6 Month Post Op Questions for the veterans
(deactivated member)
on 5/26/12 1:06 pm
on 5/26/12 1:06 pm
First off, thanks to all the folks who take the time to post their experiences on this great board, I don't know what I'd do without the collective wisdom of this community...unlike anything else you may have done by a Doctor, this procedure takes constant personal vigilance to overcome...not negative, just real.
Anyway, here is a quick rundown of my DS Experience:
50 year old male
5' 11", starting weight 316. Insulin pump dependent (130U/day),
hypertensive, sleep apnea, family history of heart disease but mine is still perfect as confirmed via angiogram performed last year.
7 years of research led me to the DS as the best cure for diabetes DS Performed by Dr. Felix Spiegel on 11/17/11, diabetes and high BP gone
by discharge on 11/19/11
1 month post-op total weight loss: 55 (includes 13 from 1 week Pre-op diet)
2 month post-op total weight loss: 76
3 month post-op total weight loss: 89 (all labs stellar, HB1aC 5.1)
4 month post-op total weight loss: 104
5 month post-op total weight loss: 115
6 month post-op total weight loss: 122 (most labs good but AST 118, ALT 116,
Pre-op always normal, HB1aC 5.0)
Bloodwork redone 2 days later: AST down to 32 (normal), ALT down to 76
MRCP MRI shows all bile ducts open so no mechanical issues. My current issue is that about a month ago I started having burning stools
that were loose and about a week ago they turned to full on diarrhea with lots of
cramping, etc. (it almost feels like my lower GI is battery acid, that's the best way to describe it). I have been very careful with food (ie. low carbs, high protein, etc.). Saw Dr. Spiegel this week and he prescribed Lomotil and advised I eat only lean protein with white bread and white rice in an attempt to slow my GI down (of course the bread causes gas, etc.). He said I need to keep this regimen up for 30 days then stop the Lomotil. If weight loss doesn't slow down and diarrhea resolve he may need to revise my common channel from 100 cm to 150 cm! He also told me I would have to avoid virtually all cheese for the rest of my life as well as anything else with fat in it...I know fat can work like a laxative but in all of my research I have never heard anything this extreme, have any of you?
Question #2: has anyone else ever been prescribed Lomotil? It's like a super Imodium and now on the 3rd day I am finally seeing some results. Trouble is, this is a band-aid at best, both medicinally and from a quality of life perspective...I never expected to be able to eat anything I wanted but expected the good list to be longer than the bad list (in moderation of course)...this has not been my case so far.
Question #3: Pre-op I had asked about a 150cm Common Channel as resolving diabetes while maintaining as close to a normal life as possible was my main goal (far above weight loss as I have been obese my entire life). Dr. Spiegel said he could do it but doing so would make me unique as he always uses 100 cm CCs and performs 6-8 DS procedures per week so I opted for staying in the normal croud (in retrospect I should have insisted but then again, I am not a doctor). Has anyone had personal experience with lengthening their common channels? I am most curious if it would give some help in gas, diahrrea, food tolerance, etc.
Question #4: Has anyone else had any experience with Dr. Spiegel?
Question #5: I have a GREAT PCP that I have been seeing for almost ten years. I trust him above all other doctors but also know WLS is not his specialty. That being said he is a very busy internal medicine doctor that sees a wide variety of patients with a broad spectrum of health issues and he feels the Lomotil is a bad idea and that the root cause of my issue is likely my lower bowel being exposed to too much unmixed bile since my gall bladder was removed during the DS Procedure so he has prescribed Actigal. I have seen many folks have taken this for 6 months following their surgery but in all cases I have read they have had kept their gall bladders. Has anyone else had this burning butt issue and been prescribed actigal? FWIW I have been on it for two days but since it started almost in sync with the lomotil it will take some time for me to know if it is actually helping.
Question #6: I am still on Nexium. I don't like it and feel like many of my issues may be a result of simply continuing to take this medication so am in the process of weaning myself off of it (one every other day now). BTW, both doctors agree The reason I don't stop cold turkey is that I did so about 6 weeks ago and a week after stopping it I the burning butt started with heartburn (I never had heart burn pre or post op until then so have been taking the nexium for fear of a bigger issue). Stomach pH is a touchy thing as both low and high values present the same symptoms (ie. heartburn, diahrrea, etc.). How do you know when the bit has flipped from high to low? As I said, I believe my proton pumps have cooled down now so I can remove the control rods (nexium) but would love to hear if anyone else has faced this dilemma (I'm sorry if I have missed posts...it seems like I am reading here too much and it starts to make you a little crazy I think).
Final Question: For those who have had success with Flagyl, did any of your pre-flagyl symptoms feel anything like my battery acid lower GI I have described? I ask because it seems plausible to me that perhaps with low stomach pH (taking the nexium longer than I need to) the environment in my lower GI may have changed just enough over the last month or so to allow the colonization of bad bacteria which would help to explain just about all of my current symptoms...
I'm sorry to have asked so many questions here and thank-you all in advance for any guidance you can give me on any of this.
Thanks.
