VSG to DS: 9 Weeks Post-Op (LOW CARBS!)

[Stefanie S.]

How time flies once you have to go back to work and resume life. But many of you have asked that I continue to post updates on this particular revision surgery. I will try to make these updates more frequent as I know it is super helpful to see someone else's story.

Weight Loss
My surgery was Jan 24 so I am 9 weeks out. On the day of surgery I was 301 pounds and today I weigh 276, so that's a 25 pound weight loss. Yep, MUCH slower than everyone I see or read about that got, well, really, any other surgery. During my revision surgery, my stomach was not re-sleeved. Sometimes I wish it was so that I could experience the fast weight loss that I see others have. However, with a DS, it is imperative to consume enough protein and fat. Almost immediately, I was able to do that with no problems AT ALL. I feel healthy and I don't think I will lose any of my hair because of this. Maybe more important than fast weight loss?

What do I eat right after surgery?
Well, I will tell you that I can literally eat anything I want. And that was the case immediately as well. Once home from the hospital, it only took 3-4 days to have my appetite back. And my stomach was untouched so it was VERY difficult to not indulge. I was eating food 5 days after surgery. I'm not telling you to do this as my surgeon gave me the same instructions as the gastric bypass and first timers of not eating food until 2 weeks post-op. What I did do was eat protein only, and very mashed up. I ate fried eggs (mashed) and scrambled eggs. I ate refried beans with sour cream and mashed up avocados. And I ate tuna salad with full fat mayo and hard-boiled eggs. By 2 weeks out, I was finally not constipated, and really ate anything I wanted. HOWEVER...

What not to eat:
I KNEW not to eat sugars and high carb foods, but I did it anyway. This is my 2nd surgery and I went through all of the classes and read up on eating disorders, so you'd think I would have known better. But I suppose that something was in the back of my mind telling me that I absorb far fewer calories now so go ahead and eat what you want. Let me tell you - don't do this! Weight loss completely stopped. I stayed at 286 for almost 3 weeks straight and this was only like a month post-op. I was eating between 150-250 carbs per day. I don't know if carbs affect everyone like this, but I want to share my mistakes and experience. Had I continued on this track, I suspect my DS Revision would have just maintained me for life at 286 pounds, at best. I wanted much more than that.

Bathroom Issues
Yep, the higher carbs story gets worse. I went from constipation (right after surgery) to full on diarrhea. I was going 3-4 times a day and I even had a few accidents. Talk about being horrified! So there I was just fresh out of a revision surgery that I had to SELF-PAY for no less... not losing a bit of weight, running to the bathroom, and pooping my pants! OHHHHHHH... the other thing I had DAILY was the most horrible smelling CONSTANT gas. These are the horror stories that you read about DS. And they are VERY REAL... but don't have to be.

The Cure
So about 3 weeks ago, I had to have a reality check with myself. I spent an entire weekend studying this site (again!) and others on the proper way to nourish and take care of myself after this surgery. (So no lectures please - I took care of it already I made food plans. I shopped for high protein, satisfying foods. I made menus consisting of 100-150 grams of protein a day (we only absorb approximately 50%) and around 100-125 grams of fat per day (we only absorb around 20-50%). (Also, I found that I needed the higher fat to avoid constipation.) I immediately felt better. No gas. No smells. Only a morning bathroom trip and then done for the day. Plus I'm eating some very tasty food! (By the way, I'm often pushing 1800-2000 calories). For sweets, I am currently hooked on organic strawberries smothered in heavy whipped cream. Sometimes I'll go grab a spoonful of peanut butter. My daily carb intake is now down to around 50-60, and I seem to do okay with that. Total weight loss in the last 3 weeks after finally eating right: 10 pounds. Effortless.

Conclusion
So I've already made a ton of mistakes. I'm definitely on a journey and the surgery was NOT the easy button. But if I make the proper diet modifications, which are still MUCH easier than the other surgeries, then it is one heck of a great tool to get this weight off and regain health.

