Single-anastomosis duodenoileal bypass with sleeve gastrectomy/SADI-S/SIPS
Most nutritionists are clueless about DS nutrition, I'm afraid. They will likely bundle you in with their RNY information. Some will change the top of the documents to say DS - but many just say WLS and they don't bother to differentiate. Surgeon's often aren't too much better, either. We've shared a lot over the years between each other to help others.
Valerie
DS 2005
There is room on this earth for all of God's creatures..
next to the mashed potatoes
Now, keep in mind that I've had plenty of years to tailor this to my needs, so your may vary some:
- Double dose of Centrum multi (or generic equivalent)
- 2000mg Calcium Citrate, split into two doses
- double-dose of zinc
- copper
- B-complex
- 50,000 iu dry D
- 25,000 iu dry A
Variables
- Some people add a probiotic, while I keep my gut-bugs in line with yogurt.
- I get 100g of protein daily, most of the time just with real food. I keep egg white protein powder in house when I don't eat enough.
- I drink a gallon of fluids per day.
- Many people need iron, paired with vitamin C to aid absorption. I needed it my first year, but not since.
Valerie
DS 2005
There is room on this earth for all of God's creatures..
next to the mashed potatoes
Oh heavens no! Some need to be taken apart from others. Iron and calcium, for instance, completely cancel each other out, so you should take your calcium apart from iron and multi-vitamins (because they usually contain iron).
- I take the multi with my B
- I take copper with my zinc
- I take calcium with my A and D, and split it in 2-3 doses.
Valerie
DS 2005
There is room on this earth for all of God's creatures..
next to the mashed potatoes
Just to catch everyone up and hopefully help someone else:
Awesome visit and I have settled on the SIPS procedure.
The expectations, hospital experience, and after care are all the same as VSG.
He expects a loss of ~85% extra weight (based on the Spanish studies) which would put my BMI at 28, but my body fat % at 21. The studies did not sight the "ideal weight" mean or which BMI formula which does make a difference since the formals vary considerably. For example, being 5'10":
Based on the Robinson formula (1983), my ideal weight is 156.5 lbs
Based on the Miller formula (1983), my ideal weight is 155.0 lbs
Based on the Devine formula (1974), my ideal weight is 160.9 lbs
Based on the Hamwi formula (1964), my ideal weight is 165.3 lbs
Based on the healthy BMI recommendation, my recommended weight is 128.9 lbs - 174.2 lbs
This is all kind of arbitrary, since I was between 200-220 my entire military enlistment and stayed between 15% - 20% body fat.
I will have to take a multivitamin with iron, along with A, D, E, and K, additional iron, calcium, vitamin B-12, and Vitamin D for life to avoid health issues.
The likelihood of losing "too much" weight is unknown at this time, but just like any WLS you can "eat around" the procedure if necessary to prevent further weight loss/gain weight.
The Common Channel will be 300cm which makes it less malabsorptive then other procedures, but will still act as a "safety net" for the sleeve. Spanish studies used a 150-200 and 200-250 common channel, with the conclusion settling on 250cm-300cm as the ideal.
The Sleeve will be a loose 36 fr bougie.
Distance between the sleeve and the pylorus will be 5-7cm to prevent dumping syndrome.
Gallbladder will not be removed since my ultrasound was clear. Out of 1200+ patients only 80 have needed post-op gallbladders removed.
Symptoms of “comfort” issues such as gas, heartburn, nausea, etc. mimic VSG
Does not have a negative impact on the immune system or future screenings/treatment of unrelated health problems such as cancer.
Most importantly for me, this solution will be a powerful tool to help get me to goal and to maintain. To me, it is a “once and done” procedure, which should prevent the need for future operations/revisions!
