New here- hello 3 weeks out DS

[Pattycake813]

I had DS in Peoria, IL on April 1, 2016. So far so good. 3 weeks out today, down ~35 lbs .

I'm feeling pretty good...have my discouraging moments when I just want to chew some food and eat more than a freaking 1-2oz serving.. But I'm sure I'll get there.

It has been especially hard to get a decent amount of protein in with such little appetite and how slowly I drink.. But most days I manage to get 70g ish.

I'm from the middle of nowhere and traveled to Peoria for the surgery because no surgeons in my area do the switch. The support groups near me are filled with RNY patients but no DS...so looking for support from people who have been through DS since it's a very different post op world.

 

[Clematis]

Welcome!

You'll find all you need to know here about nutrition, vitamins and other details of DS.

Around here we follow the rule of 30 grams a day of protein at 30 days out, 60 grams at 60 days, 90 at 90 days... so you are way ahead of schedule at 70 grams at 3 weeks. At 3 weeks out I was just allowed to eat a few soft protein foods like yogurt and cottage cheese. Protein drinks were and still are my salvation.

 

[southernlady]

Welcome @Pattycake813

You are doing great...actually your primary focus the first month is hydration. IF some of it is protein, great.

 

[Larra]

Welcome! Don't kick yourself about the protein. Your body has stores to get you through the first few tough weeks. You are FAR ahead of how I was doing at that point and I turned out just fine.

 

[-Flo-]

Welcome PattyCake! I'm just about 2 weeks out, so we are in a similar boat. I too traveled for my surgery. I'm in Boston and no one does the DS around here yet, so I went to NJ. Was this your first WLS?

 

[DSRIGGS]

Hi - I live in central, il and has my original DS with Marshall. Did he perform your DS, or one of his partners?

 

[Pattycake813]

Thank you guys so much for the encouragement... Im still on pireed food, which makes me gag a bit because the texture is gross to me (ive never liked purred food). But I do sip sip sip all day, but get so tired of protein drinks and sometimes just want water or some liquid without the protein aftertaste.

 

[Pattycake813]

This was my first WLS following failed diet after failed diet. I've struggled with weight since puberty, even while playing sports in HS.. I've yoyo'd through adulthood until this past 2 years where I have yo'd only in the up direction... Which is what ultimately lead me to WLS


Marshall did my surgery robotically. I go for my 1 mo follow up on Monday, and plan on asking for my detailed records so I have them for wherever the journey ultimately takes me.

 

[Clematis]

I don't understand. Why can't you drink water? You should be having about 64 oz of liquids a day which can include protein drinks but doesn't have to be all protein drinks.

I agree. Pureed foods are gross. I did manage to eat some ham salad spread -- but that was farther out than you are now. Greek yogurt was my mainstay. Maybe wet scrambled eggs? (I couldn't tolerate eggs, although after a whole I could make a soft boiled egg and egg the runny yolk with a spoon and ignore the white.)

Good idea to get full records, including total bowel length, limb lengths and common channel.

 

[DSRIGGS]

This was my first WLS following failed diet after failed diet. I've struggled with weight since puberty, even while playing sports in HS.. I've yoyo'd through adulthood until this past 2 years where I have yo'd only in the up direction... Which is what ultimately lead me to WLS


Marshall did my surgery robotically. I go for my 1 mo follow up on Monday, and plan on asking for my detailed records so I have them for wherever the journey ultimately takes me.

Welcome and my best wishes to you.

I don't understand. Why can't you drink water? You should be having about 64 oz of liquids a day which can include protein drinks but doesn't have to be all protein drinks.

I agree. Pureed foods are gross. I did manage to eat some ham salad spread -- but that was farther out than you are now. Greek yogurt was my mainstay. Maybe wet scrambled eggs? (I couldn't tolerate eggs, although after a whole I could make a soft boiled egg and egg the runny yolk with a spoon and ignore the white.)

Good idea to get full records, including total bowel length, limb lengths and common channel.

Unless Marshall changed his tune after me, he doesn't measure the small bowel so I am betting he gave Patty a 100cm CC & a 150cm AL without any idea how long her BPL is. It is how Prachand taught him to do the DS.

Patty, I don't want to worry you but you will see my posts at some point so I want to get this out of the way. Marshall does what we refer to as the cookie cutter DS where he doesn't measure the small bowel length (SBL) and then make the common channel (CC) 10% of the SBL and the Alimentary Limb (AL) at 40% of the SBL with Bilopancreatic Limp (BPL) at 50% of the SBL. What I just described is known as the Hess Method or proportional Limb DS. It is tailored to the individual patient because we all have differing SBL's. ......so what does all that mumbo jumbo mean? Well what it meant for me was that my SBL ended up being 725cm so with a 100cm CC and 150cm (These are the nutrient absorbing part of the small bowel after the DS) my absorbing small bowel was 250cm/725cm or 34% of my SBL absorbing (Should be 50% for optimal balance between weight loss and health). Had he followed the Hess Method my CC would have been okay 100cm (10% is rough guideline) but my AL would have been roughly 275cm.

