Carol J.
DS Recipes
Jan 29, 2007
Italian Cheese Cake..(Kryst's Mom)
1 Dozen Lg Eggs
3 Lbs Ricotta (whole milk)
2 1/2 to 3 cups Splenda (depends on how sweet ya like it)
1 Table spoon Orange juice
1 Table spoon Lemon juice
3 table spoons Annisitte Liquore.. (this is what we "Italians" put in Black coffee) LOL
Mix Eggs and sugar (splenda) first, then add annisitte, orange juice, lemon juice and Ricotta..
Mix everything well
Do not grease pan.. Glass pryrex dish is best (Rectangle)
Oven 350 - 375 for about 1 hour and 20 mins.. or until you see light golden brown top..
Do not refridgerate until cooled off a bit...
Serve chilled.. it taste best that way..
BT's Cottage Cheese Fruit Salad
1 carton of cottage cheese
1 tub of Cool Whip
1 box (dry) of jello
1 can of crushed pineapple (drained)
Put the cottage cheese, Cool whip and pineapple in together, and then mix the jello in last.
I haven't tried these but I'm going to. I loath cottage cheese so hopefully the other ingredients make it palatable.
Ezpy's Cottage Cheese Pancakes: 1 Cup Peanut Butter 1 Egg 1 cup Splenda (i use 1/2 c, it's too sweet otherwise) Mix the stuff up with a blender, bake at 350 about 10 minutes... Have a big glass of milk handy, these are a little dry, but goooood.
Ingredients:
1 cup of cottage cheese (any kind -- I like Knudsen small curd)
4 eggs (3 if they're really jumbo)
1/4 cup of flour (this can be almond, but is best with wheat)
2 tbsps of butter melted (can be salted)
Cinnamon and salt to taste (I like LOTS of cinnamon)
Milk to thin (optional)
Scoop the cottage cheese into a blender. Add 2 eggs and blend for like 30 seconds. Scrape the sides of the blender. Add flour and 2 more eggs, blend for another 30 secs or so until pretty smooth. Add cinnamon and salt to taste. If batter is too thick and thinner is preferred, or to use as crepes, blend in milk to thin.
They cook just like regular pancakes on a oiled skillet. I use real maple syrup heated very hot so as to make it very thin and use less. That way I don't add too much sugar but to get the taste. Besides, ain't nothin' like the real thing.
These absolutely ROCK! 4.5 grams of protein per pancake. I batch made about 12 pancakes for me. Even non DSers like them!
Maureen's Ricotta Cheese Fruit Pie
1 1/2 lbs Fresh Ricotta Cheese (not the stuff in the containers)
1 tin drained Pineapple tidbits or crushed
1 handful or so of Raisins
I now add a few tablespoons of Splenda and some cinnamon.
Spray an 8x8 pan with Pam
Mash everything together right in the baking pan.
Bake at 350 degrees about 40 minutes until the edges get a little brown.
I like this warm with SF Cool Whip
or
Cold with some SF pudding
or
Just about any way you want to serve it. It's good made with Mandarin oranges too but I prefer the pineapple.
Cheryl's Peanut Butter Cookie Recipe
Homemade Peanut Butter Protein Bars
1/4 c. butter
1/2 c. natural peanutu butter at room temp
4 oz. cream cheese, softened
1 3/4 c. vanilla-flavored whey protein powder (I like Designer Whey)
1 TBSP vanilla
2 TBSP Splenda
1/2 c. chopped peanuts
1. Melt the butter in the microwave and add the peanut butter and softened cream cheese to it. Mix together with a spoon and then add the protein powder, vanilla, splenda and peanuts. Mixture will be very crumbly.
2. Taste and see if it is sweet enough. If not, add a little more Splenda.
3. Press the mixture firmly into an 8 by 8 inch pan. Slice into 12 pieces and put the whole pan in the freezer. Remove when the bars are firm.
Each bar: 8 net carbs, and 31 grams of protein!
Val's Roast Chicken
1) Take a chicken and coat with melted butter and squeeze lemon juice over it.
2) Stuff the cavity with 1 or 2 lemons cut in half and top with seasoning (I like salt, pepper, garlic, Adobo, rosemary, poultry seasoning) and roast breast-down to get those lemon juices sinking into the meat..
3) In the roasting pan, include a head of garlic with the bottom cut off and an onion or two quartered
4) Flip the chicken back over the last 30 min to get the breast browned.
The meat (even the breast) comes out so moist with the lemon juice enhancing the goodness. The lemon flavor also comes out in the gravy, too. When making the gravy, add the onion with the tidbits, and squeeze out the garlic cloves from the head, too.
