Hello - RNY or SIPS? That is the question of the week...

[aaa]

Oh that's true! Nuts! I love nuts. And there's my fat too. I always avoid them though because the calories add up so fast.

I eat tons of nuts.

If you decided to have a DS remember: we don't count calories. You'll be freed from that.

And since we malabsorb fat we need it to 'grease the wheels' so to speak. It keeps things moving.

 

[Stefanie S.]

I eat tons of nuts.

If you decided to have a DS remember: we don't count calories. You'll be freed from that.

And since we malabsorb fat we need it to 'grease the wheels' so to speak. It keeps things moving.

Almost seems too good to be true Does increased fat intake mean more bathroom trips?

 

[harrietvane]

I think the choice of surgery is very personal, but for me this was my second time around. I wanted something that was proven to work long-term, and that kept the weight off. I also had incredibly high blood pressure and family history of Type 2 diabetes, and I wanted something to fix those for good. I also wanted to be able to eat 'normally', because I'd lived with a shitty lapband for five years. For me, taking into account those factors, the DS (once I heard about it!) was the obvious choice.

I think you need to think seriously about how you'll get your protein without animal-based food sources (including eggs and dairy), as this is a non-negotiable part of the DS lifestyle.

 

[aaa]

Almost seems too good to be true Does increased fat intake mean more bathroom trips?

I guess it does if you really, really eat a ton of fat. But I can't remember the last time I had an oil slick and it's been years since I had an accident. They're pretty well formed. Fats are impt. for a DSer so you keep things moving. You might want to search for posts on the site regarding constipation. Some people have had issues with it. I have not. Correction: once I did. A family member became gravely ill and for one day things went haywire. Then everything returned to my normal.

As a matter of fact, I've had 'to go' for the last half hour or so while I've been online (I'm eating some junk today) and I haven't. I'll go soon, but it isn't as if I just have to drop everything right now.

 

[KathrynK]

DS has been wonderful for my health, but you need to know there are no guarantees that any one else's experiences will be yours. I travelled for work frequently had meetings nearly daily, and attended day long conferences, and in my experience, DS can be tough in the workplace. to get through a business trip I ate nearly 100% animal protein, nuts and a few "safe" for me vegetables. No bread/pasta/rice carbs. I have a very sensitive gut since DS and developed lactose intolerance. Even yogurt gave me gas, except for the most most pure, no-additive kind. To avoid gas or frequent poop at work, I ate very carefully M-F, and even then, it wasn't perfect. Most people do not have this reaction. You have a few "prexisting" requirements that might require compromise after DS. Getting over a reluctance to poo at work might be one of them, and the vegan diet might be tough for protein requirements and for gas. Despite the difficulties, I would still have DS again, because everyone has gas and smelly poop sometimes, with and without any WLS, and I chose my health over the occasional embarrassment and need to eat carefully before some events. I hope your doc told you that even the RNY and the Sadi have side effects, and my friend's husband has the RNY and can out-fart me on a daily basis and has regained most of his lost weight. If you are going to go through this, in my opinion, the chance of durable weight loss should be high in the list, because 5 years from now you don't want to be looking into another surgery. If there are compromises you are unwilling to make, I would go through a very honest and tough look at myself and make an appraisal of how important it is to get rid of morbid obesity. There are going to be changes after making the decision, some will be troublesome and some will be absolutely fabulous.

 

[southernlady]

Almost seems too good to be true Does increased fat intake mean more bathroom trips?

However, not enough fat is a recipe for constipation and painful bathroom trips. http://bariatricfacts.org/threads/fats-are-not-the-enemy.3185/

I start my day with coffee with butter (real butter not the fake crap) and HWC (heavy whipping cream). I easily use two tablespoons in one cup of coffee. Not pats but tablespoons. I usually go for the second time after it. First is between 7 and 8 AM cause I don't HAVE to get up to a clock 99% of the time. Being retired is freeing.

