First "educational" DS class

Hello! So today I had my first educational NUT class. I was expecting it to be a lot worse than it actually was! The class was made up entirely of DS patients (2 revision to DSers) which was nice. The educational paperwork was also geared toward the DS life, as apposed to the RNY life (surprising, I know!). But there were a couple RNY-esque comments that made me raise my eyebrows.

First off, I am having to do liquids for 3 weeks pre-op and 3 weeks post-op. For the pre-op, they required we buy BariEssential shakes (1 tub per week) which came to a whopping $225 for 3 tubs. They gave us a taste test of the chocolate and vanilla types, which was a plus. Usually you're stuck with whatever you think sounds best. Also, they recommended a brand of chew-able vitamins called Celebrate Bariatric Vitamins. Anyone heard of those? So after the 3 weeks of post-op liquids, we get to switch to "full liquids", whi*****ludes cream of wheat, scrambled eggs, and blended tuna/chicken salad. That was the first eyebrow-raising moment. The NUT said "make sure to mix your tuna salad with LOW FAT mayo... Um, no thank you!

The 2nd thing she mentioned is that "dumping is common with the DS and RNY", which I know for a fact it's not. I'll keep my pyloric valve, please :-)

Anyways... I honestly can't complain. It was pretty informational and it was nice to spend a couple hours with a few other DS gals. Pretty impressed with Dr. Kim's pre-op regimen thus far. 

Quick question for the vets- I asked the RN what length common channel Dr. Kim uses and she said "I think 75". Is that about average? I expected maybe for her to say 100cm or 125cm, but 75 seems pretty small. Opinions?

You're right, 100cm common channel is the most popular but 75 isn't unheard of. The drinks they're selling and the Celebrate are gimmicks and I would wonder if they get kickbacks. When they put everyone on the same thing it makes it easier for them to manage patients even though it might not be the best for you personally. The length of time they have you on liquids is excessive, IMO, and not the standard either. They sure want you drinking their gimmick brew a long time. Just makes me go hum.

--gina 

I agree. To be honest, I'm going to drink their shakes for pre-op (they were actually pretty tasty!), but I plan to do my own thing post-op. I'm not messing around with their gimmicks after I have my DS. Not worth the potential issues. I didn't buy those vitamins. Just ridiculous that they would even push those before we have had any labs done. 

It's not really a bad thing to get in the habit of taking vites pre-op, just know that taking them at post-op levels could lead to hypervitaminosis (vitamin toxicity).

It's a good thing to get copies of your pre-op labs, just to have a baseline to see what your levels are as a normie.

First I want to say I'm not an expert on most of these questions. I am also just getting approval for revision surgery from RNY to DS and my Dr. Is very vetted, Dr. Roslin in NY. That said is your Dr. Kim in TX? If so I was told he didn't preform this type of surgery when I called. Dr. Kim was my surgeon in 2000 performing my RNY. I am not sure what type of surgery you are looking into but if so please vett him. Ask questions. Call his office and make sure he is also the same Dr. Kim who worked at Beth Isreal in Boston. Also I would be concerned about such a long liquid phase and any "buy our brand" I would suggest you let them know your budget and there are much cheaper and just as good drinks out there. They sell many in the 10 dollars a tub range that are great. Just my personal experience good luck

If your surgeon is using a val-trac ring the soft foods postop are necessary.  Find out.  But the stuff you are being sold is not necessary at all.  And those vites are not for you long term.  Look up vitalady and see what you really need.  For a few weeks postop they are just fine but don't make the mistake of thinking you should stock up!

75 is what I have too.  But be sure to ask your surgeon.  Don't rely on the NUT who 'thinks' it is 75!

Immediately postop, lower fat is not a bad idea.  But that means don't use low fat products, just don't seek out fat till you are out of the diarrhea stage!  And if you do get diarrhea, treat it!  Imodium, imodium, imodium!

I went to a seminar my NUT put on where they offered free samples of Celebrate vitamins. They seemed OK as long as you knew what you needed but they were more expensive than I could get other places. They might be a good choice for some chewables the first month or so.

My surgeon did liquids pre and post op. It took me about 4 weeks post op to get to solid food. A lot of Docs don't do that. I was a happy guy when I got to the puree stage. 

It must be nice to have a room full of DS'rs. I was the only DS'r in my post op nutrition classes. 

Same here!  I am the only one that was at all of mine.  My doctor is very specific about who they do the DS on.  A BMI of 50 and higher is required with some pre-existing conditions.

Hi Pete! It was definitely nice to have some real-life DSers to talk to. Dr. Kim is really expanding his practice to cover the DS and it was nice to have some good information. I see that a lot of people aren't having to do a liquid diet pre-op, but I'm not really worried. It will be good practice for afterwards and it will be nice to lose some weight pre-op. My surgeon said since my BMI is higher, any pounds lost will help with shrinking the liver. 

75cm is the shortest "normal" accor5ding to the literature...and my CC is 75cm.

I have read that 75-125cm is the normal range, but it seems I have seen some on the board post a CC as long as 150cm.

The pre-op liquid diet is supposed to help the body use the fat stored in the liver to shrink it, and reduce the chance of injury during surgery.  Some surgeons require it, some don't.

Post-op liquid is for healing purposes, but I was on liquids 4 weeks post op. 

As for the vites and the shake mix, they're probably getting something from the companies that make them, and that's why they're  pushing those brands.  Check Vitalady and the web for your pre-op/post-op vites and shakes. 

My hospital also gave us a formula using skim milk and powdered milk for an inexpensive protein supplement.  I think it was 3 parts skim and one part powdered milk.  Don't hold me to that though, because I never used it, and I'm at a loss to find the program sheets now! (4.3 years out!)