Why DS?
Jan 13, 2007
The following is from Dr L's website.
(I did not make it up!)
You can lose more of the excess body weight
(85-95 %).
In this stage of knowledge we know that excess body weight loss after adjustable laparoscopic banding is approximately 50 %. Failure rate is approximately at 30 %. 25 % of diabetics are not cured. 20 % of patients with high cholesterol and triglycerides are not cured. In comparison, the duodenal switch procedure cures approximately 100 % diabetes and 98 % hypertension and 98 % lipid disorders. Vomiting, esophageal dilatation and motility disorders are possible if band is to tight. Remember, the longer the band is around the stomach, the risk for complications increase.
Modifications of the duodenal switch procedure performed in our practice is designed individually. The factors taken into consideration are weight, body mass index, age and goals. This procedure, for the most part, is totally reversible from the absorption point of view.
We know that a patients response and successful weight loss varies. The most important factor is weight (body mass index), especially a BMI greater than 60. This is why we developed a new approach that allows us to achieve excellent results in weight loss independent of patient's BMI. This is contrary to gastric bypass or the banding procedures, which are performed the same way regardless of the patients weight (BMI). There are a few things that patients need to realize. Duodenal switch is for the compliant patient that is willing to take vitamins and minerals daily, attend support group meetings and post-operative follow up. * easy to control with oral intake- in some instances intravenous iron infusions necessary
CAMPARISON TABLE
[ X ]
Type of Operation
Duodenal Switch
Gastric Bypass
Adjust Lap Band
% excess wt. loss
75-95%
Approx 50-60%
Approx 50%
Stomach size
100-140 cc
3cc-30cc
15cc-25cc
Preservation of stomach physiology
Yes
No
Yes
Stenosis of entero gastrostomy
No
Yes
No
Vomiting
No
Yes
Yes
Band slip, obstruction, erosion, infection
No
No
Yes
Port migration - infection rate
No
No
Yes
Esophageal dilatation
No
Yes
Yes
Early perforation of staple line
Yes
Yes
No
Connecting system leak
No
No
Yes
Possibility of anemia *
Yes
Yes
No
Possibility of protein malabsorption **
Yes
Yes
No
Vitamin and mineral supplements needed
Yes
Yes
No
Risk of osteoporosis ***
Yes
Yes
No
Risk of incisional hernia
Yes x3
Yes x3 -open
x1 lapYes x1
** rare and temporary (in some cases requiring iv nutrition TPN)
*** easy to control - rare- if patient is compliant and patient is taking recommended supplements
The Smiling Fool! Month 2
Jan 09, 2007
Well, cry I did, me and my doctor, when I went for my 2nd month check up! Both of us sitting in her office sniffing and carrying on over my progress.
So here is my update!
For month two I lost another 17 lbs! That's 47.5 lbs in two months!
My blood pressure is down and is now at the high end of NORMAL! Yay!
I'm sleeping like the DEAD and when I wake up, I actually feel rested!
My ankle no longer swells and my feet and knee doesn't hurt when I'm out and about.
My pants are getting very loose. My doctor said, "Oh my God! You need a belt!"
Overall I am loving the DS lifestyle. The weight loss has been absolutely effortless. I'm eating well and feeling very good.
I am so grateful to Dr L and his staff for giving me a second chance at life and I'm grateful to each and every person on this forum who share their journeys with the rest of us! May the DS be as good to you as it has been to me!
The First Month (What I've Learned)
Dec 07, 2006
The first week you feel like you've been hit by a truck. There is no getting around it. Grin and bare it!
Thank goodness for painkillers and anti-nausea drugs! Take 'em if you need 'em! No one ever got an award for toughing it out.
Being in the hospital just plain SUCKS! The noise, the nurses, being hooked up to multiple lines and machines, being poked and proded every 15 mins. Grrrrrr!
I started to feel better when I was released from the hospital and could look after myself. I could rest and no one was going to bug me!
For the first little while, showering or even getting dressed is exhausting. You need to adjust your expectations until you feel better.
Everyday gets a little easier. Slowly you'll feel better and your energy will return.
You will never be SO THIRSTY in your entire life! Stay hydrated!
Some smells will make you instantly nauseous.
Strangely, you have zero desire for food. (for the 1st time!)
The Food Network is VERY entertaining immediately post op!
Zofran is a bloody miracle for nausea! Don't suffer, get some!
If you eat a little at regular intervals, it helps with the nausea.
Listen to your stomach! You will know within a bite or two if you can tolerate a food or not.