I don't have to run to the bathroom these days but there have been an occasion or two when ignoring it gets me there faster than I like. cause my system will say "okay, later is no longer an option".

 

[Larra]

A couple thoughts...

first, I have a dear, dear friend who had RNY way back before we all knew about the DS. She and I and another friend were at a hotel together, and she recommended that anyone who wanted to use the bathroom should go before she did, as no one would want to go in there for awhile after her. Very considerate, but tells you that at least some people have issues with smells even with the minimal amount of intestine that is bypassed with RNY. There is also a guy with SIPS who posts a lot on that other website (we don't mention the name of the website here but you know what I mean) and raised concerns about a long airplane trip, using airplane restroom, wearing charcoal lined undies, etc. And that's with SIPS! I have no idea what he eats, and would never want to confront him or offend him as he seems like a nice person and that's not my style, but if anyone thinks that having SIPS or RNY instead of DS is some kind of guarantee against inconvenient poop or smells, they are wrong. It's far more dependent on your diet, and to some extent individual differences.

Regarding vegan diet - I'm very glad you're open to eating at least some animal derived stuff, and there is at least one person here who does mostly vegan but with eggs and fish and does well. I'm not sure if she consumes any dairy. Many people with DS or RNY, and presumably SIPS, become lactose intolerant, but most of us can manage cheese, just not milk itself, so cheese is a good source of protein for us. Remember, you don't have to worry about the fat or calories anymore with DS. I would recommend that you be open to other kinds of fish and shellfish and not just salmon. I think it would be very tough to get in enough protein with being strictly vegan. Please understand that I greatly admire people who choose to be vegan, this is NOT a criticism, but we do malabsorb about 40 - 60% or the protein we eat, so between that and some degree of restriction with your sleeve, you need some concentrated sources or protein. Also, you need a variety of different proteins to make sure you get in all the essential amino acids.

 

[galaxygrrl]

Wow, late to the game on this one. For me, the bathroom issues took about a month to get better and then, about 2.5 months more to get really better. Now really, they are about the same as before surgery. I did not expect that, I expected it to be much worse. . YMMY on this, but most people are just fine.

It's the vegan part that I think you need to think through. But you could absolutely do the DS with fish and eggs

 

[Munchkin]

Do some thinking about why you want WLS of any kind. Will you be OK with maintaining/losing 1/2 or 1/3 of your EW? If that's OK, it doesn't matter as much what you pick. However...all post WLS diets are protein centric. Think carbs, bad; protein, good. This does not go well with being a vegetarian. If you decide to proceed, you need to take the diet on an extended trial run starting now. If you can't do it, you need to rethink things. Imagine your future. Realistically, are you going to continue to gain? Where will you be in 5 or 10 years? The DS is your best chance to be 'normal'. You have to decide if it's worth it. If not, SIPS is probably your next best choice, then the RNY. Since you already have the sleeve, SIPS or the DS would be easier ops.

I had my DS about 14 years ago. In that same time frame, 10 of my co-workers also had surgery. 8 of the 9 RNY people have gained back 100% plus of what they lost. One is pretty normal looking. The one band person never lost anything. And there is me. I am still pretty normal looking but I am always still trying to lose more. When you look at results, you need to look at people 10 or more years post-op. That's where you get the real picture.

Poop. People are so concerned about poop. I usually go twice every morning within an hour of getting up. Then I am done for the day unless I eat something really crappy. I take my supplements twice a day, morning and evening. No big deal. I use simple 7 day organizers and refill once a week. It is no big deal, it's automatic. I don't even need to think about it anymore. I am healthy as a horse and I don't consider myself medically compromised because of my DS. I have traveled all over the world including some real dumps! I went rappelling, rode a horse across Mexico, and kayaked the Amazon. I can do anything anyone else can do. And I couldn't say that when I was fat. The only thing wrong with me is a hernia I can't afford to get fixed. Those can happen to anyone but abdominal surgery of any kind increases your risk.

