Pre-Op and Nervous (okay, terrified!)

[heyclementine]

Hi everyone. I've read so many threads here I almost feel like I already know some of you! I posted a hello in the newbie forum, but I wanted to post a slightly more detailed one here as I'm hoping to quell some of my nerves and fears that are almost all due to information I'm lacking or confused about.

I've had my initial consult, psych evaluation, nutrition consult, and am on month 3/3 of my doctor supervised weight loss program. I'm very excited that I'm getting close to (hopefully) being approved and getting my surgery date. I really feel like I'm ready (I've been reading everything I can on this particular surgery for over a year now, including many posts on this forum) and just very excited to become a healthier person who can really enjoy life.

I am not worried so much about the surgery itself as I am about taking care of myself for the rest of my life thereafter. The information on nutrition and especially supplementation seems so daunting to me right now. What I've gathered that seems to be the biggest thing to know is that ADEK are the biggies (since they are fat soluble) but that they should be taken individually as opposed to in the form of a multi. I am SO NERVOUS (understatement) that I will find myself extremely low in something and not know what to do. That seems pretty irrational because this forum alone provides a wealth of information, but I still have that fear.

For instance, I know supplemental requirements differ from person to person, but what should I be taking immediately after surgery? Does my stomach have to heal for a certain amount of time before I start taking vitamins or do you start them right away? I wish I could trust my surgeon's recommendations, but from what I've gathered that is not always the best idea. So I am hoping for help from you all.

I have a ton of questions about life after DS, but I need to get this fear behind me before I can worry about any of that. I read in a thread last night where one of you said you know 3 people who've died from not taking care of themselves after surgery, and that TERRIFIED me. I'm trying to use my fear to motivate me to absorb as much knowledge as I can, but I need your help. I am 100% sure the DS is the right surgery for me, but I need more help getting ready for my life afterwards (immediately and long-term!)

Thank you in advance for any replies.

 

[conceit]

first of all, welcome to bsfacts . i am a pre-op too. yes, we should be aware of the good, bad and ugly sides of the DS, so we go in with realistic expectations. we also need to know what our responsibilities will be, towards ourselves, for life- vites, proteins, labs. none of this is negotiable. like you, i am using my anxiety to keep me grounded, so i don't get carried away with just the awesome weight loss results. i do get spooked out too, btw. it's natural to freak out about such a life changing surgery. i also have worries that while i am planning now and all set for the surgery, post DS, i'll turn into some irresponsible fool and fuck it all up. *facepalm* hehe.also worry that i won't be able to make sense of how to adjust my vites according to my labs..etc. etc. basically, my fears revolve around being a total failure at managing the DS. i hear you loll. i work through them when they arise though. if you face them, they won't have as much of a "hold" over you. learn as much as you can. action and knowledge are the best antidotes to anxiety.

to answer some of your questions, look up the Vitalady regimen. that's what you should start with. in the time right after surgery, the focus is on hydration, walking and resting. there is a stickied thread "never had surgery...". look it up, and go through it. most people take 4-6 weeks to work up to the full vitalady schedule. i've read that many start with multivitamins, D and B-vitamins, and add the rest over time. but, don't rush with vites right out of surgery. we will have vitamin stores that don't get depleted overnight. i am sure experienced members will give you more feedback, but i am just summarizing some basics. as for A,D,E,K, yeah we have to take those on the dry form because we malabsorb fat. it's very hard to find the right type of these vites, so most trust Vitalady for this especially. my own plan is to start with Vitalady's package, and then in a year or two or however it works out, start splitting my vites between buying from her and amazon plus local dealers (multivitamins, calcium citrate etc.). also, look up her labs list and labs targets,so you know which labs to get and what your ranges should be.

also, keep the 30-60-90-120 rule in mind for protein. read up on DS math (i am sure there's a sticky somewhere), so you know how much protein, fats and carbs we malabsorb. we don't absorb around 60% of the protein we consume, post DS. so, we have to consume it accordingly. by 30 days post op, you need to be consuming 30 gms of protein per day, 60 gms by 60 days..working up to 120 grams which is the minimum we have to take daily for life. we only absorb about 20% of fat consumed, so fat is something we can eat freely. we absorb 60-100% of the carbs we eat, with simple carbs being absorbed completely. in the weight loss window, vets recommend not eating more than 50 gms in carbs/ day. you can increase this later. but, i've read that we should always eat protein first. so, we don't fall behind on our protein intake (protein malnutrition is a biatch). initially, people do supplement with shakes. but, some are able to get all their protein from food whereas others need/choose to supplement with shakes over time. YMMV.

hmm i think i've covered some ground above lol. hope that helps.

 

[southernlady]

For instance, I know supplemental requirements differ from person to person, but what should I be taking immediately after surgery? Does my stomach have to heal for a certain amount of time before I start taking vitamins or do you start them right away? I wish I could trust my surgeon's recommendations, but from what I've gathered that is not always the best idea. So I am hoping for help from you all.

I have a ton of questions about life after DS, but I need to get this fear behind me before I can worry about any of that. I read in a thread last night where one of you said you know 3 people who've died from not taking care of themselves after surgery, and that TERRIFIED me. I'm trying to use my fear to motivate me to absorb as much knowledge as I can, but I need your help. I am 100% sure the DS is the right surgery for me, but I need more help getting ready for my life afterwards (immediately and long-term!)

Thank you in advance for any replies.

I TRIED taking mine off the bat, and at one pill and a swallow of water, I was sick from them. so I stopped for awhile...actually longer than I should have BUT I got back on the wagon.

The best way to start is
1) Make sure you are as healthy as possible pre-op...having a lab draw helps but taking a multi, some OTC D, and calcium will help...also eating plenty of protein.
2) Once you are home, focus on hydration FIRST. If any of the fluid includes protein, great. The 30/60/90/ + rule helps.
3) About a week out, start with your multi. After a few days, add your D, and then keep slowly adding each one you need...and start with the entire Vitalady list unless your pre-op labs say you are very high in something.
4) You should be on full regimen about 6-8 weeks out...about the same time adding fat is a great idea. Some fat early on is needed but as you get further out, you may find yourself constipated. If that happens, add more fat.

Your labs the first year are not a good indication of GREAT but a tool to tweak what you may be overdoing or underdoing. Keeping an excel spreadsheet will help you spot trends. A trend was how I KNEW I was "losing" the battle of absorbing oral iron and needed infusions. I found that currently I do not need to take extra A, E,, or any of the B's. But that is me.

As to the person we just found out died...unfortunately it does happen. Usually from lack of taking PROACTIVE care of themselves. And getting help sometimes means leaning to realize doctors are human too...and CAN be wrong!

 

[Munchkin]

The fact that you are scared means you are smart. And smart is the best thing you can bring in to the DS.

Immediately after surgery and for the first couple weeks the only thing you need to worry about is healing, walking, and fluids. Period. If you can get in some vites and food great. If you can't no big deal. Do some gatoraid to get in your electrolytes. Just know the DS is going to take over your life for a year or so, after that it just becomes automatic.

Start taking multi's and extra D now! Almost everyone is D deficient anyway.

If I was starting over today, I would probably do the patches. Checkout patchmd but look for a promo code before you buy. Since all the good stuff is absorbed transdermally, normal dosages are good for you. And you can start the patches without having to worry about food, nausea, etc. The patches are relatively new but people are getting great results so far without having to swallow 30 pills a day.