So, I am hoping to find some info here. Thanks, Pat in Kentucky


nelie
11-16-2008, 09:47 AM
I would recommend asking in the Weight Loss Surgery Forum.
http://www.3fatchicks.com/forum/forumdisplay.php?f=78

I know Jillybean is looking at getting the duodenal switch.

Honestly, I'd be concerned slightly if you are looking for this surgery in order to eat 'everything that you want', lose weight and maintain that weight. From what I know of any weight loss surgery, it'll give you a boost, especially in the beginning but you will still need to exercise and control your food in order to keep losing and maintain that weight loss.

Realistically, with any 'diet' you can eat 'whatever you want' basically as long as you eat small portions of it.

rockinrobin
11-16-2008, 10:25 AM
Hey Pat! How've you been?

I would definitely agree with everything that Nelie's said to you.

"Eating whatever I wanted" got me to be 287 lbs. Ummm, because apparently I wanted a real lot. More then most people, that's for sure.

It was finally realizing and accepting that I couldn't eat whatever I wanted if I also wanted to be fit, trim and healthy. You simply can't have it both ways.

Eventually I decided that I no longer wanted to be a person who got to eat whatever she wanted. I finally wanted to have limits and boundaries and control. I wanted to have food "guide lines", in order to be that fit, trim and healthy person.


AAAA
11-16-2008, 06:26 PM
I had the DS over 3 1/2 years ago.

Sorry, but you can't eat whatever you want. It's protein first, second & third. Then fruits/veggies, then breads, junk, etc. Some people can eat more than others (remember 75% of your stomach is removed & while it does stretch back somewhat -- most can't eat what they did before. However, some can. We're all different. Then there's the whole malabsorption aspect - another topic altogether).

I can give you a list of what I've experienced as the positives and negatives of the DS if you like.

Plus, there are several websites/boards dealing with the DS (I don't know which you've already seen).

Dlocke101
11-17-2008, 01:44 AM
I would also love to know more about your experiences. Both positive and negative.

Debbie

goincrazyinky
11-17-2008, 09:48 AM
Please send me the list you were talking about. I have gone to all the DS boards and everybody tells me they were able to eat whatever they wanted and everyone has lost 80% of their excess weight. You can't absorb fats or starches and that is a huge thing for me. But, they tell me the RNY failed them as it did me and the DS is what got them down to their goal weight. I am taking vitamins due to the RNY surgery, so that is not a problem with me. Now, I have had some people say they have diahreah after a fatty meal, but the surgeon's nurse said diahreah is not normal and the doctor will make you take probiotics if you experience that to clear that up. Please send me the list because I want to hear 100% truth from everybody as I have already 'signed up' to have the surgery, yet I am still researching at the same time. Thank you so much, Pat in Kentucky

AAAA
11-17-2008, 05:15 PM
I'll post it here so both of you can see it.

You do lose a great deal of your excess weight & it's harder (but not impossible) to regain a great deal.

I rarely, if ever, have diarrhea. Some people do. It's very individualized but often (not always, but often) your surgeon & nutrit. can help you out if it's chronic with food choices, drugs, etc.

These percentages are not hard and fast but they generally go like this:

Absorb 20% fats
Absorb 60% protein
Absorb 60% carbs
Absorb 100% sugars

Also, revisions can have different results. You need to find someone very experienced in revisions (I know 1 or 2) as it's a more difficult operation.


Here's what I post when someone asks for the good/bad of the DS:

The Good:
I didn't want to dump (although more and more RNYers I know don't dump).
I wanted a stomach and pylora.
I wanted to be able to eat just about anything.
I wanted to lose more and have less chance of regain.
I like protein and welcomed the chance to eat a lot.
I can't eat nearly the quantity I used to. But I can eat enough to feel full.
I don’t count calories.
I drink with meals.
I look good and this gives me confidence.
I can still eat junk. I just have to eat less (smaller stomach) and choose to eat it a lot less frequently.

The Not So Good (As you need to know both):
My gas and stool stink more & it can be difficult in a public setting.
I go to the bathroom more times a day than I did preop.
I’ve had a couple of ‘accidents’.
I take a ton of vits/minerals each day (it's not cheap).
I have bloods taken every 6 months (more if needed).
I eat protein first, second and third. I generally don't mind but once in a while it gets tiresome.
You can have vitamin issues no matter how diligent you are.
If I eat junk I get gas and/or spend time in the bathroom.
I have some excess skin.
I see more doctors and have more tests than I did preop. But I'd prob. be seeing a lot of doctors as time went on anyway for the physical problems that were beginning to creep up when I was heavy.

