New to OH

I am a new member, but not new to WLS.  I got the lap band in 2005 -- had great success and then 2 years later, struggled A LOT with restriction -- too tight, not tight enough ... went through a band slip and then a band repair.... more struggles...  they said maybe it slipped again ... I gave up and had all saline removed.  Fast forward to Jan 2013 (all weight gained back) and I was determined to do something different, so I met with a doc about DS.  I knew that it was known for long term results and I really want/need a change.  I fought with insurance for a full year -- with no luck -- and so here I am, about to have my surgery Jan 7, 2014.  When I was first banded, online support was huge for me.  I know that I will need the same type of support with this surgery.

 

Here's my first question/issue:  I just went to the education class where protein and supplement requirements were discussed in detail.  I hate to sound uninformed -- but maybe my head was just in la-la land.  I knew there would be requirements, but seeing it laid out on paper, I kind of freaked out a bit.  My surgeon requires 120-150 grams of protein via protein shakes every day, plus 12 multivitamins and 4500mg calcium.  Looking at the numbers, all I can think to myself is "can I reallllly do this?  Is this even possible to sustain long term?"  I am somewhat fearful of failure again -- "losing" at weight loss after being banded was emotionally devastating.  I worry that I am spending a lot of money only to fail again.  It's not that I'm UNWILLING to take the required supplements... it just seems like such a large amount.

 

It made me think that maybe the sleeve would be better?  The supplement requirements are about 1/2 for the sleeve as compared to DS.  I am hoping that some of you out there that have struggled with the same thoughts can help me "work through" them - or provide me with some advice about how to incorporate these changes successfully for the long term.   Or is this doubt in my head enough of a red flag that I should delay my DS surgery ... or go with sleeve only??  I just feel so torn -- one minute I know I want to do it with my whole being... then the doubt creeps in - that small voice that says "you can't do this - you will always be fat."

 

Just a reference, I am 5'4" and 380 pounds... so I have A LOT to lose, and have been heavy/fighting obesity my whole life.  I know I need the change.  I WANT the change .... but at the same time, I feel scared and unsure.  Any words of wisdom?

 

Thanks-

Melanie C.

You can do this, Melanie.  Compared with living with morbid obesity, it's easy peasy.  

I'm 20 months out and never imagined living life at goal without following a strict and intense diet and exercise program as I had to in the past when I lost weight.  I supplement with protein shakes and take about 35 pills a day spread out over 4 doses.  I have labs drawn every 6 months.  Truly these are minor inconveniences compared to living with the side effects of a BMI of 46+ twenty-four seven year after year!  I'm thrilled with my DS.

With the amount of weight you want to lose, the DS is your best bet, not only to lose it but to keep it off long term... check out all the great info on dsfacts.com if you haven't already.      

 

At first, you may need supplements to get in your required protein.  In time, though, you'll be able to eat that much with real food if you're strategic with it.  I'm 8 years out, and keep a bag of powder in case of emergencies (or bad eating days).  Taking vitamins becomes routine, too.  I just set reminders for myself.  

One thing I can offer is that many nutritionists do not "get" what we really need, and usually give sub-standard recommendations.  Stick around and you will learn lots about what the nutritionists don't tell you.

I wondered if it was the right thing up until the night before surgery and then I think I was just too scared to think about it any more. I just knew that it gave me the best chance to take the weight off and keep it off. I'm 8 months out and still appreciate the changes the DS has brought to my life. It's very hard to make the DS fail but it happens. Just much less that the lap band and gastric bypass. All the newbies have that fear of failure but you can get past that.

The vitamin list does sound a little strange to me. We do take a lot of vitamins.  

Also, I don't know what your Doc expects but no one here would expect you to hit those numbers on day one. Liquids first and then work on protein and vits. The shorthand rule on protein around here is to try for 30 grams at the end of 30 days, 60 grams at the end of 60 days, and so on for 90 and 120. I found that after the first two months I could move that along a little faster once I had time to heal. Once you get in more protein from food you will be able to cut back on the shakes. I take one double scoop shake in the morning (total 48grams of protein) and get the rest of my protein in from food. Usually between 150 and 200 grams. I add another shake at night if my schedule doesn't allow mw to get in an adequate amount of protein that day.

