QUESTIONS and a rant...

 I need to wrote my questions down as I think of them.  I have lots, bit the one my husband asked recently is...if they staple the stomach inside after the do the gastrectomy..what happens to the staples  do they dissolve?(hubby does not like staples..mind you he has no medical  training whatsoever..I guess its a pre conceived notion). 

Been lurking here for about a month,  glad I found this. My feelings have ranged from hell no I am not doing the DS....to well this makes the most sense for me.  The hardest thing for me to accept is that I have a BMI of 50...I participate in vigorous exercise 4-5 days a week in the form of jogging/walking, how am I a 50..oh well.  .   The malabsorption part concerns me a little...little concerned about losing too much weight, or not being able to get what I need, or worse, having some sort of complication that affects my ability to work (I am the breadwinner in the household) or my quality of life.  No one goes into surgery to end up with a worse quality of life, and although my quality is good now, I know remaining on this path my quality of life will get worse.   

Working through pre-op requirements including the endoscopy this Friday.  Followed by 3 months of nuttritional counselling and a psych consult. Originally hoping for surgery in March, however, after reading Elizabeth N's post about wrong timing, I am seriously considering changing to late summer to early fall since I work in disaster response and recovery in a region with many states affected by Hurricanes, and being deployed for recovery and subject to irregular hours (12 hour days seven days a week) will not be ideal while my body adjusts to it's new plumbing, will have talk with boss and surgeon regarding those issues before I decide on final date. 

Obviously still working through this for myself, it is interesting to see the process. I have gotten over the surgery itself (not as convinced I will die under the knife, not worried too much about post op pain..it is temporary) , understanding there are risks for every surgery, now workiing through the life long committment....and those fears....

Process...process...process...

The staples are made of a nonreactive metal. They do not dissolve. Hubby needs to get over this. These staples are used every day in multiple types of surgery and have been used for many years now.
     Regarding malabsorption - if your bmi is 50 despite daily exercise and, unless I miss my guess, multiple attempts to lose weight, you will not be successful longterm without malabsorption. As long as you eat plenty of protein and take your vitamins and supplements faithfully and get your labs, malabsorption is nothing to be afraid of.
     And your fear of losing too much weight? Priceless! Seriously would you rather have a less effective operation and spend the rest of your life living in fear of weight regain? Or living WITH weight regain? Or not losing enough weight in the first place? That's the reality with RNY (30% failure rate) lap band (higher failure rate and highest rate of reoperation of any wls) and VSG longterm results unknown but short term looks a lot like RNY. Very few people with DS require reoperation for excessive weight loss; I think you need to keep this concern in perspective.

Larra

Thanks Larra...that is exactly why I am opting for the DS. Before I found this site and started researching, I totally ruled out the lap band, was on the road to ruling out RNY.  When I found Dr. Stewart and received his information DVD the DS intrigued me, and he and I talked about it for almost 2 hours in my initial consult.   It became very clear this choice makes the most sense, unfortunately i came to this site shortly after a member. passed from complications, but I am smart enough to know she appeared to be at the hands of an inexperienced surgeon and got through that.....now just honestly assessing the long term comittment.  Like I said, it is definately a process for me that I have to work through.   

I'm so glad you found Dr. Stewart! He has a great reputation. The death of one of our group was devastating, and all the more so because people begged her to take a little more time and get herself to a more experienced surgeon, esp since she was a revision patient. It was very sad.
     The DS was the only choice that made sense to me, but each of us has to go through that decision process for ourselves.

Larra

staples bother your wife, becasue they don't dissolve?  I guess the question, why, would come up?  I have staples, clips, etc.  they are used not just for the stomach but throughout the body?  I would be much much more concerned with the malabsorption part of the DS, as that is nothing to sneeze about.  Losing too much weight, did you ever think you may not make it to a normal bmi and stay overweight?  everyone is different.  There are many choices to make for any surgery, every decision impacts us in different ways.  I have to dissagree, you quality of life can't be good at a bmi of 50, I think it is insidious, you probably don't know what good is anymore, being a prior bmi of 61,  I opted for the lap band,because I sure didn't want the DS because I would lose too much.   went down to bmi of 19 with the lap band. (yes I am unusal) after a decade with the lap band I developed severe irreversible damage, I revised to the DS 11 months ago.  I love my quality of life now, but weight loss and maintenance is extremly difficult for me with the DS, my bmi is 23 now, and it has been the same for months now, I would like ot lose 10 lbs but it is not budging-so there you have losing too much weight is not always the case.......I love that I can eat like a normal person,geesh with the lap band I ate sooo little,  don't have pain in my chest area anymore, don' t like all the supplements, blood work, no medical professional knowing what hte DS is, but for me the DS has brought back normalcy, as the last 2 years with the lap band were disasterous.....good luck with your choice don't worry about PO pain too much that is temp. and it can be managed

