Since we talk about a "DS IQ test...."

OH yes you make great sense! I don't know how to overcome the testing issues--like people who don't comprehend written/spoken/reading language and stuff like that--which presents still more issues that I hope might get addressed here. But I believe there is some kind of basic level of knowledge about anatomy, physiology, biology, nutrition, language, etc., that NEEDS to be assessed in order to get a DS. These terms might not be all inclusive or accurate, which is another reason I'm saying to give input here and hash out SOMETHING we could present to the "experts."

MY personal level of comfort about knowledge of the DS appears to be rather higher than average. Or so I've been told, dunno how accurate that might be. I got put on my first diet, using diabetic exchanges, at age 7 in 1971. I LEARNED the information and how to use it. Diets followed that godawful experience at the approximate rate of one per school year, so that by the time I got trapped in the hospital with a badly broken arm during the Democratic Presidential caucus in 1976 and sentenced by my family doc to 1,000 calories per day (because I was "so fat" at 5-4 and 160 pounds and well past puberty) that I knew EXACTLY what was coming to me and how to fight for something "more." I knew the calorie content of celery, cucumbers, iceberg versus romaine lettuce.....

Okay, you get the idea. Apparently most morbidly obese people today don't have that kind of knowledge, or so I'm told. This is confusing to me. If you've been "dieting all your life" and you're 30 years old, how can you NOT know the difference between a sugar gram and a fiber gram, or the fact that a gram of protein has half as many calories as a gram of fat? I do not get it. And don't get me started about the ignorance among type II diabetics.

Anyhow, all of this to say that the stuff that I considered to be common knowledge among self identified "dieters" apparently ain't so. Therefore, I have to dial back my expectations about general/common knowledge. Okay. If that's the case, well, then IMNSHO there needs to be a way higher bar regarding education of WLS people, especially DSers. Very simple. You gotta pass a certain level of nutrition exam before you get cut open.

So, I'm willing to talk about what that exam should contain. If you can't figure out that there is protein in foods other than steak, you need to just die fat. Pardon my prejudice.

I'm still shaking my head about steak being the only source of protein.

This is a VERY good question. I need to think on it a while. Preferably after I get over this damned cold.

outside of the board most people I know had RNY.... half of these people never even TRIED to diet in their lifetime before a random doctor suggested WLS and then the person was fast tracked and had it ebfore they had ANY IDEA what they were doing....this is more common then you think!!!  These are teh folks who dont know calories, fat, carbs etc.  It's really unbelievable how the medical/insurance system is in the United States...it should be a crime!!!  Then there are people like me *****search the ehck out of everything but then it takes me years and many fights to get there...and I'm not done yet!!! (hopefully gettign close)  Anyway, I agree with a lot fo these things. I think some of it is overboard I mean if a person doesnt know the name of everything inside them, it's ok!  As long as the person understands how their system works and differs from pre WLS It'll be alright :)

The main problem I see with some sort of "test" is that all too often, one can easily figure out what answer is correct, but that doesn't mean that one will demonstrate that behavior in a real life application.

On the serious side, I think that a person should have to meet weekly with a qualified mental health professional who does more than accept a copay for an hour's worth of *****ing.  I happened to have a great therapist who has been a great resource for me in this process, both pre and post op.  That said, a truly gifted therapist is rare.

On a less serious note, maybe a candidate for surgery should have to present proof of membership here on the DS message board, and submit copies of his/her posts for the surgeon to see.  We both know that some red flags are evident from the very first posts of some people who post here.

An OH screening board for the DS?   *smiles* 

ROFL @ evidence of membership here!! That would be right up my ally, bring it on!

Okay, but seriously, we're back to that funky term "qualified professional." There is no such thing. If we had the Great Magic Wand, how would we construct such a beast? 

Another way to look at it: I've gone back to college to study psychology and plan to get my masters degree and become a therapist. (I don't think I'm the only one here doing this, but let's use me anyhow.) What would you do/say/invest in me to make me a "qualified professional" for "bariatric psychotherapy"?

(The fact of my DS success is not good enough. Try harder.)

