Insurance Approved and DS scheduled! New Questions...

Reading the lab reports is easy. They include the range you should be in alongside of your results. I look to those here and on the facebook to learn how one affects another. Most docs dont make a copy without you specifically asking. Be sure to compare your readings from your last tests and watch for up or downward trends. Many docs dont bother to do this, only checking to see if your numbers are in range, so they miss signs of emerging deficiency.

Vitalady.com has a starting recommendation for DSers that is awesome. I have seen nobody go deficient that took her recommendations from the start. These are not bariatric multis, but a collection of what we need. She does offer a packaging that has everything sorted out for each day. After about six to twelve months of comparing test results, you can start to adjust to what you really need.

OK, I'm probably not the person who should answer your questions. I had my surgery last December. It was an open DS with gall bladder removal and hiatal hernia repair. I was initially in the hospital for 5 days, then I was back off and on for 40 days. I had complications. After I got past the issues that were causing me to be hospitalized, I had to get over being weak. Learning how to eat was not as hard as I thought it would be. I wasn't hungry. I set timers on my phone so that I would know when it was time to eat again. A couple of bites and I was done. I wasn't in discomfort per se, I was just sick. The surgery wasn't bad, my body's reaction to it was. I do still supplement with protein. I've found that Premiere Protein drinks taste the best. As far as the vitamin intake, I follow the Vitalady guidelines. I order my vitamins from Amazon--we live in the middle of nowhere and I have to drive at least an hour to get to the closest Wal-Mart. In addition to the vitamins, I take a probiotic and Moringa for skin elasticity. I also wear compression garments to help keep from having hanging skin. (I know, it sounds weird, but it works. As soon as your wounds are healed, start wearing girdles--legs, stomach, arms, back--anything you can find a girdle for. They have them for virtually all the areas of your body. I don't have hanging skin around my stomach and a friend of mine who laughed at me for doing this had her surgery the same day as I did. Her skin is hanging down and mine isn't. By the way, I've lost more weight than she has.) Don't worry about your surgery. Prepare as much as you can and leave the rest to God, or your higher power. What happens to me may not happen to you. Besides, you can't control it so why waste your time obsessing about something that may or may not happen? I hope and pray everything goes well for you. After going through the complications, I still would choose my surgery. I'm so much better now that I ever was before. You will be too.

ILoveFlowers -- Such a sweet reply! :) Truly, thank you. I appreciate your persepctive, and for sharing your experience with me. While I neither envy nor wish for the complications that kept you in and out of the hospital for 40 days ;-( I actually am reassured by your description of "learning how to eat" not being as difficult as you thought it would be -- this is something I think of often, as well! Since I'll be starting out on "clear liquids" and the liquid diet post-surgery and just kind of going from there, I'm realizing it's not as *immediately* daunting as I'd initially made it out to be.

Also -- I've wondered about compression garments. Not so much as a remedy for hanging skin, but rather as comfort (even necessity) after a surgery such as this. A few coworkers/friends who've had various bariatric surgeries in the past couple of years have shared their experience with abdoment compression bands worn after surgery, and many said they made them just "feel" better - i.e. negated the pain/discomfort. But not all...I appreciate your perspective on this - thank you. :) And yes -- while I am trying to learn/absorb/plan as much as possible in the weeks leading to surgery, prayer that all goes well with myself and for my surgeon is important. :) Thank you.

• 4 days in the hospital
• Different challenges all along the way. Nothing drastic but the first month stands out because not only do you realize there is no backing out but you stay tired for the first couple of weeks home so you have a lot of time to think. Still just something to get through. I had a lap DS so there was pain the fist couple of days in the hospital but then it quieted down to just a sharp pain when I sat down or got up. I side sleep and that was too uncomfortable for me so I slept on a recliner. It took the whole month before I was near ready to start regular food. First month was liquids and soft foods. After that when I started back on more regular food I needed to figure out how to tell when I was full. Much later I eventually learned the signs but early on I would eat too much and either get the foamies or once or twice I threw up but I learned to weigh my food and was happy that I kept 3 oz and later 4 - 5 oz per meal. Foamies are this funny reaction just short of throwing up - you produce a lot of liquid kind of like saliva, doesn't hurt but just strange.
• I still do Optimum Nutrition protein shakes. Mostly I'm too lazy to fix a protein breakfast and have that instead. Some days when I know I didn't get in enough protein I may have one at the end of the day but I could do without completely if I wanted too. Just a convenience for me at 4 years out. First year I would have never made my protein goals without the shakes though.

