Scared

[-Flo-]

So last night I was confident in my decision to revise to the DS. I had a restless night sleep and I woke up with all sorts of questions. Hopefully, you guys will be able to help me out. One thing that is bothering me is , if the DS is such a great surgery why don't more surgeons do it. I live in Boston, which is supposed to be a healthcare mecca and only one surgeon has even performed it, and he has only done 10. Why is that?

I am also scared of the vitamin deficiencies. Will I end horribly malnourished and have all sorts of weird diseases? Will I forever be taking vitamins around the clock. I know this is crazy but I'm scared that we will have some sort of war/ natural disaster/ depression and I will be unable to get the vitamins that I need.

Also what about bowel movements. Will I end up with foul smelling diarrhea that I can't control.

Ok, I realize that I am freaking out and some of my concerns are ridiculous but I'm just scared. This is the biggest most extreme surgery that I have ever considered. I'm scared to get it and I'm scared not to. This will be my 3rd type of wls. I had the band, then the sleeve and now I'm considering DS. I don't want to make a mistake again. I lost 100 lbs with the sleeve, but in the last year i have had a 15lb weight gain that i keep loosing and regaining. I want to stop the regain before I balloon up. With the band I lost 80lbs but regained 130! That can't happen again.

I appreciate any advice or experiences. Thank you.

 

[CaraOC]

So last night I was confident in my decision to revise to the DS. I had a restless night sleep and I woke up with all sorts of questions. Hopefully, you guys will be able to help me out. One thing that is bothering me is , if the DS is such a great surgery why don't more surgeons do it. I live in Boston, which is supposed to be a healthcare mecca and only one surgeon has even performed it, and he has only done 10. Why is that?

I am also scared of the vitamin deficiencies. Will I end horribly malnourished and have all sorts of weird diseases? Will I forever be taking vitamins around the clock. I know this is crazy but I'm scared that we will have some sort of war/ natural disaster/ depression and I will be unable to get the vitamins that I need.

Also what about bowel movements. Will I end up with foul smelling diarrhea that I can't control.

Ok, I realize that I am freaking out and some of my concerns are ridiculous but I'm just scared. This is the biggest most extreme surgery that I have ever considered. I'm scared to get it and I'm scared not to. This will be my 3rd type of wls. I had the band, then the sleeve and now I'm considering DS. I don't want to make a mistake again. I lost 100 lbs with the sleeve, but in the last year i have had a 15lb weight gain that i keep loosing and regaining. I want to stop the regain before I balloon up. With the band I lost 80lbs but regained 130! That can't happen again.

I appreciate any advice or experiences. Thank you.

Hi Flo, I revised from crapband to DS 5 weeks ago so I'm very early out of the gate. I just looked at the available statistics on weight loss for each procedure and more importantly I researched what the odds were of maintaining that weight loss. I knew I didn't want the RNY, because I would puke like I did with the crapband and I wanted my pyloris intact so I didn't have to deal with dumping syndrome. I also knew I needed to be able to take ibuprofen. Yes I will for life have to take vitamins. A very small price to pay in return for dropping the fat suit.

 

[newanatomy]

So few surgeons perform the DS because it is a more difficult surgery to perform and it takes longer to perform than other types of bariatric surgeries. Plus, most are simply uninformed and uninterested in learning how to guide their patients recovery.

The vitamins are not that big of a deal, really! They are a bit overwhelming at first when you are trying to figure where to get all the right types but, with the BF STORE tab even that is a bit easier. There are tons of threads with examples of what each of us take. Your labs will guide you and you will feel much more confident after your first lab draw.

As far as bowel movements, everyone is different. Most in the beginning have loose stool. I rarely did and still rarely have loose stool. A lot of us battle constipation, myself included.

Foul odors are also an individual/somewhat diet controlled deal. I stayed with my sister for 10 days in October, she never once complained about me stinking. Believe me when I tell you, she lives in a 700 square foot apartment with one tiny bedroom and one bathroom which we shared, she would have told me if I was stinking her out. Sisters are like that!