I'd estimate I spend about $1000.00 per year on vits/minerals (including protein supplements) plus more on things like acidophilus to help with gas/stool smells at 3 1/2+ years postop.

BTW, I can't PM you till I have 10 posts, so I'll answer your PM by emailing you.

One more thing: Tonight on the Discovery Channel 9PM & 1AM/Eastern is a DS Story. It's called, Extreme Bodies
Super Obese. As there have only been a couple of DSers [ever] profiled on Discovery you might want to catch it. I know the guy (from the boards) so I'll be watching.

jillybean720
11-17-2008, 06:52 PM
Please send me the list you were talking about. I have gone to all the DS boards and everybody tells me they were able to eat whatever they wanted and everyone has lost 80% of their excess weight. You can't absorb fats or starches and that is a huge thing for me.
I think you may need to do a bit more research. I am having the DS hopefully in the spring (I'm almost done jumping through insurance hoops and then my surgeon is scheduling about 3 months out for the DS since he only does 1 a week). Yes, there are a few who can eat whatever they want, but that is not the majority.

Protein is priority #1, 90-120 grams of protein a day. AFTER that, if you have any room left, you can reach for other foods, but know that simple sugars are absorbed at 100%. You eat a donut, you get ALL of the cabrs and sugar in that donut. Period.

They DO absorb fats and starches--about 20% of fats, 60-70% of complex carb, and 100% simple carbs.

Some DSers who eat too many carbs get major gas as a side effect. Some DSers who eat too much fat can get diarrhea as a side effect. Some DSers who don't eat enough fat may get constipated. It's all trial and error as to which foods affect you and which don't, as everyone is a bit different.

DSers also malabsorb different vitamins/minerals than RNY patients. I believe for RNYers, B vitamins and iron are usually the biggies, but for the DSers it is primarily calcium and the fat-solubles (A, D, E, and K). So you would have to add more supplements to those currently being taken for the RNY.

If you really want to know more, check out www.duodenalswitch.com (http://www.duodenalswitch.com) and www.dsfacts.com (http://www.dsfacts.com) (recently created by a DSer in Canada) and, for all types of WLS, www.obesityhelp.com (http://www.obesityhelp.com).

I have yet to find more than 1 DSer who actually regrets having their DS. I have met a couple DSers who DID gain some weight back, but they've found it easier to re-lose it than it was to lose weight before the surgery. It is not a magical cure-all, and the average is 85% excess weight loss--some do better, some do worse.

goincrazyinky
11-18-2008, 03:33 PM
WHAT HAPPENS IF YOU CAN ABSORB 100% OF THE SUGAR? My biggest problem IS sweets. So, do you absorb 100% of the calories? :?:

jillybean720
11-18-2008, 03:41 PM
WHAT HAPPENS IF YOU CAN ABSORB 100% OF THE SUGAR? My biggest problem IS sweets. So, do you absorb 100% of the calories? :?:
Yes. There is NO surgery that results in malabsorption of simple sugars since sugars begin breaking down as early as in your mouth (think about holding a sugar cube in your mouth--your saliva alone will begin breaking it down, and it will melt away and be processed by your body).

yogajane
11-18-2008, 03:58 PM
Friend of mine had lipo but the weight came back within 6-9 months.

goincrazyinky
11-18-2008, 04:02 PM
I have been reading about the diet following DS. You have to carefully get your proteins in. That's easy. But the diet of being careful to not ever eat any breads/starches or simple carbs...well....if I could eliminate those and stick to a diet, I could lose the weight anyway. So now I am quite confused. I do eat healthy lean meats and veggies and fruit, but my weight problem is due to overeating the starches, sweets. I know how to eat now, but have never been able to stick to a strict diet. And if you could, why would you need gastric surgery. Like Weight Watchers, I write everything down I eat and I can do well for several days, but then I have a desire to eat a piece of cake or a cookie or well, maybe even a dorito or two. Not everynight, but it does happen. I remember my surgeon telling me I would lose weight in spite of myself with the RNY surgery. I lost 50 pounds but that's it. I can exactly exactly the same amount as before I had rny surgery. The first 3 months i couldn't, but my stomach kept stretching. I don't know HOW you are ABLE to stick to a strict diet after weight loss surgery if you could not do it before the surgery. I don't know what to do.

mandalinn82
11-18-2008, 04:17 PM
Pat,

There is no surgery that will allow you to lose weight while eating whatever you want, in whatever quantities. Really! It simply doesn't exist. All bariatric surgeries are tools to help you, but aren't cure-alls that will cause you to lose weight without intentional eating restrictions.

