Duodenal Switch Qualifications

If you meet the following guidelines, weight loss surgery may be an appropriate measure for permanent weight loss:

Be age 40 or more

BMI of 35 or over with serious obesity-related illnesses such as:

• Diagnosed with Diabetes Mellitus Type 2, Coronary Heart Disease or Sleep Apnea
  
  
• Have a complete understanding of the procedure and the lifestyle changes necessary afterwards.

Effectiveness: Percentages of weight loss of the excess weight:

3 months - 29 - 37%

6 months - 51 - 55%

24 months - 80-91%

Do not be afraid of the distance between your dreams and reality. If you can dream it, you can make it so.

Eating after the DS…
Dr. Huacuz will give you a list of foods to eat following surgery. The information provided here presents a synopsis of information gleaned from a review of many, many pieces of advice from former Duodenal Switch patients over many months. It is collected here to (hopefully) be of help to those who are wondering what to do, early out. Please remember, we are all different, and what works for one may not work for another. Always listen to your body, and let Dr. Huacuz know if you are having major difficulties.

Rule #1 Stay Hydrated!!
 DS patients that we can easily become dehydrated. We must stay hydrated not only to lose weight... but also to avoid telltale headaches and dizziness. We have had folks who have ended up hospitalized for IV treatment of dehydration. Aim for 64 oz. /day.

Sip, sip, sip watr all day.
If you can’t stand cold water, try room temperature water. If you don’t like that, try some Crystal lite or water with a squeeze of lemon..

The Other Rule #1 Protein First!!
TWO Rules “#1”??? Yes. But only because both are so important. Your body needs protein for healing, and you need to heal. So get as much as possible, aiming for 80-100 grams a day. In the first weeks, getting that much protein through food will be just a goal to shoot for, and you may feel better if you supplement with protein drinks. If you don’t take in enough protein, your body will begin to break down your muscle for protein... this can include the muscle of your heart and other important organs... ADEQUATE PROTEIN IS ESSENTIAL to your long term health! Develop the habit during your early days of eating protein first at each meal, and fill up on other nutritious foods after your protein. This habit will serve you well all through your weight-loss window and during maintenance. 

Getting your protein during the first days and weeks following surgery:

• Eggs  but often it has cheese added to it. This can be tolerated by some of us, while others cannot handle the cheese in the beginning. Just ask and they will scramble you some eggs with no cheese.)
  
• Chicken Broth
  
• Eggs beaten and stirred into chicken broth, to make an “egg drop soup...” very easy on the tummy soon after surgery.
  
• Yogurt, if you are not lactose intolerant
  
• Pudding, plain or with protein powder added.
  
• Cheese (White cheese has less fat in it than yellow cheeses and thus will be easier on your new tummy in the early days.)
  
• Oatmeal or Cream-of-Wheat (adding wheat germ will increase protein).
  
• Peanut butter (if you want to try this while in Curitiba, better bring some from home because the Brazilian peanut butter is nothing like ours). This is high in fats, but most of us tolerate it well--in small amounts--in the early stages.
  
• Cottage Cheese (with fruit if you like).
  
• Soy products (powder, tofu, noodles).
  
• Low-acid fruits such as watermelon, papaya, or bananas.

 If necessary, you can supplement your protein intake with supplements such as Mioplex or Unjury.  After two weeks you can start adding more regular foods to your diet.
Listen to your body as you gradually add new foods, noting what sets well with your tummy and what does not (you’ll know!!).
• Seafoods are usually easier to digest before going on to denser meats such as beef and white meat of chicken, but avoid fried seafood in the beginning.
• Soups containing tender cuts of beef or chicken.
• Crock-pots tend to cook meats well enough for easy digestion, and the archives online provide many recipes shared by DSers.
Protein Value of Selected Foods, USDA

During the first year after the operation you should use vitamins and mineral supplements. You may use Centrum, One a Day, Multivitamins or other.  Use adult medicines that have adult doses. Big tablets or pills have to be broken in pieces and then swallowed with water or some kind of non-sparkling beverage. Iron and Calcium (Citracal ultradense) may be added as needed. They may be used prophylacticaly or postoperative laboratory work up will tell you when to use them.
Here is a short list of vitamins to start taking.... take these up to twice a day and do not take the calcium and iron at the same time.

2 Centrum Silver
2 Iron
2 Dry A&D
4 Calcium Citrate.
Others can be added as needed.

Immediately after your DS procedure, you do NOT have to take large pills and vitamins.  Your body has plenty of reserves to last for weeks, however, you should begin supplementation as soon as possible.  You can also use liquid or chewable forms of vitamins.

Lab tests are to be done every 3 months after the operation for the first year, every six months the second year and once a year after that (more often if results are not in normal ranges)

BLOOD

AMYLASE
CALCIUM
CARNITINE
CBC
COMPREHENSIVE CHEMISTRY PANEL
COPPER
FOLATE
RBC FOLATE LEVEL
IRON
TRANSFERRIN SATURATION
FASTING LIPID PANEL
LIVER FUNCTION PANEL
MAGNESIUM
PREALBUMIN
PTH, intact
TSH
VITAMIN A
VITAMIN B1
VITAMIN B6
VITAMIN B12
SERUM METHYLMALONIC ACID
SERUM HOMOCYSTEINE LEVEL
VITAMIN D, 25 HYDROXY
ZINC

Note:

VITAMIN A REQUIRES 2 ML FROZEN SERUM
VITAMIN B6 REQUIRES PLASMA – FOIL WRAPPED

Have a Bone Densitometry done every 6 months for the first year and every year from then on.