Best of luck!

 

[Stefanie S.]

DS has been wonderful for my health, but you need to know there are no guarantees that any one else's experiences will be yours. I travelled for work frequently had meetings nearly daily, and attended day long conferences, and in my experience, DS can be tough in the workplace. to get through a business trip I ate nearly 100% animal protein, nuts and a few "safe" for me vegetables. No bread/pasta/rice carbs. I have a very sensitive gut since DS and developed lactose intolerance. Even yogurt gave me gas, except for the most most pure, no-additive kind. To avoid gas or frequent poop at work, I ate very carefully M-F, and even then, it wasn't perfect. Most people do not have this reaction. You have a few "prexisting" requirements that might require compromise after DS. Getting over a reluctance to poo at work might be one of them, and the vegan diet might be tough for protein requirements and for gas. Despite the difficulties, I would still have DS again, because everyone has gas and smelly poop sometimes, with and without any WLS, and I chose my health over the occasional embarrassment and need to eat carefully before some events. I hope your doc told you that even the RNY and the Sadi have side effects, and my friend's husband has the RNY and can out-fart me on a daily basis and has regained most of his lost weight. If you are going to go through this, in my opinion, the chance of durable weight loss should be high in the list, because 5 years from now you don't want to be looking into another surgery. If there are compromises you are unwilling to make, I would go through a very honest and tough look at myself and make an appraisal of how important it is to get rid of morbid obesity. There are going to be changes after making the decision, some will be troublesome and some will be absolutely fabulous.

Many words of wisdom here... thank you for taking the time to help me.

 

[Stefanie S.]

However, not enough fat is a recipe for constipation and painful bathroom trips. http://bariatricfacts.org/threads/fats-are-not-the-enemy.3185/

I start my day with coffee with butter (real butter not the fake crap) and HWC (heavy whipping cream). I easily use two tablespoons in one cup of coffee. Not pats but tablespoons. I usually go for the second time after it. First is between 7 and 8 AM cause I don't HAVE to get up to a clock 99% of the time. Being retired is freeing.

I don't have to run to the bathroom these days but there have been an occasion or two when ignoring it gets me there faster than I like. cause my system will say "okay, later is no longer an option".

Very helpful! Thank you

 

[Stefanie S.]

A couple thoughts...

first, I have a dear, dear friend who had RNY way back before we all knew about the DS. She and I and another friend were at a hotel together, and she recommended that anyone who wanted to use the bathroom should go before she did, as no one would want to go in there for awhile after her. Very considerate, but tells you that at least some people have issues with smells even with the minimal amount of intestine that is bypassed with RNY. There is also a guy with SIPS who posts a lot on that other website (we don't mention the name of the website here but you know what I mean) and raised concerns about a long airplane trip, using airplane restroom, wearing charcoal lined undies, etc. And that's with SIPS! I have no idea what he eats, and would never want to confront him or offend him as he seems like a nice person and that's not my style, but if anyone thinks that having SIPS or RNY instead of DS is some kind of guarantee against inconvenient poop or smells, they are wrong. It's far more dependent on your diet, and to some extent individual differences.

Regarding vegan diet - I'm very glad you're open to eating at least some animal derived stuff, and there is at least one person here who does mostly vegan but with eggs and fish and does well. I'm not sure if she consumes any dairy. Many people with DS or RNY, and presumably SIPS, become lactose intolerant, but most of us can manage cheese, just not milk itself, so cheese is a good source of protein for us. Remember, you don't have to worry about the fat or calories anymore with DS. I would recommend that you be open to other kinds of fish and shellfish and not just salmon. I think it would be very tough to get in enough protein with being strictly vegan. Please understand that I greatly admire people who choose to be vegan, this is NOT a criticism, but we do malabsorb about 40 - 60% or the protein we eat, so between that and some degree of restriction with your sleeve, you need some concentrated sources or protein. Also, you need a variety of different proteins to make sure you get in all the essential amino acids.

