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.

Wednesday, June 25, 2008

Saturday, June 14, 2008

19 months postop

I am 19 months postop. Time flies. I have been extremely busy with life and enjoying it. I live as though I never had bariatric surgery since I do not have to watch what I eat. I see many postops from other sugeries speaking alot about calories in versus calories out. But, that just does not apply to the DSer. I eat because I want to and not freak out or worry if I will gain weight, especially at times the amount or frequency. I am still not able to eat much. But, then there are times, I am able to eat a medium size portioned plate of food. I make sure most of my protein and nutritional value is obtained from bulk food. I know I have to live on using protein powder for life, since I am unable to eat that much to get my protein that way. I usually eat either cereal, grilled ham & cheese, western omelet with cheese , grilled salmon or even a cheeseburger for breakfast. I make sure my first meal is high in protein. I also noticed that I have to eat 5-6 meals a day. I will not able to get over 80gms of protein using the 3 meals, 2-3 snack per day plan. I make sure my snack time is a meal that consist of some sort of protein that is at least the minimum 24gms per serving.

I sit back and realized one of the beauty of having the DS is I never exercised and still lost weight and have no saggy or loose skin. I am 44 yrs old and expect some sort of skin issue, but I don't. My highest weight was 305 lbs. I am right now at 139 lbs. Other than that, I like to readjust my vitamins and supplement as often as needed and according to my schedule and agendas. My bloodwork at 19 months postop is STILL great and within range. I have not once or ever had any deficiencies. I did have vitamin D deficiency prior to surgery and was placed on Drisdol therapy for it. But, since having surgery, all my vitamins, iron, panels and other levels have been amazingly good. I have not once since after being 12 months postop, had any reactions to eating food as I did prior to that. I am still unable to have certain sugar subsitutes and had to observe sugar alcohol amount or suffer severe stomach cramps.

I get A LOT of PM from members here that are pre-ops and especially post-ops. Many are interested and even drawn to know more about the DS surgery and how it works. I do get RNY post-ops asking about vitamins and supplements and even food choices and even help them with their vitamins and supplements. Many post-ops from the Texas board private message me regarding my food log and do like reading what I post. They find it very informative. I am a bit taken back because there are some who write to me that don't want the other members to know they are struggling with their RNY, there are others who just don't want others to know they are dealing with weight gain and there are others who are beginning to have a hard time dealing with certain issues that they didn't expect. To each their own how they want to reach out to someone and who they want to know about what they are going through. But, they are struggling with their weight and disappointed they have to subject themselves to having to use the 5 day pouch test or the liquid protein test or whatever they call it. They are tired having to still worry about what they eat and food being their enemy. All I can do is provide them support and guide them to help them out. They know I am discreet and won't disclose what we speak of. Many are ashame to post about their struggles on the board. I can understand. Paying it forward doesn't mean to just help those get surgery. Paying it forward also mean and MANY forget that it is to help those who are post-op as well.

There are some RNY postops who are struggling with their health and bloodwork. They ask me a lot of questions about vitamins, proteins and supplements. They appreciate that I take the time to listen to them vent and that I post and share info that may help them with their struggles and post-op life. I may not have the RnY, but these postop who do have the RNY look up to me and know I am sincere to help them. They just don't see the support or help from others on the board that they need. They tell me their peers are struggling as well and can't see how they can help them, if they can't help themselves. I think those on the TMB would be surprised who I have been helping with their RNY struggle and work with them to sort solutions to their problems. I may not have RNY, but they rather reach out to me than to their fellow peers. Life is odd sometimes.

Some are also very disappointed in the way postops lower themselves to insult me when a person ask a question, seeking feedback and they come on in to post as though it is about them. I had a woman who wanted feedback regarding VSG vs RnY. The VSG is a part of the DS. Thing is we have been posting back and forth privately and she was offended by by a RNY postop who posted to not provide her with any answers or support, but to incite drama when there wasn't any. I told her, people like that I ignore because they are showing their true ignorancy and class level they are. She thanked me for posting all the info to her and to open her mind to other options to think about. She didn't appreciate what this postop posted, since she said they did not answer her question or helped her out at all. She said I was very straight forward and didn't see any bashing from me. She did said, the other RNY man was stirring the pot and to even insult instead of being polite to answer her question regarding what I wrote and if there was any misunderstanding or incorrect statement. She was disturb how he replied to me and with such degrade, it turned her off to post again to the TMB. I told her, I just ignore them because my reply was to help her and any pre-op out there. What matters to me is what she thinks and if my input helped her in her journey that is she taking to WLS.

Overall, I live a good life without much worry about dieting or having to obssess myself with the scale. I always invite members whether pre-ops or post-ops of various surgeries to visit and read the DS board. Many message me how different and easy going life is with the Ds since we don't care about calories or fat. They still find that amazing. Right now, I am helping out 4 postop RnYers who are longterm and struggling in one way or another.

One has reactive hypoglycemia and she was never diabetic. It has been hard on her and she thought those who have RNY are cure of diabetes. She learned it doesn't and can even develop diabetes (reactive hypoglycemia is a form of diabetes) when you never had a history of it pre-op.

Another RnYer is 5 yrs postop in dire need of support. Her health and emotional state is very messed up. I will be there for her and work with her to get her back on track.

Another RnYer is 3 years post-op and eventhough she exercise and eating right, she is regaining weight. She is now going from one diet after another and done the 5DPT that she says is a useless waste of time and gimmick. She has tried everything and nothing is working. Her carb is very low, she is eating high protein, low fat and low calories. Yet, there is no success. She wants a revision to the DS after reading all the success other RnY had with their revision to it. She is disappointed she wasted her time with having the RnY.

Another RNYer is a regular poster and well known to the TMB. She is struggling and don't want the others to know about it. She is ashame and see her friends are having problems with postop issues too. I have been communicating with her back and forth. She came to me to help her. Eventhough, I am not RnY, she feels comfortable talking to me about her issues and receiving help to get her back on track.


That is what paying forward is about, helping others without taking sides or feeling you need to belong or be accepted among others or to feel you need to be a part of their group just to fit in.