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on 7/21/19 12:54 pm
I'm always reluctant to post on this topic but maybe it's helpful for you. I had the exact same concerns as you especially with the malnutrition and side effects like gas. I was worried the DS might be overkill since my BMI was around 40, not 50+. I was ok with the vsg but worried about regain. Also my surgeon was moving cross country.
In the end, I was referred to a dr at Lennox Hill in NY that specializes in DS but also does a variation called a Sadi DS. He sold my on the longer common channel and lower surgical risk. There are also fewer vitamins needed and less risk of malabsorption.
I had this done 5 years ago and lost every once of fat, had some minimal regain which I needed. I'm generally very lean and healthy today. I would suggest researching this, but only use a surgeon that has experience with whatever procedure you decide on.
My vitamins are limited to about 6 pills in the morning. Flatulance is not an issue if you stay away from certain foods. For me it's too much dairy. I can eat anything and not gain weight which was also important to me.
I think the low ferritin is typical, but I think you should still get the colonoscopy. If you get a clean bill of health there you probably won't need another one for 5 years.
Laura in Texas
53 years old; 5'7" tall; HW: 339 (BMI=53); GW: 140 CW: 170 (BMI=27)
RNY: 09-17-08 Dr. Garth Davis
brachioplasty: 12-18-09 Dr. Wainwright; lbl/bl: 06-28-11 Dr. LoMonaco
"May your choices reflect your hopes and not your fears."
You are not alone. We see new people with VSG or even gastric bypass looking into revising to the DS all the time. It has the best statistics of any bariatric surgery not just for percentage excess weight loss, but also for maintaining that weight loss and for permanent resolution of almost all comorbidities.
Yes, it comes with side effects, but malabsorption isn't a side effect. It's how the surgery is intended to work, and it does work. It allows for a diet that requires sufficient protein and allows you to eat fat freely, though you do still have to watch carbs. As others have stated, there is a both an adjustment of your guts and also a learning process necessary for success, but that success is there for you if you want it.
Deficiencies can be avoided if you eat adequate protein and take your vitamins and minerals faithfully. This is a commitment that you make to and for yourself, and it's a life time commitment. Most (not all!) of the people who get into nutritional trouble are the ones who decide they are special and slack off on the supplementation. You will need to be well informed and follow your labs, but really, it's all doable.
Larra
The vitamin C is 500 mg. The proferrin is 10.5 mg per tablet. Expensive, but it worked for me.
What dosages do you take of the C and Proferrin?
And thanks for the info on symptomatic bowel movements. I'm definitely not having those.
No question that this is a major change to your digestion and it will affect the rest of your life. Your concerns:
malabsorption. If you have the DS you are going to malabsorb many nutrients, such as protein, fa****er, vitamins, minerals etc. You will perfectly absorb sugar. Malabsorption is one of the key reasons DS works. Its your responsibility to eat a diet high in protein, relatively low in carbs, and healthy in other nutrients to counteract some of the malabsorption. Some people have encountered bad surgeons and have had greater problems with getting enough nutrition than most, but it does happen.
vitamin deficiency. You are committing yourself to a lifetime of blood tests, at least annually and more often for some people. You will have probably have deficiencies that can be corrected by changing your doses in most cases. You are responsible for studying what vitamins and minerals you will need, because most nutritionists aren't very good when it comes to this surgery. The blood tests will pick up what you need to change. Most people have to tweak their doses over time. Those that stop doing blood tests and taking daily vitamins get into trouble.
other worrisome effects. For the first year or so I felt like my gut was ruling my life. If I made bad food choices, I paid for it in putrid gas, stinking poop and urgent diarrhea and multiple daily poops. I tested the limits sometimes and paid for it. Now, I know the limits, my gut is more accepting of food adventures and those problems are much less frequent. Something that I didn't appreciate starting out was that the cost of groceries would be higher because carbs are cheaper than protein, multiple daily vitamins are a new monthly expense for our budget, and health insurance copays and deductibles can add up for 20+ blood tests and doctors visits and infusions. The good news was that I was hired for a much better job with better benefits because I wasn't morbidly obese!
Don't take this surgery lightly. It's a lifetime decision. I had worsening diabetes and arthritis and that was the tipping point for doing it. Losing diabetes for me was worth every little post-op aggravation.
Do not fall for a two procedure suggestion unless there is a true medical danger for you. A top surgeon has successfully done a one-procedure DS on a 500 lb patient laparoscopically - so no excuses. Two surgeries means twice the copay, twice the risk, twice the recovery and twice the downtime.
Deciding factor for me on the DS was the superior long-term statistics compared to all other procedures. Also ready the regrets and revision forums and take note of the procedures being complained about.
Valerie
DS 2005
There is room on this earth for all of God's creatures..
next to the mashed potatoes
Expect some regain of your weight lost to the tune of 15-20%. Lose as much as you can the first year to have some buffer for that.
I am 13.5 years out and hover around 15% regain effortlessly and I don't diet. Every year, I usually do a detox of sorts when I find myself actually craving carbs. With that, I cut back simple carbs for a few weeks, focusing on meat veggies and cheese.
Valerie
DS 2005
There is room on this earth for all of God's creatures..
next to the mashed potatoes
The good news about the side effects is that they are controllable.
Stinky gas and loose stools - controlled by what you eat. Simple carbs, lactose (for some) and other random individual foods (onions for me) cause this. Avoid them and you don't have it. Take probiotics and the smell is about 80% reduced.
Vitamin deficiency - this is hard because we want to trust docs, however the docs really have no clue. They are notorious for giving bad advice - even nutritionists like to bundle us into one WLS file and our needs are very different. Find the Vitalady schedule and start there. I cannot think of anyone who went deficient following that regimen and you adjust dosages as labs dictate. Also learn how to read your labs and take control yourself.
Valerie
DS 2005
There is room on this earth for all of God's creatures..
next to the mashed potatoes
It is true we have an impaired ability to absorb iron. After having infusions every year or so starting about 5 years into my DS life, I have not needed an infusion for 2 years now because I changed the type of iron I take, heme iron (Proferrin), take it with vitamin C on an empty stomach, and do not take it with copper, calcium, zinc, or milk products. My last ferritin test was normal. In my low-ferritin years, I was advised to get a colonoscopy to rule out colon cancer, and it was completely normal. My obese sister currently has stage 4 colon cancer. The doc said losing large amounts of weight is protective for colon cancer and he felt I was now at low risk, despite my family history. Visible blood in the stool or black tar-like poop are more obvious symptoms of colon cancer, more than diarrhea or constipation.
