Why Did You Choose DS Surgery?

[jdinsc 0]

Well, it's a long story but I just had my band removed and replaced. Seems the tubing broke, which is ultimately why my fills gave me restriction for 24 hours and then it all just "went away." My doctor suspected slippage but then when he did an endoscopy he found that my band tubing was "in pieces" and he removed and replaced the band. Needless to say, when I woke up I was a bit surprised by the turn of events. :faint:

I haven't had a good fill on my new band yet and am starting to play head games with myself already about the band not working. I went from 240-145-170 (now) and none of my clothes fit. I'm really hoping my first fill does the trick.

However,

I mentioned to my doc that if this band doesn't work, I want it removed and I want DS surgery. He told me that DS screwed with ones digestion and that I would "smell like an 80-year-old woman" and that people who lived with me would not want to use the bathroom after I did.

Can any of you who have had DS surgery explain why you went that route, and how it's working for you? Is any of this true?

Obviously I'm hoping my band works this time--please think good thoughts--but a little education never hurts.

JD

Banded 1/2003, weight: 237

Hit goal weight 2005: 145

Band stopped working 2005: 162

Rebanded 3/2006: 165

Just ate dessert: 170

[rachele 0]

I just got home from working 3rd shift, but I promise I will come back and answer. Didn't want you to think we are ignoring you. I'm sure Sue will be along shortly, and I'm not sure who the 3rd person here is.

[GeezerSue 7]

I just ate Breakfast. A (one egg) ham and cheese omelette, toast with butter and Peanut Butter and two cups of coffee with half-and-half. (OKAY! I confess! I had a little sugar in the coffee, too. Should probably NOT have done that. But there will be no "dumping," as a RnY person might have.)

And (LOL) I have an 82-year-old mother who called me this morning to discuss her diarrhea so I know my bowels are working better than hers are.

My poop looks very different and it DOES stink. And I have probably three BM's every morning before I get in the shower and start my day. No doubt about it, it's different. But I do NOT poop all day and strangers sit next to me in waiting rooms and restaurants, and the bra-fitter at Nordstom's didn't rush out of the room, so...? (And I have an impaired sense of smell, so it's a real psychological issue for me because most of the time I don't KNOW if it's smelly in my bathroom.) To tell you the truth, that rumor is one of the reasons we (my husband and I) moved to a two-bathroom condo last June.

But there ARE ways to deal with that issue. If I avoid wheat flour and too much baked potato with butter and sour cream, I have more socially acceptable (?) poop. There is a product called Devrom (a pill) that ostomy patients use which is called an "internal deodorant." I have some, but--again--I don't detect much smell, so I haven't used it. I installed a little bidet attachment (< $100), called Biffy ( http://biffy.com/ ) to keep clean while using the toilet, and I stocked up on Oust! and Ozium.

I choose the DS for a couple of reasons. I'm older. VERY long term issues don't concern me the way they might concern a younger woman. (I'm not asking myself how this will impact my health 50 years from now.) I had been in touch with band, RnY and DS patients for over three years, and I knew that I did not respond well to all of the restrictions required by the band and would likely get crazier with RnY restrictions. I figured I'd take up compulsive drinking or gambling or even complusive origami..I dunno.

And, I wanted a procedure that let me eat what I want to eat. With the band, one "wrong" bite could send me to the restaurant's restroom or parking lot with sliming or barfing or whatever. My RnY friends wait until other people order something and then taste it to see if it's too sweet for them and might cause a dumping episode. My DS friends pretty much eat what they want, but sometimes say stuff like, "Wanna split a ___? If I eat the whole thing I'll be sorry tomorrow!"

And...I needed rapid weight loss. My knees were acting up. My orthopedic surgeon wanted me to limit walking and avoid treadmills, stairs and low chairs until I lost a significant amount of weight. And he told me that every step I took with the excess weight on my frame was a step toward a knee surgery that was only about 60% successful.

My PCP read up on DS and liked it better than RnY. My cardiologist was excited about it and wants me to keep him informed so that he can tell other patients how I'm doing. My husband THANKS ME for not giving up when the band had to come out and for giving him his old playmate back!

I am 5.5 months post-op. I weigh twenty pounds less than I did at my lowest post-banding weight and figure I have the opportunity to lose more. I had the same hair loss issues--only more so--that I did post banding and post PS...but I think that's slowing down. My nails (says my manicurist) are thinner toward the cuticle. I don't know if that's from the malabsorption immediately post op (I lost 54 pounds in two months) and is already correcting itself or if I have a problem I need to supplement. I'll find out in two weeks at my six-month check-up.

