DS pre-Op...Any advice???

HI ladies and Gentlemen,  I am a 33 year RN and I will be having the DS WLS sometime in August. I am currently doing my 6 month medically supervised weight loss that my insurance requires and that will be complete on 8/3/12. My surgeon says I should have no problems getting approved once that is done. I have seen the nutritionist and had an EGD. There are only a few other things I have left to do like EKG, lab work, and a psych eval.  I work for the largest health system in Houston, TX and I have hospital administered health insurance so hopefully they won't give me too much hassle about approval. The question that I have for the board is, what can I expect AFTER the procedure? Also, are there any fellow DS'ers that can tell me about their weight loss journey...how fast did the weight come off, what foods to avoid, are you loosing too much weight, etc? Thanks for any help you guys can give me and I look forward to geting to know u!

Hello Karmel42, Welcome to BAF. I can't tell you anything about DS WLS but I wish you nothing but the best. Hope to hear more of you journey and please keep us posted. Good luck and best wishes!

Thanks Thicklin and I will keep u guys posted.

Hi,
DS Facts is a good website for that info,also over on the DS board you can find info. You can use the search box to find past answers,which I have found  is really helpful. :-)

Hope that helps!

karmel-

I had the DS on 2/25/2009.  My highest weight was 405, on surgery day, 397. I count from my highest weight, because I still had to lose it.  I lost my first 200 pounds in the first year. 
As of today, I am 165 pounds at 5'5'', gearing up for reconstructive surgery on my thighs.  I carried most of my weight below the waist. It is estimated that I have at least 15 pounds of redundant skin and adheiscent fat deposits.

I've heard it said that the more you have to lose, the faster you lose it, and it does make sense, because it takes a lot of energy to move extra weight around, and with the reduced calorie absorption, you would expend more energy than you have fuel to support, so your body kicks into the reserves - fat! Since you are an RN, you probably know that ketosis is partly responsible for the rapid weight loss, and that's why we have to be KILLING  protein supplements, to keep from losing muscle mass in the process, and also because we malabsorb, we only get 50-60% of protein and complex carbs ingested,       18-20% fats, but 100% simple carbs and simple sugars. 
the 100% items are the things that cause the foul gas and dhr that give the DS such a bad rap.  Your bowel habits do change with this surgery, but for many, they regulate  the farther out you get,  after about a year an a half it was three times upon rising, and I'm done for the day.

If you are lactose intolerant now, you will be even more so after surgery.  If you are not, you may likely be LI for a while, until your gut adjusts to the new configuraton,.  You'll know, because regular whey protein will run right through you.  I was back in the hospital 48 hours after release for IV fluids, NPO for 24 hours because of extreme LI.  I had it as a pre-op.

Use Whey Protein Isolate.  Most of the lactose is processed out, and you're covered either way. 

That being said, when you're just out, hydration is the most important thing, protein next, supplements next.  Invest in a compact pill crusher, or see if you can get a Silent Knight for home use.  It will be easier to get your vites in that way, sprinkled on pureed food or applesauce, as you will be still be quite swollen inside. Don't stress about getting them all in.  You should be on a pre op vitamin schedule now, to build up reserves and make sure you have no deficiencies going into surgery, and work up to your full post-op vitamin schedule by three months out.

I had eating and drinking issues after six weeks, so my surgeon ordered an upper endoscopy, to make sure everything was OK.  That did the trick!  I've been eating like a champ ever since. 

You will be given an eating plan,(my program mapped out the entire first year of re-feeding!)  and you'll be doing pureed foods, and very moist, well cooked, easily digestible baked fish for at least 4 weeks post op, or whenever your surgeon feels you are sufficiently healed to progress to more solid foods.  Follow the eating plan your own surgeon gives you.  This is just what I did.

HYDRATION, HYDRATION, HYDRATION!

Good luck to you!!!

WOW thanks Jazzy!  U gave me some great tips! And congrats on your weight loss. I hope your reconstructive surgery goes well. I am taking notes of all the advice you have given me and Im going to get started on those supplements ASAP. My goal in this process is to lose 170 lbs. Im a little nervous but Im very excited about getting my life back! I will stay on the forum and keep you guys updates on my progress. Thanks again for all the information!