The following foods were easily tolerated immediately post op: yogurt, applesauce, soup (I lived on soup!), and puddings.
You will only be able to eat 3-4 bites at a time and then you'll be full!
If you overeat, IT IS PAINFUL!
Eating out is a complete waste of time unless you are just there for the company. You will have your 3 or 4 bites and everyone else will still be chowing down.
It's very hard to get your protein in, even with protein supplements.
Getting used to the vitamin regiment is easier if you eat small meals at regular intervals.
Some foods or drinks just don't taste the same and you might not like them anymore.
The DS Forum on OH will become your best support group and your new extended family.
Being a Lab Rat is FUN!
The weight will begin to literally melt off! I lost 30.5 lbs in the first month and it was absolutely effortless!
You will love your DS! (And will want to shout it from the roof tops!)
3 Week Update
Nov 23, 2006
My eating habits can be described as nothing short of BIZARRE! It costs literally NOTHING to feed me and I can probably carry a weeks worth of food in my purse!
I am so unaccustomn to NOT experiencing hunger. (It is truly a wonder to me! I don't feel completely controlled by my stomach now!) I just get busy and forget I should eat. When I do eat, I might have 4-5 bites and feel full. Yesterday I had 4 - 5 bites of ricotta cheese for breakie, no lunch (drank a protein supplement while xmas shopping) and 1 piece of cheese and 2 crackers for dinner. My hubby found this very funny - that one piece of cheese and 2 crackers could fill me up.
Protein is still difficult for me, but fortunately I've finally found a protein drink that doesn't taste like monkey butt. GNC has a product called "Whey Cool" which is similar to Nectar's Roadside Lemonaid. On it's own it tastes a bit bland, but I find if I add a little bit of real lemon juice and some ice cubes, it is quite tolerable.
I am very conscious of getting in all my liquids and taking my supplements and I *try* to focus on getting as much protein as I can.
I hope this is all normal and I would hope that you all would tell me if it wasn't.
When you were newly post op, did you absolutely make sure that you ate 3 meals a day or did you just eat when you felt hungry? I don't have any urge to eat unless I really feel like it, and even then, I only get in a few bites.
Why I Chose DS
Nov 12, 2006
DS has the best statistical record for patients taking off their unwanted weight and keeping it off. While the stats vary - RNY patients can expect to lose between 50-65% and DSers lose 80-95%.
DS patients lose more weight and keep more weight off. The DS Forum has many patients who originally had RNY and they gained back most or all of their weight and were then revised to DS. For me, I wanted a surgery with the least possibility of gaining back my weight. I thought that if someone was going to be messing around with my internal organs, I only wanted to do it once.
DS provides for a fully functional (although smaller) stomach, complete with a pyloric valve. It is not a man made "pouch". This stomach is much larger than the RNY stomach. (DS stomach is between 150cc-200cc and RNY pouch is between 15cc-30cc) This allows for more normal small meal sizes.
Retention of a natural stomach and the pyloric valve also means the stomach functions as it was mean to so there is less vomiting, no dumping, no staple line problems, to clogged stomas, no ulcers of the stomas, and no bleeding ulcers. DSers can drink with meals and do not have to blend or chew their food to the consistency of baby food.
After comparing the two surgeries, it appeared to me that DSers had a very good quality of life post op. There can be issues with gas and loose stools. This is not a issue with all DSers, in fact, some report to have less gas or BM problems following sugery.
Bathroom issues are largely due to what you are eating and once you identify that a food doesn't agree with you, you can avoid it, or enjoy it when you won't offend anyone. Foods high in sugar will give you gas, but at least you can have them once in a while without dumping. Foods high in fats may give you diarrhea but once you stop eating them, the problem is corrected.
Both DS and RNY require a life long commitment to taking your supplements. If you are not prepared to do so, you should not be considering these procedures.
Now for the Scientific Studies
A study published In the October 2006 issue of The Annals of Surgery pointed to biliopancreatic diversion with the duodenal switch (BPD/DS) as the most effective type of surgery for mobidly obese patients (with BMI over 50).
Dr. Hess' study of 120 patients who had the DS at least ten years earlier, shows 94% were in the satisfactory category, having lost 50% or more of their excess weight. The average excess weight loss at the ten year mark was 76%.
The Cornell team published in the November Surgery for Obesity and Related Diseases a new study of WLS in people between year one and year two. (Strain, GW, Gagner M, et al) These weren't super-superobese people (BMI mean 48 for GBS, 53 for DS)
This was their bottom line: "The BPD/DS procedure is more effective in reducing the BMI and promoting fat loss than is GB. The assessment of the impact of these two operations on an individualized basis offers additional information to assist in the evaluation of these procedures.