First off your labs are always your guide once you have some post-op labs behind you ( 3 month, 6 month). The list I got from my surgeons office was clearly for RnY patients. I did some research and was too intimidated by the vitaldy list so I combined my surgeons list with the recommendations from the ASMBS for the DS on vitamins as a starting point. It was initially challenging because everything was so new and you are thinking if you get it wrong really bad things are going to happen. The truth is if you have a stable starting point and then adjust you won't get in any real trouble before you can correct unless there is something else going on.

Truthfully I was panicked the first couple of months. Now I blame it on hormones :) from my weight loss but I was still scared. It just took time for me to get used to it. It seemed like the first year I was always making some kind of adjustment. Now at 4 years out I do two months in advance and don't really think about it very much.

I had the bariatric vitamin discussion with the nutritionist several times and they never convinced me that it was a better option. You will run across some people that do OK with them but there are also some that don't and you usually don't find out until your first year labs.
My arguments against are:
Can't easily adjust individual vitamins up or down. You can add separate but if you do that why not just go separate to start. Even my early labs showed me that I would need bigger doses for some things than the multis provided. Vit D was my first indicator.
Cheaper to go individual. Bariatric multis are expensive and I've never seen a sale on any of them like centrum or citrical etc.

While I've seen a few people get their vits covered by insurance or at least use FSA money most can't seem to do that.

That's at least a start. I'm sure you'll have a million questions. Feel free to ask. We all had different concerns and worries but given some time it all works out.

Pete

Pete - thank you for sharing this wonderful information and your experience. It seems a recurring sentiment that while there are some things I worry about and am able to control, there is an element of having to wait and experience it for yourself to really understand. A big part of me wants to know, right now, three weeks before I have my surgery, what exactly will I be eating? What protein shakes will I need/want/like? Exactly which vitamins, and what brand, and what dosage, will I be taking? I hate the feeling of uncertainty I have, when I think... "Well, you're not going to know what foods you can and cannot eat until you have the surgery. You like Premier Protein shakes now, but you won't really know if you will still love them after the surgery. You can buy the appropriate "DS" vitamins recommended by your surgeon's office right now, but you need to wait to see how your labs look after surgery to know exactly what you need...." I need to be better at preparing for what I can right now...but taking each thing one step at time, as it comes, definitely seems not only the best, but truly the necessary path to take. :)

And I so appreciate your last sentiment -- "We all had different concerns and worries, but given some time it all works out." Thank you for that! :) It is an attiude and mindset I am using more and more to reassure myself that this is the right decision, and I will know what to do/learn what to do at each step that comes. Thank you.

It's hard because things change as you are healing. I read through you other replies just a few things caught my attention.

Boy, I understand the idea of guzzling water but those days will be gone for who knows how long. Sips when you first post-op are the best you will get. That gets better but at 4 years I still can't guzzle like I used to but I can down 20 oz after exercise in 4 or 5 minutes.

A lot of people start off with the bariatric vitamins recommended by their surgeons and nutritionists. While some people get along by adding what they need based on labs I always found that to be an expensive way to go and, of course, easier to add things than to try and take smaller amounts ( should that be necessary ).

Vitalady published a list of what her experience showed her was a good starting point. I've never seen anyone come back and say the list led to deficiencies. There are some people, like me, that started with a different list based on our own research and adjusted. Really, I think you pick a starting point and adjust accordingly. No one falls over the first 3 months or so of any new vitamin deficiency.

