Nutrition Levels with DS

My common channel is 100cm and that's my surgeon's standard. I've not heard of any of his patients getting too low. He even assured me that as a lightweight I wouldn't get too low and if I did for a short time, bounce back would bring me back up. He's been doing the DS since 2002 or maybe a year earlier. 

My goals are 100+ grams of protein via shakes, give or take, and more that I don't count in food. Carbs when I was losing was around 50 grams of net carbs. Now I'm probably getting 100 grams of carbs and need to cut back. They are carbs from peanuts not sugar.  Fat I've never counted, I just don't avoid it. Fluids, I aim for 64+ fluid ounces a day. 

My dietitian and I experimented with cutting back on the protein shakes to 90 grams and my protein serum, albumin and prealbumin dropped a little, so she said keep doing 4 shakes a day.

With a 150 cm common channel you may find you need to be more strict with your carbs.

You will still want to check out www.Vitalady.com for her basic DS vitamin plan. Most surgeons and their dietitians are clueless about what we need and they won't help you reach optimum nutritional levels on your labs. They will give you RNY guidlines and think you'll be ok, not great but ok. There are a few out there that will give DS specific advice that can be proven by labs, but not many.

Good luck getting your approval.  : )

--gina

That's the key.  YMMV.  Guidelines are ok but you have to adjust them to meet your needs.
 

Just for example, my CC is 75 and I never reached my goal of a normal BMI.  And I think 50 carbs a day is a lot.  For me 20 is more like it, think Atkins induction till you go below goal.  Then you find out what you can eat in the carb department.

Sounds like you have the basics down pat..but you might want to add more fat to your diet down the road...I would say at least twice what you are talking...more like 120-150g is good, I think., but work up to it, don't try to get it all in from jump street.  I really don't count fat grams very much any more, since I know I'm getting them in,  but I do keep a close eye on protein and fluids. Since my common channel is only 75 cm (that was beginning of normal range when I was switched) I really eat a lot, and I'm on Creon (Rx digestive enzyme) for life, to help with absorption. Revision?  NO WAY!  I'll work with what I've got, thank you very much!

You will be amazed by your DS.  All the nutritional rituals may seem daunting at first, but it will become automatic before you know it!

You will need a boatload of vitamins and minerals daily to stay healthy.  Some programs are still pushing that Flintstone vitamin and Tums (for calcium) crap, but that just won't cut it.   I'm pasting in my daily routine, just as an example.,  Not saying that this is exactly what will work for you.  Check out Vitalady's list for DSer's.  I ordered her DS program once for right after surgery, then, using the list of supplements, I hunted for my own, less expensive versions of the same vites,  Her markup is ridiculous, but the plan is complete.  I guess she is running a business, so she's in it for the profit as well as being a resource for knowledge.

So...here's what I do...congratulations on your choice of the DS.  You *will* be amazed!

Corrie’s Duodenal Switch LIFETIME Nutrition Requirements

64+ oz of hydration qd, preferably H2O

90-100g protein qd

(Whey Protein Isolate shakes (30g each) with Daily Nutrition Plan)

4 Centrum Complete-type Multivitamin/Mineral Tablets(4 pills) daily

(supplemented with NOW Multivitamin/Mineral Liquid PRN)

 2400 mg (8 pills) Calcium Citrate with Vitamin D-3  8 Tablets qd

(supplemented with NOW Cal-Mag with D Liquid PRN)

1-2 1.0ml B12 inj monthly, IM

(IM = intramuscular injection - you can do sublingual pills, I just prefer this)

(supplies 1000-2000 mcg Cyanocobalamin per inj, per bariatric supplement plan,/lab results)

200 mg(4 pills) Thiamin (Vitamin B1) daily

650 mg Iron(2 pills) daily taken with 500 mg(1 pill) Vitamin C

B Complex 100 – (2 pills) daily

Chelated Zinc -  200 mg daily (4 capsules)

THE FOLLOWING VITAMINS ARE *VERY* IMPORTANT - DSer's ARE AT HIGHEST RISK OF DEFICIENCY IN THE FOLLOWING FAT-SOLUBLE VITAMINS:

Dry Vitamin A – 25,000 IU  daily

Dry Vitamin D – 50,000 IU daily

Dry Vitamin E – 800 IU daily

Dry Vitamin  K 1- 2,000 mcg daily

Dry Vitamin K 2 – 10,000 mcg daily

All fat soluble vitamins *MUST* be in dry form! Duodenal Switch patients *cannot* use oil/softgel based capsules! You will have to order most of your dry fat solubles. Vitamin shops just don't carry the type and potency that we need. Vitalady is one source for immediate post-op, but once you get your complete kit of DS vites and the list from her ( I can send it to you if you like),  you can go hunting online for a cheaper source.  My primary sources are Lucky Vitamin and eBay (yes, eBay!) You will have to order most of your dry vites, as OTC stores just don't carry them, and health food stores aren't much better.

This is such great information.  Thank you all for your responses!  It looks like I might need to adjust a few of my nutrition goals, but slowly.  It's crazy to think that my food choices could soon do a 180.  At the age of 15, I started my first low/no fat diet.  Now, 20 years later that's all I know.  Really!  I'm great at eating low fat.  I love skim milk, low fat cheese and light butter.  The real, full fat stuff actually upsets my stomach now.  So this will be a huge learning curve, one that I'm sure I will learn to enjoy.   And now I suspect the low fat life (which usually means higher carbs) has been more a hindrance than a help over the years.  You think you're doing great eating low fat but there are usually extra carbs packed into those products.  Oh well.  The DS seems like a great chance to make a permanent change.

On a side note, I'm in line with vitamins.  I have to give credit to my new surgeon's office for that.  They have specific regimens for each type of surgery.  The DS regimen is clearly different than the RNY.  They get it!  Yay!  My surgeon also said that if my appeal/reconsideration is denied for DS, we need to discuss the RNY in more detail before she would even support me getting that. Because of my having lost 100+ pounds twice in the last five years, and gaining it all back, she isn't sure that I could adequately keep it off when the malabsorbtion lessens with RNY.  She's on it!  That is exactly my fear with RNY.  So I'm crossing my fingers for my appeal with the DS.  The insurance company has 15 days to respond...but then again we did send them 68 pages of information.  Cross your fingers!

Again, thank you all for your feedback!  It has been really helpful and keeps me hopeful for a healthy life....with bacon.

You've got a great surgeon!  The challenge after the DS will be the education of the PCP and other healthcare professionals you may come in contact with.  DS Facts has a great printable emergency card for your wallet.  I would suggests printing one and laminating it, to keep in your wallet with all the other emergency information, as well as making "ER Folders" for your home and car, that includes your surgeon and PCP  contact information, other emergency contacts, dietary and supplement requirements, and a diagram and simple explanation of the DS.  It will be invaluable if you ever have a hospital stay for *anything*.