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.