 

[Munchkin]

It's great you were able to see the problem and fix it logically. Maybe about the hair loss but most attribute it to anesthesia and general trauma. I didn't lose any hair but my sister almost went bald. We both have really crappy hair anyway.

Some people still do well while eating carbs but...almost all the time they are back in a couple years fighting the regain or trying to lose the last 30lbs. Or they are male. The DS just works better for them.

Feel free to ignore my advice. I know you are a smart woman and very capable. If I was in your place, I would cut the carbs even more. I would want to give myself the best possible shot to get the weight off. And I would do everything I could to increase my activity level.

I didn't get a 'good' DS. My CC is supposed to be 75 but I don't believe it. I never had any easy weight loss and I have had 0 deficiencies over the years. You will never know how badly I wanted to be one of those wearing size 0 jeans and complaining about losing too much...but of course it didn't go that way for me. That's why I tell everyone to put the hammer down and lose as much as possible as fast as possible because it will never get any easier to lose than it is right now. I want everyone to have the best possible chance to reach their goals.

 

[Stefanie S.]

It's great you were able to see the problem and fix it logically. Maybe about the hair loss but most attribute it to anesthesia and general trauma. I didn't lose any hair but my sister almost went bald. We both have really crappy hair anyway.

Feel free to ignore my advice. I know you are a smart woman and very capable. If I was in your place, I would cut the carbs even more. I would want to give myself the best possible shot to get the weight off. And I would do everything I could to increase my activity level.

Thank you for sharing and for the advice. I do want to try lowering my carbs even more, but it seems like when I do, then I cave and carb binge... trying to find that balance. I didn't realize that's why people lost their hair!

 

[Butterfly]

Thank you so much for posting this detail @Stefanie S. In 3 weeks I'm going to be a VSG to DS person and I am going to do my very best to learn from your experience.

 

[Stefanie S.]

Thank you so much for posting this detail @Stefanie S. In 3 weeks I'm going to be a VSG to DS person and I am going to do my very best to learn from your experience.

You are welcome. I learned so much from this site. I'm still learning, but it's also my time to give back so it makes my day that I might be able to help you on your journey. You are making a great decision! It takes some tweaking and some patience, but I think we'll both figure it out

 

[DSRIGGS]

It's great you were able to see the problem and fix it logically. Maybe about the hair loss but most attribute it to anesthesia and general trauma. I didn't lose any hair but my sister almost went bald. We both have really crappy hair anyway.

Some people still do well while eating carbs but...almost all the time they are back in a couple years fighting the regain or trying to lose the last 30lbs. Or they are male. The DS just works better for them.

Feel free to ignore my advice. I know you are a smart woman and very capable. If I was in your place, I would cut the carbs even more. I would want to give myself the best possible shot to get the weight off. And I would do everything I could to increase my activity level.

I didn't get a 'good' DS. My CC is supposed to be 75 but I don't believe it. I never had any easy weight loss and I have had 0 deficiencies over the years. You will never know how badly I wanted to be one of those wearing size 0 jeans and complaining about losing too much...but of course it didn't go that way for me. That's why I tell everyone to put the hammer down and lose as much as possible as fast as possible because it will never get any easier to lose than it is right now. I want everyone to have the best possible chance to reach their goals.

Munchkin, I would not be shocked at all if your problem is with the AL being too long and therefor the total AL is likely too long. That was certainly the case for me. I wish that could be fixed for you and that you knew exactly what your numbers are. How cool would it be if the small bowel could be measured via imaging instead of having to open a person up to measure.

Anyway, I hate that your DS hasn't been effective as you rightfully expected. Nonetheless I have always been impressed with your great attitude being dealt a shitty hand, and the great support you provide to Newbies and the rest of us here. I really respect you.

 

[DSRIGGS]

Thank you for sharing and for the advice. I do want to try lowering my carbs even more, but it seems like when I do, then I cave and carb binge... trying to find that balance. I didn't realize that's why people lost their hair!

The carb binging when doing extreme restriction is exactly why after the first year I never tried to keep my carbs low. I am always mindful of what I am eating but I believe strongly in the importance balance in virtually everything we do in life and that includes our diet. Having some carbs as normal part of the diet it provides balance and IMO lowers the risk of train wreck binging.