So again, what does all of these numbers mean. It meant that at a year out from my DS surgery I ended up in the ER because I was extremely dizzy and couldn't stand. My Heart Rate was 35 BPM and my Blood Pressure was 70/40.....yep just above dead. I was admitted as they though I had coronary issues. Well I was at OSF for a week and they realized I had severed malnutrition so I had to go on a huge amount of a pancreatic enzyme (CREON) to help with my nutrient absorption. I tried this for a year but my nutritional values were no better so I had to fly out to LA and have Dr Ara Keshishian revise my channel lengths to improve my absorption. He did what was called a side to side anastomosis which effectively lengthened my AL to 275CM of absorbing bowel and my to my CC he added 25cm. I was able to go off the creon immediately and my nutritional situation improved greatly. I am not back to perfect because I am battling an hernia and it is causing some issues.

Now as I said, I don't want to worry you and chances are that your total SBL is a lot shorter than mine as there is a direct relationship to height and small bowel length. I am 6'2 and I am assume you are shorter than me. So if you have a shorter small bowel length the length at which he made your CC & AL are probably just fine and you will do well. For example I believe Clematis has around 500 cm total SBL so if yours was a similar length and Marshall gave you 100cm CC and 150cm AL like he did me, you would be in very good shape at 50% of your intestine absorbing and 50% BPL.

I just wanted to get that out of the way because you won't hear me speak in glowing terms of Dr Marshall because he really caused my life to suck the last 2.5 years. That being said, I suspect you are going to do well.

Best luck and ask lots of questions of folks here as this site is loaded with TONS of knowledge and some folks who are close to 15 years post DS surgery. You will get much better nutritional and supplementation advice from this board than you will from the Nutritionist at PSG. That is true of most DS surgeons who are typically very good cutters but typically not good with guidance on nutrition and vitamins.

 

[DSRIGGS]

and do me a favor and kick Marshall in the nuts for me on Monday.

Just kidding.

I will tell you that I have a love, not so much love relationship with Marshall. He is a very good surgeon and I don't know if you know it but he is Director of Trauma for OSF. He actually performed a trauma surgery on my 22 year old son (was 21 at the time) and did a fantastic job. He just failed me by not taking the extra 15 minutes to do a Hess Method DS (again the "cookie cutter" DS works for most people other than folks like me who are on the tall side of the spectrum).

and BTW, like Clematis said, you can absolutely drink as much water as you want. ....and yes the pureed foods sucked. You should be able to eat soup, greek yogurt and things like that now....actually you are far enough out that you should be able to advance to a completely unrestricted diet where you try to add things back in a little at a time. You won't be able to eat much volume right now but you can go to real food.

 

[southernlady]

Thank you guys so much for the encouragement... Im still on pireed food, which makes me gag a bit because the texture is gross to me (ive never liked purred food). But I do sip sip sip all day, but get so tired of protein drinks and sometimes just want water or some liquid without the protein aftertaste.

DRINK whatever fluid tastes good. Don't worry about the protein as much. That comes with time.

I didn't do pureed food (sounded too gross) but I did do soft food. If I could cut it with a fork, it went in my mouth.

 

[Pattycake813]

Thanks you so much. I do and can drink water.... I have just been so focused on darn protein drinks that by the time I get all of the protein liquid in me, I don't have a lot of room for water. I'm getting about 56-74oz of fluid a day, but about 30-40 is protein drinks because I have been so paranoid about falling under 80g of protein.

As far as how Dr Marshall operates, IDK if he has changed anything, I know the consent form had a length range for the CC, AL AND BPL rather than just a specific length, but we shall see when I get my full records how it was all determines/done in me.

I am actually being transferred to NJ for work here shortly, so I am hoping I can find a good group out there to help with follow-ups -- TY for the heads up on that info, as it is good information to have . when was your surgery/ how long was it before you started really feeling we

and do me a favor and kick Marshall in the nuts for me on Monday.

Just kidding.

I will tell you that I have a love, not so much love relationship with Marshall. He is a very good surgeon and I don't know if you know it but he is Director of Trauma for OSF. He actually performed a trauma surgery on my 22 year old son (was 21 at the time) and did a fantastic job. He just failed me by not taking the extra 15 minutes to do a Hess Method DS (again the "cookie cutter" DS works for most people other than folks like me who are on the tall side of the spectrum).

and BTW, like Clematis said, you can absolutely drink as much water as you want. ....and yes the pureed foods sucked. You should be able to eat soup, greek yogurt and things like that now....actually you are far enough out that you should be able to advance to a completely unrestricted diet where you try to add things back in a little at a time. You won't be able to eat much volume right now but you can go to real food.

Thanks you so much. I do and can drink water.... I have just been so focused on darn protein drinks that by the time I get all of the protein liquid in me, I don't have a lot of room for water. I'm getting about 56-74oz of fluid a day, but about 30-40 is protein drinks because I have been so paranoid about falling under 80g of protein.

As far as how Dr Marshall operates, IDK if he has changed anything, I know the consent form had a length range for the CC, AL AND BPL rather than just a specific length, but we shall see when I get my full records how it was all determines/done in me.

I am actually being transferred to NJ for work here shortly, so I am hoping I can find a good group out there to help with follow-ups -- TY for the heads up on that info, as it is good information to have . when was your surgery/ how long was it before you started really feeling weak/sick?

 

[aaa]

Hi, glad you made it over here.

 

[Pattycake813]

Good to see you here AAA