SADI-s out 2 weeks 2 Days.........needing some feedback

[Up2Me3]

I am 2 weeks 2 days out. I feel like everything is SO dry.....my hair, my skin, my eyes even. I wondered if it's just fall and turning on furnace .....but I've tried to increase my water. Still only getting in 50 oz consistently....64 on a good day. But I also - am SO tired. I am working my 10 hour shifts but then just want to go home and veg. I battle between constipation and diarreha....my stomach is gurgling and active always which is bothersome. What worries me is there seems to be a constant ....burning feeling....kind of the feeling you get before diarreha...but it's up high and centered ......is this normal?
WORRIES
Fatigue.......when does this get better?
Burning sensation..............is this normal?
Vitamins.........right now I only get in 1 multi, 2 calcium, 1 D3 50,000, 1 K2.......I think I'd upchuck to get anymore in.
Food......have moved to soft foods - sliced turkey, cheese stick, tuna w\ mayo....all staying down. Did try a fruit cup that stayed down but got the tummy REALLY active...? QUESTION: My food list suggests cooked veges....but I thought I'd read on a post from vets to NOT eat veges yet....what was\is your experience with that?
I guess I just want to make sure I'm doing what I should. I have a call in to the doctor about the burning feeling........just seem to trust the opinion of those who have actually LIVED it! Thanks for any feedback......

 

[Charris]

I am 2 weeks 2 days out. I feel like everything is SO dry.....my hair, my skin, my eyes even. I wondered if it's just fall and turning on furnace .....but I've tried to increase my water. Still only getting in 50 oz consistently....64 on a good day. But I also - am SO tired. I am working my 10 hour shifts but then just want to go home and veg. I battle between constipation and diarreha....my stomach is gurgling and active always which is bothersome. What worries me is there seems to be a constant ....burning feeling....kind of the feeling you get before diarreha...but it's up high and centered ......is this normal?
WORRIES
Fatigue.......when does this get better?
Burning sensation..............is this normal?
Vitamins.........right now I only get in 1 multi, 2 calcium, 1 D3 50,000, 1 K2.......I think I'd upchuck to get anymore in.
Food......have moved to soft foods - sliced turkey, cheese stick, tuna w\ mayo....all staying down. Did try a fruit cup that stayed down but got the tummy REALLY active...? QUESTION: My food list suggests cooked veges....but I thought I'd read on a post from vets to NOT eat veges yet....what was\is your experience with that?
I guess I just want to make sure I'm doing what I should. I have a call in to the doctor about the burning feeling........just seem to trust the opinion of those who have actually LIVED it! Thanks for any feedback......

Maybe you are so tired because you a working already. I know whenever I had a surgery the anesthesia in my body made me get extremely tired. A lot of DS people have that embarrassing gurgling of the stomach.

 

[Elizabeth N.]

I think you are working way too much, too soon, and doing so in a state of mild to moderate dehydration. Of course your skin is dry. You're dehydrated.

Are you taking an acid reducer like Zantac or Prilosec? If not, get on one.

If you can't hydrate beyond 50 or so ounces most days, you have no room for supplements. Forget them and focus on hydration.

If you can't eat 100 grams of protein from food sources, you don't have any room for fruit or any other carb.

 

[Munchkin]

Get an acid reducer and cut back to part time at work. It is too soon to be working that much!

 

[Up2Me3]

I think you are working way too much, too soon, and doing so in a state of mild to moderate dehydration. Of course your skin is dry. You're dehydrated.

Are you taking an acid reducer like Zantac or Prilosec? If not, get on one.

If you can't hydrate beyond 50 or so ounces most days, you have no room for supplements. Forget them and focus on hydration.

If you can't eat 100 grams of protein from food sources, you don't have any room for fruit or any other carb.

Ok so forget the fruit and vitamins until I can get all water and protien in.....? I just worry - you hear the horror stories of falling below on the nutrients. My work is a desk job....I do try to get up and walk every 2 hours. The Prilosec.....that is an OTC...that you only take once a week isn't it? Is this what you are suggesting for the burning feeling I'm having....it's not like heartburn feeling?

 

[Charris]

@Elizabeth N. Isn't the acid reflux issue something Diana had pointed out when she was talking about the cons when getting the Sadi. She said something about bile backing up?

 

[Elizabeth N.]

Ok so forget the fruit and vitamins until I can get all water and protien in.....? I just worry - you hear the horror stories of falling below on the nutrients. My work is a desk job....I do try to get up and walk every 2 hours. The Prilosec.....that is an OTC...that you only take once a week isn't it? Is this what you are suggesting for the burning feeling I'm having....it's not like heartburn feeling?

Let's think for a moment about the things that are necessary to sustain life.

You can live (roughly estimated) approximately four minutes without oxygen, four days without hydration, four weeks without caloric nutrition, and many years without adequate micronutrients.

You're basically a few days out from a procedure with which you will live the rest of your life. You're not going to get malnourished that fast.