T
5' 11", starting weight 316. Insulin pump dependent (130U/day),
hypertensive, sleep apnea, family history of heart disease but mine is still perfect as confirmed via angiogram performed last year.
7 years of research led me to the DS as the best cure for diabetes DS Performed by Dr. Felix Spiegel on 11/17/11, diabetes and high BP gone
by discharge on 11/19/11
1 month post-op total weight loss: 55 (includes 13 from 1 week Pre-op diet)
2 month post-op total weight loss: 76
3 month post-op total weight loss: 89 (all labs stellar, HB1aC 5.1)
4 month post-op total weight loss: 104
5 month post-op total weight loss: 115
6 month post-op total weight loss: 122 (most labs good but AST 118, ALT 116,
Pre-op always normal, HB1aC 5.0)
Bloodwork redone 2 days later: AST down to 32 (normal), ALT down to 76
MRCP MRI shows all bile ducts open so no mechanical issues. My current issue is that about a month ago I started having burning stools
that were loose and about a week ago they turned to full on diarrhea with lots of
cramping, etc. (it almost feels like my lower GI is battery acid, that's the best way to describe it). I have been very careful with food (ie. low carbs, high protein, etc.). Saw Dr. Spiegel this week and he prescribed Lomotil and advised I eat only lean protein with white bread and white rice in an attempt to slow my GI down (of course the bread causes gas, etc.). He said I need to keep this regimen up for 30 days then stop the Lomotil. If weight loss doesn't slow down and diarrhea resolve he may need to revise my common channel from 100 cm to 150 cm! He also told me I would have to avoid virtually all cheese for the rest of my life as well as anything else with fat in it...I know fat can work like a laxative but in all of my research I have never heard anything this extreme, have any of you?
Question #2: has anyone else ever been prescribed Lomotil? It's like a super Imodium and now on the 3rd day I am finally seeing some results. Trouble is, this is a band-aid at best, both medicinally and from a quality of life perspective...I never expected to be able to eat anything I wanted but expected the good list to be longer than the bad list (in moderation of course)...this has not been my case so far.
Question #3: Pre-op I had asked about a 150cm Common Channel as resolving diabetes while maintaining as close to a normal life as possible was my main goal (far above weight loss as I have been obese my entire life). Dr. Spiegel said he could do it but doing so would make me unique as he always uses 100 cm CCs and performs 6-8 DS procedures per week so I opted for staying in the normal croud (in retrospect I should have insisted but then again, I am not a doctor). Has anyone had personal experience with lengthening their common channels? I am most curious if it would give some help in gas, diahrrea, food tolerance, etc.
Question #4: Has anyone else had any experience with Dr. Spiegel?
Question #5: I have a GREAT PCP that I have been seeing for almost ten years. I trust him above all other doctors but also know WLS is not his specialty. That being said he is a very busy internal medicine doctor that sees a wide variety of patients with a broad spectrum of health issues and he feels the Lomotil is a bad idea and that the root cause of my issue is likely my lower bowel being exposed to too much unmixed bile since my gall bladder was removed during the DS Procedure so he has prescribed Actigal. I have seen many folks have taken this for 6 months following their surgery but in all cases I have read they have had kept their gall bladders. Has anyone else had this burning butt issue and been prescribed actigal? FWIW I have been on it for two days but since it started almost in sync with the lomotil it will take some time for me to know if it is actually helping.
Question #6: I am still on Nexium. I don't like it and feel like many of my issues may be a result of simply continuing to take this medication so am in the process of weaning myself off of it (one every other day now). BTW, both doctors agree The reason I don't stop cold turkey is that I did so about 6 weeks ago and a week after stopping it I the burning butt started with heartburn (I never had heart burn pre or post op until then so have been taking the nexium for fear of a bigger issue). Stomach pH is a touchy thing as both low and high values present the same symptoms (ie. heartburn, diahrrea, etc.). How do you know when the bit has flipped from high to low? As I said, I believe my proton pumps have cooled down now so I can remove the control rods (nexium) but would love to hear if anyone else has faced this dilemma (I'm sorry if I have missed posts...it seems like I am reading here too much and it starts to make you a little crazy I think).
Final Question: For those who have had success with Flagyl, did any of your pre-flagyl symptoms feel anything like my battery acid lower GI I have described? I ask because it seems plausible to me that perhaps with low stomach pH (taking the nexium longer than I need to) the environment in my lower GI may have changed just enough over the last month or so to allow the colonization of bad bacteria which would help to explain just about all of my current symptoms...
I'm sorry to have asked so many questions here and thank-you all in advance for any guidance you can give me on any of this.
Thanks.
T
Larra's a smart gal.
If she hasn't mentioned it, I'd be wondering about the intestinal flora. Flagy will eliminate it, but I've learned over the years the importance of good balance of bacteria in the intestines. If you eliminate it, you have to repopulate the colony. Some take probiotic pills. I do just fine with regular yogurt every day and my gas and stools have a significant difference. It's an easy fix. I would stray away from avoiding fats idea. Your body NEEDS fat. It just doesn't sound right.