  Fantastic summary of the pros and cons as you experienced them.  I am bookmarking this thread for future newbies in case you are not around that day.  We are both Feb 09'ers but I don't remember you from back then.  I also don't remember yesterday's outfit or breakfast so please don't take offense, lol.  You likely know the DS vets I'm thinking of.  I hope you'll stick around. Thanks for including realistic stats, the pros, and the cons. 

It is what each individual can live with that determines which side effects are pros and which are cons.  I could not fathom the change in bathroom habits making DS a no go.  I am a serious head case when it comes to public pottying.  However, RNY's major con of possibly violent dumping and reactive hypoglycemia is a pro for me.  I dumped once and will be sure never to let that hapen again.  Still, I understand why some folks won't risk rny even though few people seriously dump.  Its all down to what we each feel we can handle. 





 

The bathroom thing...It's not as bad as you've heard. 

In the begining, it can be a little frequent,  especially with a shorter common channel like mine because your digestive system is pretty much like a newborn's - not used to anything - and with the DS being so much more distal than a RNY, the enzymes,  motility and  everything else are all out of whack. That's part of what makes it so powerful...the absorption areas are reconfigured.  My CC is 75cm - shortest of "normal" my surgeon does,  but that's just the way I measured out

Within the first 6 to 9 months, most DSers get more regulated.  Personally, it's 3 times the first thing upon rising, and I'm done for the day...unless I've gotten hold of something that doesn't agree with me.  You can pretty much count that as being simple carbs and/or simple sugars.  Sometimes you do it to yourself, sometimes it's an accident. Just remember to avoid white flour, white pasta, white sugar...well. brown sugar too, because it's just white with molasses added.  White Potatoes are ok, because  they're a vegetable, and a complex carb.  Use plenty of butter!

The one thing I did immediately post-op was bought some Depends.  Yes, I said it!  A few times during the adjustment period, they came in very handy...but most times they just made me sweaty. 

Unless I'm having tummy trouble, which is more often *not* the case at three years and change out...I rarely use them anymore. 

Invest in an internal deodorant ( you'll see one amongst the ads here on OH) - even if you only use it for special/public events, it's worth it. 

I like the capsules, because the sweetener in the chewables tears me up.   I haven't bought the chewables in such a long time, I don't even remember what the sweetener was! Some people use charcoal capsules, but  that can negatively impact  nutrient absorption, and we don't need that! 

Odor and gas is usually controlled by leaving the simple carbs/simple sugars out of your life.

I like the DS  because really, there are no forbidden foods.  Nothing is going to make you deathly ill, it just might make your tummy a little angry, and *you* decide whether it's worth putting up with any side effects a certain food may have. 

A *very few* people luck out, and have absolutely *no* ill effects from anything - they just malabsorb and lose. 

Hope you grow to  your DS!

If I could time my "drops" to be in the right place when the urge strikes, the alterred bathroom habits would have been less of a concern.  My major bathroom consideration related to having to go when I am not at home. Actually, the bathroom issues you described are a bit more than I considered, lol.  I ignore message boards for this type of info because it is way too subjective.  I read clinical studies from around the world before crossing ds off the list.  Depends was a smart move although the possible need never crossed my mind. Even if you never need it knowing you are protected is priceless.  
Like potty habits and ds, food limitations and dumping are way over exagerrated with rny.  Like you its protein first; nutritious veg; simple carbs from fruit; adequate good fats; and a limit on white sugar and flour, plus similar foods with limited nutrition and higher calorie absorption.  With moderation most folks can eat anything a few years post rny.  It is over indulgence that generally triggers negative reactions like dumping and reactive hypoglycemia.  There are always exceptions, but few rny folks who eat well from the start can never indulge in a treat of any kind for life.  The same simple carbs you mentioned are the enemy of all wls procedures.  Many of us must give up certain foods because of what wls can't fix in us. 

. 

I've been here infrequently, I am a regular on the DS board, just because I know so many people over there from my program,  but I will come over more often. !
 
  I loved the '60's and '70's!  It's so nice to see healthy 'fros and braids and locs again!  Y'all thought you invented that ish?

You better ask somebody!