Staples are your friends. Hubby needs to chill, and it's none of his business anyway.

Almost nobody loses too much weight. There's always some bounceback anyhow.

You need to continue that vigorous activity level now and forever, except for while you're healing from surgery. That lean muscle mass is your ticket to far, far better health and excellent weight loss with better overall nutritional status....as long as you eat your protein, cut the carbs wayyyyyyy down (two things you can practice starting NOW) and pay attention to your supplements and labs.

Malabsorption is what you need if you're doing that much activity and still have a BMI of 50+. You have a VERY efficient metabolism, I'll bet :-).

LOL EN..Thats what I told him.  I think he was worried about corrosion inside my body. 

I have started religiosuly tracking my intake on Livestrong.com to get an idea of what kind of protein I am getting in now.   I am pretty good at getting 70 grams a day in.  Carbs are in check when I do not cave to the candy dishes at work..learning to walk around them and drink water when I am craving it.

Overall my husband is in huge gavor of this surgery, and actually was the one who started gently suggesting I look into it WLS about 2 years ago.       I was always a healthy weight and a religious runner until my 6th month into  my first pregnancy at which time I twisted my ankle walking up stairs and quit exercising..problem was I never replaced my running with any activity and used the injury and the pregnancy as an excuse to eat whatever I wanted, I gained 85 lbs...and its been with me ever since.  He feels  I can be a pro at maintaining it because of my love of  exercise and the weight  holds me back from doing what I really want  and love to do (marathons, triathalons, rock climbing, etc) plus being older..gosh if Id only listened to my mother, so much easier when you are 20 and 30 than 40 or 50.    Ultimately hubby tells me (when I am asking his opinion and bouncing things off of him)  its my decision, my body, and his job to support whatever I decide.  When I bring up possibility of any of the complications..hes like, listen to your doc, do what you are supposed to do, and you will be fine..bowel obstrution..no problem they can fix that...deficiencies..they can fix that...I think I am more worried than he is.

I get the supplements for life (have even started taking my multi vitamin, calcium and vit d every day to get in the abit of supplementing every day, I know 6 pills is monor compared to post surgery, the idea is to establish a habit ). I understand labs are vital.  Activity not a problem.    I am even realizing the complications I read on here, are the exception and not the norm.  My mind is in a very different place than it was 4 months ago.  I only want to do this once, and DS makes the most sense.  DS Facts, You guys, and a whole bunch of other things I have read has convinced me of that.

When you say your carbs are "in check", how many grams a day are you eating? I ask because carbs are SNEAKY.

70 grams of protein a day is good for a 'normal' person. As a DSer, I eat a minimum of 120 grams of protein a day, and around 150 on a good day.

 This past week my carb intake ranged from 80 (lowest daily intake) to 159 (highest daily intake) most days were between 100 and 130 grams. 

I knew post op I would have to heat a min of 120 grams of protein a day...so I wanted to see what I am eating now without effort. if I am getting 70 to 80 grams without trying I feel like with a little effort I can achieve that min of 120 grams with protein powder, extra cheese, yogurt, etc...

Yeah, so the staples.  I'm allergic to lots of crap, including metals containing even a smidgen of nickel.  Which is in almost every metal they make.  But it's not in the surgical staples I got.  Call the surgeon's office manager and ask them to contact their surgical supply man to get the metal content if you're concerned.  That's what I did.  Don't bother asking the doctor or his nurse.  They don't know.  The one who orders the nuts and bolts is the one who will know.

As far as metal detectors, I go through one several times a day at work, and my staples never set it off.  I've even had them scan me with the wand, nada.  Must not be enough metal to ping. 

Even really high quality jewelry can give me problems, but so far at 2 years out, not a problem with my staples.