I think I covered it all. (Except to mention that if Rachele can work on an assembly line, she must not be having major bowel issues either.)

[Cindy Krebs 0]

Dear GeezerSue,

Would love to email you personally re: DS. I'd like to know who did your surgery.

Is that okay with you?

Thanks so much,

Cindy

[GeezerSue 7]

Just PM me when you're in the mood, Cindy. I'm in CA and my surgeon was Ara Keshishian in Delano, CA.

[bbd 0]

Does Everyone On Here Know Stuff I Do Not? Or What? All These Abbreviations Are Drivingme Crazier Than I Was Thinking I Already Might Be.....lol

[Nana~ 4]

doh missed in the other thread! here ya go lol~

http://lapbandtalk.com/showthread.php?t=7959&highlight=switch

[jdinsc 0]

Sue:

This was a fantastic post. As always, you're a great teacher. I think I remember seeing your posts on that old site. I have no doubt that the bra fitter at Nordstrom was nothing but impressed.

My second fill on my new band hasn't actually done the trick yet. Just minimal restriction so far, but I'm not giving up yet. Think good thoughts for me!!

[Time2live 0]

Holy cow....I can't even begin to tell you how often your posts really make me laugh.

I think it's the complete honesty with no screening...it's so good for me to read some of that and I don't even know what DS is...lol

Lanie

[fabfatgrl 10]

I do know that there was an older form of the surgery called the BPD without the duodenal switch which is supposedly where all the smelly rumors came from. I've met a few people who've had a DS, and I never knew that they had it... until they told me. (Didn't smell either. )

You do have to be much more vigilant with labs and Vitamins and such.... most Bandsters I know are total slackers regards to that... and never really had to worry much about them. You also have to more vigilant with birth control (if you're of child-bearing age)... most docs want you on two forms of birth control for the first 18-24 months.

I've pretty much decided that I'm going to have my Band removed and do something. I'm leaning towards the VSG (part 1 of the DS) with a potential DS later.... but there's part of me that's saying why not do the whole shebang now?

[fabfatgrl 10]

Thought I'd also post an article that looking at the DS after a failed restrictive operation, such as the Lap-Band:

Obes Surg. 2006 Mar;16(3):258-61.

Duodenal switch without gastric resection after failed gastric restrictive surgery for morbid obesity.

Di Betta E, Mittempergher F, Di Fabio F, Casella C, Terraroli C, Salerni B.

Department of General Surgery, University of Brescia School of Medicine, Brescia, Italy. edibetta@libero.it

BACKGROUND: Several surgical treatments have been proposed for patients in whom gastric restrictive operations have failed. The aim of this study was to analyze the effectiveness and safety of duodenal switch (DS) with restoration of normal gastric capacity in such patients. METHODS: Between May 2001 and May 2003, 11 DS with restoration of normal gastric capacity were performed without other gastric procedures in patients who had had previous gastric restrictive operations which had failed because of inadequate weight loss or weight regain. Data were collected and follow-up was 2 years for all patients. RESULTS: At the original operation, mean BMI was 47.3 (range 38-53) kg/m2, and mean age was 42 years. 7 of the 11 patients (63.6%) had previous vertical banded gastroplasty, and 4 of the 11 (36.4%) had previous laparoscopic adjustable gastric banding. Mean percentage weight regain and mean BMI at the time of DS were 92.1% and 44.6 (range 35-53) kg/m2 respectively. After the second operation, mean BMI at 6 months was 35.4 kg/m2, at 12 months 31.7 kg/m2 and at 24 months 28.6 kg/m2. The % excess weight loss was 41.1 after 6 months, 56.6 after 12 months and 69.6 after 2 years. There was minor morbidity and no mortality. CONCLUSION: After this experience, we suggest that patients with failed gastric restrictive operations (weight regain or inadequate weight loss) may undergo DS with restoration of normal gastric capacity. This second operation proved to be safe and effective.

PMID: 16545155 [PubMed - in process]

[jdinsc 0]

Thanks everyone for clarifying DS for me. Fabfatgrl: Thanks also for posting those statistics. After all, it's the OUTCOME that matters, right?

My doctor continues to be adamant against DS surgery. When I mentioned I'd heard of a surgeon that would revise the band to DS, he positively panicked! He insists DS results in smelly stools, so bad it could risk a relationship! ("You can never share the same bathroom again.") I haven't really heard this on the board, so why do you all think he's being a drama queen??

