How We Moved and What We Ate On One Thirteen Nine

Nada so far.  No major pains to report.  Oh I did get out of and breathered in nine degree air.

Two SlimFast

One ounce cheese

Two cups chili, one pork chop, one cup brussels sprouts, popped corn, water(64)

Four halls, five floors down and five floors up

Aaargh! I almost missed the whole day!

Breakfast and Snack (long Mom's coffee gathering):

4 pieces of quiche
piece of birthday cake
cinnamon roll
1 small cupcake
3 cups of coffee

Lunch:

1.5 cups of loaded mashed potatoes (extra butter and cheese)
some lemonade

Snack:

1.5 Cheese garlic bread sticks, dipped in marinara sauce

Dinner:

1 large gyros (meat, pita and with onions fried in butter)
lemonade

Snack:

probably nuts, cranberries and edamame mixture

Whats loaded mashed potatoes? Sounds yummy!

After having your DS, you can still eat that kind of food? I had a RNY and I can eat just about anything, but I stay away from fried foods and butter because I dont want to regain my weight. Are you worried about regaining your wieght with eating that? I am just curious becasue it seems you are eating fried foods. (I hope this does not come across badly or anything. I was just curious.)
Thanks!
Jill 

Whats loaded mashed potatoes? Sounds yummy!

After having your DS, you can still eat that kind of food? I had a RNY and I can eat just about anything, but I stay away from fried foods and butter because I dont want to regain my weight. Are you worried about regaining your wieght with eating that? I am just curious becasue it seems you are eating fried foods. (I hope this does not come across badly or anything. I was just curious.)
Thanks!
Jill   
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Hi, Jill!

Oooh.. .Loaded mashed potatoes are my go-to comfort food when the weather is crummy.

Ingredients:

Red potatoes, boiled to soft
sour cream
butter
bacon
green onions
cheese

A serving (about 1 cup) has about 10-15 g of protein in it. When I reheat some for myself, I add more butter and more cheese to up its fat and protein some more. After having a DS, this is considered practically "health food." The DS has more malabsorption than the RNY. We only absorb about 20% of the fat we eat.

I've had labs drawn at 3, 6, and 9 months and my diabetes is gone, my cholesterol is rock-bottom. I'm just as amazed as you are!

We need lots of protein (like RNYs do) and fat (so we don't have constipation). If anything, it's the simple carbs that will do me in. While we do NOT have dumping, simple carbs can slow down weightloss and cause a few pounds to creep on. That's why I'm posting to the daily food thread--to keep myself accountable for those!

As to weight regain, I'm not worried. The stats on the DS are solid scientificaly and anecdotally. According to recent consensus guidelines issued by the American Society of Bariatric and Metabolic Society and the endocrinologist guys, after 7-10 years, DSers have an EWL of 60-80% while the RNY has an EWL of 25-68%.

http://www.aace.com/pub/pdf/guidelines/Bariatric.pdf.

Right now, I am still losing my weight (about 174 pounds down so far in 11 months, 13 of which were during the last month). I have about 15 more pounds to go until I hit my surgeon's goal.  I exercise regularly, take all my vites and I follow my surgeon's guidelines. I have no crystal ball, so I can't predict what will happen to me, but I like my odds.We'll see where I end up.

I am NOT offended by your questions. In fact, I am one of the ones who loves to "pay it forward" and tell people about the DS--a weight loss option with incredible results and an incredible post-op lifestyle. I want people to know they can demand something they think is better, even if that means switching insurance, going out of town for surgery or fighting insurance (I did all of the above). I am sooo glad I did. I love my DS. (BTW, there ARE some Illinois DS surgeons, I just wanted mine.)

I welcome any respectful questions like yours, anytime!

If anyone reading this wants info on the DS, please visit the DS forum here, or www.dsfacts.com. If you are considering a revision to the DS, please be sure to see an experienced DS surgeon.

Have a great day!

Nicolle

Nicolle- Thank you SO much your your reply! You really summed it up for me and I am grateful you did not take offense to my questions. I see how a RNY and DS are so different. I wonder why surgeons dont reccommend a DS vs. a RNY. I picked the RNY becasue thats all i knew and it fit for my lifestyle. I needed a reminder of not to eat certain foods. Although I can really eat anything at this point. How are your portions sizes? Do you eat small meals like RNY ppl? I think I eat a normal amount of food now. I still wont be able to finish a whole meal, but its more than in the begining. Why did you choose DS over RNY?

Thanks again for sharing Nicolle! I really appreicate it!! Congrats on your AMAZING weight loss!! WOW is all i have to say!!!!! I bet you look fantaistic and feel great!!!

BEst wishes and talk to you soon!
Jill 

Oh boy, you have opened the floodgates, Jill!  This is LONG and only my opinion!

Well, I believe there are lots of reasons surgeons don't recommend a DS over a RNY.

1) The main reason is that they do NOT know how to do it!
2) Another big reason is financial.
3) Misinformation

1) The DS is a more complicated surgery to do, because you have to keep the pyloric valve intact and cut lengthwise, up the stomach, instead of a straight lop, straight across the stomach to make a pouch. Then you have to rearrange the intestines. That part is harder than the rearrangement of the RNY innards, as well. It's a longer surgery and more could go "wrong" in inexperienced hands.

