Pre-Op - Surgery Scheduled - Have questions!

Good for you for coming and asking questions. Remember you are in charge of your body. Not your mother. You can do this. 

I have RA, and diet helps as much as WLS.

The loop DS is very new, and will have a better result than the bypass.  Who is your loop surgeon?  Make sure they have already done the procedure several times.  There is some controversy, as the SADI/SIPS/loop DS is not yet approved by the FDA.  It has been done in Europe for 7 years, and I do think it's a decent surgery.  However, it may be unlikely your surgeon has done many of them.  Seek out a very skilled surgeon if this is the route you must pursue.

As for the SADI/SIPS procedure, you will need to take several vitamins long-term.  I would suggest following the Vitalady regimen for DS patients, actually.  You will need to be very careful and have labs yearly at minimum to make sure you are getting correct nutrition.  You should also ideally follow a low carb/high fat/high protein diet, as the intestine bypassed (really in either procedure) will cause you to need to ingest more of both.  Expect to spend 50-100 a month on vitamins.  TEchnically we don't need chewable vitamins with the sleeve/DS/loop after a while, but you will at first.  Eventually you may need water miscible vitamins of the fat-soluble ones (ADEK) in addition to a multivitamin.  The loop is too new to say.

Having said that, low carb diets typically help those of us with autoimmune diseases because insulin is inflammatory and the swelling and leaky gut can contribute to autoimmunity.  Here's some science you might find interesting, and here's a specific study about rheumatoid arthritis and diet. 

I was in disbelief myself about this.  My arthritis is so bad I need a knee replacement because it has mechanical failure, basically.  I have almost no pain and can still walk - when I eat a higher carb diet (over 75g or so) I lose function.  Maybe it's the placebo effect to be fair?  My point is that food is the ultimate drug.  The foods that got us to 300 pounds are almost all high inflammation, severely processed foods. 

No matter what surgery you choose you will likely need one of many versions of a low carb diet.

I have severe osteoarthritis, lymphedema and lower lumbar arthritic damage and lived on 2400mg of ibuprofen daily (with my Dr's reluctant consent) so my ability to exercise is also rather limited. My heaviest weight that I saw on a scale was 342 , but it was probably more- I just didn't look, lol. I opted for the RNY even with the restrictions for nsaids for several reasons, mostly because I did not want the DS, and I have GERD, so I knew I didn't want any chance of increasing my reflux. 

There are horror stories about all of the weight loss surgeries- and limitations for them as well, but they are all a tool to assist with keeping you on track with your diet and lifestyle changes. Yes there can be bowel changes with the loop ds, and because it had a sleeve as a part of the surgery, I immediately ruled that out. Which left me with a choice between gastric band (which my surgeon will not even do anymore) or RNY. 

I am completely happy with my choice. I no longer have reflux -a BIG plus!- and I have found that between my weight loss, and my lower carb diet my joints and pain levels are doing much better. I explored other pain management tools prior to surgery and have Tylenol, a narcotic (that I hate because of the constipation) gabapentin, a tens unit and if I need it I can have steroids. I use a recumbent stationary bike for exercise and I'm doing pretty well with that.

I take the bariatric vitamins and calcium, and since I will probably need the chewable calcium forever because I can't tolerate the horse pills, I just get the celebrate chewables for both. My husband figures that what I'm saving in food costs more than covers the price of my vitamins, so I get the ones I like and am willing to be compliant with. My bariatric center will allow a fresh post op to take the 'flintstones' chewables for the first month only- and then directs us to change to bariatric supplements or the equivalent amounts of adult vitamins (I think they suggested 3 of the centrum multi vites for example) but the key is my blood draws. They check my levels frequently and adjust my supplements based on my labs. 

Make a list of the pro's and con's of each surgery and talk to your surgeon/bariatric center about them, literally put them on paper and take it with you to your appointments and write their answers down on the same paper :). Read up on them here, and make sure you look at both the positive and negative posts! And good luck :)

Thank you.. GERD is a big issue for me, too, so I think the bypass is going to be the best bet for me. As much as I want to avoid the re-routing, I know I need the drastic surgery to help me. A stationary bike would be great. I have one of those ski type machines, called a gazelle, and I'll be using that once I'm able to. 

Thanks for your response. It's helped me to decide what the better choice for me will be.

So don't listen to internet people! You and your mom both should listen to a real doctor when it comes to vitamins unless they tell you to take children's vitamins in that case run away.  

So let's break this down.  You are going to have some deficiencies in the vitamin category after WLS.  This will come from several things: not eating as much, malabsorption, less variety in your diet, and several other things.  So just agree with me that somewhere an important vitimin will get skipped in your new eating habits. 

So what are you going to do about that?  Well if it was me I'd get the best vitamins I could! Why?  Just Google vitamin deficiencies and look at all the gross and messed up medical stuff having any one deficiency can do to you.  We're talking about your hair falling out, tooth loss, lack of energy, skin break down, rashes, immune system issues, the list goes on and on. 

So please for the love of your body get good vitamins and get invested in your lab work pre and post WLS.  If you have drops in certain vitamin levels find some way to replace them.  Your doc will probably suggest a solid multi, calcium, B12, and iron.  Take them as they wish and if they suggest more then take more.  It's far more rare to have issues from having a little extra vitamins than it is to have less of them.

Basically, I'm saying don't get scurvy just because your friends tell you to take Flinstones :-)