Another question: What are the dietary questions with DS? And is there the same "full to capacity" feeling that there is with the band, or is it different?

My replaced band finally has a bit of restriction (after 3 fills, one month apart). I have about 2.4 ccs right now and I get tight only if I eat bread or chicken. The good news is that I have stopped GAINING weight. I'm gonna try to stick with it (no pun intended) until I find the sweet spot, but with one failed band under my belt--and the realization that my body will go immediately back to the way it was--I need to have other options in mind.

JD

237/145/180

banded on 1/2002

rebanded on 3/2006

P.S.: Guys: What are your dietary restrictions with DS?

[GeezerSue 7]

1--Yes, the BM's stink more, but I don't recall having rave reviews about my pre-op BM's, either LOL.

The first two DS people I met in 3D are married (as am I) and have husbands who chase them around (as do I), so it can't be all THAT bad. One woman is the "professional wife" of a very successful businessman and they host A LOT of business-related events. She is still a very popular hostess and is also involved in DS-related events that many people attend. The other has a business of her own and spends a lot of time in the presence of others in a situation that depends on referrals. She gets those referrals. HOWEVER, to prevent smelly stools, we limit carbs. And, there is a product called Devrom, which is used by ostomy patients, to "deodorize" their stools. I have it here but haven't used it yet. The problem for me is that I have very limited olfactory ability...generally speaking I LITERALLY "can't smell shit." So I worry about stinky poop all the time.

2--Sharing a bathroom might be a problem, at least at first. But mostly because immediately post-op, there are a lot of BM's and less warning time than usual. (You get used to that, AND the warning time increases over time.) But our immediate post-op mantra is "never trust a fart."

One time, my sister went right into the bathroom after I had used it and came back out to report that the body I had hidden in there was now ripe. But she has used it since then and I always ask and she says there have been no repeat incidents. I worry about it all the time...but I can't smell it. So I use a lot of stuff...at home I have absorbent deodorant crystals and an oil reed diffuser thingy and I use fragrance-free Oust each time and, because there is no window, there is a bathroom exhaust fan. When we remodel the bathroom ...at the end of the month...ARG...we will upgrade the fan, but mostly because the old one is so noisy and I use it all the time, "just in case." I have a small can of Ozium in my purse when we go out AND a small container of disposable baby wipes. I think I've used the Ozium three or four times, just in case...and the baby wipes a couple of times, just to feel clean.

3--My dietary restrisctions are:

a) no booze first year post-op...not because of the surgery itself, but because my surgeon feels that the very rapid weight loss puts enough strain on the liver and alcohol adds to that burden. Some doctors say to drink "in moderation." One DS girlfriend laughs and asks why her doctor would think that, at 334 pounds, she had any concept of "moderation." (She's the one who stopped at In'n'Out Burgers on the way home from surgery!!)

:cool: excess carbs will likely cause smelly poop. Banded, even one or two bites of sourdough bread at my favorite restaurant would send me to the restroom hurling. Now I can easily enjoy that bite or two. But if I want to eat two big slabs of the stuff, I have to ask myself if I'm willing to pay the price of having two or three extra BM's the next morning. It's a judgement call. But it's my decision.

c) Other than those warnings, NOTHING IS FORBIDDEN. I can drink beverages before, during and after meals.

4--I do not feel "full to capacity" like with the band. I feel "full to capacity" and satisfied...like Thanksgiving before any wls.

I just get full on less food. LOL. This was a question I kept asking while deciding. But since I didn't know any band-to-DS-revision people, nobody really understood the question or had anything to compare it to. It feels like you never had any surgery at all. You just have way more food to go in the doggy-bag.

5--WHAT KIND OF chicken AND BREAD?

If it's white meat chicken, it's likely too dry. Banded, I had to change to thighs and drumsticks--dark meat only. And, the only bread I could eat without getting plugged up was the crispy crust of the sourdough served at my local favorite restaurant and that had to be slathered with butter...which kind of defeated the purpose of the band. But what I'm saying is that those foods may be on your permanent no-no list if they make you uncomfortable.

6--You already have the band, give it your best.

A lot of people do very well with the band. With what you've been through already, you just have to really, honestly give it your best effort. But if you develop any complications or if you cannot comply with the program, there are other options.

[Anthony 1]

Please remember that you can always have a VG, which can then later be converted to DS if needed.