I also know that I am a very unique DS'r and can eat many more carbs than most and not have it make my weight go up.

Obviously you are very diligent about your diet and you are going to do very well.

 

[countryham]

It's great you were able to see the problem and fix it logically. Maybe about the hair loss but most attribute it to anesthesia and general trauma. I didn't lose any hair but my sister almost went bald. We both have really crappy hair anyway.

Some people still do well while eating carbs but...almost all the time they are back in a couple years fighting the regain or trying to lose the last 30lbs. Or they are male. The DS just works better for them.

Feel free to ignore my advice. I know you are a smart woman and very capable. If I was in your place, I would cut the carbs even more. I would want to give myself the best possible shot to get the weight off. And I would do everything I could to increase my activity level.

I didn't get a 'good' DS. My CC is supposed to be 75 but I don't believe it. I never had any easy weight loss and I have had 0 deficiencies over the years. You will never know how badly I wanted to be one of those wearing size 0 jeans and complaining about losing too much...but of course it didn't go that way for me. That's why I tell everyone to put the hammer down and lose as much as possible as fast as possible because it will never get any easier to lose than it is right now. I want everyone to have the best possible chance to reach their goals.

Thank you Stefanie for this post. I had my revision two days after you and listing to you is exactly how I feel and am on track about the same give or take a pound or two. I really thought the weight loss would be faster but I am thankful that I am loosing and not gaining! Good luck and please keep posting I enjoy reading all of the posts. I have so much to learn. I know I came to the right place.

 

[LindaDarnell]

How time flies once you have to go back to work and resume life. But many of you have asked that I continue to post updates on this particular revision surgery. I will try to make these updates more frequent as I know it is super helpful to see someone else's story.

Weight Loss
My surgery was Jan 24 so I am 9 weeks out. On the day of surgery I was 301 pounds and today I weigh 276, so that's a 25 pound weight loss. Yep, MUCH slower than everyone I see or read about that got, well, really, any other surgery. During my revision surgery, my stomach was not re-sleeved. Sometimes I wish it was so that I could experience the fast weight loss that I see others have. However, with a DS, it is imperative to consume enough protein and fat. Almost immediately, I was able to do that with no problems AT ALL. I feel healthy and I don't think I will lose any of my hair because of this. Maybe more important than fast weight loss?

What do I eat right after surgery?
Well, I will tell you that I can literally eat anything I want. And that was the case immediately as well. Once home from the hospital, it only took 3-4 days to have my appetite back. And my stomach was untouched so it was VERY difficult to not indulge. I was eating food 5 days after surgery. I'm not telling you to do this as my surgeon gave me the same instructions as the gastric bypass and first timers of not eating food until 2 weeks post-op. What I did do was eat protein only, and very mashed up. I ate fried eggs (mashed) and scrambled eggs. I ate refried beans with sour cream and mashed up avocados. And I ate tuna salad with full fat mayo and hard-boiled eggs. By 2 weeks out, I was finally not constipated, and really ate anything I wanted. HOWEVER...

What not to eat:
I KNEW not to eat sugars and high carb foods, but I did it anyway. This is my 2nd surgery and I went through all of the classes and read up on eating disorders, so you'd think I would have known better. But I suppose that something was in the back of my mind telling me that I absorb far fewer calories now so go ahead and eat what you want. Let me tell you - don't do this! Weight loss completely stopped. I stayed at 286 for almost 3 weeks straight and this was only like a month post-op. I was eating between 150-250 carbs per day. I don't know if carbs affect everyone like this, but I want to share my mistakes and experience. Had I continued on this track, I suspect my DS Revision would have just maintained me for life at 286 pounds, at best. I wanted much more than that.

Bathroom Issues
Yep, the higher carbs story gets worse. I went from constipation (right after surgery) to full on diarrhea. I was going 3-4 times a day and I even had a few accidents. Talk about being horrified! So there I was just fresh out of a revision surgery that I had to SELF-PAY for no less... not losing a bit of weight, running to the bathroom, and pooping my pants! OHHHHHHH... the other thing I had DAILY was the most horrible smelling CONSTANT gas. These are the horror stories that you read about DS. And they are VERY REAL... but don't have to be.

