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The DS (Duodenal Switch) Contract

Discussion in 'Duodenal Switch' started by southernlady, Feb 8, 2017.

  1.  
    southernlady

    southernlady Administrator Staff Member

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    Written by Lisa Lauenberg:

    The DS (Duodenal Switch) Contract

    When you sign up for a DS, here's what you are agreeing to - whether you like it or not.

    You *will*:

    1) Know the DS Anatomy well enough to explain it to a Paramedic or ER tech in an emergency
    2) Educate your family members on what a DS is, so that they can do the same.
    3) Eat enough protein - this varies by person, but is generally 90g of protein and up.
    4) Get blood work done annually - most of us have 15-20 vials of blood drawn during an annual lab.
    5) KNOW your lab levels --- You have a right to your labs, and you should look at them. Don't accept "you're fine"
    6) UNDERSTAND your blood work. What is PTH? Do you want it high or low? What are three causes of anemia? What mineral does not work well with iron?
    7) UNDERSTAND Malabsorption --- YOU are NOT normal. You never were and you never will be. You are recovering from Morbid Obesity and you will ALWAYS malabsorb. Understand what that does to EVERYTHING you take - anti-depressants, birth control, antibiotics, antipsychotics, pain medication and more.
    8) TAKE VITAMINS EVERY SINGLE DAY FOR THE REST OF YOUR LIFE. You have to take the right amounts (as guided by your labs). You have to take the right kind. And most importantly - you have to TAKE them. Every day.

    When you agreed to have your body surgically altered, you gave up the right to be ignorant or stupid or stubborn or frail. You must be your own advocate. You have to do what needs to be done whether you goddamn well like it or not.

    *The DS doesn't care if you're not feeling it today.
    *The DS doesn't care that you want to pretend you're normal.
    *The DS doesn't care that you're busy, pre-occupied, not feeling well or rebellious.
    *The DS doesn't care that you don't feel up to it today.
    *The DS doesn't care that you're in crisis - dealing with rejection, surgical complications, the death of your child, divorce, loss of job or addiction.
    *The DS doesn't care that you're broke and can't afford it.

    That's the cold hard truth. People have died because they refused to take ownership of their decision and FOLLOW the RULES. Remember - you *chose* this. If you cannot do these simple things, then you need to have your DS taken down before you die.

    -- if you violate the contract --

    the DS *will* kill you.
     
  2.  
    kim79

    kim79 New Member

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    that's is laying it out there. THANK YOU
     
  3.  
    Spiky Bugger

    Spiky Bugger Well-Known Member

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    And...when a bunch (not just one or two) of DS patients tell you that you are getting bad info, or that the lab results you posted look really bad, or that, no, the prescription Vitamin D (in oil) that your doctor who told you to ignore us says you need, or that malabsorption is NOT malnutrition, or that NO (dammit!) six months post-op is NOT a great time to get drunk and/or pregnant or any other stuff that we may gang up on you about...it is because we have ACTUALLY observed that people who did not CONSIDER that we know what we're saying have DIED.

    So there.
     
    JuliaDS, Jbandmmomma and kim79 like this.
  4.  
    Marquis Mark

    Marquis Mark Well-Known Member

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    OK, what are three causes of anemia?

    I just explain my anatomy like this: My doudenum was divided a few centimeters below the pylorus. From there, one limb carries food only, the other, the longer one, carries just juices. They meet up again about 85 cm before my colon. In addition my stomach has been sleeved. Does that sound about right. If not, please correct.
     
    JuliaDS and Susan in Tennessee like this.
  5.  
    Spiky Bugger

    Spiky Bugger Well-Known Member

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    I carry a picture of the procedure...so does my husband.
     
    Butterfly, Jbandmmomma and kim79 like this.
  6.  
    Munchkin

    Munchkin Full of Fairy Dust

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    There are some people who just don't have the brain to get the DS. I don't know how they do it seeing that so many of us have to fight for it. Many of these folks are lacking in assertiveness, they are doormats who would never DARE question a medical professional.

    Lots of these folks on the FB group and over time I guess Lisa learned the only way to get their attention is with a 2x4. She can be harsh but kudos to her for trying so hard. You wouldn't even believe some of the stuff posted there! And the subsequent disasters.
     
    JuliaDS and KathrynK like this.
  7.  
    southernlady

    southernlady Administrator Staff Member

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    At least three causes: http://www.emedicinehealth.com/anemia/page2_em.htm
     
  8.  
    Butterfly

    Butterfly Well-Known Member

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    Thank you for posting this. I've had a few people trying to talk me out of doing this procedure. They want me to have a gastric bypass instead because 'it's safer" and less people die from it. I'm really starting to think it's not because the *procedure* is (in and of itself) more dangerous, but that people don't take care of themselves AFTER like they should.

    Thanks again.
     
    k9ophile, aaa, Munchkin and 1 other person like this.
  9.  
    Sandy

    Sandy Been Around A While

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    That is exactly correct.
     