As for how you'll be able to stick to a diet - well, something just has to CLICK, is all. Something in your brain has to say "You know what? I can control this. I have the power to choose what I eat and to get my body into the kind of shape that will keep me happy and healthy for years to come. I choose every bite and every step or lack thereof. There are plenty of tools out there to help me, but no one can do this for me. I have to do it myself".

goincrazyinky
11-18-2008, 05:04 PM
okay, okay, I confess. I ate an entire Peppridge Farm cake within an hour.

nelie
11-18-2008, 05:50 PM
Pat,

I'll make an assumption here and say anyone who is 100 lbs or more over weight has issues with food. Of course there is the small minority that do have medical issues that could cause them to gain that amount of weight, I believe they are the minority.

So I will say that you are not alone in having issues with food. I've had issues with food since around age 6. I do believe that things like PCOS didn't help the situation but I was the one that learned how to binge my weight to well over 300 lbs.

I also had to learn how to get myself down to nearly 200 lbs. Every day is not perfect. There will be days that I eat way too much and don't get in enough activity but I have to balance those days with the days that are good. Its been a struggle and a learning process. I feel a bit defeated because I am stuck. I know why I'm stuck though and it is because of my issues with food. If I could get past it, I could lose the rest of the weight I want to but I struggle. Each day though I'm mindful that I can't live like this forever. I've become so much better at using the tools I've learned but I know I need to perfect my tools or learn new tools to battle the weight that is left.

Anyway, I'd say that you probably weren't prepared for your RNY surgery. You expected to be able to eat whatever you wanted to eat. I would suspect that anyone with that mindset going into surgery would end up gaining the weight back. For your upcoming surgery, in order to be successful, you should prepare to be in the right mindset once the surgery is done. Prepare to eat the right foods, nourish your body, etc etc.

One thing I'd say about refined carbs is they are something I can't allow myself to eat because they make me crave more and more and more. I think you need to help yourself by learning what foods you can eat that will be helpful to your weight loss and what foods will not help you.

This website has been a large help for me in getting the support I need as well as helping me learn the tools I need to learn. I hope you can also utilize the support here for your weight loss journey.

AAAA
11-18-2008, 05:55 PM
I don't know any DSer who doesn't ever eat carbs (though some are more careful about what type they eat than others). I sure do. I have some everyday. 1/2 bagel, bread, potato chips, pretzels. Not a lot, b/c I can't & b/c I always think protein first. If you don't you'll feel very tired and not good, believe me. I could eat an entire Pepperidge Farm cake preop, too. I can't now. I could prob. eat 1/4 -- it depends how big it is. Then I'd have to come back to it a few hrs. later. I do eat junk. I think I mentioned it in my earlier post. Just not as much and less often.

Like you said, you need to get all that protein in. I eat 80-120gr/day and it's almost always over 100gr. Then I try to drink as much as I can (I'm not great about that). Then a piece of fruit (I'd like to do at least two). Then some carbs. If not, I lose too much weight. One of the interesting things about the DS is that if you want to lose wt. you eat more protein and drink more. So if you don't have some carbs, many of us find we get too thin. Hard to believe:dizzy:, but that's a problem I'm having for the last 9 mos. or so.

RE: the protein: I have a ticker in my head. Now for the first 6 mos. I kept a food diary my surgeon's nutrit. gave me. Once I learned the protein value of most foods I ate, the ticker in my head just kicked into gear. It isn't intrusive, I just know it's running in the back of my mind what my count is. So a day I don't have enough protein at lunch, I make sure I eat a good amt. of nuts and/or cheese (I do most days anyway) or maybe drink a protein bullet. Like I said, it's not in the front of my mind any longer (it was the first couple of years) now it's just quietly in the rear.