We discuss our surgeries all the time, she had RNY 5 years ago. I am a little over 2 years post DS.

 

[Clematis]

I'm in Cleveland with the same situation. The Cleveland Clinic promotes itself as this uber bariatric center but they don;t even list the DS as an option. However they will do it for SMO only. They only do a few a year. So if I fought to get one through them, did I really want a surgeon who rarely did the procedure? And pay $40k? This is why I went to MX.

Why don;t more surgeons do it?

1. It takes more time to do the procedure. There is a shortage of bariatric surgeons, so a surgeon can do, say, 3-4 RNY or VSG a day but only 2 DS. There's not enough money in it. And so some are doing the faster [NOT] DS aka SADI, SIPS or LoopDS. Remember these are NOT the DS and most often these surgeons are misrepresenting it to their patients.

2. In the very beginning, only people who were SMO or SSMO were offered it -- people who came to the OR already with one foot in the grave -- therefore the early statistics made it look riskier. (It is not.) Many physicians and insurance companies have held on to this old >50 BMI requirement therefore skewing their anecdotal statistics to make it seem like patients don't do as well. When done by an experienced surgeon, this is a very safe procedure.

3. Surgeons, too, get scared by the vitamin/nutrition issues. Yet they are the very ones touting inaccurate and dangerous regimes. Makes me want to scream.

"Southern" issues: I was terrified of this too, and bought bottles of Poo-pourri, jars of Devron, gobs of probiotics but have used NONE if it. I do not have stinky poop or gas or diarrhea (well, of course it has odor but I honestly think it is better than before the surgery). Others do have this issue though. YMMV. I don;t know why we are so different. Perhaps their surgery was done differently (i.e. too short a common channel) or perhaps they eat troublesome foods. Who knows.

I too have the Armageddon fear, mine centering on how will I or a nurses aide manage all the vitamins if I get dementia. I decided that if I get dementia, I DON'T WANT TO LIVE and malnutrition will help me get off the planet.

But YEAH this is a major life change and SCARY. This surgery scared the figurative poop out of each of us but the Jabba the Hut death from diabetes, heart disease, stroke was just as scary.

Good luck with your decision.

 

[hilary1617]

Hi Flo,

I don't understand why DS is so hard to find in MA. As a result of this dearth, my beloved SMO cousin suffered through lapband with revision to RNY, when he clearly needed DS (600+lbs). I worry every day about his limited longevity.

DS is one of the best decisions I ever made. I agree it is scary and I understand that it must be even scarier as a revision. There are real risks and real impacts. Most of the DS'ers I know do have some bowel movement changes, especially early on, however most are readily managed. I don't even think about it anymore.

That said, given the long term results, I honestly believe it is the best procedure available for any morbidly or super morbidly obese person who is willing and able to be compliant with protein intake and vitamin supplementation for the rest of their lives.

All the best,
Hilary

 

[Marquis Mark]

Remember it can be REVERSED. So, if you are one of the SMALL number of people with uncorrectably low vitamin deficiencies, you can do that. But the odds are greatly in your favor that you won't be one of them.

Taking the vitamins is no big deal. It's like brushing your teeth, peeing, washing your clothes, etc. Just part of the daily routine that you won't even think about.

Most people actually seem to get constipated, instead of diarrhea. The odds that you'll be sharting all over the place are virtually nil. And, again, reversible (or, more likely adjustable -- by increasing your common channel that should take care of the diarrhea). You can also take an Imodium if it gets out of hand.

Stinky farts? Yes, mine do smell worse than before, but guess what? I can hold my farts until I go outside or to the bathroom, etc, so no issues there. Small price to pay to have the bane of my existence relieved. It's also very diet dependent. "If it's white, don't bite." In other words, stay away from white flower and sugar if you're going to making love to someone you're trying to impress. (or not horrify) If you're going to be alone, knock yourself out.

It's normal to be scared. I was, too. But now that I'm on the other side, it's fine. It's like the fear you have before getting in a small plane, but, once you're in the air, you just enjoy the ride.

