Getting DS surgery November 2015. Last minute advice! And opinions

[Kittykatkris]

Hi everyone!
I have been off and on a lot of boards and love this one the best. You give honest, accurate, and very helpful advice. I have been going back and forth with getting the DS for two years now. It is not something I have entered into lightly.
This month is my 6 month weigh in to meet insurance requirements.

I meet with my surgeon this Friday, my surgeon is Dr Julio Teixeira.
The first time I met with him he said that he did on average a 200 cm common channel and I believe he said 4 oz stomach.

I will be finding out the exact specifics this Friday, when my surgery date will be and so on.
It is with Lenox Hill Hospital in Manhattan NY.

I am 5'5" and 240 lbs. I know I am a light weight. I suffer from PCOS, PsuedoTumor Ceribi, and possibly Lupus (it has never been confirmed).

Carbs are my mortal enemy they always were. My body just has never seemed to handle them like the average person. My boyfriend of 7 yrs has an ongoing joke that I could eat a piece of lettuce and gain weight.

So since I am 32 yrs old (female, will be 33 yrs Jan 31/2015) I have decided a life time of battling weight is enough. I want to enjoy what younger years I have left, I also want to have children and have the energy and physical ability to run around after them.

My post is for advice and opinions. Any recommendations on what I should have prepared to ask Dr Teixeira on Friday.

Any advice and heads ups for pre and post op.
Also I am getting all my vitamins and supplements now. So if there is a vetted list of what to get to be prepared that would be awesome. I know a few on here are very informed and I want to stay ahead of the game. No problems for this lady, I want to do preventive measures not have to go crazy correctly a screw up after the fact.

I appreciate it EVERYONE!!
Kittykatkris

 

[southernlady]

Welcome @Kittykatkris
I would ask these questions:
1) How many DS's have you done
2) Who proctored you (to learn the DS)
3) Have him draw the DS to be sure it's the DS and not the SADI/SIPS, etc.

 

[newanatomy]

Congratulations on your decision and making it through the 6 month diet hoop.

200 cm cc seems a bit long to me.

 

[Larra]

Well he there! Good to see you here.

I answered your question about traditional (to my mind real) DS vs SADI/SIPS/loop DS elsewhere, but will add to that that a 200 cm common channel is exceptionally long. Makes me wonder if he's planning loop DS. Even for a lightweight, that seems excessive. I would ask/insist that he use the Hess method to determine all the limb lengths rather than consigning you to such a long common channel before he even gets in there.
the 4 oz sleeve sounds ok. A really narrow sleeve isn't a good thing.

so you do still have a few questions that need to get settled to your satisfaction. Remember, you are the one who will live with the results of this operation, not the surgeon (with all due respect to the surgeon), and if it doesn't work adequately, you are the one who will have a huge struggle on your hands to get insurance approval for a revision. Revisions suck to begin with, and getting coverage for them can be difficult to impossible.

 

[DSRIGGS]

Larra said it so very well. I can attest, revisions suck (mine was not the typical revision and not nearly the lengthy procedures those rough ones are, but I have had a rough time recovering from my revision).

 

[duh_Mom]

Hi @Kittykatkris glad you are here. this board rapidly became my favorite and most trusted site. I read others, but often just shake my head. I am a relative newbie so can't offer a lot of post op advice as I am still learning and absorbing it all.

you mentioned you were stocking up on vits, and supplements - Here is a link that will give you a wealth of info on vits, dosages, frequency etc. http://bariatricfacts.org/threads/vitalady-links.11/ . There is a whole forum devoted to vitamins and labs. I actually have a spread sheet of lab values of per-op and post op - I got it off this site. My first post op labs are today actually.

As for supplements we recommend that you don't stock up on them because your tastes will change post op and having several containers of drinks you don't like is a bummer. We stocked up on liquids I could drink post op and I ended up giving some of them away and dumping others. I heeded the advice on protein supplements or would likely have been doing the same there.

Good luck in your journey.

 

[aaa]

Welcome. Were you at the last support group at Lenox Hill?

The was a preop DSer there and I'm wondering if it was you.

 

[Kittykatkris]

Welcome. Were you at the last support group at Lenox Hill?

The was a preop DSer there and I'm wondering if it was you.

I had gone to the seminar 6 months ago. No support group though.

 

[Kittykatkris]

Well he there! Good to see you here.

I answered your question about traditional (to my mind real) DS vs SADI/SIPS/loop DS elsewhere, but will add to that that a 200 cm common channel is exceptionally long. Makes me wonder if he's planning loop DS. Even for a lightweight, that seems excessive. I would ask/insist that he use the Hess method to determine all the limb lengths rather than consigning you to such a long common channel before he even gets in there.
the 4 oz sleeve sounds ok. A really narrow sleeve isn't a good thing.

so you do still have a few questions that need to get settled to your satisfaction. Remember, you are the one who will live with the results of this operation, not the surgeon (with all due respect to the surgeon), and if it doesn't work adequately, you are the one who will have a huge struggle on your hands to get insurance approval for a revision. Revisions suck to begin with, and getting coverage for them can be difficult to impossible.