Pre-surgery essay exam (to be taken without notes or access to internet):

What surgery are you having and how does it work to cause weight loss? (Be as specific as possible.)

IMNSHO, if a person is unable to describe the surgery they are having, they have no right to have it. I'd expect an answer in line with:

I'm having the Duodenal Switch surgery. The DS works in two ways to effect weight loss, one by producing Restriction. The stomach is cut down to 1/3 it's usual size. Two by producing Malabsorption. The small intestine is measured, cut, and the ileum is attached to the stomach, and food is carried in that limb (called the Alimentary Limb). The small intestine that used to be attached to the stomach directly is left in the abdominal cavity, remaining connected to the liver and pancreas ducts, in order to provide the digestive enzymes and fluids needed to digest food (this limb is called the Biliopancreatic Limb, and no longer comes into contact with food). The Biliopancreatic Limb is then attached to the Alimentary Limb to create a Common Channel, whereby the enzymes needed to absorb the food eaten, can and does come into contact with food. The Malabsorption component of the DS is created due to the Biliopancreatic Limb (the duodenum and the jejunum portions of the small intestine) no longer coming into contact with food, as well as the Malabsorptive component of mostly the ileum component of the small intestine coming into contact with food, yet unable to absorb food the way the duodenum or jejunum did in the past.

What is the most common, most accepted "diet" for those with the DS, and why and how does it work best for optimal weight loss and maintenance of weight loss?

What complications can arise in the first month as a postop to the DS?

What complications can arise in the first year as a postop?

How often do DS postops need their blood labs taken?

Why supplement with vitamins and minerals?

What vitamins and minerals are the most frequently found in postop DSers to need adjustments in order to get and stay in normal range?

What are three or four common daily lifestyle modifications you've heard of that have been made by people who are living with the DS configuration?

These questions are just off the top of my head, EN. I hope you are able to find a surgeon who is willing and able to care enough about DS candidates to impose such tests. Not a bad idea at all, and hopefully will raise awareness...

Aw hell I already have at least two surgeons on board, you know that! It's all those other people who are so complicated :-p.

I LOVE these questions. Now, can we find material that the so called "experts" will listen to in order to support them? That's the bigger question, cuz we know how they go deaf, blind and mute so easily.....

I believe Dr. Gagner did a Poop Study on the malabsorption of fats. We could use that one as proof that we can and do eat fats without damaging our ability to lose weight, yes? I think Diana Cox has that one on her profile here, or a link to it? Or perhaps in some of the material on dsfacts.com. I'm not sure where to find it, I just know I've read it before.

As far as the D, PTH, ferritin, and calcium...do surgeons even have to give a rip about what they've caused? I doubt they've put the effort to create postop studies to this cuz once the cutting is done, many times, their job is done. I'm not sure, but I don't think I've seen a vitamin/mineral study done on DSers. I think there have been some (PubMed.com) on RNYers, though (especially regarding vitamin B).

The complications should be tracked by primary doctors, and hopefully the primary doctors loop the surgeons in - regarding surgical complications (cellulitis, open wounds, adhesions, small intestine blockages, abnormal bowels, and more), and what is done to remedy such complications.

Surgeons may or may not buy in to the DS layman's test, but if they could get it set up, and task their PA's and Bariatric Coordinators to bear the burden of not just educating RNY preops and postops, but get MUCH BETTER at educating DS preops and postops, and run 'educates' seperately for both...then this could become a win-win situation.

Good luck, EN. Hope my 2cents are helpful.

I am pre-op. It seems that as soon as I think I have a pretty good idea of what is in store for me, I learn something else! I'm not sure it's possible to know every little detail about the DS. 

"I'm not sure it's possible to know every little detail about the DS."

LOL! Probably not---I'm closing in on being seven years post-op, and I'm STILL learning things.

But it's very possible to learn the basics, pre-op. And one of the MOST basic things to learn is that you have to be vigilant.  Not JUST about weight-loss, but about absorption rates, deficiencies and how to prevent and/or cure them, what vitamins don't mix with what, etc.