My surgeon had only done 20 DSs and I've had zero problems (neither have any of the other three that I know used him). I was OK with him because he is a bariatric surgeon, does 10 surgeries a week, and knows the GI system backward and forward. A lot of the techniques used - stapling, suturing, oversewing, repairing mesentary defects, making anastomoses are what he does every day anyway. I think as long as your doctor does a lot of surgeries and specializes in the GI system, you'll be OK.

Good luck. It's normal to be nervous, but I really think you'll be writing a note like this to someone else three months after you have the DS.

MM

 

[DS fan]

I agree with the above posters. The DS is a far more complicated surgery and it takes much longer to complete. Surgeons can do the sleeve, rny or lapband typically within 2 hours. My DS took almost 4.5 hrs.

I am a year post op and I only had loose bowels the first two weeks. After that I was able to maintain nearly normal bowel movements. Typically I go twice every morning and then I'm done until the next day.

As far as odor goes, do you know anyone who's poop doesn't smell ? I mean seriously everyone's poop smells.

There are things you can do. Eat correctly for your surgery type, use poopourri, and air freshener after.

Good luck on your decision. I have ZERO regrets !

 

[Munchkin]

If it's your intent to take your supplements and do what you are supposed to do, you will be fine!

There are fewer docs because it's a more complicated surgery. And surgeons are in it to make money. If you could do 10 crap bands per day or 1 DS, what would you do?

The DS has better results than anything else available today. I don't understand why people settle for anything less but they do!

 

[Marquis Mark]

Agreed on why the DS isn't done more. If any putz could do the DS and it only took an hour, I'm pretty sure 80% of the weight loss surgeries would be DS. Ultimately, in this country anyway, it IS a business. Sleeves, for example, take 45 minutes, are very easy by surgical standards, and have very little maintenance (so you won't be calling the Dr's office and cutting into their time). BTW, 5% of the bariatric surgeries in Europe are DSs, compared to 1% here.

 

[-Flo-]

Thank you all for your reassurance. I know that I'm being alittle dramatic but it's just such a huge change. I have always been afraid of the malabsorptive procedures that why I got a restrictive surgery right after a restrictive surgery, but i realize now that its not working. I need the malabsorption. I just need to mentally prepare myself for the changes that will be coming.

 

[bearmom]

It would be abnormal for you to NOT be concerned about a major surgery. I won't bother with all my details, but once I decided this was best for me, I had to go into a sort of denial and just go though the motions and always tell myself "I can change my mind any time I choose" until I was literally being rolled into the O.R. and prepped for surgery (in India!!). I'd gone through so so much to get there, and only managed by thinking I'd probably back out. SO grateful I went though with it!

What it took for me to know I'd be successful, was knowing that I couldn't treat it as a "set it and forget it" surgery. I'd have to monitor my labs rather than assuming my pcp was on top of it, and I'd have to adjust supplements to labs, or for poop issues. Once I knew I could get on board with that, I knew I'd be OK. I actually enjoy getting my annual labs now, and analyzing them, in part because my Dr gushes about how healthy I am, and I NEVER heard that when I was obese and on multiple medications (btw, I'm off all prescription meds now, except thyroid, and potassium for kidney stones, which I had prior to my DS).

So I've exchanged my morbid obesity and a bunch of prescriptions for health, with the occasional need to help educate a dr, or push for something I want, and a small amount of time to stay on top of information about my DS, and supplements. It's easier than I though it would be.

 

[Spiky Bugger]

If a Lamborghini is such a good car, why don't more people own one?

Welcome.

 

[BebeZed]

So last night I was confident in my decision to revise to the DS. I had a restless night sleep and I woke up with all sorts of questions. Hopefully, you guys will be able to help me out. One thing that is bothering me is , if the DS is such a great surgery why don't more surgeons do it. I live in Boston, which is supposed to be a healthcare mecca and only one surgeon has even performed it, and he has only done 10. Why is that?

