Taterweight

I am going to have surgery for the DS in under 3 weeks, but I can tell you why I chose the duodenal switch over the sleeve. Firstly, the DS has the best track record of keeping the weight off permanently (so long as you adhere to Vitamin regimen and limit carbs). Secondly, with only a sleeve, the stomach will stretch and I would have to diet the rest of my life - the malabsorption of the DS limits that! Thirdly, I have over 150 lbs to lose, while nothing is a guarantee, I have a better chance of loosing all of my excess weight with the DS. The sleeve would hopefully get me 100 lbs lighter. Lastly, while I'm not diabetic - yet - odds are I will never have to worry about being diabetic because of the DS procedure.
Hope that helps!

A good reference for anyone looking into the DS (or any WLS for that matter, as the DS should at least be on everyone's radar along with the other mainline procedures) is
http://www.dsfacts.com/
My wife had a DS around nine years ago (and I'm three years out on a VSG.)
What is the protocol to get to surgery?
It should be the same as any other WLS, though you do have to find a DS qualified surgeon as it is a more technically challenging procedure than most other WLS, so many surgeons don't find it worthwhile for them to develop the requisite skills (but that also means that most of your experienced DS surgeons tend to come from the top of the class!) Go to a surgeon's seminar and become familiar with them and what they need to get the ball rolling; some insurance may require a PCP referral, so it pays to be knowledgeable about the procedure so that one can educate their PCP on it.
Pre-op and post-op diets/experiences (I know this will be different for all depending on doc)
As you note, there can be wide variation between docs' programs. Our doc doesn't do any pre-op diets other than the semi-usual day before bowel cleansing diet (similar to what's done before a colonoscopy.) Post op, progression is more rapid than many docs prescribe, with liquids, purees and soft Proteins like cheeses, yogurt and many seafoods for the first month and most everything else after that.
How long is the surgery?
IIRC, typically 2-4 hours, though can be longer depending upon complications that the patient may bring to the table (extreme obesity, adhesions from prior surgeries, etc.)
How long were you in the hospital?
3-4 days would be typical.
How was your recovery? How long before back to work?
IIRC, my wife took a month off, but she always milks these things - some may take longer while others may be able to get back to it sooner, depending upon the work.
Are there foods you can/cannot eat?
She became lactose intolerant, which is not unusual, and that has become worse over time - lactaid tablets with dairy don't do quite the job anymore. She has also become gluten sensitive, which may or may not have anything to do with the DS.
Side effects from surgery?
Similar to the RNY in that one needs to keep up on supplements and follow up labs, though the profile is somewhat different. Gas and stool can be rather aromatic at times as one would expect from incomplete digestion, though most work out what foods trigger problems so they can be avoided, and Probiotics can also be useful in helping the system adapt to its new reality.
Why did you chose this surgery?
Of the procedures readily performed at the time, neither the bands or bypass offered sufficient weightloss performance relative to their complications and side effects. The DS (and VSG) allows use of NSAID pain relievers which are a giant no-no with the bypass. The DS offers better regain resistance than any of the other mainstream WLS procedures, along with a generally more normal diet long term than most (no place for things to get stuck like there is in the bypass.)

DS is the Duodenal Switch (for more information you can check out dsfacts.com) which is in the simplest of explanations a vertical sleeve gastrectomy (or VSG) with an additional component of bypassing a portion of the small intestine. The sleeve offers the restriction and the bypass a level of malabsorption. The DS is done both laparoscopically or open. This procedure is usually, though not always - depending upon co morbidities, reserved for people with a BMI over 40.
Hope that helps!

DS is the Duodenal Switch (for more information you can check out dsfacts.com) which is in the simplest of explanations a vertical sleeve gastrectomy (or VSG) with an additional component of bypassing a portion of the small intestine. The sleeve offers the restriction and the bypass a level of malabsorption. The DS is done both laparoscopically or open. This procedure is usually, though not always - depending upon co morbidities, reserved for people with a BMI over 40.
Hope that helps!

