Introduce myself

Hi All - Just came across this site today, and am finding your insights incredible.  I have been working through the UHN bariatric program since June of 2013, and meet with Dr. Aarts on Friday (hopefully for a surgery date!).  I am looking to get any advice you may have on questions I should ask, etc.  I have seen mention of VSG (I assume this is sleeve), but my understanding is only RNY is covered in Ontario.  I am comfortable with the decision to go forward with RNY, just want all the facts if there is any other options available.

Existing conditions:  Diabetes (insullin dependent right now), Sleep Apnea.  I do have some aches and pains, but nothing that really stops me from doing anything.

Any comments are welcome, from protein powders that have worked well, as well as ones to avoid.  Vitamins have also confused me, so anything you can help with there is appreciated.

Hi Viper im from Elliot Lake On.  I had RNY surgery on April 22nd so im just 4 weeks post op.  I feel great.  I had my surgery at St Josephs in Toronto.  My surgeon was Dr. David Lindsay.  I was on Optifast for 4 weeks prior to my surgery.  I use SISU non flavored whey isolate protein powder.  I also use fat free powdered milk I put it in almost everything.  I eat sugar free popcicles they are nice every once in a while.  There is so much good info on this site im sure you will have no problem finding assistance.  Any questions you have just ask we are all here for you.  I was 319lbs when I started and im down to 258lbs.  Im so glad I did this.  :-)  Val

First off, Val that is so amazing!! I have been on opti for 3 weeks. I started this journey at 344lbs, and I'm down to 318 currently. You've lost quite a bit in 4 weeks, that is amazing! I'm in for surgery tomorrow morning in Guelph, and I met someone on here who has surgery the same day, also in Guelph, and with my surgeon! She is in 3 hours after me. This website is fantastic. I wish I knew about this earlier, but the support and suggestions have been amazing! I am determined to do well at this project! 

Good luck tomorrow I just know all will be fine.  You are doing awesome!  Im so glad that you have met someone that will be there the same time.  All the best  :-)   Val

Welcome to OH Viper!

VSGs are covered in Ontario, if your surgeon will support this path.  It's more used for those who are on medications where the malabsorbtion with an RNY would cause real problems.  It's been almost 3 years out, so I can't think of questions for you.  But I will say this, make sure you keep monitoring and taking your insulin until you are told not to.  My room mate in the hospital had her meter die on her the night before surgery so she didn't take her insulin, and the dose wasn't enough when they preped her in the hospital.  She ended up having a lot of issues with her sugar.  First they couldn't get it down, then it went too low and they had a hard time getting it back up to normal.  It just meant that she had to stay in the hospital for a couple extra days.  I saw her at my one week check up and she was doing great.

Make sure you have gas-x strips or papya enzyme and MOM at home when you get out.  Pills smaller than the tip of your baby finger are fine to swallow whole.  Don't try just crushing vitimins, get chewable or drops (you can't hide the taste of the pill).   For things like Vit. B, get the sublingual or strips. As for calcium, Jamison Chews are good, you will eventually switch to Calcium Citrate, but it's not important the first couple months.  Your taste buds will change, so don't try protein powders now, as what you like now, you may not later.  As for which is good, and which is bad, that is very individual.  Some like Premier Protein from Costco, others hate it.  I can't have anything with milk, so I have had Webber Mango Peach, and getting through some 4Ever Fit strawberry kiwi (not my fav flavor).  Some places will let you exchange powders if you don't like them, or they'll give you a sample to try before you buy.  Sipping and walking are very important after surgery.

As for Opti, you can add SF flavorings to it, no problem.

You may not lose in the first few days, but that's a catch up from losing on Opti, an then you may get the 3 week stall.  Don't worry when the scale doesn't move, just keep following the program, and you will lose.  One thing that will help you see your loss is to measure yourself before surgery (inches and lbs) and then regularily after surgery.  When the scale doesn't move, the tape measure will.  As you gain muscle, you will lose inches, but not lbs as muscle is heavier than fat.

And most important NSVs (Non Scale Victories) are a lot more satisfying than the scale victories.  And be prepared for a lot of firsts, or firsts in a long time.

