Elisabethsew

There are 4 valves in the heart; mitral, atrial, pulmonic, and tricuspid. I spoke with a cardiologist and the bubble echo is used to detect abnormalities in the heart; specifically a defect in the atrial septum (upper part of the heart) or the ventricular septum (lower part). He stated the test is obsolete in my area of the U.S. If an atrial or ventricular septal defect is suspected, a heart MRI or a transesophageal echocardiogram is done. I hope that helps! :-)

Hi McBRachel, I would advise not settling on what your insurance will pay for. The weight loss surgery proven most effective over the long term is the DS procedure. It's restrictive and malabsorptive. With IBS, you might start by seeing your GI MD. At least that MD should be knowledgeable about the GI tract. Be aware that MANY MDs have not heard of the DS procedure. This means you need to educate yourself on the procedure so you can educate them. With 150 pounds to lose you likely need more than a restrictive procedure (lapband, sleeve). RNY and DS off the malabsorption with the restriction. Research both. Obviously, I advocate for the DS procedure. Finally, read through this and other forums and ask whatever questions or concerns you might have. Welcome!

Hi Tater, I am familiar with an echocardiogram but what is "with bubbles"? And, of course you're special. :-)

I've tried a lot of OTC and prescribed Fe oral replacements but not Proferrin Forte. I'll have to give it a try. My medical MD is useless as far as post-op DS goes but trusts me enough to honor my suggestions. Presently, I'm at a Ferr of 7 and an Fe sat of 4. I needed to get through x-mas and will be scheduling Fe infusions (Infed) in the next week. I last got one in Feb. I'm glad to hear you're absorbing it better. Thanks for the tip. Merry Christmas. I, too, needed Iron infusions. Funny thing, though, after infusions I can now absorb iron orally. My ferritin is actually coming up nicely on Proferrin Forte, which I now am getting by prescription, so that's a savings for us. At $50 per bottle, that's the most expensive Vitamin I take. But it's cheaper than infusions, so I'm not complaining.

I "found" vita lady when my medical MD proved that he knew nothing about post-op DS requirements and appeared not to have an interest in learning. People who have blood drawn have the right to receive a copy of their results. Like others, I track my labs on a spread sheet. The ones I have to keep an eye on are Iron (Fe), iron saturation, ferritin, total iron binding capacity (TIBC), and Vitamin D. I absorb little to no Fe and need to get infusions once or twice a year. It's very important to be informed and trend your blood work.

For the sleeve I had to do the psych eval, a pulmonary consult, and medical clearance. I was self-pay for the DS and only needed blood work pre-op.

Switcher, I would follow the advice of your nutritionist. After surgery, getting in adequate Protein and staying hydrated are very important. As you heal and experience the results of the DS, the nutritionist can help you with your individual needs. Merry Christmas!

Many of the members posting in this DS forum belong to other sites. When a false quote is posted on another forum, it's important to address the truth. Earlier in this thread I posted that I can live on 3 meals a day. This illustrates the differences people have with eating after the DS procedure. Many "light weights" do need to supplement with Protein shakes and frequent meals. This holds true for many "heavy" weights as well and I did need Protein Shakes the first 18 months post surgery. People who have the DS in one surgery often lose weight faster and have been outcomes in terms of weight loss. I was 445 pounds and had a revision to DS. I lost a large amount of weight over 18 months and still struggle with getting to a healthier weight. For me, 3 meals a days and Snacks on cheese or another protein/fat is fine (as evidenced by my lab tests). Never did I state this was fine for everyone and no place did I advise others should limit themselves to 3 meals a day as I was accused of saying and reported on another site. Age, gender, metabolism, past surgeries, co-morbidities, intestinal length, common channel length, sleeve size, and many other variables all play a role in weight loss. I would never offer "all or none" advice to anyone and I would never dispense medical advice. Sharing and supporting others is my goal. I value the opinions of those who are considering surgery, who are freshly out of surgery, as well as those from experienced DS'ers. Thank you.

Welcome, Protein, I certainly welcome your experiences and comments and hope you feel free and safe to express your opinions. It is absolutely necessary to be informed about any surgery, the surgeon, the outcomes, and the consequences. One of my consequences of DS surgery is the need to get IV Iron infusions once or twice a year. This site is new and all are welcome. Bullying will not be tolerated and those who are walking the line are known and will be dealt with if necessary. My style is not to police but rest assured, if I need to take action I have no problem doing so. Liz

No, I do not post on other boards. I work 2 jobs and host here. Thank you.

