I'm Having Second Thoughts......

[Munchkin]

People have asked us before what our biggest regret was. Most popular answer...we wish we would have done it sooner!

And I agree someday there will be something better than the DS. If my baggy ass is still alive I will be right there waiting in line for it!

 

[Spiky Bugger]

Spiky, I think that was a great summary of some of the long term concerns. I'm a couple years younger than the OP and your daughter (36) and have thought many of the same things. I don't know if I would have gotten heavier, but I do know that I would stay obese, even if I lost and kept off significant weight. I also know that most likely I would be diagnosed with type 2 diabetes, probably within the next couple of years, based on my blood sugar trends. I suspect, looking at the disease progression in my grandfather, father, and brother, that by the time I would have been 45 I would start to develop diabetic neuropathy no matter how well controlled my sugars are, and by 60 the neuropathy at best would include significant pain (my father, who is very active, eats low carb) or limb loss (my grandfather, who was sendentary and alcoholic). I was on 3 blood pressure medications, so I also have a good chance of suffering slow organ damage, and more recently my lipids are going up, making heart problems and strokes a possibility.

So, I could have waited, as I am still pretty healthy. But in 10 years? In 20? I had assumed a shorter life span. Duodenal switch offered me the possibility of a more normal one, or at least a higher quality of life. I could wait until I started to get sick and then have the surgery, but prevention of disease progression makes more sense than trying to treat it later.

I have thought about the real possibility that within my life span we will have much better options. I sure as hell hope so, for the DS certainly isn't a good response to the obesity epidemic. I do believe, though, something as effective as the DS will take a while to be offered, and new treatments are risky. Even if I knew in 15 years a super probiotic as effective as the DS would be available, the decision would be much harder. However, thinking like this is such a gamble. You could have thought the same thing in 1990. The only new options are the sleeve and some meds, and we know how ineffective these can be compared to the DS.

Maybe the DS will have deleterious effects long term. I think it has been around long enough that at least most of the time the negative effects aren't as bad as the effects of morbid obesity. At worse there is always surgical revision (*shudder*) and/or enzymes to increase absorption.

I had a fecal microbiota transplant after c diff. (Yeah, it's disgusting, at least in theory...but it cured a deadly disease after months of diarrhea many times per day.) @DianaCox recently posted a blurb about a woman of normal weight, who also had c diff, and whose poop donor was her obese daughter. After the transplant, the c diff was cured, but the woman started gaining weight...for no identifiable reason. Then, the concept was tested on rats...and duplicated. It MAY BE that a transplant of bacteria from a skinny person could help an obese person lose weight. There is soooo much to learn about the gut microbiome...fascinating real estate.

 

[DianaCox]

Here's the thing - if you get malnourished, the malabsorption can more or less be reversed, either by complete reconstruction of the linear gut, or by doing a kissing-X revision. The latter in particular is a pretty simple laparoscopic surgery. And as we all know, the stomach will eventually stretch out quite a bit, and you can always eat more frequently, so making the stomach bigger is rarely necessary.

I too take my pills twice a day, except my thyroid which I set out in my nighttime pills in my pill box but I put it aside on my nightstand and take it in the middle of the night when I get up to pee. I set out 4 weeks at a time in a 4 times a day pill box I got from Walgreens - so 2 boxes each with 2 weeks of pills - it takes me about 30 min once every 4 weeks, including slicing my Lunestas in half. Each compartment is really full, and I sort them into three swallows - one calcium with one big pill (mag cit or probiotic or biotin), other calcium with the next largest pill, then the rest of the little ones in the last swallow. Then a chewable orange vitamin C that tastes like an orange SweeTart (Costco 500 mg) for a reward.

I almost never forget to take my pills, especially since I have linked taking pills with the twice-a-day "Treatie-ing of the Cats" - the cats know to expect it - when they hear the pill box click open, they come running - but they also have an internal clock, and when it's Treatie Time and I haven't taken my pills yet, they sit on my bed in front of me and stare, with an icy-cold glare, and I must take my pills before they get treats, so I am pretty regular, as are they. It's a mutually beneficial arrangement.

 

[Caitlunn]

@DianaCox I have little else to add to this, but I just HAD to say how cute your cats are. Oh my goodness. I didn't even see the black one at first. So precious!!

My surgeon had the same concerns about the effects of long term malabsorption, since I am on the younger side (26). He wanted to do a longer common channel on me, between 125-150, and wants me to monitor my calcium and bone density carefully. We can be as prepared as we can be, of course, but there could always be some wild new discovery about living with WLS. I'm currently only 4 months out, but it's been the best 4 months of my life. I wouldn't change it.

 

[southernlady]

@DianaCox I have little else to add to this, but I just HAD to say how cute your cats are. Oh my goodness. I didn't even see the black one at first. So precious!!

My surgeon had the same concerns about the effects of long term malabsorption, since I am on the younger side (26). He wanted to do a longer common channel on me, between 125-150, and wants me to monitor my calcium and bone density carefully. We can be as prepared as we can be, of course, but there could always be some wild new discovery about living with WLS. I'm currently only 4 months out, but it's been the best 4 months of my life. I wouldn't change it.