I did not have to do a pre-op diet. I am also not on here very often. I actually go to another board that has many members that have had or are going to have the DS. IT is a very active board with DSers. It is bariatricfacts.org and you should also read dsfacts.com

If I had it to do over again, my pre diet for the DS would be to count Protein (striving for 90-120 grams) and 64 oz of Water, go gluten free, and wean off sweeteners. I had a preconceived notion that all I needed to do was Atkins after the DS. While this is somewhat true, I found I spent a lot of time figuring out how many grams of Protein was in everything I ate, having caffeine withdrawals, and having super sensitive taste buds that made everything taste sickening sweet. I would have certainly lost weight, been protein loaded for surgery, and been better prepared for recovery and what 120 grams of protein looked like.
Everyone is different though, you need to think about your situation and what your demons are. I'm not a binge eater, but for someone who is, then Portion Control and measuring would benefit you. If your thing is carbs...which is mine...then Proteins are your thing to work on. If you have a sweet tooth, then finding alternatives that are healthy - things made only with stevia, honey, or maple Syrup might help slow down your consumption and make you expend effort for a treat.
Sorry to take your question in a little different direction!

Hi all, I'm slated to have surgery in July if all goes well. I'm looking forward to the journey with excitement and curiousity. I have 3 aunts, an uncle, a cousin and his wife, and finally my own father that have all had various forms of WL surgery. My dad had the sleeve last year and is doing well. I'm having the DS as recommended by my doc. The more research I do the more it seems like the only real choice.

Hi everyone. My DS was March 31st, so as of today I am 7 days post op. I decided to have the surgery after the death of my aunt last year. I want to be healthy and to be around for my children. Other members of my family have had the gastric bypass, and both had regained weight. I researched my options before I made a final decision and the DS was best for me.
Before I made a final decision, after meeting the nutritionist I changed my diet completely to make sure that I can stick with it and I could, I was eating healthier pre op and lost 20 before surgery.
The first week post op diet is a little difficult but once you get use to it, its not so bad. I find that keeping a journal of your intake is very helpful in making sure you are getting what you need. I am looking forward to seeing what the weeks, and months post op will bring.
Good luck to you all

Hi! I am hoping to have DS surgery in April 2014. No date yet. I am nervous but also looking forward to being the new me!!

I just purchased Champion whey Protein plus for after surgery in strawberry Sundae andbody tried this and anything else I should have at home besides propel, sf pops and Jello? Finally got all the Vitamins but I do know that I won't be able to start vitamins right away.

I'm a 43 year old mother and wife, daughter, sister, aunt and friend. Although I would like to say the unselfish thing and say "I did it for all those people around me that love me." I didn't. I was selfish and did it for myself - I want to be around longer. I want to see my son become a man. I want to see him get married and have kids. I want to grow old with my husband. Those are all for me!!!!!
I have not been an active participant in life for about 10 years - I tired easily and wanted to nap on a daily basis. I got sick all the time, so I was expected to just sit on the couch and do nothing. I had no expectations - not even to shower or get dressed every day. That life sucked. I owed it to my family to do better, but more importantly, I owed it to myself.
Did I feel guilty that I was taking $11K out of my family's pockets to pay for the surgery? Of course, that's a lot of money. (I still cringe a little when I write that figure.) I can guarantee you, I wasn't going to lose the weight without the surgery and I wasn't going to get any healthier.
Only you know if this surgery is right for you. It was absolutely the right thing for me to do, even self-pay.

I ordered the $3 sample pack from Celebrate (celebratevitamins.com) and have been taking them pre-op to make sure my levels are up before surgery. While I like them for flavour and the fact that they are mostly chewable and not horse pills, I will be ordering the DS pre-packaged Vitamins post-op from Vitalady.com.
Celebrate is fine for other surgery types, but from what I've researched, DS patients need much higher levels because of malabsorption and must have "dry" Vitamins. Vitalady had surgery specific packages, understanding the differences in people's needs. I'm only going to buy two months worth, since post op I know I won't be able to take much at first, and then after I start getting labs I may need to adjust.
Hope that helps, Diamond Girl! Good luck to you!

