DS Pariah

[1970Jon 3]

I had the sleeve about 8 years ago. I have gained most of my weight back now so I was thinking about finishing off my VSG with the DS now. To me it seems logical: Since I have already had a sleeve I am already half way there so why not just finish it off with a DS? Unfortunately, the surgeon that did my sleeve got killed in a plane crash about 3 years ago so now I am looking for a new surgeon. I have contacted a few places to see what there cost would be and whatnot so I can decide. When I contacted one of the places they tried to talk me out of it telling me that the DS is a very extreme procedure and it is performed only as a very last resort. They told me that usually the only time when they do a DS is if the patient is extremely obese and the patient is going to die at any moment if they do not do it. I am currently 350 lbs and 5'11" for a BMI of 49. Eight years ago when I had the sleeve I was 412 lbs for a BMI of 58.

The doctor said that DS patients have a very bad body odor for the rest of their life. He told me that he could always tell when a DS patient was in his office because he could smell them while they were sitting in their office. He said that if I got this procedure I would have social issues the rest of my life because I would always smell bad. I would in effect become a permanent pariah for the rest of my life. People would be ablel to smell me over a mile away! He said that I will have permanent diarrhea for the rest of my life and that my stools will be very foul smelling. It will be like after I go to the rest room it will smell really bad so that everyone will know that I was in the rest room. I can imagine going to church and having to sit by myself in a pew that is far away from anyone and having to use private rest rooms.

This doctor also said that since I have acid reflux that he could not do the DS on me. I have however found other surgeons that would be willing. This doctor recommend that I revise to a mini gastric bypass (not sure how that would be possible since the half of the stomach that would normally remain attached to the duodenum piece that would be attached downstream is already gone. I have also found another surgeon that has a different type of DS called the SADI-S that is supposed to be better for acid reflux people like myself but the weight loss results are not quite as good as a traditional DS.

What are your experiences? Is the DS really as bad as that one doctor says for your social life? Is this SADI-S a good thing? In my situation would mini gastric bypass be better (even though I am not sure how they would do it)?

[court2180 30]

OMG!!! Run as fast as you can away from that quack!!! I was sleeved in 7/13, lost 100, gained 105 & just had the DS two weeks ago. From what my support groups say you will have bathroom issues but he is trying to talk you out of it so he way exaggerated. If you're on FB look join Duodenal Switch Patients or DFW DS, there are A LOT of vets on there who can help you chose an actual DS Dr & one that's not a quack like this one. Just copy & paste this entire thing and I will tag some very knowledgeable vets [emoji4]

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[Berry78 4,259]

It always is a good idea to get as much info as possible. Don't think I would use that surgeon though!

Another option is a RNY bypass. Can be done after a sleeve and will likely help with your GERD.

[donnacath 0]

Looks like you are in AZ. Contact the Bridges Center for Surgical Weight Loss Management in Phoenix. They work through St Luke's and Mountain Vista hospitals. They are wonderful!!! You will find many surgeons are not trained nor possess the skills to perform the DS so they do not discuss it. Sounds like you meet all of the requirements. I will be having it myself within the next few months. The surgeons there are highly skilled and will have your best interest in mind and not push you to something that doesn't make sense for you.

[1970Jon 3]

3 hours ago, donnacath said:

Looks like you are in AZ. Contact the Bridges Center for Surgical Weight Loss Management in Phoenix. They work through St Luke's and Mountain Vista hospitals. They are wonderful!!! You will find many surgeons are not trained nor possess the skills to perform the DS so they do not discuss it. Sounds like you meet all of the requirements. I will be having it myself within the next few months. The surgeons there are highly skilled and will have your best interest in mind and not push you to something that doesn't make sense for you.

Unfortunately my health insurance does not cover the procedure so I have to self pay. I will be doing it in Mexico. I was able to find a different Surgeon in Mexico that has done over 500 DS's and he also does SADI-S which is similar to DS. I am right now leaning towards this guy as he seems to be more knowlegeable about the DS type procedures.

I am still trying to decide if I want DS, SADI-S or Roux-en-y. I am kind of torn. On the one hand I think it would be logical to just finish off where I started on the VSG with the second half and do a DS or a SADI-S. Also, the DS offers the most weight loss potential. I do however have acid reflux and am on pantoprozole (generic Protonix) so that may be more amenable to Roux-en-y. Do I want to lose more weight or do I want to cure Acid Reflux?

I know a person here in Phoenix that had Roux en y and gained almost all of her weight back so I am a bit leary of that. I am hard headed so I think I need an extreme solution....LOL. I think I need the most extreme one out there which would be DS.

From what I understand, Robin Blackstone, MD is the only surgeon in the Phoenix area that is trained on how to do the DS. I like her but since I have to self pay I can not afford her.

[Postop 404]

I remember when your surgeon passed.

If you're going to Mexico you're in luck. There's a great surgeon there: Dr. Esquerra. He's the only one I'd go to.

I also sent you a PM.

[court2180 30]

I went with the DS based on if you eat all your Protein & fat, limit carbs, you WILL lose the weight. Sometimes people lose too much and it has to be reversed but that's very rare. I have horrible reflux also. After my sleeve I had to start taking 1 40mg omeprozole in the morning and another at night. For ME not running out of breath, having hurting knees, sleeping better & having more energy is worth more than getting rid of my reflux.

