Insurance Approved and DS scheduled! New Questions...

Well -- I just found out yesterday that my insurance has approved the BPD-DS (and cholecystectomy, aka gallbladder removal, at the same time). Today, the surgery was scheduled for July 13th -- a mere six weeks away! Ahhh! It seem so cliche that people describe a "rollercoaster of emotion" when getting news of a firm surgery date, but here we are -- I am SO excited, and am actually tearing up with relief and happiness. But at the same time, and this is what really surprises me -- I am suddenly nervous and unsure, emotions I had not experienced at all, up until now. I am not unsure on whether I want the surgery -- there is not one part of me that desires to call my doctor's office and ask them to delay while I think about it longer; I am not even saying to myself, Amanda, do you really want to do this? I know I do. I feel -- I don't know, "unsure" in a greater, more existential sense -- how am I going to live the rest of my life like this?

Lol -- just re-read what I wrote, sounds rambling and doesn't even make much sense. Anyway -- not to worry, I know we all figure it out in the end. I know I will. But I was hoping I could ask some of the "veteran" DS'ers a few basic questions -- I know a lot of this info is generically available with a quick Google search, but I so appreciate hearing real-world responses from individuals who have experienced this procedure themselves.

• How long were you in the hospital for?
• Was the first month really the worst, as I've seen people say? I mean -- I realize it will certainly be challenging, as it is the beginning of a long learning curve of relearning "how to eat." But was there a lot of discomfort? Either from the surgery, or from eating the wrong thing?
• Do you still supplement with protein in powder/liquid (i.e. shake, etc.) form?
• This is the big question, something I considered putting in a separate post by itself -- how do you manage the vitamin intake? Do you take the vitamins recommended by your surgeon's office, or did you to begin with? Do you tailor your own vitamin intake based on your labs? Have you found it challenging? And does anyone take bariatric multivitamins that are covered by insurance?

Thank you, in advance! Now, back to my cliche rollercoaster of emotion...!

Congrats on your date. I'll try to answer some of your questions (I'm 14 years post-op).

• How long were you in the hospital for?
  • I was in the hospital for 4 days. My surgery was performed lap and I did not have my gallbladder removed.
• Was the first month really the worst, as I've seen people say? I mean -- I realize it will certainly be challenging, as it is the beginning of a long learning curve of relearning "how to eat." But was there a lot of discomfort? Either from the surgery, or from eating the wrong thing?
  • Actually no discomfort or pain at all (done lap). You need to follow your surgeon's guidelines about how to eat, how much, when etc. If your surgery is lap, you actually have to remind yourself you had MAJOR surgery. I took a month off work and by week 3 I was really starting to feel like myself. When I did go back to work, I went back part-time for two weeks. That really helped ease back in. I was fortunate to have had plenty of sick time plus short term disability so I never lost a day's pay. Also remember you're not really "eating" in the true sense of the word. First few months you're literally eat a couple of bites at any one time. I could take an hour to "eat" a meal. You find yourself eating something every couple of hours, even if its just a few bites of something, a half an egg, a few spoons of yogurt or cottege cheese. Finding the balance.
• Do you still supplement with protein in powder/liquid (i.e. shake, etc.) form?
  • No, but like I said I'm 14 years post-op. I think I did supplements for about 6 months or so. The goal to remember is 30 grams of protein by 30 days post-op, 60 grams by 60 days, 90 grams by 90 days. Doesn't matter how you get that protein in. Remember you're also balancing fluids. You should ALWAYS have a water bottle with you. I didn't want to rely on supplements (also when I had my surgery the supplements were disgusting).
• This is the big question, something I considered putting in a separate post by itself -- how do you manage the vitamin intake? Do you take the vitamins recommended by your surgeon's office, or did you to begin with? Do you tailor your own vitamin intake based on your labs? Have you found it challenging? And does anyone take bariatric multivitamins that are covered by insurance?
  • I started out taking the bariatric vitamins my surgeon sold (Vita-4-Life) though not covered by insurance. By the first set of labs at 6 months postop, I was starting to show deficiencies so I ultimately switched to follow Vitalady's recommended vitamins for the DS (probably spent a year on the surgeon's vitamins). I've modified them over the years based on my lab results. Vitamins are definitely the biggest learning curve. Even at 14 years post-op I'm always tweaking what I take. All based on lab results done once a year.

Keep asking questions!!

Thank you for the reply -- I agree, thinking about your answer to the "first month being the hardest" -- there won't be actual eating there, will there. Liquid intake, soft food intake, etc. No rushing getting to baked chicken or grilled steak...

I guzzle water, now! I drink about 1/2 of a 32 oz camelbak eddy bottle at a time...usually get 64 oz in in the first hour of the morning. I am going to need to learn to sip, continuously. That'll be a learning curve, too...

And yes -- the vitamins are what weight heavily on my mind. Thank you for your candid answer - the surgeon's office does sell a specific bariatric vitamin and I will likely go with that, at least in the beginning. There'll almost be a lifelong learning curve on that, I suppose. Lots of learning going on, haha! But that makes sense -- a lot of learning must happen for a complete lifestyle change.