BTW, I don't eat 'lean, healthy meats'. Neither do many DSers I know. That'll be your choice when you're postop depending on your cholesterol and what your dr. says. I happen to be a DSer who watches it more than most b/c everyone in my family takes a statin (but me b/c my cholesterol, lipids, etc. are so good postop) due to high cholesterol (and none are obese) and heart disease in the family. I generally don't eat the skin on chicken and only eat ice cream once a week. But others eat much more in the way of fats due to the malabsorption. But I do eat fatty steak & stuff like that.

mandalinn82
11-18-2008, 06:35 PM
AAAA - Do you think your inability to eat an entire cake is due to your surgery, or due to not eating those things in such quantities for so long? I'm wondering if it is the SURGERY that made that particular change for you, or your change in eating habits? I'm just curious because I could have eaten a whole cake before, and I would probably get about a quarter into it now and feel sick also, but I haven't had any bariatric surgeries. So it's an interesting chicken-and-egg situation...did the surgery cause your inability to eat junk in quantity, or did the surgery cause you to change your eating habits, thus getting you out of the habit of eating junk in quantity and making your body react poorly to it?

It's an interesting point to ponder...was it the behavioral change or the physical change?

nelie
11-18-2008, 06:58 PM
AAAA - everyone eats carbs. Personally I follow a high carb diet but the carbs I eat now are considerably different than before my weight loss. Also, like Amanda I've had no surgery but I can't eat the amount I could before my weight loss.

It is my belief though that weight loss is very individual and there are subtle differences even between those that lose via similar methods.

AAAA
11-18-2008, 07:23 PM
AAAA - everyone eats carbs. Personally I follow a high carb diet but the carbs I eat now are considerably different than before my weight loss. Also, like Amanda I've had no surgery but I can't eat the amount I could before my weight loss.

It is my belief though that weight loss is very individual and there are subtle differences even between those that lose via similar methods.

I agree with you, Nellie. Everyone does eat carbs and I hope I made that clear when Pat worried about eating them after a DS. You can't live without them and who would want to? Not me. It's just that with the DS they're not the first thing one generally thinks of. Protein is first, second and third. Oh, and one other thing. Part of the reason many DSers eat fewer carbs is the noxious gas. Personally, I generally only eat them in private (unless I have the probiotics going) ;)

I also agree that it's completely individual no matter if you've had surgery or not. I seem to eat much smaller amounts that many DSers I know. When I go out to dinner with a few they eat from soup to nuts while I can eat about 1/2 my entree (always have enough for another meal, tho ;)). Also, just as none of us eat the same, nor have the same bathroom or gas habits.

AAAA
11-18-2008, 07:30 PM
AAAA - Do you think your inability to eat an entire cake is due to your surgery, or due to not eating those things in such quantities for so long? I'm wondering if it is the SURGERY that made that particular change for you, or your change in eating habits? I'm just curious because I could have eaten a whole cake before, and I would probably get about a quarter into it now and feel sick also, but I haven't had any bariatric surgeries. So it's an interesting chicken-and-egg situation...did the surgery cause your inability to eat junk in quantity, or did the surgery cause you to change your eating habits, thus getting you out of the habit of eating junk in quantity and making your body react poorly to it?

It's an interesting point to ponder...was it the behavioral change or the physical change?


It is an interesting question. Sounds like with you it maybe your head giving you that full feeling. That's a great thing.

With me, I have to say it's probably both but more the physical. Believe me, there are times I'd love to eat that whole cake and really, really want it, but physically I can't. I feel ill & uncomfortable if I eat too much or drink too much while eating. For the first year, I threw up if I ate too much or drank too much after eating. Nowadays, I can still hang over the sink retching if I do it, but rarely throw up. But it still does happen if I just push it a bit too far. I'm not talking about junk, but just dinner. I have to know when to stop and come back and finish and hour later. It's a physical sensation I sometimes ignore...

mandalinn82
11-18-2008, 07:42 PM
AAAA, no it DEFINITELY isn't my head talking. I've had that same "Wow, I really want another cookie!" feeling. It makes me nauseous, though, and shaky from all of the sugar. I think my stomach just isn't USED to vast quantities of junk, and so it rebels when I give it too much. Even if I wanted to, I couldn't eat another cookie without throwing up.