Both drop in BMI and drop in body fat was better in DS patients. The drop in body fat was particularly impressive: "The decrease in fat was 17.1% +/- 8.2% after GB and 24.2% +/- 7.2% after BPD/DS (P <.001). "
The drop in BMI was also better: "The BMI had decreased by 16.5 +/- 4.8 kg/m(2)after GB and 23.3 +/- 6.8 kg/m(2) after BPD/DS (P <.001).
Duodenal switch
From Wikipedia, the free encyclopedia
The Duodenal Switch (also known as Bilio-Pancreatic Diversion with Duodenal Switch or the DS) procedure is a weight loss surgery that alters the gastrointestinal tract with two approaches: a restrictive aspect and a malabsorptive aspect.
The restrictive portion of the surgery reduces the stomach along the greater curvature so that the volume is approximately one third to one fifth of the original capacity. The malabsorptive portion of the surgery reroutes a lengthy portion of the small intestine, creating two separate pathways and one common pathway. The shorter of the two pathways, the digestive loop, takes food from the stomach to the large intestine. The much longer pathway, the bilio-pancreatic loop, carries bile from the liver to the common path. The common path is a stretch of small intestine, approximately 75-100 centimeters long, in which the contents of the digestive path mix with the bile from the bilio-pancreatic loop before emptying into the large intestine. The objective of this arrangement is to reduce the amount of time the body has to capture calories from food in the small intestine and to selectively limit the absorption of fat.
Contents[hide] |
[edit] Advantages
The primary advantage of the Duodenal Switch (DS) surgery is that its combination of moderate intake restriction with substantial calorie malabsorption results in a very high percentage of excess weight loss for obese individuals, with a very low risk of significant weight regain.
Because the pyloric valve between the stomach and small intestine is preserved, people who have undergone the DS do not experience the dumping syndrome common with people who've undergone the Roux-en-Y gastric bypass surgery.
The chance of developing anastamotic stricture (common with the RNY) is extremely low.
Diet following the DS is more normal and better tolerated than with other surgeries.
Those who undergo the DS often find that comorbidities such as (high blood pressure), diabetes mellitus type 2, and arthritis are significantly relieved in a short time after the surgery.
Type 2 Diabetes is "cured" - or put into remission - in 98% of patients having the DS. These benefits occur long before great losses in weight are seen.
Some surgeons do the "switch" or intestinal surgery on non-obese patients for the benefits of curing the diabetes.
Some surgeons are so confident in the benefits of the DS that they will accept super-morbidly obese patients, who are often turned down for other weight loss surgeries; however, anyone who qualifies with a body mass index (BMI) of 40 or a BMI of 35 with comorbidities qualifies for the more successful DS surgery.
[edit] Disadvantages
The malabsorptive element of the DS requires that those who undergo the procedure take vitamin and mineral supplements above and beyond that of the normal population, as do patients having the RNY surgery. Commonly prescribed supplements include a daily prenatal vitamin and extra calcium citrate.
Because gallstones are a common complication of rapid weight loss following any type of weight loss surgery, some surgeons may remove the gall bladder as a preventative measure during the DS or the RNY. Others prefer to prescribe medication to reduce the risk of post-operative gallstones.
Far fewer surgeons perform the DS compared to other weight loss surgeries because it is a more difficult one to learn compared to the less successful RNY and Lap Band procedures.
[edit] Risks
All surgical procedures involve a degree of risk however this must be balanced against the significant risks associated with severe obesity. Some of the risks or complications that can attach to a bypass are:
Almost one-third of stomach bypass patients suffer from nutritional deficits due to non-oberservance of medical guidelines on the type and amount of food supplements to be taken after the operation.
Soon after the bypass operation patients may suffer from the following: staple failure causing leaks, infection, deep thrombo-phlebitis, ulcers and stomal stenosis.
Latterly other problems can arise that may necessitate corrective surgical procedures. The mortality and morbidity rates of these secondary operations are higher than those of the initial surgery.
[edit] Qualifications
The National Institutes of Health state that if you meet the following guidelines, weight loss surgery may be an appropriate measure for permanent weight loss:
- BMI of 40 or over
- BMI of 35 or over with obesity-related illnesses such as:
- An understanding of the operation and lifestyle changes necessary following the surgery.
[edit] Effectiveness
The following statistics are taken from Pacific Laproscopy and Duodenal Switch Information Zone.
