Hey all,

New to the forum, and have been struggling with this new opportunity. I had the sleeve done in 2013 and have been successful with nearly 150lbs lost. However, I gained a bit and am still at 364lbs. My sleeve surgeon has brought on a new partner who specializes in the DS and has called me to offer it up as I am a "prime" candidate with a successful sleeve and more to lose.

While I am happy to have lost all the weight, I still struggle with being the "big guy", and I find it hard to say no to it when I could lose another 75-100lbs My wife is also totally against having another "elective" surgery. She says I should work harder... Cautions me on all the skin surgeries I will need to have after as I already have some sagging skin.

I am concerned with what the surgeon says will be "multiple" trips to the bathroom daily, and possible runny stool thanks to the non absorption of the fat in my foods. I am quite happy with 1 trip daily now since my VS I also forget to take my Vitamins sometimes... so there's that.

Anyone else done the DS after already having done the VS first? And please don't make the replies about my wife, as she has said she will be there for me no matter what I choose, but prefers not to risk me dying on the table when I don't really "need" to be there.

Thank you,

I had the sleeve in 2012. Good success, lost weight etc. Have maintained the loss for the most part. Then my gallbladder began giving me issues and my surgeon expanded his practice to a new doc that did the SIPS/DS. I figured since they were in there, why not. I could go for some more weight loss. I'm still only 3 weeks post op, but down 20lbs. Still having cramping, stinky, poo but I'm told this shall pass.

Thanks BigRed! I am having the surgery on the 27th I'll be finding out next week in preadmission anyway, but I am curious, what was your post op diet after the switch given you already had the sleeve?

3 day pre-op diet for liver shrinkage.

Post op: 1 week clear liquid, followed by 3 weeks pureed. I start my soft diet tomorrow and that's 7 weeks.

Glad to hear you're moving forward, sometimes just making the decision takes a load off.

Thanks BigRed! I am having the surgery on the 27th I'll be finding out next week in preadmission anyway, but I am curious, what was your post op diet after the switch given you already had the sleeve?

My surgeon has the same pre- & post-op instructions for all surgeries whether is a sleeve, gastric bypass, traditional DS or single-anastomosis DS.

pre-op: 2 weeks Clear liquids with 3-4 30-gram Protein shakes. Shakes must be made with powdered protein, no pre-made shakes ever.

post-op: week 1, clear liquids only

weeks 2 - 4 clear liquids plus Protein Shakes (sleeve 3 shakes/day, DS & bypass 5 shakes/day)

weeks 5 & 6 puree

weeks 7 & 8 soft foods

week 9 start introduction of regular foods

I think I've seen only one other person post that a surgeon with a similar severely restrictive program.

Because STATICALLY a person my weight and age would lose 80 pounds over an 18 month period my Dr really encouraged me to have a VSG or DS because due to years of (mostly "successful" yoyo dieting my body had learned to hold on too every ounce of fat.

In the end, I decided I would NOT be a statistic and had the gastric sleeve, lots of reasons but mainly because it wouldn't alter my anatomy as extremely.

The other reason was that despite what you might read on the internet, the sleeve doesn't stretch. As you have already learned you can eat around it and if you do you will gain weight.

You are extremely overweight, I can see why a Dr would encourage another surgery because you really need to loose weight now. But what happens in 6 months? In a year? People regain their weight after DS surgery too. On the other hand you already have a functioning weight loss tool that you can start using immediately if you are motivated to lose weight and save your life.

If it were me I would go back to square one with the sleeve you already have instead of having another major surgery. And, at the same time, get some treatment for your underlying eating disorder.

The sleeve can stretch. Mine did although it still only held about 4 ounces. I had a "pouch test" x-ray where I ate a measured amount of food with radio-opaque material added.

Even though the vast majority of the stretchable portion of your stomach is removed in a sleeve gastrectomy, there still is some left.

I had the sleeve in 2015 only lost about 60 pounds. My surgeon wanted me to have the DS originally but I didn't want to. I had the revised DS that allows less malabsorption in March 2017. I am now down a total of 120 pounds. I loose about 15-20 pounds and then I stall for at least a month or more and them I start losing again. I have no regrets. i have gone from a size 4x to 1X so far. Be patient with your weight loss it will happen.

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On 12/27/2016 at 4:33 PM, Kaylamh said:

In my opinion, the DS is the best surgery out there. I had mine a few weeks ago, and I already couldn't be happier. I feel great, I'm lighter on my feet, and I've already lost 25 pounds. It could really be a game changer if the sleeve isn't working for you. The sleeve typically has a lower success rate and a really high weight regain rate. The switch does not.

I had my DS this past June and love it! No regrets. I would do it again in a heartbeat. If you look at the stats, very few have regain with the DS. In fact, I have't read any posts on this site where a DS patient complains about regain. Not one.

Edited November 8, 20178 yr by Strivingforbetter

I too have hit a plateau. I am considering all of my options - and some version of DS is very high on the list. The dietary changes from the VSG have been very positive, to be sure, but there is still about 75 pounds of work to be done.

The VSG removed some foods from my diet because I no longer want or desire them, would DS surgery expand that list? Aside from the changes to the Vitamin regimen, what else could I expect? Does the absorption change affect medications that I might need in future years (my 70's and afterwards)?

Thanks for your help

23 hours ago, BigDog Bryan said:

I too have hit a plateau. I am considering all of my options - and some version of DS is very high on the list. The dietary changes from the VSG have been very positive, to be sure, but there is still about 75 pounds of work to be done.

The VSG removed some foods from my diet because I no longer want or desire them, would DS surgery expand that list? Aside from the changes to the Vitamin regimen, what else could I expect? Does the absorption change affect medications that I might need in future years (my 70's and afterwards)?

Thanks for your help

Yes. The full DS can affect medications. Everyone is different with it, but many of us have been affected.