SADI tomorrow!

[jellybunny]

Hi everyone,

I'm excited to hsve found this forum but cutting it close having just found it with my surgery TOMORROW. lol.

Info- I'm 26F. I've had a long road with PCOS with two prior abdominal surgeries and lost a fallopian tube, hx of diabetes, hypothyroidism and overall issues with weight.
My highest weight 330lbs and currently 312 with pre-op. I'm scheduled for a SADI with Dr. William Rice. I tried finding him on the forum but was unable to find. ("Rice" comes up with lots of results-Ha!) But he showed me his office's tracked data of modified-DS he's completed, and there were hundreds of patients over 10+ years. He's also a medical director.

Backstory, I previously was at a DIFFERENT bariatric clinic and due to lack of confidence I switched over to Dr. Rice's clinic. I feel confident in his office and their/his experience level, they seem knowledgeable and kind. Due to having to switch clinics, I had to recomplete pre-op preparation (nutrition, psych eval, etc etc) twice over to qualify at this new clinic. It's been over a year trying to get approved, and I've switched insurances 4 times since then. Because of this I'm very eager and have thought about my decision and motivations a lot, done a LOT of research on my own but still super nervous and would love to introduce myself to the community and hear any feedback.

I had not heard of the Hess method previously, but he said he would be measuring backwards and would give a longer channel than a traditional DS especially due to my age. Personally, I'd prefer a longer one as I'd love to have kids one day and worry about malabsorption so I'm happy with this. My goal, while to lose weight, is to be healthy and not rail thin. I dont know the exact number for the CC length it will be but I had a specific discussion with him.out of "concern for the length remaining" and he reassured me it would be a longer channel with the loop.

I'm nervous about these things and would love to hear some reassuring things but not sugar coated either:
-hair loss (already thin..)
-osteoporosis and malabsorption issues, anemia due to severe menses+PCOS
-future cancer risk or malabsorption of important meds (I have positive BRCA2+ genetic testing)
-pain and nausea, I always puke after anesthesia at baseline (told doctor). Ive had 2 laparascopic procedures but worried this one will hurt a lot.


Excited for everything else.. lol
Wish me.luck!! 😊

 

[southernlady]

Good luck tomorrow.
BTW, I’m moving this to the SADI board as it’s not a DS by definition.

 

[hilary1617]

Hi and welcome @jellybunny! I had a DS, so can't really speak to the points you raised as pertains to SADI, as DS and SADI are really apples v. oranges - but wish you an uncomplicated procedure and speedy recovery!

 

[JackieOnLine]

I hope you have a routine surgery and a fast recovery from your surgery tomorrow!

I am not sure who here has had a SADI but hopefully someone will address your questions. I have had a VSG only, but most members here have had a DS.

 

[jellybunny]

Thank you everyone! I'm happy to be here, and appreciate this being moved to the correct SADI section of the forum. My doctor also referred to it as SIPS (intestinal/plyorus saving)
I have read thru pretty much all of the current SADI posts on here and, though experimental, pleased with my decision on the choice of surgery. I understand that the trad DS' additional malabsorption (shorter CC) beneficial to reduce fat absorption (big cause of weight regain) but I'm worried about long term effects seeing as I'm only 26.

I'd love to share some of my additional decision making on why I think this one is a great fit for me since theres so little info as it stands.

Pros for me about this surgery that I've read across months of search:
-Retains the valve and allows for NSAID use (I plan to use sparingly regardless but, I was afraid of a hard "no NSAID" rule for the rest of my life).
- some studies cite the goal of the modified SADI vs DS is reduced risk of ulcers, diarrhea with less malabsorption than a trad DS but more than a sleeve/RNY. being reported to improve these in some cases not a lot of data to support it yet.
-Reduced risk of potential intestinal twist/obstruction with less junctions compared to DS and RNY (not sure if I'm wording is 100% accurate here but it was my general understanding)
-Larger sleeve as opposed to RNY pouch, but still has malabsorb benefits as opposed

-Cons:
-Potential for regain as opposed to trad DS, less data overall, newer experimental surgery
-Saw study citing that diabetes benefits will not be as impactful in SADI- but I'm hoping to still see some improvement as opposed to a traditional gastric sleeve w/o intestinal change.
-Potential for acid reflux and bile reflux - Not an issue for me at all pre-op, maybe once every 4-5 months usually attributed to a super acidic meal

my vitamin regimen will include a high ADEK multi, iron, + calcium citrate 2000IU (avoiding iron at same time), vitamin D 2000IU , biotin (I know wont stop telogen effluvium hair loss) and adding PRN whatever is needed with labs as we go.

 

[southernlady]

Cons:
-Potential for regain as opposed to trad DS, less data overall, newer experimental surgery
-Saw study citing that diabetes benefits will not be as impactful in SADI- but I'm hoping to still see some improvement as opposed to a traditional gastric sleeve w/o intestinal change.
-Potential for acid reflux and bile reflux - Not an issue for me at all pre-op, maybe once every 4-5 months usually attributed to a super acidic meal

The data on the SADI is reaching 15 years out in Turkey where it originated. And almost 13 years here in the states, so it’s getting there.

The biggest issue still is doctors lying to their patients about the procedure they are receiving.

Data on diabetes is better than the VSG but not as good as the DS. It’s about equal to the RNY which is acceptable.

Bile reflux is the biggest concern post op and never having reflux before is no indication that it won’t happen, but the indication is about 25-30% of SADI patients develop it. Only known cure is a conversion to a traditional DS even if it’s a long common channel. I sincerely hope you are one of the ones who avoid it.

Even those who get the DS who’ve never had reflux can develop it post op, it’s not the common channel but the sleeve that the issue. Taking a PPI for 3-6 months post op as a corrective action helps. Most can stop by the end of 6 months.

The SADI had a rough start here due mostly to surgeon actions.

 

[southernlady]

my vitamin regimen will include a high ADEK multi, iron, + calcium citrate 2000IU (avoiding iron at same time), vitamin D 2000IU , biotin (I know wont stop telogen effluvium hair loss) and adding PRN whatever is needed with labs as we go.

As far as vitamins, no to the ADEK, I’ll link the best one here.

VL-2, the updated replacement for the Vitalady list.

This list took the original Vitalady list, and under the prevue of quite a few long term DS veterans who have been using the original Vitalady list and successfully managing their own vitamin levels, we updated recommendations and created this new list. It is still based on the Vitalady list and...

bariatricfacts.org

 

[JackieOnLine]

Taking a PPI for 3-6 months post op as a corrective action helps. Most can stop by the end of 6 months.

I wish I had known it's a good idea to get off of PPIs in the long run. I only learned that much later!