I wonder if thats a different cause of a "shrunken stomach"? Eating less for long enough?

yogajane
11-18-2008, 08:44 PM
Isn't there an issue though with this procedure and nutritional uptake afterwards?

rockinrobin
11-18-2008, 08:49 PM
Pat, I truly believe the only way to lose weight, and enough of it to get to a healthy size, is that the desire to be thin and healthy MUST outweigh the desire for the food.

You have to want to be healthy so, so badly that you pass up on all the "bad food", even though you want to eat it. It doesn't matter if you want Doritos or a cookie. You want the weight loss MORE.

I know for me, until I hit that point, longterm weight loss simply could not occur.

PhotoChick
11-18-2008, 08:50 PM
I'm with Manda. I used to be able to eat quite a bit of junk, but in the last year I seriously cannot eat the same volume of junk that I used to. The last time I ate about a 1/2 can of Pringles I felt sick the rest of the afternoon. And I used to be able to put down a couple of cans at a sitting.

Same with sweets. I used to be able to eat a whole piece of Godiva chocolate cheesecake at Cheesecake Factory. Now, I can eat maybe a 1/4 or less before I start to feel really icky and sugar-overloaded.

There are a lot of things that I can only eat small amounts of now w/out feeling queasy.

And it's definitely not mental - because as Manda said, there are plenty of times that I've WANTED more ... but I know that I can't eat more because it will make me feel utterly awful.

.

rockinrobin
11-18-2008, 09:09 PM
I used to be able to eat quite a bit of junk, but in the last year I seriously cannot eat the same volume of junk that I used to.

Same for me. There's no way on earth I could ever get down a fraction of the volume that I used to eat. I get full sooooo much quicker now.

And that Godiva Cheesecake from the Cheesecake factory. I've had enough after a couple of bites. I think it's the chocolate though, because I've managed to eat full slices of other cheesecakes. Although when I did eat that full slice, I felt just horrible. Horrible. Amazing how I used to be able to eat and eat and eat. The volume was scary. Of course I DID feel horrible, but now it's just simply out of the question.

jillybean720
11-19-2008, 11:16 AM
I have a few comments, as someone who has researched the DS to death and decided it is the way for me, and as someone who pretty much eats like a DSer right now due to a high protein, low-carb diet being the best way for me to control my type 2 diabetes. So, my comments come from my experiences as one not yet having had the surgery and from my extensive DS research and discussions with those who are living with the DS.
I have been reading about the diet following DS. You have to carefully get your proteins in. That's easy. But the diet of being careful to not ever eat any breads/starches or simple carbs...well....if I could eliminate those and stick to a diet, I could lose the weight anyway. So now I am quite confused.
This is exactly how I used to think about WLS. I would say, "Umm, hello, if I could eat a quarter of a cup of food for each meal like you have to after surgery [thinking of RNY gastric bypass], I could lose the weight--why have surgery?"

Here's the difference: your stomach is made smaller, and the outer curvature of your stomach that produces grehlin (the hormone that increases your appetite) is removed. When you eat those 100+ grams of protein a day, you have little room left in that smaller stomach for junk food. And no, you don't have to avoid carbs and junk for forever. You can still have them--but not until you've had your protein. DS Rule #1: Protein first, second, and third. And without your stomach producing grehlin (or very very little of it), your appetite is suppressed.

Also, many people find their tastes have actually changed after the surgery (can't explain why). I've watched many many people get protein drink samples before their surgery so they know which ones they like, and then they order a bunch of their favorites. Well, come time to go home from the hospital after surgery, they find they can't stand those flavors anymore! So there's a lot more at work than just "eat this, don't eat that" diet rules.

It's an interesting point to ponder...was it the behavioral change or the physical change?
I've made the bahavioral changes before (as I know you've seen me do multiple times!). I used to be a fast food junkie--I could put away 3 Happy Meals at once. But after going cold turkey on fast food for a while, it makes me naseous to have more than half a cheeseburger and a couple of fries. My stomach no longer likes all that grease and junk. This is due to my behavioral change. However, as I understand it (and I'll let you know in a few months for myself), after the surgery, it's not necessarily just a matter of feeling sick after eating the junk--it's a matter of your stomach literally not having the capcity to hold it anymore. Yes, the adjusted stomach can stretch over time, but never back to the size it was prior to surgery. So, I would think the answer is a combination of both. But I can also answer that the behavioral changes can easily be undone (as I've done to myself multiple times :( ).