As for foods it was strange for me, although I'm not unique. Sometimes I just wasn't interested in food and had to eat to a schedule to make sure I ate. It worried me for a while but it didn't last all that long. Once I was back on food I didn't really find things that I couldn't stand any more it was more of choosing what I had room for. The first month or so can be wonky and truthfully I think if I had not tried premier protein the first week and found it too thick for my new stomach I would probably use it more today but I got to like the thinner powder and stayed with that.

Pete

How long were you in the hospital for? In the hospital approx 24 hours including pre-op, DS and hiatal hernia repair. I still have my gallbladder. No complications.

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? Well, the good news is that after the first month is behind you, the worst is over. For me, the uncomfortable part is so integrated with the core benefit of the DS. Post surgery, everything felt different, my brain, my sense of smell, sense of taste, the feel of my mouth, my gag reflex, swallowing, my stomach, hiccups and burps, digesting were all different, sensitive and unusually interconnected. I distinctly remember thinking, "Now, I understand the saying. 'Nothing tastes as good as being thin feels.' Because nothing tastes "good." During the first weeks post op, I felt that eating, getting supplements and meds down, staying hydrated and getting some exercise in (just moving the body) was real work. There was no pleasure in eating or drinking. I just didn't feel good. However! During that same time I was losing weight very very rapidly. Since my excess weight was causing me significant health issues and concern for my life expectancy and worry that I would not be around to raise my kiddo. So there were also tons of positive things happening that made it worth it. I survived it by focusing on the positive things that were occurring and considered it my full time job at the time to follow my personal DS handbook.

Do you still supplement with protein in powder/liquid (i.e. shake, etc.) form? yes, I use protein shakes almost every day and have dozens of shake recipes that I enjoy. Thank heavens for torani sugar free syrups.

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 with a goal to work up to the Vitalady DS recommended regimen. This took some time post op but I was very well nourished (wink) prior to surgery so I felt i had plenty of stores. I follow the full Vitalady list with additions based on labs and other health occurrences. The only challenging part is keeping from getting lazy. I have to prepare my vitamin setup ahead of time - there are just too many pills to keep straight and try to pull out the right dose of the right vitamin on the fly. The vitamins take up space to store, are sometimes hard to find to buy. If Vitalady is backordered on something, it takes a little work to find another source. The bottles run out at different times so you are always needing something or you have to do a lot of pill counting to try to order everything at the same time, etc. these can be a tiny bit annoying. But these are such little problem in comparison to the health benefits I receive on an ongoing basis. There are a lot of tricks for this but mostly its trial and error which setup works for you. Also, it is more than a little weird taking this load of pills in front of new people who dont know about my weight loss. But, meh, who cares! If you want tips on pill organizers, vitamin sources, and techniques people use to help stay organized, I'm happy to help - as are others, I bet. I'm always up for hearing others' ideas and tweaking my process, too.

Dogma2Karma -- THIS! :) Thank you -- I so enjoyed the candidness of your response and your experience! So many people express something similar -- I'm worrying so much, right now, about what I'm going to eat after surgery. But I will be so led by my own body/response to food stimuli (taste, smell, desire, etc.) that I will need to just start figuring it out after my surgery.

The vitamins are still something that concern me, if only because they are such a stringent part of the post-DS lifestyle -- critical, non-negotiable. I don't even know if I'm expressing myself correctly -- I kind of feel like the vitamins are this huge test I need to take the day after surgery, and I have the time up until I have surgery to study and cram as much info as possible...and I'm afraid I'm not going to receive a passing grade! But no -- I will start off with what is recommended, and wait to get my first set of post-surgery labs back, and make more educated/informed decisions from that. I've seen other forum users mention this "Vita Lady" -- I am definitely looking her up to see what she offers, at least to start off with.

It sounds crazy, but "nothing tasting good" -- not enjoying eating is something I have almost been looking forward to in those weeks/months immediately following surgery.... My surgeon advocates that patients lose as much weight as quickly as possible after surgery, as that is the "easiest" (fastest?) time for the weight coming off. Thank you, again, for your candid reply. :)