Tag Archives: duodenal switch

One Month post-DS

This past Thursday marked one month since my DS procedure. It flew by a lot faster than I thought it would, but the first two weeks after a major surgery that alters how you eat, drink, move, and pretty much do EVERYTHING will make you feel like time is moving at a snail’s pace.

The first two weeks were the hardest because that was when I was in the most pain. Strangely, I did not have nearly as much pain as I did with my sleeve surgery. I had a few gut spasms about the 3rd and 4th days post-op, but nothing after that. I’ve really only had one day where I struggled with getting in enough fluids and protein so I consider myself pretty lucky. At my two-week follow-up appointment, my doctor advanced my diet a week ahead of schedule and moved me from liquids to soft solids which was a surprise. I fully expected to be on liquids for a full three weeks but I was so glad I was able to move to soft solids because I returned to work after three weeks of recovery at home. Teaching all day and moving around a classroom was definitely going to require more calories than I was getting on all liquids!

I’ve changed my approach to charting progress this time around. I learned a lot about what NOT to do when I had my sleeve surgery and documented EVERYTHING. In documenting everything, I developed some unhealthy behaviors centered around eating and measuring my progress that I did not want to repeat. I decided this time, I would only step on the scale at my doctor’s office when required, and once a month otherwise. I also decided I’d snap progress photos once monthly rather than weekly since the changes would be more obvious that way.

I tend to lose weight like a snowman melts: from the top down. My face and neck have thinned out a little, and my arms are more narrow (even though it may not be obvious from these pictures). I wore a pair of pants and a pair of jeans this past week that are embarrassingly large on me now so it will be time soon to take them to be tailored to fit. I learned the hard way last time not to buy clothes so often since I didn’t stay in a size range long enough to get enough wear out of what I purchased. I know some folks say “you can thrift, or go to Goodwill while you’re in between sizes” and my response is “no thanks.” I’d rather choose something new I really enjoy wearing that makes me feel good and that I chose with intention than wear something used because I had to. I spent most of my life wearing stuff I didn’t really want to wear because I HAD to–clothes for plus-sized women were hard to come by when I was growing up, and what was available was neither stylish or age appropriate so I always HATED clothes shopping. Now that there are more choices for plus-sized women (which I will likely always be), I choose pieces for my wardrobe that are classically styled, flattering, and brightly colored. Life is too short for a boring, drab wardrobe. 🙂

My blood sugars are still running a little higher than my PCP or I would like so I was told to resume taking Mounjaro. I’m not gonna lie, the fact that it quiets the “food noise” in my brain is a lovely bonus that comes with being on the medication so I am glad she is having me resume it. It did drive my a1c down a point and a half but as of last month, it was still in the prediabetes range which is not where I want it to be. I’d like it to be in the low 5s if possible so that is something I hope will change over the next couple of months as more weight comes off. My a1c measurement is one of the ways I’m measuring progress so it is important to me that it drops into a normal range.

I also went back to the gym for the first time in months Friday night. I’d been working with a trainer up until October when she moved abroad. Then because I was in the midst of my principal internship, I did the thing I did not want to do and let my health take a backseat to everything else. I asked my doc at my 2-week follow-up when I’d be able to go back to the gym, and he indicated that I could go back then, because as he said “You’re not going to do anything to cause yourself a hernia.” In my head, I laughed because I thought, have you seen me deadlift? I decided I’d wait until a full 8 weeks have passed before I attempt to start deadlifting again. I’m going to try and make getting into the gym a habit again because I know from past experience, I know purposeful movement accelerates my weight loss. And this time I don’t want to lose muscle mass because of the malabsorption I’m experiencing due to my DS.

Life with my remodeled digestive system has been interesting to navigate so far. Because my common channel is a little longer than most folks who have a traditional DS (200 cm vs 100-150 cm), I have to be more conscious of my fat intake. I haven’t been given a set of guidelines for my daily macros yet as I was told that would come at my 6-week follow-up. I’ve been trying to consume 100-120 grams of protein daily, 50-70 grams of fat (to keep things moving through my colon and to prevent dry skin and brittle hair), and between 40-60 grams of carbs a day. I also aim for 96 oz of water daily.