Isn't there an issue though with this procedure and nutritional uptake afterwards?
If you are careful, then there is very little chance you will have an issue with nitritional uptake. However, by being "careful," what I mean is you must be proactive. The sad truth is that most doctors, surgeons, and nutritionists (even those who specialize in bariatrics) do not fully understand what DSers need after surgery. I've seen DSers told to just take multivitamins and calcium only to become severely anemic or otherwise nutritionally deficient later on. DSers only absorb about 20% of the fat they eat, so fat-soluble vitamins NEED to be supplements (A, D, E, and K). Also, calcium is a must, and it should be calcium citrate as opposed to calcium carbonate (since citrate is a more easily absorbable form--this is also true for RNYers, not just for the DS). Occasionally, I also see people with low iron, which is relatively easy to supplement as well.

The trickiest part is that you really have to do some research yourself and that you need to closely follow your own follow-up blood labs. Often, a doctor will get your lab results, and as long as everything is withing the "normal" range, the doc tells you you're fine, and you're on your way thinking you're just dandy. However, you really need to get copies of your lab results and compare them to each other. You may be in the normal range this year and last year, but if you were in the high end of th enormal range last year and are in the low end of the normal range this year, that's a sign that that nutrient is trending downward and likely requires additional supplementation. You have to be proactive, educated, and responsible for yourself.

I'm with Manda. I used to be able to eat quite a bit of junk, but in the last year I seriously cannot eat the same volume of junk that I used to. The last time I ate about a 1/2 can of Pringles I felt sick the rest of the afternoon. And I used to be able to put down a couple of cans at a sitting.
I think I already answered most of this previously in my response to Manda, but I also want to add that right now, I can even overeat non-junk foods. While your stomach can naturlly shrink without surgery (since it has been stretched out from years of over-eating), it won't shrink to the size of a post-WLS stomach.

I used to be very against surgery for myself. VERY against it. Why not just eat less? Why not just stop eating all that junk? Why not just change your lifestyle? And I still agree that these things should be tried multiple times (in different variations--maybe low carb isn't the right solution for one as it is for the other; we're all different) prior to seeking surgery, as surgery should NOT be someone's first attempt at weight loss. If I were healthy but fat, I would likely still not be seeking surgery. When I bring it up to people, I say I am having surgery to possibly cure my diabetes, not that I am having weight loss surgery, but that in the U.S., the diabetes-reversing procedure is only done as part of a WLS procedure.

And, I have to say, we have some exceptional people here on 3FC. On average, fewer than 5% of people who lose 100 pounds or more can maintain that loss for 5+ years. I've seen multiple 3FC chicks do it, so I know it can be done! But some people need a stronger tool to help them.

PhotoChick
11-19-2008, 11:26 AM
Hey Jill. Thanks for the long response.

I think it sounds like you've done a lot of research and come to the right choice for you. I guess what concerns me about a lot of the posts I read, is that I see a fair number of people saying "I can still eat normally" or "you can eat whatever you want". Obviously, from what you've written, that's just simply not true.

I just wonder overall if people really realize what they're getting into by making these permanent changes to their bodies that will impact them for the rest of their lives. And how many of them really realize that they *cannot* "eat normally" afterward - even if there is a physical change in the desire for food as a result of the surgery, the emotional issues haven't been addressed.

I dunno ... I haven't had WLS, I don't plan to have WLS and so I don't really have a dog in this hunt. But it's just something that I wonder about when I happen to hit a thread on the topic.

.

nelie
11-19-2008, 12:19 PM
Hey Jill,

Is your surgery date set? When is it?

Also, I know with other surgeries, your stomach can expand back with certain things like carbonation and just eating too much, is that the same for duodenal switch?

For me, I never investigated surgery because my issues aren't hunger, they aren't health, they were just eating too much of the wrong thing. Now I eat mostly too much of the right things.