DEFINITELY!
I am saving all concerns and questions on a notepad and will print tonight before I go to the appointment tomorrow morning.
I am still very concerned of course its natural.

One thing I had read yesterday was that we all absorb differently after surgery (which I knew) but I read that sometimes it can be 60% to 100% of carbs?
IS THAT RIGHT?
The whole point of the surgery for me is the less carb absorption. Eating too much is not my problem honestly I barely eat. Carbs are my enemy, and with PCOS it just makes carbs even more of an issue.

If I could get some more information on how much carbs will be absorbed after surgery that would be sooo helpful for me.

 

[newanatomy]

DEFINITELY!
I am saving all concerns and questions on a notepad and will print tonight before I go to the appointment tomorrow morning.
I am still very concerned of course its natural.

One thing I had read yesterday was that we all absorb differently after surgery (which I knew) but I read that sometimes it can be 60% to 100% of carbs?
IS THAT RIGHT?
The whole point of the surgery for me is the less carb absorption. Eating too much is not my problem honestly I barely eat. Carbs are my enemy, and with PCOS it just makes carbs even more of an issue.

If I could get some more information on how much carbs will be absorbed after surgery that would be sooo helpful for me.

We all absorb 100% of simple carbs, like sugar. We absorb a bit less of complex carbs but carbs will always be something you will have to limit.

 

[southernlady]

What NA said ^^^^ but if you treat ALL carbs like they are absorbed 100%, you will be better off.

 

[Munchkin]

200? Are you sure you are getting a real DS? Seems very long to me. Mt CC is supposed to be 75 and I never got to a normal BMI.

 

[Kittykatkris]

He said that it was the DS and that he usually does 200 cm common channel.
To tell you the truth the first time I met with him was six months ago, the only time. After that it was Nutritionist and monthly weigh ins. Tomorrow is my finally weigh which they told me to have with him. So I am guessing tomorrow is the time I get all the details and questions personally asked. thats why I am printing a list and asking all vets for any last minute advice.

I knew the 100% of sugar and such. But I had though it was 60% protein and carbs that we absorb. Either way I know avoid carbs and eat protein first. The only way I can loose weight now, pre op, is basically atkins level one. Not even fruits and such cause of their natural sugars. Eating every 2 to 3 hours to boost metabolism and exercising every single day at least 1-2 hours. And that is just not realistic for me to keep up my whole life. Especially when I have kids.

I think the surgery will really help me, as long as I stick to taking my vitamins and supplements and protein first second and third lol. I really think it will work.
I am of course getting cold feet. One hour I will be so excited to get the surgery and the next hour I am like no I am insane this is crazy!

 

[newanatomy]

You are mistaken about the amount of carbs we absorb. We don't really know how much we absorb, unfortunately. It has never been studied. I am sure you can find a lot of information on here.

 

[southernlady]

The ONLY study done on how much of any macro a DS'er absorbs was done on fat grams and was a very small study.

http://bariatricfacts.org/threads/ds-math.735/#post-9834

Note that in this DS math explanation, while the 80% fat malabsorption had been documented by a study by Gagner et al. [68], the 40% malabsorption figure I use for both complex carbohydrates and protein malabsorption are only estimates, and are probably quite a bit more variable person-to-person than the fat malabsorption, because there is SOME digestion and absorption of protein and complex carbs in the small intestine as the result of acid digestion by the stomach and enzymes secreted in the mouth and the jejunum and ilium, together with the much more variable length of the alimentary tract between patients, whereas fat digestion and absorption essentially only occurs in the common channel. The 40% figure comes from conservatively averaging a number of figures -- guesstimates, really -- that I have read and heard from surgeons over the years. These numbers are rough estimates for the purpose of explaining generally how the DS works - these numbers are NOT intended for you to use with any hope of accuracy. And not only will each individual vary in their malabsorption from another person, but each individual's malabsorption will vary over time. This is for illustrative purposes only!

Here is a discussion on fat intake: http://bariatricfacts.org/threads/fats-are-not-the-enemy.3185/

But protein and carbs WERE NEVER actually studied. We guesstimate those. We know we have malabsorption of those but how much??? WHO knows. And what one person's level is will not be another.

But if you assume that every gram of carb you put in your mouth is absorbed, then you will be fine. If you eat 100 grams of carbs in a day and assume you absorb all 100 grams, you are better off than most. And if all 100 grams of carbs is sugar, you are most likely correct. Sugar starts absorbing in the mouth.