Elizabethsew, do I read correctly that you are an RN? If so, I am very confused about your statement that Type 2 Diabetics still need insulin until they reach a "healthy weight". This is simply not true. Most do not need insulin any longer IN THE HOSPITAL. Yes, you do read correctly but perhaps you misread what I wrote. I did not specify when I said diabetics. Type 1 diabetics can significantly decrease their dosages of Insulin. Type 2 diabetics may be cured and no longer require PO (by mouth) or insulin. Each person is unique so I could never make an all or none claim. Second, I think that your initial opening statement leads newbies to think that it's routine and acceptable to perform the Duodenal Switch in two parts, that is, two separate surgeries. It is not desirable. The best metabolic advantage to the Duodenal Switch is attained when it is done in one operation all at once. Again, I think you are reading into what I type. I am a proponent of having the DS in ONE surgery. Had I known about it before I had the sleeve, it would have been my first choice and I think my outcome would have been better. Also, the DS is not rare or selectively done only on patients with a higher Body Mass Index, or BMI. It is frequently done on much smaller obese people and has been for several years now. When compared with other weight loss surgeries, the DS procedure remains the least performed. This is a skilled surgery that many band and sleeve surgeons do not perform. All surgeries, regardless of BMI, must be discussed in relation to co-morbidities and a host of other factors before the "right" weigh loss procedure is selected. I advise several MD consults. I would visit as many sites as possible if I were researching weight loss surgery today. You are correct. This is a new site where all people are encouraged to share. As it grows, I am sure we'll have many "vets" like yourself to offer their opinions and experiences. Thank you.

I started at 445 pounds, had the sleeve first, and then had the rest of the DS procedure about a year later at 375 pounds. I am currently at 245 pounds and the lowest I got to was 199 pounds. The final phase of my surgery was in 2009 so I'm a little over 4 years out.

I think it depends on the person. I can live with 3 meals a day... just do Protein first, fats second, and then carbs if there is room. LOL

Good points, Sheanie. For patients who are diabetic and obese, DS can be the best choice. Many diabetics no longer need insulin when they reach a healthy weight.

I know quite a few people who get constipated. Like you, they increase the fat intake and Water and Fiber to "fix" the issue. I still need to consciously stay away from the carbs or I'll regain.

Congratulations on your success, Sheanie. I love that you don't own a scale. Do you ever have difficulty with weight gain?

I have heard of Dr. McCullough and I'm sure you'll be in good hands with his partner. Hopefully, more surgeons will develop expertise in the DS procedure. Not a lot do this surgery.

Welcome and congratulations on making the decision to get DS. You have lost a phenomenal amount of weight already. What surgeon did you select to do your procedure?

Hi Tater, DS is the newest, most involved, and least "popular" of the weight loss surgeries. Hopefully, it will get it's own headline soon. I too was a self pay but revised to DS after the sleeve did not give me the results I needed. Going to a sunny climate to have the surgery in the dead of winter sounds great to me. Welcome! Liz

DS is a dual surgery where you have restriction (the sleeve part of the surgery) and malabsorption (the rerouting part of the surgery). The shortened part of the intestine prevents the absorption of about 70% of the fat calories. Like all surgeries, carbohydrates are still mostly all absorbed (carb absorption begins in the mouth). Some people have the surgery in one phase and others have it in 2 phases about 6 months apart. You need a skilled surgeon and it's a surgery that is usually reserved for the most obese patients. It is associated with the best outcomes in terms of weight loss. Liz

Could it be that there are no people who had DS or are considering here on this forum?

Who is doing your surgery?

I've only had my surgery shy of 2 months ago so I'm still dealing with my food addiction and will be for quite some time as I have a lot of weight to lose. I did read that many successful weight loss people develop substitution addictions. I can easily see myself having to resist becoming a shop-a-holic and will probably have to use a lot of restraint to stop myself from buying too much. Wearing cute clothes in small sizes is something I always wanted to do but never could. Has anyone suffered from this? Anyone worried about it?

I'll start by saying that I am a registered nurse and hold a PhD in education. Given my medical and research background, you can be sure that I did a lot of searching before deciding on who I would allow to operate on me. Because I was a self-pay for the VSG revision (banding was via insurance), I looked into Mexican surgeons. The three U.S. surgeons I explored wanted $22,000 - $26,000 and that only included the surgery and one night in the hospital. I wanted a surgeon who was certified in bariatrics, one who had done over 250 revisions, one who operated out of a clean hospital with an intensive care unit in case I needed that level of care, and one who insisted that the people taking care of me post-op were registered nurses. I also looked into complication rates and talked with others who had used the surgeons I was considering. Finally, I wanted to be sure that when I left Mexico, I would be safe to carry on with my life in the U.S. That meant making sure complications were prevented. Dr. Aceves met my criteria. He did 3 different leak tests to make sure all was fine and kept me in the hospital for 3 nights. I had a chest x-ray, an EKG, a urinalysis, and blood work prior to the surgery and a complete unfill of my band after a barium esophagram. I was seen by Dr. Aceves, his assistant surgeon, the anesthesiologist, and a medical MD all prior to surgery. My experience was text book and I have no regrets. If you're considering going to Mexico for surgery I highly recommend Dr. Aceves and his team.

As many members are aware, advertising is against the rules of the forum. If a reputable person/medical group/organization, etc. wishes to pay for advertisement, they go through the proper channels. Thankfully, the great majority do just this. Of course, people always find ways to "beat the system" and one of the latest is paying people to post. This occurs when members are giving opinions or sharing bad experiences that they had with a particular group/surgeon, etc. Obviously, this is bad for busine$$. To combat the negative posts, a few actually pay people to create an account and do battle with those who post negative experiences. Many of the paid posters are easy to "find" because they only post on threads that speak negatively about the person or group paying them. Please do your own research and choose your surgeon carefully. The great majority are wonderful and it's sad that a few spoil it for the rest and make it necessary for a thread like this to exist. We have a GREAT forum and we intend to keep it that way. Please trust that paid posters will be dealt with. Thank you,