Pre-Op - Surgery Scheduled - Have questions!

So my mom is freaking out because I've not posted my question here... I've posted and gotten responses on other forums, but apparently this is the only one she'll accept advice from.

I'm scheduled for surgery on March 24th. We've bounced back and forth between the sleeve and the loop DS (sleeve plus) and decided on the loop DS. I'm 300lbs and have a lot to lose. I also have RA which makes exercise at this weight difficult. Now the reason we didn't go with the bypass was the re-routing, but now that we've decided on the loop DS, and there's routing involved, I'm trying to decide which one is better.. bypass or loop ds? There are horror stories with both, but my mom read something about people ending up in diapers for the rest of their lives with the loop ds, so I'm going to look into a bit more. I've done a lot of research, but somehow that one has escaped me.

As far as vitamins go - I've had several friends who have had the bypass tell me not to get into the hype of the bariatric vitamins, that they take two flinstone vitamins a day and their surgeon has approved this. Anyone else take the flinstone vs the pricey bariatric ones? Any noticeable differences?

Thanks for any feedback. I appreciate it.

Getting scared!

I would ask how the surgery will affect treating your RA.  I have RA/PsA, started at just over 300#, and we went with the sleeve because it would give me the ability to take NSAIDs and steroids when needed postop.  The RNY has an absolute contraindication to those classes of meds, whereas the VSG has only a relative contraindication (as it was explained to me anyway).  We didn't consider the lapband for several reasons.  The DS wasn't even offered to me, so I don't know what its implications are for NSAIDs/steroids.  But as an RN and having extensively researched auto-immune, that is the question that made the decision for me about which surgery.  The team I consulted about all of this included both my surgeon and my rheumatologist.  My rheumy doesn't like steroids, but she likes to have them as an option for bad flares, and NSAIDs are frequently needed for proper management of RA.  

So the VSG was hands-down the surgery my team and I thought best.  That being said, there are people with RA and other auto-immune on the boards who went RNY (and I would presume DS, but I'm fairly new on OH and haven't seen any) and have had excellent results and have not needed NSAIDs or steroids.  All I'm really saying is make absolutely certain that the RA's been given the proper consideration in choosing the surgery, and make sure your team has a treatment plan for you postop that can respond to flares whichever surgery you end up with.  If you don't have that, don't get the surgery until you do.

(And just a side note - if you're on any DMARDs for your RA, I hope you have already gotten instructions from your rheumy about tapering off before surgery and when to start back postop?)

For vitamins, my surgeon says with the sleeve it's not as big of a deal, so she just recommends whatever once daily multi I want to take.  For her RNY patients, it's serious business, and I would assume with the DS it is as well.  Both of those are malabsorptive surgeries, and I wouldn't risk a deficiency, personally.  I would go with whatever your doc says.  And ultimately, your bloodwork is the only way to know if your vitamins are effective.

I had RNY, and couldn't be happier. Flintstones vitamins sre crap. Eventually they'll catch up to you. And there is no need for pricey bariatric vitamins. I took generic CVS brand for 3 years, and they cost me about 13 bucks per year.

I won't argue VSG vs RNY. As I said, I'm thrilled. But I would not touch the loop DS with a ten foot pole. Too many problems and complications, and the vitamin requirements are more severe.

I had RNY too and could not be happier. Lost 152lbs. My multi vitamin plus iron is a walgreens generic in which i buy one bottle get one free. There are 365 pills in one bottle so it us cheap and approved by my bariatric team.

i will say that my calcium citrate chews are bariatric advantage that i buy from amazon. They are specific and a bit more pricey but I had a hard time finding quality calcium citrate that i could swallow. Not because of bypass but because of cervical fusion that went through my throat. Ever since i cannot swallow fat pills. And calcium citrate is import because in RNY we malabsorb calcium. The citrate is important to keep kidney stones at bay.

Same here, but CVS. 365 in a bottle, 13 or 14 bucks, and BOGO.

My surgeon didn't even offer loop so honestly I don't know much about it. I had the sleeve and have been very happy with my results. My surgeon recommends flintstones (as well as other brand vitamins) as long as it is the flintstones complete. I have taken two a day since surgery a year and a half ago and all of my blood work has been perfect. I also take seperate calcium supplements. 

You definitely need to research all procedures and determine which one is the best for YOU!   I had RNY, but back in 2001 my only choices were lap band, RNY and DS.  DS was too extreme for me and I did not want to have some of the issues that come with the surgery.   So, I opted for RNY.     There are more BM's with the DS procedure and from what I have encountered of friends who were DS patients, they are very smelly and can be very loose.   Does this mean you have to wear a diaper, no.  But, you do need to be aware of the possiblity of that, and how and what you eat can impact them.

As for vitamins.  Don't listen to your friend.  Vitamins are important in the RNY and DS procedure because of the malabsorption.   My Dr. told me in 2001 all I needed was Flintstone vitamins and a few years later I had a vitamin def that was across the board.    We need vitamins and we need specific vitamins and you need to take those vitamins.  Don't go the route of not taking a vitamin becuase of the cost, you can find vitamins that meet the ASMBS guidelines in just about any store.   Depending on what your labs are, you might need to take some extra ones, but the inexpensive ones will work fine and many people here do that.  

Wishing you the best of luck!

Nik

Nik, we sure didn't know much, back then, did we????

In 2002, I was sent home on Flintstones and Vivatic calcium chews...period...Later, I got educated...by the peeps on OH!!! I, in turn, educated my surgeon. That info, by the OH peeps, probably helped a kagillion people, down the road :)

Not to derail the original post, but had to wave at a fellow Johnson County person!!  Well, used to be, I grew up in Keene and went to Cleburne High.  I live in Arlington now.

Definitely not!   I think everyone who had surgery prior to 2003 was told to take 1 Flinstone a day, for life.   The fact surgeons are still telling people to do this, scares me.