Hello, friends,

I am fairly certain no one will remember me, since it has been a long time since I posted anything on any bariatric forum. I am not a big fan of social media, but I have found good information and support on this and other sites, so I read what's new from time to time without comment. However, something I read on a forum has been weighing heavily on my mind for the past several weeks, and I want to offer my two cents worth.

[Quick background: 5 1/2 years since the lap DS that literally saved my life -- long story, so details upon request.]

So here is the gyst of what disturbed me. A DS hopeful asked, "Do you eat normal?", to which a DSer replied, "Yes, I eat normal."

Normal. Ah, what an interesting word, isn't it?

Before my surgery, "normal" was a lot of carbs. Bread, potatoes, pasta, sugar -- the works. Today, I allow myself three days a year to eat such things, and those are on holidays. The rest of the time, I DO NOT. If I wish to maintain my weight, not to mention the health and quality of life I have worked so hard to improve, I CANNOT. Today, "normal" is pretty much an Atkins-type diet. If I eat like the old "normal", I will become the old normal, and that won't work for me.

This body I live in and with is improved, but not new. This is the same body I was in before the surgery. The same one that clung to every calorie I put in my mouth. The one that grew bigger and bigger through the years, especially after those many times when I starved to beat it into submission and it blew back at me with a vengeance. This same body would still love to be obese! That has not changed. The disease of obesity is, for my body, "normal".

Fortunately, the DS has proved to be the wonderful TOOL I hoped it would be. It is also a tool I must still continue to employ every day. I just don't have much wiggle room. I HAVE to be as diligent about keeping the weight off as I was in getting it off, and that is MY "normal".

Bottom line: My "normal" requires a hard core compliance even this far out from my WLS. I have made peace with the foods I have to avoid. That took some time. I much prefer slipping into my size 6 jeans and a functioning heart to the near death hell I was in 6 years ago.

What bothered me about this "normal" conversation is that a person who is hoping to have any WLS may still be thinking this is a magic wand, not a tool, and that after recovery, eating normal pasta and normal cookies will still be okay. I never want to pass that message along, even by mistake.

A successful WLS of any variety requires permanent CHANGE. "Normally", human beings don't opt to make such gigantic changes in their lives unless they are in so much pain mentally or physically that they have little choice but to do so. Ask any recovering addict. Ask a battered spouse who finally found the courage to leave. You have to create a NEW "normal", right?

In fairness, I think that some DS patients with a slightly shorter common channel may have an easier time in terms of what they eat than I do. They may also have a much harder time with labs than I do. I take my supplements religiously, and I have never, thank God, had an issue with my labs.

Diligent compliance has been the key to my success with this tool.

Please note, it may have been on this site or another, I don't remember. If it was on this site, please know that I do not intend to rebuke anyone. Every patient's experience is different. I just want to make sure every prospective DS patient goes into this in the right frame of mind -- ready for change. Ready for a new normal.

I had RNY and I have days when my gas is absolutely horrible. I can often relate that to for I've eaten earlier.

Last night was horrible. But as you think back what I ate and how much, I know that it was combination of Chinese dish and some fruits I ate.

When do I get a horrible gas:

• Any food or drink or even chewable vitamins and minerals that contains any type of Sugar Alcohols
• Any type of beans - no matter how well they are cooked, prepared, or what digestive enzymes or herbs I take with them - even small qty of beans would cause me to have a horrible stinky gas.
• Any high FODMAP tape foods - Google FODMAP.
• Most raw veggies and most fruits (high in FODMAP)
• High fiber - fiber feeds gut bacteria and I do have SIBO (Google that) so almost anything with lots of fiber, the prebiotic type fiber would cause a lot of gas created not only in my colon but also in my small intestine. That gas dies not only smell horrible, but it can cause a severe intestine pain.

To find out what was causing my issues - I went on a very specific elimination diet. Very clean eating, cooked meat and a very few cooked veggies (low FODMAP veggies), plus fat. After a week on the very restricted diet, when the gas was minimal and with almost no odur, I started introducing different foods, one item at a time, every 2 days. And recorded my body reaction to that food. If I got a lot gas, I would clean my eating again, wait a couple of days and then try adding another food.

Discovered that done foods my body tolerates better than others. The type of food, how it was prepared, and how much I ate would determine if I can eat it "freely" Ori have to limit the quantity. Or if I decide to just "have it", then I know that I probably would need to sleep upstairs. With a window cracked open, and fan going on. On days like that even the cats don't want to be near me. My guy is really super and he often knows I can't help having gas like that, but it is not fair to him and our relationship, prevent me to get exposed daily to things like that.

Some days I chose to walk in a treadmill in our exercise space to clean the "air out of me" (again with a window cracked open and fan running). (But with the doors closed).

Well, depending on how late i eat the night before. But if I stop before 6.30, i use the rest room once in the morning, or it depends on my diet. But I was talking about # 2...urinating. Im too sensitive with caffeine for some reason. I love coke zero, but not my bladder, Every hour on the hour. I was use to wonder Diabetes, or a the DIM...i take for hormones....not sure, but im sick of giving up the stuff i enjoy.

It has been a long time since I have been on here, but I have always gotten great information and advice. So, I'm curious to hear what you all think or have experienced about vitamin patches and their effectiveness after DS

There is a new-ish single anastomosis procedure that goes under various names such as the SIPS, SADI, Loop DS, and a couple of others. They are a simplification of the traditional BPD/DS (much like the "mini-bypass" is a simplified RNY). It is being promoted as being "as good as" or "almost as good as" the traditional BPD/DS, but more "accessible" (requires lower skill levels so more surgeons can offer it.) Whether it lives up to the claims is uncertain at this point - it doesn't have enough of a track record for the ASMBS to endorse it yet, and most insurance doesn't cover it for that reason. At best, it is likely to fall in somewhere between the RNY and the BPD/DS in effectiveness, which would be a good thing, particularly if it has fewer side effects and limitations than the RNY and DS.

To find the closest experienced DS surgeons to you, then yes, you will have to come down the CA - either to SF for Rabkin or Jossert, or LA for Keshishian. Rabkin used to have a WA based support group, but I think that it has been inactive for some time.