The Cure
So about 3 weeks ago, I had to have a reality check with myself. I spent an entire weekend studying this site (again!) and others on the proper way to nourish and take care of myself after this surgery. (So no lectures please - I took care of it already I made food plans. I shopped for high protein, satisfying foods. I made menus consisting of 100-150 grams of protein a day (we only absorb approximately 50%) and around 100-125 grams of fat per day (we only absorb around 20-50%). (Also, I found that I needed the higher fat to avoid constipation.) I immediately felt better. No gas. No smells. Only a morning bathroom trip and then done for the day. Plus I'm eating some very tasty food! (By the way, I'm often pushing 1800-2000 calories). For sweets, I am currently hooked on organic strawberries smothered in heavy whipped cream. Sometimes I'll go grab a spoonful of peanut butter. My daily carb intake is now down to around 50-60, and I seem to do okay with that. Total weight loss in the last 3 weeks after finally eating right: 10 pounds. Effortless.

Conclusion
So I've already made a ton of mistakes. I'm definitely on a journey and the surgery was NOT the easy button. But if I make the proper diet modifications, which are still MUCH easier than the other surgeries, then it is one heck of a great tool to get this weight off and regain health.

Thank you for posting this...chock full of simple advice and tips!! I'm about 4 weeks out and really need a guide. This helps. You and I are alot alike in that carbs are our devil!! I'll admit that I'm a carbaholic..doesn't matter if it's sugar or salt, bread or drink..I love carbs but they do not love me back because they stick around and turn into fat. So, I too need alot fewer of them, but have to find a balance in which I don't feel deprived. But I do know anything more than 40 a day for me is going to be hell to pay later. Thanks for sharing about the "carb dump"..that's how my surgeon described the bathroom and gas issues related to carbs. His words to me were "let me dispel the myth that DSers don't dump..you do..in the toilet" . He said you don't experience traditional dumping like RNY patients...but the diarrhea from carb overload is his example of dumping. My husband experienced this recently (he's a virgin DS)...3 weeks post op he tried potato soup (though I warned him!!), and hard heads make a soft behind, literally! It took two days to resolve. Needless to say, he learned the hard way, but you can't pay him now to look at any carb at all.
Again, thank you for sharing your story..hopefully I'll be smart and learn from your trials and errors

 

[KathrynK]

I have always thought that no two DS patients or two DS surgeries are the same. For everyone the ideal food intake is a unique balancing act and you are learning the balance that works for you. You are right to look at carbs (and especially sugar) absorption. There is no malabsorption of liquid sugar! For me, I am a little more foregiving of the good carbs of vegetables and whole wheat, so they can exceed 50g, but white carbs, fruit, wine, sugar, soda, etc were better eliminated during weight loss. For me, I found excess protein can also slow weight loss. The RDA for adults is about 45-50 g, so an average of 80-90 g of protein/day was where I started and where I still am and my labs confirm that works for me. I agree that fat is your friend when it comes to hunger and constipation, but I probably eat less fat than average because of bowel symptoms and, as you have found, about DS, she is a cranky master! No one's DS is exactly like mine, in that you may have a larger stomach or shorter common channel or different inherent absorption ability or higher metabolism based on age or height or gender. There's no "text book" diet, but a trial and error phase based on variations of the basic rules for everyone. But there is hope beyond the "golden" first year. Weight loss is easier in the first year, but you can still lose weight a decade out, as I learned recently, by giving up Reece's cups (even though they each have 2.5 G protein!) and all forms of sugar and liquid or white carbs for a few months. Sounds like you found the right path for you. Can't wait to see where it takes you!