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[1970Jon 3]

6 minutes ago, Postop said:

I remember when your surgeon passed.

If you're going to Mexico you're in luck. There's a great surgeon there: Dr. Esquerra. He's the only one I'd go to.

I also sent you a PM.

Dr. Esquerra and Dr. Ungson where the surgeons I were referring to in my earlier post. They seem to be the authority on DS in Mexico.

[1970Jon 3]

1 hour ago, court2180 said:

I went with the DS based on if you eat all your Protein & fat, limit carbs, you WILL lose the weight. Sometimes people lose too much and it has to be reversed but that's very rare. I have horrible reflux also. After my sleeve I had to start taking 1 40mg omeprozole in the morning and another at night. For ME not running out of breath, having hurting knees, sleeping better & having more energy is worth more than getting rid of my reflux.

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This is off topic but you might want to ask your physician for a prescription for pantoprozole, It is a lot cheaper at only $4 a bottle. I used to take Nexium and one day my physician asked me if I would rather take pantoprozole (generic Protonix) because it was a lot cheaper and I said sure. My physician told me that pantoprozole is just as good as Nexium only a whole lot cheaper.

[summerset 5,261]

5 hours ago, court2180 said:

I went with the DS based on if you eat all your Protein & fat, limit carbs, you WILL lose the weight.

Just out of curiosity: do people start gaining back weight once they introduce too much carbohydrates or is it more of a digestion matter that carbs should be limited?

[Berry78 4,259]

DS patients have trouble absorbing Protein and fats, but no trouble absorbing carbs. So they eat more protein and fats and get a "normal" amount of carbs (which may need to be limited during the weight loss phase and even after).

What many people don't realize is that surgery helps, but long term success is up to the patient. We have to watch what we eat forever if we hope not to regain.

The DS requires people "watch what they eat" even more than the sleeve. Not eating less, but making sure they get enough of the right things so as to not become deficient. A couple handfuls of Vitamins every day, etc.

[Postop 404]

13 hours ago, summerset said:

Just out of curiosity: do people start gaining back weight once they introduce too much carbohydrates or is it more of a digestion matter that carbs should be limited?

Too many simple carbs (sugar) can cause weight gain. Plus....gas & stool you wouldn't like.

[SandraD_PDX 78]

I am concerned that you are taking such a drastic step physically without considering the mental/emotional aspect of your eating choices. If you gained your weight back with the sleeve, how will you prevent it this time? It can't be a solely physical solution - your body adjusts and your brain learns how to get the calories it wants, you've already proven that. Weight gain isn't solely a physical thing - the solution isn't solely physical either. It really worries me to see folks keep cutting away at themselves thinking the next surgery will be their nirvana, when what really needs to happen is dealing with the mental issues that drive the weight gain. From a personal perspective, I started looking into WLS two years ago and went in to therapy to deal with my compulsive eating issues before I had the surgery, and I think it's still a challenge even after all of that work. Just a thought, this isn't a judgment by any means, I found therapy to be really helpful and I'm so glad that I have that support right now as I deal with post-op stuff.

[Strivingforbetter 246]

I had the DS and my BMI was only 40 the day of surgery. I do not have a foul odor about me, and my social has never been better. When I use the bathroom, I do not have unusually foul stools. This is probably because my common channel is 150 cm long as opposed to the traditional 100 cm long for a DS patient. The reason for this is my lower starting BMI. It sounds like the doctor doesn't know how to perform the DS, so he is making up stories to persuade you to accept a surgery he actually knows how to perform. You absolutely qualify for the DS if that is the option you feel would work best for you. But, as others have said, you still have to make choices about your intake with the DS. It's not a magic bullet, only a tool to help you feel less hungry and absorb less fat. I agree with the first person who posted a response; I would run as fast as I could way from this doctor. He has absolutely no idea what he is talking about. I, too, was a self-pay patient and chose to have my surgery in the states. However, I have heard fantastic reviews about Dr. Esquera in Mexico. Best of luck to you. (Your first step is to find a different doctor who can actually advise you properly.)

Edited August 9, 2017 by Strivingforbetter

[1970Jon 3]

8 hours ago, Berry78 said:

DS patients have trouble absorbing Protein and fats, but no trouble absorbing carbs. So they eat more Protein and fats and get a "normal" amount of carbs (which may need to be limited during the weight loss phase and even after).

What many people don't realize is that surgery helps, but long term success is up to the patient. We have to watch what we eat forever if we hope not to regain.

The DS requires people "watch what they eat" even more than the sleeve. Not eating less, but making sure they get enough of the right things so as to not become deficient. A couple handfuls of Vitamins every day, etc.

2 hours ago, Postop said:

Too many simple carbs (sugar) can cause weight gain. Plus....gas & stool you wouldn't like.

You know, I wonder if the diabetic drugs Miglitol and Acarbose would help a DS patient. These 2 prescriptions are known to be carbohydrate blockers so that is why physicians give them to diabetics to lower their blood sugar. I am not diabetic (I am insulin resistant though). This is just a thought. Maybe Bariatricians should think about using those 2 drugs in their DS patients.