I think with anything we go into we just need to be informed. For me, I did a lot of research on my current eating lifestyle before I went into it. Investigated macro and micro nutrients I would require and how to get them. I think even those that don't have surgery or don't restrict their diet in some manner are in danger of being malnourished. I think it is just the overall way our eating habits are going.

jillybean720
11-19-2008, 01:47 PM
I just wonder overall if people really realize what they're getting into by making these permanent changes to their bodies that will impact them for the rest of their lives. And how many of them really realize that they *cannot* "eat normally" afterward - even if there is a physical change in the desire for food as a result of the surgery, the emotional issues haven't been addressed.

I dunno ... I haven't had WLS, I don't plan to have WLS and so I don't really have a dog in this hunt. But it's just something that I wonder about when I happen to hit a thread on the topic.
I agree 110%, and the point of my writing so much about it really is to try to help people become fully aware of what it entails. I can't tell you how many posts I've read from people on other message boards who have had WLS who come in asking questions where my initial reaction is, "really? How are you asking this AFTER your surgery; how did you NOT know this before letting someone cut you open and rearrange your insides?" With the DS, there are only about 20 surgeons in the U.S. who really perform the procedure, and most of them are quite particular about who they will perform it on. Because it does require so much follow-up and close watchign of labs and such, DS surgeons tend to be quite strict about who they accept as a patient. I know when I went it, the nurse I spoke with before I even spoke to the surgeon sort of grilled me on the ins and outs of the DS. If you aren't 110% sure it's what you want and can't explain in great detail the procedure, how it differns from the RNY gastric bypass, what possible issues you may have after the surgery, etc., you're not getting a DS from my surgeon! I only wish they were all so stringent, including RNY surgeons.

Hey Jill,

Is your surgery date set? When is it?
No date set yet. I just finished my insurance's required 6-month medically supervised diet yesterday, so as soon as my doc is done with all her notes, they will get sent to the surgeon's office who will submit my entire package of info to my insurance company for surgery approval. Then, my surgeon is scheduling DS procedures about 3 months out since he only performs 1 per week, so, assuming I get insurance approval in my first try without having to appeal, I'm looking at around March for surgery.

Also, I know with other surgeries, your stomach can expand back with certain things like carbonation and just eating too much, is that the same for duodenal switch?
Yup, the stomach can stretch out, but not back to as large as before surgery. The outer curvature of the stomach is removed to make sort of a banana-shaped stomach (a "sleeve"), which also happens to be the "stretchiest" part of the stomach. After surgery, a typical DS stomach (they do vary in size) can hold about 4-6 ounces of food and may expand over time to hold up to 8-10 ounces. The typical stomach size without surgery is about 2-3 liters, so even a stretched out stomach after surgery is still smaller than a shrunken stomach without. Oh, and the carbonation thing is a myth--carbonation does not stretch out stomachs or pouches (though some surgeons and nutritionists still tell patients it does--studies show this to be false).

PhotoChick
11-19-2008, 01:57 PM
my initial reaction is, "really? How are you asking this AFTER your surgery; how did you NOT know this before letting someone cut you open and rearrange your insides?" Yeah, this is my exact response.

It's good to hear that the DS doctors are being so thorough and strict with the process ... at least for all intents and purposes. :)

.

AAAA
11-19-2008, 06:31 PM
Here's the difference: your stomach is made smaller, and the outer curvature of your stomach that produces grehlin (the hormone that increases your appetite) is removed. When you eat those 100+ grams of protein a day, you have little room left in that smaller stomach for junk food. And no, you don't have to avoid carbs and junk for forever. You can still have them--but not until you've had your protein. DS Rule #1: Protein first, second, and third. And without your stomach producing grehlin (or very very little of it), your appetite is suppressed.

While it's true much of the grehlin is gone, there are differing opinions as to whether it's gone for good and/or how much is produced again as time goes on. Most DSers I know definitely regain their appetite. I did at 6 mos. out. Was it the same as preop? No. But part of that is b/c I know I can't fit in what I did preop (b/c while my stomach has expanded it isn't nearly as large as preop). Plus, like Jilly said, I know I have to get in the protein before the junk & that fills up most of my stomach.

Also, many people find their tastes have actually changed after the surgery (can't explain why). I've watched many many people get protein drink samples before their surgery so they know which ones they like, and then they order a bunch of their favorites. Well, come time to go home from the hospital after surgery, they find they can't stand those flavors anymore! So there's a lot more at work than just "eat this, don't eat that" diet rules.