I am also scared of the vitamin deficiencies. Will I end horribly malnourished and have all sorts of weird diseases? Will I forever be taking vitamins around the clock. I know this is crazy but I'm scared that we will have some sort of war/ natural disaster/ depression and I will be unable to get the vitamins that I need.

Also what about bowel movements. Will I end up with foul smelling diarrhea that I can't control.

Ok, I realize that I am freaking out and some of my concerns are ridiculous but I'm just scared. This is the biggest most extreme surgery that I have ever considered. I'm scared to get it and I'm scared not to. This will be my 3rd type of wls. I had the band, then the sleeve and now I'm considering DS. I don't want to make a mistake again. I lost 100 lbs with the sleeve, but in the last year i have had a 15lb weight gain that i keep loosing and regaining. I want to stop the regain before I balloon up. With the band I lost 80lbs but regained 130! That can't happen again.

I appreciate any advice or experiences. Thank you.

Flo, first of all, I want to assure you that it is perfectly natural to question your decision. Goodness knows I did that too! I revised from band to DS last October and it's been the best thing I've ever done. And yes, I had the same perfectly normal concerns, plus a few rather neurotic ones as well

I only ONCE had a poop accident since October, and that was in the liquid phase of my recovery. Liquid in, liquid out...and I made the fatal mistake of trusting a fart. Ooops. I haven't had any issues since. Yes, my poop stinks but it's poop for goodness sake. It's going to stink anyway! As for the runs, you can control those easily with diet... it's easy once you get past the liquid stage of recovery and just keeps getting easier as you get to know how your body reacts to things.

As for vitamins... I take mine four times a day and I know many others who do the same. It's part of my routine now and it's easy. I don't feel like I'm constantly swallowing pills at all. Your concern about war/natural disaster/depression etc may be valid but if you base all your decisions on "what-if" type questions, you'll not do anything at all. I stockpile vitamins as much as I can (taking into consideration potency expiration etc) by buying on sale and that gives me some leeway in the event of something major.

I revised from a crap band - I only lost 40 pounds with it and regained that plus another 30 - so I know how it is to have a surgery not work for you. I applaud you doing the research, asking all your questions, expressing your doubts because this is the only way you'll make an informed decision.

As for me, the DS was the best thing that's ever happened to me. I'm only five months out but I'm feeling sooo much better physically and emotionally. I'm actually looking forward to seeing what the future brings now because the future looks bright.

No matter which way you decide to go, I wish you all the best.

 

[BebeZed]

I too have the Armageddon fear, mine centering on how will I or a nurses aide manage all the vitamins if I get dementia. I decided that if I get dementia, I DON'T WANT TO LIVE and malnutrition will help me get off the planet.

Typically, vitamins are crushed and delivered in some nice, yummy (bleh) applesauce or other foods/liquids. We had a couple at the "memory care" home who had problems swallowing and that's how vitamins and medicines are administered to them. They seemed to like the applesauce...

But yeah, after having taken care of alzheimer and dementia patients, I discovered that there's a certain point beyond which I would not want to hang on. Some of the residents were almost all there, could more or less take care of their own needs, and could socialize and they were still fairly engaged in life. Then there were the ones who were end-stage... and that was very sad. I'd rather check out at that point.

 

[Clematis]

Typically, vitamins are crushed and delivered in some nice, yummy (bleh) applesauce

That wasn't my point exactly, rather that there would be no one monitoring which vitamins to take and in what dosage based on labs. Assisted livings/in-home nurses aides aren't nursing homes -- they don't sort all that out, just administer whatever they have been told to administer. (If they even do that -- some states don't allow aides to administer ANY meds, technically.) Saying "don't give iron within two hours of calcium" would be met with a quizzical stare. So unless I am coherent enough to take care of it myself, let me go.

BTW I take no more vitamins than I have taken in the past. I have gone through periods where I take all sorts of supplements -- fish oil, chondroitin, D3, countless others and ginkgo in order to remember it all. In fact I may take LESS. Now I take a PPI when I first wake, about 8 pills taken in 2-3 swallows at breakfast, 8 pills taken in 2-3 swallows at dinner, and iron and C at bedtime.