Cathy

Thanks so much for the info.  I really appreciate the insights.  Also appreciate the expansion of the TLA (three letter acromyn).  I couldn't figure out what NSV was from some of the other posts!  I assume SF=Sugar Free. 

Is there anything in my medicine cabinet I should avoid going forward?  Pepto?  Tums? Rolaids, etc?

The biggest things are NSAIDs such as Advil, and high sugar syrops that you would use for a cold.  You can find some cough syrups that are SF.  Buckley's is one but there are another one or two out there.  Also, you won't be able to have time released medicines any more due to how you'll process them.

Cathy

Welcome Viper!

I just had VSG in February and I can confirm what was said: VSG and RNY are both covered by OHIP if your surgeon supports the choice. Here in Ottawa, there has to be a valid reason to go with the VSG so it's not the type of surgery that is seen as frequently as the RNY. It really depends on your surgeon, your centre and then OHIP's approval based on the surgeon's recommendation. I think these are the only two types of surgery covered in Ontario at the moment. RNY is the 'gold standard' (I take that with a grain of salt as VSG results at 2+ years are comparable to RNY) so that is the one they tend to assume you will have, unless otherwise determined.

Protein Powders:

Your centre may have specific recommendations for protein powder. My centre did, and I spoke to them about another type of protein powder that I like and they gave that one the thumbs up as well. For your reference, they told us that AllMax Whey Protein Isoflex was preferred (I love the peanut butter/chocolate combo!) and they also okayed Bio-X Xtreme Power Isolate as well. Bio-X is Canadian and they have amazing flavours like Strawberry Banana, Cookies and Cream, and Orange (tastes like an orangsicle when mixed with lots of ice and water... delicious and great for frozen popsicles!). We get our powders at Popeye's, and I believe this coming weekend, Popeye's has a sale happening. I intend to pick up another flavour; I'm running low at the moment. A lot of people also swear by the unflavoured protein powder available at Bulk Barn. You can add this to soups, SF puddings, yogourt, applesauce, etc. That is very handy to have around in the first stages after surgery.

Vitamins:

I know your centre will also give you information about what vitamins are recommended. We got lists of options here in Ottawa. And I got additional information from my dietitian for some vitamins from the USA as well (we go there often, so I wanted options to save money). Post surgery, my vitamins look like this:

6 a.m. (with my protein shake as I head out the door)

• two multi vitamins (Centrum chewable orange flavour, from the USA)
• B12 strip or sublingual pill (Jamieson's at the moment)
• prescription PPI (to help any acid or reflux that might occur post-surgery)
• vitamin D (1000 mg)
• calcium citrate (300 mg, Opurity chewable from the USA)
• 2 x Metamucil capsules (to help keep me regular!)
• 2 x docusate sodium capsules (stool softener, again, keeping me regular!)

10 a.m. (midmorning)

• calcium citrate (needs to be taken several times a day because your body can only absorb so much at a time)

2:30 p.m. (after my workout)

• calcium citrate (300 mg)

6:00 p.m. (just before supper) 

• calcium citrate (300 mg)

7:30 p.m. (when I give my daughter a bath)

• vitamin D (1000 mg)
• prescription synthroid (for my hypothyroidism)
• prescription diclofenac (for my psoriatic arthritis... the reason I had to have the VSG in the first place rather than RNY)
• 2 x Metamucil capsules

11 p.m. (or right before going to bed)

• 2 x iron (I'm low in iron so I need these)
• Vitamin C (to help absorb the iron overnight)

And all day, I drink water that has 5-6 tsp of inulin fibre (e.g., Benefibre) in it to keep me regular. Many of us have a problem with that if we are doing low-carb early after surgery, which is the particular route I'm taking. I reiterate though, this is my vitamin regime; yours may be very different depending on your needs. You and your dietitian or nutritionist will be able to figure that out when you have that appointment. It's important to note that blood work is taken frequently to check various levels and ensure that we are on the right track. Check it out with your centre. They are the experts and can help you with this. Guaranteed.

I hope this helps you. Welcome again to the forums, and I will keep my fingers crossed for you that you have some information from Dr. Aarts on Friday about a possible time frame for surgery. Good luck!