- Percentage of Excess Weight Loss Expected:
- 3 months - 29 and 37%
- 6 months - 51 and 55%
- 24 months - 80 and 91%
[edit] References
My Surgical Experience
Nov 11, 2006
I was then taken to a room where a nurse asked me some questions, I blood taken, I had to pee in a bottle for a pregnancy test, and they shaved my pubic area (why is beyond me, but rules are rules you know!). Due to my sad little veins, the nurse decided to let the anesthesiologist put in my IV.
During this process, which lasted the better of 2 hours, my nerves got the best of me and the only way I could relieve the tension was to cry. Both the anesthesiologist and Dr. L. came in to see me and reassured me that everything would be ok. Thankfully they let DH come in and sit with me until I was taken into the Operating Room.
Once in the OR I was promptly put under and the next thing I remember was waking up in the Recovery Room complaining of pain in my abdomen. They must have given me something because I went back to sleep and slept for the whole first day.
The next day I woke up with the following equipment attached to my body - an NG tube in my nose, and central line in my neck, two drains in my abdoment, and IV in my hand, and a cathetar in my bladder. I felt like I was hit by a truck but was kept comfortable with the PCA, which happily I could hit every 6 minutes.
The next day, the NG tube began to slip out and something must of broken behind my bed because there was an awful mess from the NG tube on the floor. The mess was never cleaned up, despite repeated calls to housekeeping by the nursing staff. The NG tube actually fell out and I was worried that some nurse might want to try to put it back in, but they called Dr L who said that it was ok because it was due to come out anyway.
The nurse I had decided that I needed to get up, which was a chore unto itself. I managed to drag myself into a chair and she said that she would be back in ten minutes to help me back into bed. After 25 minutes I started to get uncomfortable and tried calling the nursing station. Even when someone did answer, which didn't always happen, they still didn't come. After I'd been in the chair for more than an hour I advised the nursing station that I would be calling the doctor if I didn't get some help. Suddenly a whole team of nurses arrived to find out "what my problem was". The Head Nurse Cratchet started out very aggressively and tried to put me in my place. Fortunately for me, there was nothing wrong with my lungs and she backed down. Suddenly they could not do enough for me. I even had someone in from Customer Service to take my complaint, ie. that the nurses are in the habit of ignoring patient calls for assistance.
The next 3 days were spent sleeping, taking the odd short walk, and drinking, drinking, drinking! I was so thirsty that I thought I'd never get enough to drink. Ice chips were better than the best gourmet meal I'd ever had. I didn't feel any hunger, only thirst. Nausea was being kept at bay by regular injections into my IV. I had occasionaly pain, but thankfully none of the awful gas pain that some people complain of.
Dr L visited me everyday, including the weekends. On the Sunday, I had my PCA removed and my catheter taken out. This required me to get up to use the toilet myself, which was frequent between the IV fluids still being pumped into me and the water I was drinking. Dr L also prescribed a Ducolax suppository to get things moving. It worked without discomfort although there was not much of a movement after the bowel prep and having no food in my system to speak of. I think that this was a good thing.
On Monday morning everything was unhooked - the IV and the Central Line. The Central Line was mildly painful because it is stapled into your neck. I also had the drains removed by Dr L, which was very weird and painful, but thankfully only lasted for a few seconds. I felt like someone was trying to pull a worm out of my stomach that didn't want to come out.
Then I was free, free, free! It had been a difficult day, so I was happy to return to my hotel and take some pain medication and have a long, uninterrupted sleep. I woke up and felt like a new person.
The Big Countdown!
Nov 01, 2006
DH and I went to see Dr. L. this morning and finalized everything for tomorrow. He went over all the risks again and I have to admit that I was a little shaky leaving there.
My pre-op diet failed miserably, which is really a lie because I didn't diet at all. I just couldn't, I didn't have another diet left in me. The result? I gained 12 pounds since July, so I am not 272 pounds.
I had a long nap this afternoon, which I really needed after last night. I am feeling surprisingly good and surprisingly calm. Just hanging out here at the hotel with the DH, drinking white grape juice.
4 Days to Go
Oct 29, 2006
I couldn't get vicodine in Canada, so I'll have to get Dr. L. to write me a script for it when I see him. I was able to get the Zofran though. My PCP was reluctant to write me a script for it, saying that it is usually only prescribed for patients undergoing chemo. Well, "hello", I'm having most of my stomach removed! Naseau may be a problem! Sheesh!
Right now I am sitting at the cottage watching the trees blowing in the wind. It has gotten quite cold. They were calling for 15cm of snow, but so far that hasn't happened.
Bag of Nerves!
Oct 23, 2006
