Duodenal Switch

I would like to share my personal post-op experiences, fact based knowledge and background regarding my surgery which is a combination of the Vertical Sleeve Gastrectomy (VSG) and Duodenal Switch (DS), performed under 1 surgical procedure. It is medically known as a a gastric restriction with partial gastrectomy, pylorus-preserving duodenoileostomy and ileoileostomy to limit absorption. It is known by its formality as a bilio-pancreatic diversion with duodenal switch and abbreviated as BPD/DS or DS. A not so wordy way to say it is sleeve gastrectomy with duodenal switch or just the DS.

I had my laparoscopic duodenal switch procedure on Nov 14th, 2006 for the surgical medical treatment of morbid obesity that can kill you. I am still the same person within, only my outer shell has morph to what I once looked like before this disease imprisoned me. The most important thing that matters is, I have my health back and that means more to me than the actual weight loss.

What is your body if you are not healthy with your respiratory, circulatory, cardiac and digestive system working properly and have mobility to be able to do things on your own, independently with no limitations, no complications or becoming a fatality?

This is what bariatric surgery outcome has done for me, give me my health as well as my life back!

The Duodenal Switch (DS)

The DS procedure has been performed since 1988 and combines restrictive and malabsorptive elements to help achieve and maintain long-term weight loss:

1. by restricting the amount of food that can be eaten through a reduction in stomach size

2. limit the amount of food that is absorbed into the body through a rerouting of the intestines

3. have a metabolic effect induced by manipulating intestinal hormones as a result of intestinal rerouting

The overall effect is that DS patients are able to engage in fairly normal, free eating, while having the benefit of taking on the metabolism of a lean individual.

Monday, May 14, 2007

6 months post-op

Today, I am 6 months post-op. I had not had any complications whatsoever in my outcome with my bariatric surgery. I am healthy and doing well. Have to remember, anyone reading this blog of mine. I do not have gastric bypass, also known as RNY. I had a bilio-pancreatic duodenal switch which means, I still have portion of my stomach (only the outer curve of my stomach pouch was removed) and I do have my pylorus valve that allow food to pass from the stomach to the duodenum. In a RNY, this muscles is missing, hence it is called a gastric bypass. With the DS, you have this muscle and your stomach functions regularly. Therefore, there is no gastric bypass with this method of surgery and your digestion does function as normally as possible except there is a switch and with that a 2nd intestinal tract meant for your digestive juices to process, which then meets at a junction known as the common limb at the end of the small intestine.

Have to also remind those reading this, that with the DS, you have greater chance of malasbsorption also with it being a restrictive. You must live the rest of your life, taking vitamins and supplements. I take 10-12 pills a day and sometimes it is tiring and my tummy too full to digest, even if I haven't eaten much. I do swap to liquid vitamins to help me meet my quota of intake. This is something that is a must and you ignoring or not taking your vitamins and supplements can endanger your health. There are times, I am not up to par with it, but I do my best and consume what I can daily.

Moving along, I am still having difficulties with bread and can only eat toasted sliced bread. Multigrain is more better for me than white. I like toast with alittle butter and either vegetable, salmon or chives and onion cream cheese. I don't have toast every day, just whenever the moment hits me, it is there as an option to have with my eggs and bacon. For breakfast, I will have either western omelet with just some toast or an egg over easy with an Italian sweet sausage. I don't do english muffin. I have issues digesting it and takes a long time, so I avoid that. I can have a cinnamon bun, cornbread and am careful with the biscuit. Other things I have for breakfast is Special K with berries cereal with milk and 1/3 scoop of Unjury protein powder. I drink a lot of milk, about 1 quart a day or ice tea. For lunch, I eat a lot of seafood, either crab, salmon, shrimps or fish. I do eat potatoes, either baked or mashed. I can have a few fries, maybe about 5. Veggies are staple in my food intake. I will have a burger with no buns and do enjoy placing mozzarella, monterrey jack, fontina, cheddar or american cheese on it as it cook and melts. I also like adding marinara sauce on it. That in itself is a meal for me for lunch or dinner and drink my milk with Unjury protein powder with it. I still can't eat pizza, just can't digest the dough. I am able to eat spaghetti but has to be size 9 or angel hair. Chef Boyardee spaghetti with meatballs is something I can eat, tolerate and digest. I also make some meat sauce or marinara and lots of cheese, for my pasta, lol. I only eat ribeye steaks or filet mignon, no other. I cannot eat chicken or other poultry. It still makes me sick.

I went to my 6th month follow-up post-op visit. The surgeon told me my progress has been great and very steady. The weight is slow as it should be. I do not have skin issues on my stomach or arms. My neck and face have great tone, as per his words. I am only 40 lbs away from my goal and he prefers the weight loss to be slow. As of now, My tummy is still a bit puffy and asked him to check to see if I have a hernia. He examed me, told me to cough and then said no, it is still puffy and can take upto a year for it to go all down.

Another thing, we talked about stall. I am at a stall and he told me a stall is actually a very good thing and should not be seen as anything negative. With stalls, your body rest, isn't going thru any saggy or loose skin issues, since the muscles and other part are being re-distributed within. He told me the one with obssession with the scale and stalls, he tries to divert their attention from that and look at the overview of it, that the body needs to rest since continuous weight loss also deprives your body of the nutrients. With a stall, the body begins to take the nutrients and this is the time to up the protein and all. He told me, I am doing very well and will see that my body will start losing weight very slowly now and with frequent stalls since all I got left is 40 lbs to lose and my skintone has been very good. l follow my doc advice and let the loss from here till my 1 yr anniversay be slow and remember stalls are a good thing and actually a good thing for your health and safety which many don't see. Some whine and complain about it. But, with stalls the body rest and distributes itself. With rapid weight loss, it is muscle more that you are losing, not the fat product in your body, hence saggy or loose skin. Also, the amount or length of time you have been overweight does have a factor in your skin elasticity and how it shrinks as you lose the weight.