We do take a lot of vites. There are a couple of things you might want to follow up with them. Ask them about breaking out the vitasmins instead of all the multi's. It might seem daunting at first but gives you better control. Also ask about vitamins A,D,E, and K.  These are more of a problem for many DS'rs although there are some exceptions. Most of us take our vitamins separate with one or 2 multivitamins mixed in. Personally I think that is a lot of calcium. DId they give you any kind of schedule on how they want that broken up through the day? You might want to go to vitalady.com and look for her listing of a DS vitamin regimen. Mostly that is a high end starting place for a lot of people. Maybe print the list and talk with the NUT (nutritionist) about the differences between the Doc's vitamin list and that one?

Good luck. At  8 months this was the best decision I ever made but I have walked away from the post op vitamin list I got from my Doctor. Not an issue with them as long as my labs are OK. Mostly I take more than they think necessary.

Every surgeon seems to give different advice on protein and vitamins, and I don't know exactly what your surgeon expects of you as far as timing goes, but it would be impossible for you to meet these requirements early out. Your main focus once you get home will be on staying well hydrated, and that by itself can be a full time job. If some of that hydration comes from protein drinks, fine, but get down whatever fluids work for you. Your body has protein and vitamin stores to get you through the first few weeks. My surgeon told people to start vitamins at 3 weeks post-op, and had no specific protein shake requirements for the early days. Once you start eating, focus on protein and work your way to normal eating, which will take awhile (though this varies a lot from person to person). Foods that worked for me back then were soft, easy to digest stuff like scrambled of soft boiled egg, egg drop soup, shrimp, scallops, tuna with lots of mayo, cottage cheese, that sort of thing.

Don't panic if you can't eat more than one or two little bites of food at a time. Your stomach is healing. It will all become more normal with time.

And it's ok to be scared. You seem to have a good understanding of why you need the DS. This will be a completely different experience from lap band, with far better results.

Larra

 

Every surgeon seems to have different requirements post-op (and pre-op for that matter.

I have never heard of anyone suggesting 4500 mg of calcium per day. Most DSers range from as low as 1800 to as high as 3000. Do a search on this site of "calcium and DS" and read for yourself, everyone's experience with calcium. Because most of the duodenum is bypassed (and that is where most calcium is absorbed), the need for calcium supplementation is real. Keep in mind, that even without the DS, most women should be taking additional calcium every day anyways.

I am not sure about the 12 multivitamins either. Your surgeon may run a little business on the side where he/she requires you to purchase "their" vitamins. Be assured that most of us get our vitamins from Vitalady, Vitacost, amazon, Walmart.....wherever we need to go to get the most bang for out buck, and get exactly what we need. Commit to your dr about the vitamins (if he is indeed selling them), but read up on what most people do, and make changes accordingly. Most surgeons nutritional after care, is simply not very good.

I recall hearing someone else post about their surgeon requiring protein shakes some time ago. Many of us never have protein shakes and get our protein from food only. Many of us opt for the protein shakes to ensure we get in our protein. Protein shakes are a choice, not a requirement. The main point is that you will need additional protein, the amount of which, is a frequent topic of discussion among DSers. Some shoot for 90. Some shoot as high as 180.

I aim for 90 grams of protein and my protein values in my last lab test were actually higher than they were in the five years before my DS. I've had two protein shakes early on which made me deathly ill, and I've never ventured back! If my labs dictate the need, I may try them again, but for now, I dont need them.

The sleeve can be successful, but with the amount of weight you want to lose, IF you can commit to the DS lifestyle after surgery, the DS will give you the best choice of permanent weight loss.

Lastly, the best chance of success is to pick an experienced well respected DS and/or DS revision surgery, depending on the complexity of the surgeon. I would request feedback from your surgeon's patients, specifically related to the surgery you are having.

Read pages and pages of information here and on other forums/facebook etc. You will find support in many places. Best wishes on your journey. May it be successful and life changing!

Thanks for all of the information and advice.  Yes, my surgeon did tell me that the protein and supplement process will be very slow at first - he's not expecting I get all that in from day 1.  :)   I know from my experience with getting the lap band and being involved in support that all docs seem to have a different "view" on requirements - so for now, I will follow what I have been told and see how the future unfolds.  It does make sense to me, though, that eventually real food (protein) would replace the shakes - and I am hopeful that is the case.  I will also look into the vitamin issue and make sure I'm getting the right things in -- his office doesn't actually sell vitamins, they have recommended Costco or Walmart as options for finding what I need, so I don't think it's a monetary gain issue for the doc.

I am reading as much as I can and visiting all the recommended sites.  I do feel better and more sure of my decision the more I read.  I started a pre-surgery liquids only diet today - so far it's not so bad, but I know day 2 and day 3 can be horrible.  :)

 

Thanks again!