Pre-Op Advice?

Other doctors have told you to go back to the Bridges Center?  Think about why that would be.  Perhaps because no US surgeon wants to open up to a mystery bariatric surgery?  Duodenal Switch Revision surgery is COMPLICATED.  You need an EXPERIENCED surgeon.  That's not a surgery you want to travel to Mexico to have done.  Do some more research into Juarez. 

Exactly what was non-standard about your original surgery and what was it?  What were you told it was?  Did you get a post operative report detailing exactly what was done to you?  Who was your surgeon?  Center of Excellence means absolutely nothing.  You STILL have to do your due diligence.  That means seeking out patients who didn't die from the surgery you are going to him for.  REVISION patients.  That's totally different than a virgin DS.  It requires AN EXPERIENCED SURGEON. 

YES, you should be concerned about this surgeon. There have been alarming posts about him for years, and what is also concerning, is that they seem to get cleaned up on this site.

When we come here for research, finding out butcher-like histories are things we need to find. I'm sorry I can't give links for you without getting this post pulled, but keep researching.

I travelled over 2 hours to get to a surgeon. The DS is a HUGE surgery and often takes hours to complete.

Just my opinion- but I'd travel to NYC and fork out the extra money. Dr. Roslin is one of the best and has been doing this surgery for a long time, he has done 1000s of them- and has a very very very low complications rate.

Will the travel suck- yep. Will it suck worse to have a surgery botched by an inexperienced surgery- you bet! MUCH WORSE!

Also add vitamins A and E.  DSers are prone to deficiencies in the fat soluble vitamins, which are A, D, E K1 and K2.

Hi Lex,

    If you think you can do a meal a week I don't think it hurts anything. I don't think I could have switched off and on like that. Docs are all over the place on the pre-op liquid diet. I have to say I've never heard about the firm/doughy stomach thing. My Doc told me the only issue would be if they started lap and there was too big an immediate layer of fat to be comfortable with the instruments going in he would not do it. He doesn't do open DS so that wasn't an option.

    The two reasons my Doc gave me for the pre-op liquid diet was to provide a little more room around the liver to make the operation easier and that studies show better long term results if you lose some weight before the operation.

    Have a safe surgery.

Pete

Lex, I have such mixed feelings about your plan. I agree with others that, if at all possible, it would be much better to have a surgeon who does the DS regularly and is comfortable with it. On the other hand, I understand that not everyone has the same options. If you are in a financial position to travel to NYC and Dr. Roslin, that would be the way to go. But maybe you aren't in that position.

If you do stick with your present plan, have a good conversation with your surgeon ahead of time as to what is acceptable to you and what would NOT be acceptable to you just in case, for whatever reason, he can't do the DS. And then PUT IT IN WRITING (not trying to shout at you, just that it's really, really important). For example, if all he can do is the sleeve, fine, you get a sleeve, which could be revised to the DS in the future (by a different surgeon) if need be. Not ideal, but not the end of the world. On the other hand, you might feel that RNY is totally unacceptable to you, esp since it's so very different to live with than DS, has results so inferior to the DS, and is so difficult to revise to the DS. If so, put "no gastric bypass" on your consent form and again, discuss this before your surgery with your surgeon.

Maybe you want DS or nothing - discuss it and put in writing. I don't know what your feelings are and I'm not telling you what you should feel, just that you need to communicate your wishes clearly and in advance both verbally and in writing.

Personally, I would have traveled as far as necessary, even out of the country, for the DS. I'm glad it didn't come to that, but I was ready to drag my MO carcass onto an airplane if necessary. But you may have different wishes, or different personal or financial limitations. Think over your options and make the best decisions for yourself that you can. Whatever you decide, I hope things work out well for you.

 

And by the way, last suppers are totally unnecessary with the DS. While you won't eat much right after your surgery, eventually you will be able to eat anything, though never in the amounts you did before. That's another great thing about the DS - there are no foods that are forbidden for the rest of the life.

Larra

Thank you all for your responses.  As far as I'm aware my K isn't low (I'm not sure that it was tested).  My PCP recommended calcium and vitamin D and the supplements I picked up just also happened to have vitamin K.  I'll pick up some A and D this week.  I knew I'd have to take them post-op but it hasn't occurred to me to start now.

 

The diet my nutritionist put me on doesn't leave me hungry and I'm not really battling any cravings with the exception of the first day of my period when I had some sf chocolate pudding.  I tried to do a cheat meal (one of my favorite pasta dishes) and it did not go well.  Apparently I've been doing too low-carb for a little too long to be able to handle a carb-heavy entree without unpleasant gastrointestinal effects.  That said, I think next week I may try a carb side (probably a piece of festival or a ginger and cranberry scone).  At some point I want to have a slice of my favorite pizza because I can think of no DS-friendly way to do deep dish, no cheese, bbq sauce, bacon, pineapple and black olive pizza.

 

Thank you again for all of your advice!

Okay, I guess I need to be a little more clear.  DO YOU KNOW YOUR LAB VALUES?  You need to get a copy of your lab results.  Not hard to do, but you do have to ask for them, they won't hand them out without you asking.  Then, look at them.  On the side of each result, there will be a set of parentheses (    ) with the low to high reference range in there.  If yours is low or high, it will be in BOLD numbers, with a H or L next to it.  You can read your own labs.  Next, download a spreadsheet for your lab results.  Key in your numbers.  Then next lab, do the same.  This way, you can see your own "trends" and react by tweaking your vitamin supplements.  That's what most of us do, we keep track of our own lab records. 

Have you dug a little deeper into your chosen surgeons' track record?  Have you taken a look at the "vetted" DS surgeons list at DSfacts.com?  If you are warned about a surgeon and go to him anyway, you get what you get.  You very well may NOT end up with a Duodenal Switch.  Check out the SADI Loop thread here.  She said over and over she got the DS.  She did NOT.

 

 

I HAVE ALL OF MY LABS - nothing is abnormal.  My D was low a year+ ago so I'm still taking some now even though it's now in the normal range.  My iron is normal but I have a history of iron deficient anemia so I continue to take it.  I take calcium because my PCP recommended it based not on any abnormal labs but on being over 30.  The C and K I take simply because they were included in the brand supplements I ended up with.

 

Yes, I am having the DS and not a variation.

You need to make sure that it is Calcium CITRATE and the the D you are taking is DRY D3.  Post op you will have to take the 50,000 unit DRY D3 caps.  You can only get these on Amazon, BioTech or Vitalady.  You cannot get them at a store.  Also DRY A-25, DRY K1-1000 and DRY E 800.  Those are the standard ones that most of us take.  Any combo ADEK's are useless and a waste of money.  Keep that in mind.