 

[LindaDarnell]

I have always thought that no two DS patients or two DS surgeries are the same. For everyone the ideal food intake is a unique balancing act and you are learning the balance that works for you. You are right to look at carbs (and especially sugar) absorption. There is no malabsorption of liquid sugar! For me, I am a little more foregiving of the good carbs of vegetables and whole wheat, so they can exceed 50g, but white carbs, fruit, wine, sugar, soda, etc were better eliminated during weight loss. For me, I found excess protein can also slow weight loss. The RDA for adults is about 45-50 g, so an average of 80-90 g of protein/day was where I started and where I still am and my labs confirm that works for me. I agree that fat is your friend when it comes to hunger and constipation, but I probably eat less fat than average because of bowel symptoms and, as you have found, about DS, she is a cranky master! No one's DS is exactly like mine, in that you may have a larger stomach or shorter common channel or different inherent absorption ability or higher metabolism based on age or height or gender. There's no "text book" diet, but a trial and error phase based on variations of the basic rules for everyone. But there is hope beyond the "golden" first year. Weight loss is easier in the first year, but you can still lose weight a decade out, as I learned recently, by giving up Reece's cups (even though they each have 2.5 G protein!) and all forms of sugar and liquid or white carbs for a few months. Sounds like you found the right path for you. Can't wait to see where it takes you!

Wine???!!! I was your choir until you said we have to give that up!! Just kidding #lushlife

 

[KathrynK]

No wine? Only during weight loss. I'm making up for it now!

 

[Stefanie S.]

Thank you Stefanie for this post. I had my revision two days after you and listing to you is exactly how I feel and am on track about the same give or take a pound or two. I really thought the weight loss would be faster but I am thankful that I am loosing and not gaining! Good luck and please keep posting I enjoy reading all of the posts. I have so much to learn. I know I came to the right place.

This post made my day! Interesting that we are losing at the same rate. I was really disappointed at first, but now that my perspective has adjusted, I'm okay. It wasn't that long ago that I began to feel that I'd never be below 300 pounds again, and today I'm 275, so I'm close to saying that the surgery was already worth it! Glad you are here and I look forward to hearing all about your journey too

 

[Stefanie S.]

"let me dispel the myth that DSers don't dump..you do..in the toilet"

I'm going to frame this quote somewhere! That's just perfect! I look forward to hearing more about how you're doing. I'm in the process of putting together a food list of high protein/high fat foods... low carb of course. I'd be interested to know what foods you come up with as well. Best wishes!

 

[Stefanie S.]

I have always thought that no two DS patients or two DS surgeries are the same. For everyone the ideal food intake is a unique balancing act and you are learning the balance that works for you. You are right to look at carbs (and especially sugar) absorption. There is no malabsorption of liquid sugar! For me, I am a little more foregiving of the good carbs of vegetables and whole wheat, so they can exceed 50g, but white carbs, fruit, wine, sugar, soda, etc were better eliminated during weight loss. For me, I found excess protein can also slow weight loss. The RDA for adults is about 45-50 g, so an average of 80-90 g of protein/day was where I started and where I still am and my labs confirm that works for me. I agree that fat is your friend when it comes to hunger and constipation, but I probably eat less fat than average because of bowel symptoms and, as you have found, about DS, she is a cranky master! No one's DS is exactly like mine, in that you may have a larger stomach or shorter common channel or different inherent absorption ability or higher metabolism based on age or height or gender. There's no "text book" diet, but a trial and error phase based on variations of the basic rules for everyone. But there is hope beyond the "golden" first year. Weight loss is easier in the first year, but you can still lose weight a decade out, as I learned recently, by giving up Reece's cups (even though they each have 2.5 G protein!) and all forms of sugar and liquid or white carbs for a few months. Sounds like you found the right path for you. Can't wait to see where it takes you!

I LOVE your message! I'm seeing that too... that it really is unique to each person. I've always had troubles with carbs - even have PCOS, which they've always told me to keep my carbs low for. Reese's cups... *sigh* ... my old favorite. And I won't lie - I've had them a couple times already. I have to ask myself if it's worth it. In the moments before the purchase, I say "YEP, totally worth it." A few hours later, I swear them off again! And I'm reminded that the surgery did't fix my brain - the eating disorder - so I am still a work in progress, but feeling more positive about it each day.