I've seen this a lot. Personally, it didn't happen much w/me. The one thing w/me is salt. The first year everything tasted as if it were drenched in salt. Then things tasted like they needed salt. It still goes on and off like that but to a much lesser degree. The one 'taste' thing that's happened to me is the 'richness of taste'. It's a bit hard to explain but, for instance: when I have chocolate cake or ice cream or something I taste it but not as much as before. Don't know if that makes sense but I've noticed that over the last few years.

There are also many physical changes. I won't go into great detail but here are a couple of examples I can give you about how my body has changed:
*the body shape (of many of us) changes a good deal (and looks different than when you've lost weight before) prob. due to the way fat is distributed now.
*I could also tell you about the hot water in the shower. Sometimes it feels scalding and that same temp. could be too cold the next week. There are thoughts that this has to do w/the thinner skin I now have - also prob. fat distribution (the veins in my inner arms were always good, now that the skin is so thin they're more prominent)

I've made the bahavioral changes before (as I know you've seen me do multiple times!). I used to be a fast food junkie--I could put away 3 Happy Meals at once. But after going cold turkey on fast food for a while, it makes me naseous to have more than half a cheeseburger and a couple of fries. My stomach no longer likes all that grease and junk. This is due to my behavioral change. However, as I understand it (and I'll let you know in a few months for myself), after the surgery, it's not necessarily just a matter of feeling sick after eating the junk--it's a matter of your stomach literally not having the capcity to hold it anymore. Yes, the adjusted stomach can stretch over time, but never back to the size it was prior to surgery. So, I would think the answer is a combination of both. But I can also answer that the behavioral changes can easily be undone (as I've done to myself multiple times :( ).

Jilly's right. When I do eat fastfood, I generally order 4-5 hamburgers - no buns b/c I'd never have enough room (plain b/c I'm a picky eater) and a medium fries (was a small fries for the first 2 years but now I can do a medium). I eat 2 of the burgers and then 2 an hour or so later (I always eat my meals in two shifts. My stomach seems to be quite small. Most of my DS friends manage to eat a decent amount and only need 1 sitting) and the fries later.

The trickiest part is that you really have to do some research yourself and that you need to closely follow your own follow-up blood labs. Often, a doctor will get your lab results, and as long as everything is withing the "normal" range, the doc tells you you're fine, and you're on your way thinking you're just dandy. However, you really need to get copies of your lab results and compare them to each other. You may be in the normal range this year and last year, but if you were in the high end of th enormal range last year and are in the low end of the normal range this year, that's a sign that that nutrient is trending downward and likely requires additional supplementation. You have to be proactive, educated, and responsible for yourself.

Definitely. You've got to be very proactive. Keep your lab results (preop, too, so you can compare), have your bloods done every 6 mos. (if that's what your surgeon wants) or more, take every vit/mineral/iron without fail (I take a ton each day ;)). Eventually, the DS ceases to be your whole life. You feel more and more normal. However, as a DSer told me when I was 5 weeks out -- yes, we're more normal than before but we're never totally normal. If you think that then you won't be as careful with the protein, vits/minerals, etc. Just always have it somewhere in the back of your mind.

I used to be very against surgery for myself. VERY against it. Why not just eat less? Why not just stop eating all that junk? Why not just change your lifestyle? And I still agree that these things should be tried multiple times (in different variations--maybe low carb isn't the right solution for one as it is for the other; we're all different) prior to seeking surgery, as surgery should NOT be someone's first attempt at weight loss. If I were healthy but fat, I would likely still not be seeking surgery. When I bring it up to people, I say I am having surgery to possibly cure my diabetes, not that I am having weight loss surgery, but that in the U.S., the diabetes-reversing procedure is only done as part of a WLS procedure.

I waited over a year before I even looked into it after my PCP said I had to do it. I didn't want it. I wouldn't discuss it. Finally, I began my research. Honestly, I still wish I could've lost the wt. without it but I couldn't. Too many years, doctors, etc. and I finally had to admit I had to have it.

And, I have to say, we have some exceptional people here on 3FC. On average, fewer than 5% of people who lose 100 pounds or more can maintain that loss for 5+ years. I've seen multiple 3FC chicks do it, so I know it can be done! But some people need a stronger tool to help them.

What a great statistic.