Valerie
DS 2005
There is room on this earth for all of God's creatures..
next to the mashed potatoes
(deactivated member)
on 5/28/12 1:09 am, edited 5/29/12 6:39 am
on 5/28/12 1:09 am, edited 5/29/12 6:39 am
Thanks Valerie, Larra did indeed have some great advice.
I began flagyl yesterday and I believe it's already working...seems hard to believe it can work this fast but that's my current feeling and I'm sticking to it until proven otherwise LOL. I am taking 500mg four times a day for 10 days while continuing the actigall during this period. My PCP and I will review where I am at the end of this period and adjust meds accordingly. From the collective wisdom of this community and my PCP I have learned that once you wipe everything out with the flagyl you do need re-populate via a probiotic or yogurt. Up until ~6 weeks ago yogurt was a staple for me but for some reason at that time it seemed to be giving be trouble (in retrospect this also supports the theory that around that time bad bacteria was colonizing). Once this course of flagyl is completed I had thought about a probiotic but would prefer the yogurt as you have suggested as I am looking for good calories wherever I can get them. Do you use activia or standard yogurt? I like both but would prefer to go with standard yoplait this time to mix it up, does this sound ok to you post flagyl, or should I be looking for a specific kind of yogurt? Also, how much yogurt per day would you recommend?
Thank-you so much Valerie for your advice on this.
Happy Memorial Day.
T
I began flagyl yesterday and I believe it's already working...seems hard to believe it can work this fast but that's my current feeling and I'm sticking to it until proven otherwise LOL. I am taking 500mg four times a day for 10 days while continuing the actigall during this period. My PCP and I will review where I am at the end of this period and adjust meds accordingly. From the collective wisdom of this community and my PCP I have learned that once you wipe everything out with the flagyl you do need re-populate via a probiotic or yogurt. Up until ~6 weeks ago yogurt was a staple for me but for some reason at that time it seemed to be giving be trouble (in retrospect this also supports the theory that around that time bad bacteria was colonizing). Once this course of flagyl is completed I had thought about a probiotic but would prefer the yogurt as you have suggested as I am looking for good calories wherever I can get them. Do you use activia or standard yogurt? I like both but would prefer to go with standard yoplait this time to mix it up, does this sound ok to you post flagyl, or should I be looking for a specific kind of yogurt? Also, how much yogurt per day would you recommend?
Thank-you so much Valerie for your advice on this.
Happy Memorial Day.
T
If you have Kroger in your area, they have their own brand of Carb Masters yogurt, and it's delicious. Otherwise, I go for greek vanilla, LaCreme or Dannon Pure over the others if I must have something with sugar. The greek and carb masters has the largest amount of protein.
I enjoy one or two cups daily now for balance. After Flagyl, I would recommend a more powerful punch, like Kefir. It takes all day for me to drink a bottle of kefir, and it's 48g of protein, I think, so well worth it for double-value. Do this daily for a week or so, then try regular yogurt and let your body be your guide.
I enjoy one or two cups daily now for balance. After Flagyl, I would recommend a more powerful punch, like Kefir. It takes all day for me to drink a bottle of kefir, and it's 48g of protein, I think, so well worth it for double-value. Do this daily for a week or so, then try regular yogurt and let your body be your guide.
Valerie
DS 2005
There is room on this earth for all of God's creatures..
next to the mashed potatoes
(deactivated member)
on 5/29/12 6:38 am
on 5/29/12 6:38 am
Thanks Valerie. We've got a Kroger right down the street so I'll look for your choices once I'm done with the Flagyl regimin. I also remember Kefer as a kid and liked it then so will also look for that option. I've tried a couple of greeks and didn't like either as they were simply too sour for my pallete.
I have to admit yesterday (Memorial Day) was tough. I had felt very good on Sunday but did not eat right yesterday...I say I didn't eat right but that is of course all relative, pre-DS it would have been a super light day, post DS even a hotdog, watermelon and a little potato salad seemed to almost kill me. Not from fullness of course but from GI distress. I am still praying that post Flagyl, and given a little more post-op time, I will be able to tolerate a diet that is not so rigidly Atkins-like...right now I'd even be happy with a simple "you can eat any of these 10 things without any problems" list as long as that list didn't have chicken on it 4 in four places...
Again, appreciate your feedback.
T
PS I am going to close my acct here and move to the other site as reading/posting at multiple locations can be overwhelming and time consuming. Both sites are great but I will only post on the other from now on.
I have to admit yesterday (Memorial Day) was tough. I had felt very good on Sunday but did not eat right yesterday...I say I didn't eat right but that is of course all relative, pre-DS it would have been a super light day, post DS even a hotdog, watermelon and a little potato salad seemed to almost kill me. Not from fullness of course but from GI distress. I am still praying that post Flagyl, and given a little more post-op time, I will be able to tolerate a diet that is not so rigidly Atkins-like...right now I'd even be happy with a simple "you can eat any of these 10 things without any problems" list as long as that list didn't have chicken on it 4 in four places...
Again, appreciate your feedback.
T
PS I am going to close my acct here and move to the other site as reading/posting at multiple locations can be overwhelming and time consuming. Both sites are great but I will only post on the other from now on.
Most Active
Recent Topics