Please don't take someone's word on any on-line forum as to whether you qualify for the DS or not. You need to see a qualified surgeon who actually DOES the Duodenal Switch in order to see if you are a candidate. BMI is not the only qualifier. You can also qualify with additional co-morbidities, as far as your insurance goes.

Make sure before you choose a surgeon that yours actually has DONE the Duodenal Switch. Because if they don't, you're not going to hear anything good about it. Even my own surgeon bad-mouthed the DS. You do have to be proactive about your labs and Vitamins with the DS. Most surgeons do not understand our needs, and it is frustratingly common for surgeons to give bad advice post-op to DSers. They historically hand us RNY data to follow.

The DS is no longer reserved for higher BMI's. There are a LOT of lightweights, BMI 35-40 that have had the DS and do very well. A DS surgeon can adjust the stomach size and length of the common channel to be appropriate for lightweight patients.
They have been doing the intestinal portion only on normal weight people in Europe for over 20 years to cure Type II diabetes. My diabetes was resolved the day of surgery. My blood sugars went to normal and have stayed there for 8 1/2 years.

Welcome Nikki! I'm hoping for a late January surgery -- getting all my pre-op stuff done during all the holiday rush is a bear! Maybe we'll have similar surgiversaries!

I went through all kinds of gyrations in the beginning, trying to put together a GNC, costco, Walgreens value-pak, and who needs that stress?. I have met with the nutritionist, not the surgeon, so I am taking Celebrate at post op level and Vit D3, dry, which was low, to get things up in general. In Jan, I will meet the surgeon. I will start The Vitalady Packages to build up before surgery. I have decided to pay the extra for going with the three month plan, as my "guilty pleasure." After my next labs, 14 vials worth, I will reassess. It's the cost of doing business iin DS Land!

One year ago today I was operated on. I weighed 367, had very high blood pressure, sleep apnea, and not a lot of energy. Today I weigh 175, am off of medications, etc. and feel so much better. This forum has been such a great help. 

Hi everyone! I'm planning on getting the DS. I have to lose 97 more lbs so that I am considered healthy for the surgery and also for my insurance to cover me. I have already lost 38 lbs in 1 month and 5 days. With cutting back on my proportions on my meals and eating better. I'm very excited to get the DS and can't wait.

I ordered the $3 sample pack from Celebrate (celebratevitamins.com) and have been taking them pre-op to make sure my levels are up before surgery. While I like them for flavour and the fact that they are mostly chewable and not horse pills, I will be ordering the DS pre-packaged Vitamins post-op from Vitalady.com.
Celebrate is fine for other surgery types, but from what I've researched, DS patients need much higher levels because of malabsorption and must have "dry" Vitamins. Vitalady had surgery specific packages, understanding the differences in people's needs. I'm only going to buy two months worth, since post op I know I won't be able to take much at first, and then after I start getting labs I may need to adjust.
Hope that helps, Diamond Girl! Good luck to you!

http://myfriendteresablog.com/so-youre-feeling-too-fat-to-be-photographed/

So you’re feeling too fat to be photographed . . .

Listen. I hear you. You’re a few pounds heavier than you like (or a 100lbs heavier than you like). I completely understand how you feel. I get that same blah feeling about myself when I think about booking new head shots or long overdue pictures of me and Justin. Precious, I even picked a career that has me permanently behind the camera rather than in front of it. Seeing myself in pictures actually produces the faintest sick feeling in my stomach. Isn’t it amazing we can see the beauty in our best friends, sisters, mothers, and aunts without the slightest thought to their flaws . . . but can obsess for hours on our own imperfections? We fixate on our flaws to the point we shirk at any documentation that our round faces and curvy bodies ever walked the earth. No pictures to show how we LOVE, how we laugh, how we are treasured by our families. How is it possible that a double chin can overpower the beauty of a mother cuddling her child? How does arm fat distract from the perfect shot of a spontaneous hug? I swear y’all . . . how is it that we can put more value on a TUMMY ROLL than the captivating way you throw yourself into a roar of laughter during a shoot?