On the days I eat on the high side of my fat goals, I definitely feel it. I have only eaten one thing that has caused me great GI distress, and that was instant mashed potatoes that I made here at home. Because I’m on soft foods, I’ve eaten a TON of salmon and catfish, both of which I enjoy (thankfully). I cook the catfish in foil packets with veggies–I am allowed soft-cooked vegetables–and I roast the salmon. Soft foods have presented me with a bit of a challenge in that because they are not so dense, my capacity to eat them is greater than I feel it will be once I’m released to eat more dense proteins like chicken breast. I’ve eaten ground chicken thighs and ground sirloin, neither of which have caused me any discomfort but I don’t feel the same restriction with them as I feel I will once I am able to eat a whole chicken thigh or steak. I guess I’ll have to wait and see here in a couple of weeks once I’m released to eat such things.

Something else that should be noted is the vitamin supplementation that has to happen once you’ve had a DS. The malabsorptive component to the surgery (the “switch”) all but makes it so you HAVE to take a whole host of vitamin supplements in order to maintain good health.

My vitamin regimen (as of right now) consists of:
Bari-Life Just One multivitamin with iron x 1
5000 mcg B12 sublingual
500 mg Vitamin C chewable x 2 daily
ADEK x 2 daily sublingual
100 mg B1
1500 mg calcium citrate chews (500 mg x 3 daily)
400 mg magnesium chewable
1 prebiotic/probiotic capsule
Potassium gluconate 595 mg x 1
I’ll do this until May to see what my labs look like and adjust from there. Right now I feel like I have everything covered but we’ll see what shows up in my labs in a couple of months.

I’ll try to update more often than once a month–life has been pretty busy as it’s spring semester and the school year is winding down. I’m looking forward to what month 2 post-op brings.

I’m back

It’s been a hot minute since I posted here but it felt like time to do a long-overdue update. I’ll provide the Cliffs Notes version (remember those?).

  • My sleeve worked until it didn’t. I was successful in losing over 200 pounds from my heaviest adult weight but unsuccessful in keeping it off.
  • A battle with depression and her pal anxiety helped me put back on 100 pounds. This was compounded by dealing with my mother’s diagnosis of terminal cancer.
  • After being Mom’s caretaker for almost 2 years and living with the stress that comes with assuming that role, my health was worse than it was pre-sleeve. After she passed in the spring of 2019, I decided it was long past time to regain control of my health and began losing weight again using an old tool–Weight Watchers.
  • I was pretty successful and lost 80 pounds but couldn’t get past a certain point and maintained that through most of the early days of the pandemic. The regain came slowly over the following year.
  • In the spring of 2022 after learning I would need double knee replacement surgery to fix my shot knees, I decided I needed to bite the bullet and go forward with duodenal switch surgery. This would require a change in insurance plans as my insurance policy at the time did not have bariatric surgery coverage AT ALL.
  • I had my first appointment with my surgeon that April. The surgeon I used actually worked in the office of the surgeon who did my sleeve surgery back in 2013 and was performing DS procedures then, but at the time I did not feel ready to make the commitment required and I felt that a sleeve alone would be a tool I could manage. Little did I know how wrong I was!
  • I was originally scheduled to have surgery in December, but because my insurance company dragged its feet on the pre-authorization, it was delayed two months. This was infuriating for multiple reasons: I’d just done an excruciating pre-op diet (all liquids + protein shakes), and had plenty of time off from work at the time. Delaying my surgery forced me to take FMLA which I did not want to do but alas…
  • After jumping through all the hoops my insurance made me jump through, I had my DS procedure done last Thursday. I went home Friday afternoon and am recovering well. I feel like I’m tolerating this recovery better than I did when I had my sleeve surgery done in 2013. I don’t know if that’s because I’ve done this before, because I knew what to expect, because of how I was medicated during and after surgery, or because I weighed 60 pounds less than I did when I had my sleeve done. Whatever combination of factors came together to make this recovery smoother I am grateful for because every day I have been able to drink more liquid and be more mobile.
  • I am hopeful that this tool will get me to where I want to be healthwise: free of my diabetes and better able to be more active. While I will never be a runner (according to my orthopedic surgeon), I do still want to be able to ride a bike (a trike, really; I never learned to ride a two-wheeler), swim, and walk long distances. Looking good is secondary at this point; I just want to FEEL good and be healthy so that I can live a long life. There is still so much I want to do in this life, and I want to be as healthy as I can so that I can enjoy whatever time I do have left.

I’ll try to update more than every 7 years, especially now that the journey has a different feel and path to health.