Make sure you monitor your D and PTH as well. Calcium, D, and PTH are a three legged stool. Calcium mid range normal, D high range normal, which means PTH should be low range normal.

My common channel is on the long side (175) and I still have osteoporosis. While we can control vitamins, there are so many factors that can not be changed or controlled. Such as age, sex (although people try), family history. There are several threads http://bariatricfacts.org/forums/vitamins-labs.16/ that discuss osteoporosis.

 

[Katie T.]

I just want to say how much I appreciate everyone taking the time to respond to my post. I has really helped calm some fears I'm having. I just want to make sure that everyone knows how much it's appreciated. If it wasn't for this site god only knows what would happen to me. If I went by what my doctors office says I'd only get labs once a year and not take NEARLY enough vitamins. Crazy!

 

[DianaCox]

By the way, I have literally taught the cats to sit - they know the word and they know what it means. They don't get treaties unless they're sitting.

And the picture is deceptive size-wise - Left to right: Milo: 18 lbs - his very very long and tall and a good weight; Onyx (aka FatBoy): needs a kitty-DS - 21 lbs of plush pulchritude; and Mimi is a curvaceous plump 16 lbs. That's a lotta cat.

 

[Katie T.]

That's funny. My kitty (sookie) plays hide and seek with me. She's a riot. Such cute kitties

 

[Duckman]

That's probably why I married a guy I knew for 15 days...some stuff ya just gotta DO!

YOLO!

OP: second thoughts are normal. The first week or two after surgery was only second thoughts.

You’ll live. You’ll be fine.

 

[Marquis Mark]

If you didn't have second thoughts something would be wrong with you. Almost two years after my DS I still wonder if I did the right thing, but if I could reverse it I would not. Not now anyway.

If you're old, sick and can barely move it's a no brainer. But if you're young and relatively healthy, it's a tougher decision. I was 51, a "lightweight" and in relatively good health. I walked to work two miles a day PRE DS. But I couldn't stand being fat and, certainly, if I had stayed fat the health implications would have caught up with me. I tried everything to lose weight including 8 years in Overeaters Anonymous. I could not make anything work for me.

I do worry about long-term health implications. There is so much doctors don't know. When I first joined this board I tried to find out about old timers with the DS and couldn't find much. I even called Dr. Hess's office in Ohio and asked if they knew if the original DS patient was still alive. It would have given me great comfort if I could have found out of he were, but they didn't know. I have heard of people living with the DS for over 20 years so I imagine if there were some serious malnutrition trends they would have shown themselves already. The body also has an amazing capacity to adapt - like weeds that find their way through cracks in the sidewalk and thrive.

The vitamins are easy. It's just a new habit, like brushing your teeth or balancing your checkbook. It'll just become part of your routine. Worse, and I know it seems trivial, is the gas. Unless you can eat a very low carb diet, it's coming and it can be stunningly aromatic AND voluminous. My output has easily doubled. I have navigated pretty well because I've had an angel of a steady girlfriend for 5 years, but if I were dating I might be nervous. Also, you will likely have to go #2 more and it can come at odd times and the need can be more urgent. It won't be a big issue, but it has caused me to wake up 30 minutes earlier each morning to make sure it's all out before I leave the house, fret on long plane rides, etc.

I have developed a copper deficiency since getting the DS which no one seems to have good ideas on. And, of course, there maybe others I don't know about or which will come in the future.

BUT I'm normal weight. There is a price to pay for everything and, so far, the price (vitamins, gas and anxiety about the future of my health) have been worth it.

There will definitely be something MUCH better than the DS one day. In fact, I'm sure 100 years from now (if we're still alive as a species) people will look back at 2017 and say, "Those poor bastards. Look what they had to go through to lose weight. Now we just get anti-obesity immunizations at birth and we're all at perfect BMIs." They'll look at us they way we look at bloodletting during Victorian times.

But you live in 2017 and this is the best option to maintain weight loss we have at the moment.

Please know your feelings are normal, but also recognize that the vast majority of us would do it again.

 

[writegirl]

I'm about to hit 4 months post op. Before surgery I was freaking out about taking all the vitamins. Honestly, I suck at swallowing pills and I thought that I would be struggling with that for the rest of my life. So, like you, I turned to the veterans here to voice my concerns and, as with you, they assured me I was normal and that it would be easier than I was making it out to be in my mind. THEY WERE SO RIGHT. I now knock back several vitamins in one swallow. I don't think twice about taking them, tbh. I'm still working on the balance with some supplements (what to take when, etc.), but I get it right more often than I get it wrong now. It's a learning curve, to be sure. That said, 4 months out I wouldn't change my decision to have the DS. I'm down nearly 70lbs, my health has improved, my energy levels are through the roof, and sex is way more sexy with 70lbs off my body, ijs. Do what is right for you, but my recommendation is to run toward your DS life and don't fear the unknowns. Life is full of unknowns anyway. You may as well face them thinner, healthier, and with more energy.

 

[JackieOnLine]

fascinating real estate

it really is - the more they study the microbiome of your gut, the more important to your health it is looking.