In our warped minds pictures become frozen mirrors that we can stare at as we pick apart our features over and over again.

I know girl. I know.

My personal duck-and-cover (or signature “make a funny face”) approach to having pictures of myself changed completely when I had a serious car accident last year (and started over). In the flash of a second (or a flash of the text message the young woman was reading) my entire life changed. I nearly left this earth with no physical evidence of the goofy, wide open and loud love I have for my life, my husband, my family and friends. I haven’t had professional pictures done since our wedding in 2006 . . . always waiting for this elusive moment where I would be thin enough (pretty enough) to have such a permanent record of me. Because, you know, HEAVEN FORBID there be any proof that I look the way I actually look.

So here is the harsh truth y’all. Listen good. Our vanity is no longer enough of a reason to avoid the camera. Life doesn’t wait until you “get thin” enough to capture it. Life is happening . . . it is happening right now and the only moment we are guaranteed is the one we are living. I shudder at the thought of leaving behind no pictures of my life with ME in it. My mom says of the accident she is “just glad that we’re still a whole family.” My gift to her this Christmas was a family portrait showing just that, 9 months post-accident . . . a whole family.



Do you know what my mom sees when she looks at this picture? Her beautiful family all together.
Do you know what my husband sees? The family he gained the moment he met me (and how much he looks like my dad…)

Do you know what my dad sees? The happy family he has worked for every day of his life.
Do you know what my brother sees? That he got away with wearing shorts…

Shocker: No one is looking at how fat I look.

Can we agree to put the value of family over the value of fat? Can we just accept that the weight you’ve been trying to lose for 5 years might actually just be a part of what you look like . . . and that if this magical day does come when you’re acceptably thin you’ll STILL regret not having any pictures of you with your kids from ages 5 – 10? Can we acknowledge that the insecurities we have in our heads will never be a part of how our children, husbands, and friends see us? Can we just please let our loved ones remember the YOU they love?

Your children want pictures with their mom.

Your husband wants pictures with his beautiful wife.

Your mom and dad want pictures of the happy, successful, amazing woman they raised (ok, and more pictures of the grandkids while you’re at it)

And if you’re thinking that high school friend on Facebook will say to herself (“wow she has gained weight”) then . . . newsflash you DID. You gained weight. Shed a tear. Read a book. Drink a Sweet Tea. Watch Oprah. Whatever it takes. Accept this reality . . . YOU GAINED WEIGHT. The truth is you’ve gained a lot of other things too (a career, a family, some kids, a house, a love for travel, the ability to coordinate your separetes . . . ) and that girl from high school is going to spend a lot more time hating on those things then she ever will on your double chin.
So you’re feeling too fat to be photographed? . . . Ok. But you’re the only one who notices. The rest of us are too caught up in loving you.

Hi Dave. Thank you for your reply. You are right - RNY has been the standard for a long time. I see benefits with it and with the DS. It really helps to consider all of these things. I will bring it up at my surgeon appointment and discuss. The two main surgeons here for Kaiser do not list DS as their recommended choice. Therefore, I want to be armed with all the information I can in case I decide to fight for DS. Ultimately, I know it is between my surgeon and I, but again - find everyone's information and experiences shared as valuable in the process. It truly helps! To be honest,

Alex - thanks much for the lightning fast response with the code! I've already updated my profile and am excited to be an active participant here.

Welcome! The DS forum is new. We plan on adding it as a surgical option in your profile and signup over the next 2-5 days. I'll let you know once it's live.

Hi all! I am a pre-op DS with Dr. Keshishian in Glendale, California. Hoping to get all my paperwork and tests done in order to have a late January/early February surgery date. I'm a self-pay, so going to travel to sunny SoCal for some Medical Tourism.
I just discovered this website tonight, so thought I'd join you in making a more active community for the duodenal switch - I was surprised that wasn't even a surgical option when I registered here! What's up with that?!