    Butterfly likes this.
  10.  
    Spiky Bugger

    Spiky Bugger Well-Known Member

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    Well, I never disagree w/ @Sandy , but the DS is a more extensive surgery...and many DS patients are Super MO and the cut-and-run RnY surgeons won't touch them, so there IS a slightly higher mortality rate bcause of sicker-to-begin-with patients.

    But I think that the truth is that there is so damned little follow-up out of the RnY-mills that they have no idea how many patients get sick or dead from that surgery. Whereas...we DS patients have heard the scare stories and our doctors have to defend...so people THINK all those issues are DS-related only.

    I cannot begin to tell you how many RnY patients I have observed who lose weight, try to relive the youth they never had, carry on like the town tramp, ignore warnings because they sometimes take TWO gummi multi vitamins, don't "get" the reason they are losing their teeth is surgery-related, don't "get" that they are getting crazy (google "bariatric beriberi"), end their marriages, screw over their kids, take photos of themselves in their daughters' clothes and then kind of disappear from the online groups. It is scary.

    The ones I worry about the most are the ones who sign up as "Soon 2 B sexy," or "Foxy Future," and other names focused on looks. I seldom worry about those who sign in as "Back to Healthy Me," or such names.
     
  11.  
    Butterfly

    Butterfly Well-Known Member

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    @Spiky Bugger
    I really appreciate your response. I have been approved for the DS and have an appointment with my surgeon on Monday to schedule the final details before surgery. I admit, I'm terrified.

    A few years ago I weighed over 500 pounds. I took 3 blood pressure pills, 2 different meds for diabetes, had severe sleep apnea, had PSOS, joint pain, and I could barely walk. I went to a self-pay gastric sleeve "mill" doctor who gave me a sleeve and sent me on my way. I got 3 follow up appointments afterwards with nutritionists who kept looking at me sideways when I'd tell them "I don't feel any restriction when I eat." and that was that. I got down to 299 pounds and then regained. That's when I started looking into a 2nd surgery and the DS was suggested.

    My surgeon made me feel better by explaining that it should have been explained to me from the start that the sleeve should have been step 1 in my surgical journey with either a RNY or DS to follow. My sleeve surgeon never said a word about me being "too big" for the sleeve to be my only answer.

    My surgeon is familiar with my sleeve surgeon (he's done more than a few revisions on his patients) and said he'll bet me that when we do the endoscopy to look at my sleeve he'll find that he's done it bigger than he should have & used a larger bougie than he needed to and THAT is why I felt no restriction.

    Anyway. I *so* hear you about people who just want to look good. I want to be healthier and live longer. I'm in my mid-40s. My "I'm gonna be hot" time is gone and I really, really just want to live a healthier life.
     
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    Munchkin

    Munchkin Full of Fairy Dust

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    We have a winner!
     
    Butterfly likes this.
  13.  
    Spiky Bugger

    Spiky Bugger Well-Known Member

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    You know... @Butterfly ...NOT having "weeping leg edema" is probably sexier than having bodily fluids seep out my legs, like they were doing pre-op.

    Maybe I should ask Mr. Sue.
     
  14.  
    DSRIGGS

    DSRIGGS Yes, that is chocolate covered bacon

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    @Butterfly excuse me for asking but I am not sure what surgical status is? You mention RnY GBP in your post and then mentioned that your surgeon thinks your sleeve is too big? So are post VSG and not getting a DS or are you planning on revising to a DS?

    In any case I would advise that you tread very cautiously with the smaller sleeve idea. There is no evidence that a smaller sleeve results in more weight loss than a larger sleeve when one has a DS. I am talking a 32 fr bougie up to a 56 fr bougie. There is evidence that when a sleeve is made too small it can cause severe GERD and or stricture. That is something you do not want. If you are revising to the DS the "switch" component of the DS is what will result in long term weight loss and maintenance.

    Best wishes and sorry for not knowing exactly what your status and future status is (if you are having another procedure).
     
  15.  
    Butterfly

    Butterfly Well-Known Member

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    No need at all for sorry :) I am post sleeve by about 2.5 years and revising to the DS hopefully in March. The surgeon is going to have me do an endoscopy to have a look at the sleeve and see "what condition it's in" but I don't think his plan is to make it smaller. I didn't explain myself well before. I think he was just commenting that the particular surgeon that I used for my sleeve is known for making his sleeves rather large and using a large bougie. I've read that on a few boards by more than a few people, so I wasn't surprised to hear it repeated. It really only helped me understand why I never really felt restriction with the sleeve. I did for less than 30 days, but never after that. I ENVIED the people on WLS boards who talked about eating 1/2 cup of food and felt SO FULL. I paid $14K out of pocket and never got that part of the tool to help me lose weight. In a way, I felt cheated. I know a lot of people have spent a lot more than that, but it truly was all the money I had in the world.
     

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