Extremely helpful! It is interesting how DS got such a bad reputation, and yet the other surgeries can have the exact same side effects... while not allowing for as much weight loss / maintenance. Yeah.. I have come to terms with the fact that a strict vegan diet isn't likely to work with any WLS. I am saddened, but I feel that my compromises are acceptable to me and I can make this work. Thank you again

 

[Stefanie S.]

Do some thinking about why you want WLS of any kind. Will you be OK with maintaining/losing 1/2 or 1/3 of your EW? If that's OK, it doesn't matter as much what you pick. However...all post WLS diets are protein centric. Think carbs, bad; protein, good. This does not go well with being a vegetarian. If you decide to proceed, you need to take the diet on an extended trial run starting now. If you can't do it, you need to rethink things. Imagine your future. Realistically, are you going to continue to gain? Where will you be in 5 or 10 years? The DS is your best chance to be 'normal'. You have to decide if it's worth it. If not, SIPS is probably your next best choice, then the RNY. Since you already have the sleeve, SIPS or the DS would be easier ops.

I had my DS about 14 years ago. In that same time frame, 10 of my co-workers also had surgery. 8 of the 9 RNY people have gained back 100% plus of what they lost. One is pretty normal looking. The one band person never lost anything. And there is me. I am still pretty normal looking but I am always still trying to lose more. When you look at results, you need to look at people 10 or more years post-op. That's where you get the real picture.

Poop. People are so concerned about poop. I usually go twice every morning within an hour of getting up. Then I am done for the day unless I eat something really crappy. I take my supplements twice a day, morning and evening. No big deal. I use simple 7 day organizers and refill once a week. It is no big deal, it's automatic. I don't even need to think about it anymore. I am healthy as a horse and I don't consider myself medically compromised because of my DS. I have traveled all over the world including some real dumps! I went rappelling, rode a horse across Mexico, and kayaked the Amazon. I can do anything anyone else can do. And I couldn't say that when I was fat. The only thing wrong with me is a hernia I can't afford to get fixed. Those can happen to anyone but abdominal surgery of any kind increases your risk.

Best of luck!

I love your post! Your straight-talk really reached me. I have been researching and discussing this all day long. I am 99% sure I want the full DS now. And posts like yours really put my mind at ease. One thing... with the RNY, they had told me I will need to take the multi-vitamin every morning. And then 3-4 doses of calcium spaced evenly throughout the day. And possibly more iron. This isn't the case for DS?

 

[Larra]

If that's all the vitamin instructions they gave you, you would be in trouble. With gastric bypass there is also malabsorption of B12 (and possibly of other B vitamins as well). B12 deficiency causes peripheral neuropathy, and I have seen threads on that other website where one person discusses their problems with peripheral neuropathy and a bunch of others chime in with their problems. And if left untreated, it can become permanent and disabling.

And the calcium, for both bypass and DS, should be calcium citrate, not the more common calcium carbonate.
People with both operations can have issues with iron, probably more with bypass than with DS but we see this with either operation. So you can't avoid supplementation for either calcium or iron.

With the DS, since we absorb so little fat, we also have to supplement the fat soluble vitamins - A, D, and K. E is also fat soluble but it's rare to have problems with E. And taking ADEK's won't work. They sound perfect, but in reality contain so little of each component as to be useless. So we take them separately in the "dry" form because if you take the prescription form, or the standard OTC ones, they are packaged in oil, and oil=fat so we don't absorb them.
There is a lot to know, and sadly most surgeons and their staff fail to provide adequate information. And then, they slam the DS for causing deficiencies, when in reality it's their crappy recommendations that caused the problem and not the operation.

 

[galaxygrrl]

The other thing that has not really been mentioned and was one of the key deciders for me, is that if you talk to people who have had the surgery, the people with the DS are the happiest and most satisfied. That, eating some what normally, elimination of diabetes and long term weight loss is why I picked the DS over others.