Save your money. Those bariatric vitamins are overpriced and woefully inadequate for DS

100% correct! Go to vitalady.com and get her DS list. Buy from anyone you choose but her list is probably the best. Those bariatric vitamins are great...for your doctor! Not for you!

And you most likely won't walk out of the hospital and just start slamming down the vites either. It will probably take a couple weeks to start getting them all in. Do the iron last because that's the one that most people have the worst time with. Start the calcium first, especially if you have diarrhea in the beginning.

And if you have diarrhea, treat it! Imodium is your friend.

• How long were you in the hospital for? I had an open ds (with gallbladder and appendix removed) and was in hospital for 5 days.
• Was the first month really the worst, as I've seen people say? I mean -- I realize it will certainly be challenging, as it is the beginning of a long learning curve of relearning "how to eat." But was there a lot of discomfort? Either from the surgery, or from eating the wrong thing? I struggled big time eating and consuming fluids postop. My new stomach seemed so small that I could hardly get anything in for what seemed like forever. The vets here were VERY helpful at telling me to stfu and drink or else LOL! I ended up replying heavily on protein shakes and just experimented with food.
• Do you still supplement with protein in powder/liquid (i.e. shake, etc.) form? No, but I'm 9+ years postop. I stopped with having any shakes at probably 2 years.
• This is the big question, something I considered putting in a separate post by itself -- how do you manage the vitamin intake? Do you take the vitamins recommended by your surgeon's office, or did you to begin with? Do you tailor your own vitamin intake based on your labs? Have you found it challenging? And does anyone take bariatric multivitamins that are covered by insurance? i followed my surgeons recommendations and then as I got farther out relied more on the vets here to help me figure out what I needed based on my labs and purchased through vitalady. Now I buy my vitamins locally. I have never been able to manage my iron orally and have been really on infusions multiple times a year for about 7 years now.

Thank you for your reply -- I see on your ticker your goal weight was reached in 8 months post-DS -- wow, those are impressive results. I'm not sure why, I'm surprised that everyone seems to be in the hospital for so long. I realize I hadn't asked my surgeon what his estimate of how long I'd be in the hospital was -- I was thinking one night overnight, maybe two.

It does sound like liquid/shakes/protein supplement is going to be a big part of the food intake that first month, even those first several months. It makes sense that slow experimentation is needed to figure out what works and what doesn't work.

The ds is powerful **** I was 118 lbs at 16 months postop and had to work my ass off fix that! Feel free to take a peek at my profile for pics.

• How long were you in the hospital for?
  My open DS was 12 years ago. They also removed my appendix and gallbladder while they were at it as a precaution. I was in the hospital for 4 days.
• Was the first month really the worst, as I've seen people say? I mean -- I realize it will certainly be challenging, as it is the beginning of a long learning curve of relearning "how to eat." But was there a lot of discomfort? Either from the surgery, or from eating the wrong thing?
  It took me a good six weeks before I started feeling like myself again. I progressed from pain to just discomfort within a few days of being home. What I wasn't prepared for was the fatigue and listlessness that seemed to never end. I'm glad I took 8 weeks off, so I was back to myself and had worked out a routine for eating, vitamins, and bathroom before returning to work.
• Do you still supplement with protein in powder/liquid (i.e. shake, etc.) form?
  I absolutely hated all protein supplements, so I was motivated to get my protein from real food...more cheese and custard than anything else at first, but I did it. I think it took me about six months.
• This is the big question, something I considered putting in a separate post by itself -- how do you manage the vitamin intake? Do you take the vitamins recommended by your surgeon's office, or did you to begin with? Do you tailor your own vitamin intake based on your labs? Have you found it challenging? And does anyone take bariatric multivitamins that are covered by insurance?
  My surgeon sold me on some bariatric vitamins that they sold. DS dosage was 12 pills per day, and I started on day 4 post op. After three months, we took labs and my levels tanked! Around that time, people started sharing what they were learning they needed, so I started paying attention and took control myself. Many medical professionals will spit out their coffee when they see what I take, but I dont take as much as others do, and I kindly explain that to them. They see my labs and then trust that I know what I'm doing. IMO, bariatric vitamins aren't worth anymore than Centrum, however they can cost 5x more. The surgeons and nutritionists that work in their office are useless to DS patients, so don't put a lot of value in their advice.

Thank you for sharing your experience (sorry so late in replying, I haven't logged on in a couple of weeks). I think I am underestimating how long I'll be "out of commission" for, so to speak, after the surgery -- I was hoping to be back at work within a week or two. I work a desk job with plenty of time to get up and move around, but that won't make much difference if I'm still just feeling subpar recovering from major surgery. And -- thank you for your perspective/info on the vitamins! This is one of the things giving me greatest concern right now -- I generally trust in what the doctor says/prescribes, but the ongoing opinion here definitely seems to be patient-directed, each patient determining for her or himself what is best needed based on their own lab results. Does anyone help you interpret those? Others on these forums? Your other physicians?

Again -- thank you for your candid response! :) I appreciate all of the real-world perspective/advice.