2) A surgeon usually proctors with a DS surgeon for about 6 months to learn it. Most docs do not want to take the time off from their busy, cash-cow practices to learn it. It's hard to blame them.

Even the world's best DS surgeons can only do 1-2 DSes a day at most and it requires regular follow-up appointments for years. (Many argue Lap-Banders and RNY patients should have regular follow-up appointments for years too, but it is not always the case, sady. Some are just given a pat on the head, told to take a multivitamin and sent on their way until the first signs of malnutrition pop up. And by then, it's a crisis. DS docs require frequent follow-up with their patients to stay on top of their care, which takes away fro time they could be doing new patients.)
Most docs do not want to jeopardize their profit margin. They can do lots more Lap-Bands and RNYs in the same amount of time, with minimal follow-up. And now, Lap-Bands require lots of quick fills and unfills, which are easy to do and provide lots of profit for the docs. Keep `em coming back for more at hundreds of dollars a pop. Why would you want to stop doing this type of business?

3) Misinformation. Years ago, there was a WLS called the BPD/DS. People had it done, lost tons of weight and often suffered bad after effects, extreme malnutrition or died. Even lots of today's bariatric surgeons don't seem to know the difference between today's vastly different procedure and the old one. It's maddening.

They also say that the DS is for people with BMIs over 50. That's not true, either. A BMI of 35 and over, with comorbidities, do great with it, too. Just check out the DS forum.

And that misinformation tickles out to the public and there ya go--misinformation abounds.

Insurance companies are part of the problem, too. They still think of the DS as the old surgery and call it "experimental." A DS costs more to do than a RNY and definitely more than a Lap-Band, so they don't want to pay for it. They'll find any reason to not pay more!

Even our slow-moving federal government started covering the DS via Medicare three years ago!! So now, more insurance companies like mine, Aetna, pay for it. They are starting to figure out that it's cheaper to pay more for this upfront, since it has a 98% cure rate of diabetes, and does not need to be revised. Lots of people have fought their insurance companies for their DSes and won, so the tide is turning.

Slowly, steadily, study after study is coming out showing that the DS is the way to go for successful, long-term weight loss and resolution of comorbidities. I think when consumers start demanding more, then we will get more options from their surgeons. I hope that someday, none of us ever has to get cut open to fix our obesity, but until then, I am grateful for the DS.

As to why I chose the DS, I met with a few docs in the Chicago area and none recommended the Lap-Band for me, as I had a lot to lose and they told me I would never get to goal and not be able to keep the weight off. Now that I know what I know about this "easily reversible" option, I am grateful to these docs. It is NOT easily reversible and can cause a lot of harm to your body since your body has started to accommodate this foreign body by growing over it, etc.

Plus, I did not want to diet ever again. The LapBand seemed like a diet to me and I was good at cheating on diets. In fact, I cheated my way up to 344 pounds! And the one IRL person I know with the Lap-band is a major sugary milkshake drinker and has not lost weight after the initial first pounds as she recovered and had the newbie enthusiasm. She is miserable and fights for every ounce. 

The RNY lifestyle did not appeal to me. I have herniated discs in my back and arthritis in my knee, so I wanted to be able to take NSAIDs for pain. I also was afraid of the possibility of dumping and ulcers, which do not happen as a result of the altered anatomy of the DS. Dumping scared me a lot. Plus, the one person I knew IRL who had the RNY dumped all the time on the craziest things and she never got even close to goal weight. She is now considering a DS revision.

PLUS, the doc at Northwestern who does the RNY said I probably would get to goal but gain half of it back and when I expressed my diasppointment, he chidingly said that 50% regain is what the bariatric world calls "success." He also said my diabetes could come back!!!! Aaargh!

I knew there had to be something else. The therapist I was seeing at the time for my eating issues suggested the DS to me. I had never heard of it!!

The studies out at the time I made my decision two years ago showed that the DS had better weight loss and regain rates. The DS has a 98% "cure" rate for diabetes vs. 80% for RNY. The post-op lifestyle sounded like me, too. Drinking with meals, eating regular food with sugar and fat, yahoo!

As to what I eat, I cannot eat a full meal at a restaurant in one regular sitting. I do have restriction and those portions are WAY out of control!  The other night, I had dinner with a friend at Applebees. I got the steak fajitas and ate half of them with the tortillas, cheese and sour cream. I also ate one of their mini-desserts, an ice cream sundae. I took a doggie bag. When I got home later, I ate some of the steak and went to bed.

I'm not winning any competitive eating contests at Coney Island, but I do eat like a normal person would, well, one who doesn't have to watch their fat intake. LOL I basically eat what I want, as long as I get protein first.

Hope that gave you a snapshot into my thinking. I did not intend to anger anyone about their choice of surgery. I was asked my opinion and reasoning as to MY choice.

I do not have all the answers. I took a leap of faith and here I am so far, incredibly happy with my choice.

Nicolle

Looked at your blog and what a journey you have been on!!!! YOu look gorgeous! What a transformation!!!! Great job!

Jill 

Thanks Jill! I remember watching your video months ago and thinking what a beautiful smile you have, in all the shots, no matter your size. You definitely have "something," you know?

And your progress has been great! Way to go!

I hope to get my act tgether and do a video for my surgiversary in February. Was it hard to do?

Nicolle