Look up Prilosec on Google. Same thing with Zantac. You can learn lots of cool stuff . The Google machine makes me look quite knowledgeable . But that being said, both Prilosec and Zantac are OTC acid reducers, very different types of medications, that are generally taken once a day. There are also many prescription variations on these types of meds.

I suspect you need one of those. Don't put it off. Go to the pharmacy and get some.

 

[Elizabeth N.]

@Elizabeth N. Isn't the acid reflux issue something Diana had pointed out when she was talking about the cons when getting the Sadi. She said something about bile backing up?

From what I've read so far, that is a possible concern, yes, but the surgeons who are studying the new procedures (there's a group in Turkey and a group in Spain doing real studies) don't seem to be seeing to any particular degree just yet. It's early days, of course, because these procedures are brand new. However, bile reflux and acid reflux are two totally different animals.

I'd be awfully surprised if that's the OP's problem. Lots of us have acid-related nausea problems early out.

 

[Larra]

Prilosec is taken once or twice daily, not weekly. Weekly is useless. It's fine to get it OTC, and easier than pestering docs for a prescripton.
Your body has stores of vitamins and protein to tide you over these early days. Right now your job is to stay hydrated and get enough rest to recover from major surgery and general anesthesia, and also from the changes the surgery has made to your metabolism (probably not as much change as a full DS, but still some change). It sounds like you are back at work far too soon. There is no way I could have possibly worked so early post-op, and I had been leading an active life pre-op.
Listen to your body. It's trying to tell you something, that being that you are pushing your body too fast too soon. Go home, stay there, drink as much fluid as you can, get in some protein if you can, and let your poor body heal.

 

[DianaCox]

The concerns I've heard expressed by medical people (and I can't at the moment recall who said so, but they were people with ACTUAL credentials to opine on the topic) were related to BILE reflux. There was also something about food "retrograding" (?) - going up the BP limb as it is released in a bolus from the pyloric valve directly into a T junction.

My concerns continue to be related to the lack of selective fat malabsorption, and far less malabsorption overall. And how it is being "sold" as "just like a DS" or without any clear disclosure that it is NOT a proper DS at all.

 

[Sheanie]

My concern is the backing up of food at the T junction. That has always been my greatest concern about the SADI. My second greatest concern is that it is being called "just as good as the DS", or worse, "even better" because it does not have the degree of malabsorption that a DS does.

I also worry about more risk of a bowel twist, because of the T shape join, which is unnatural to my mind.

 

[star0210]

I think it was the doctor who created the surgery perhaps that answered that question and said the connection was far enough away from the pyloric valve that bile reflux possibility and the food backing up were not issues.

From my research it seems that in both procedures food basically travels the same amount of small intestine...in the DS it doesn't mix with any of the digestive "juices" until it reaches the common channel which is on average 100cm. Whereas in the SADI, it travels the entire length of the small intestine mixed with the juices which is approx. 250cm.

So I think the question is...how much more absorption occurs in that extra span of approx on average 150 cm where it's traveling mixed with the digestive juices.

Also...I was wondering in a normal anatomy what absorption happens in the duodenum and the jejunum? All of those parts are bypassed in both procedures.

 

[Sheanie]

@star0210 , that's just it, as you just queried. It's an UNANSWERED question right now. Precisely because the SADI has not been around long enough for in-depth studies to come to fruition. So any answers to your questions are going to be pure conjecture. Your surgeon cannot possibly predict the malabsorption. Studies took decades to come out on the Duodenal Switch. Patients had to be followed, feces collected, tested, diets documented.

To a certain extent, you might be able to guess by "your" experience with the "oil slicks", or floating poo. But that's just guesswork. SADI patients will absorb more fat than DS patients. How much more is, at this point in time, anyone's guess.

 

[southernlady]

@Up2Me3, there is now a forum for the SADI so I am gonna move this thread to that forum.

 

[DianaCox]

Nobody knows the answer; however look at this math:

• Assuming the average numbers: with a 100 cm common channel and total 250 cm alimentary tract, wherein there is SOME protein and carbohydrate metabolism occurring in the 150 cm of proximal ileum due to intestinal proteases and glycosidases:
  • Lipid absorption
    • 100 cm = 20% of lipids absorbed
    • 250 cm = 20% x 2.5 = 50% absorption (which could be significantly more, because the rate limiting step is solubilzation of the lipids in bile, and with 2.5 times more time to be solubilized, the amount of lipolysis by lipolytic enzymes could be increased geometrically, rather than linearly)
  • Proteins and complex carbs:
    • 150 cm without extra pancreatic enzymes and 100 cm WITH pancreatic enzymes = 50% absorbed
    • 250 cm with pancreatic enzymes = ?? Probably at least 80% absorbed? (this is really hard to guess, because I don't know what percent of what is NOT already digested by the intestinal proteases and glycosidases, is only digestable by pancreatic proteases and glycosidases)