What's the diff in self care between DS and Sleeve?

I have several q's around is there extra work involved when a DS is done v sleeve? 

1. Do bowel issues come up more w/ DS? I just read of someone pooping 3x daily. Is this normal no matter which procedure?

2. Are you unable to eat healthy fats w/out issues? (Healthy as in high protein meats, cheeses)

3. What's the diff in vitamin consumption between the two? I am terrible about taking vitamins. I hate hate hate taking pills!

4. I failed w/ band (restriction only) does this mean I probably won't do as well with sleeve only?

5. With the band food sat in my pouch area for a while before hitting my tummy and I always felt hungry!! It was so frustrating to eat a few bites of something and feel it in the pouch but the tummy is still saying feed me. Do you have normal hunger and full tummy feelings w/ the sleeve? 

6. Do you have to chew your food to baby food consistency in order to eat? (One of my biggest beefs w/ the band!)

7. What is the worst/most annoying side effect you've encountered?

A little background on me... banded 2008 HW 240. Band removal 2012 @ 220 lb. CW 240 BMI 40. Going to a seminar this week however hoping with the history of a band I won't have to go through a long waiting period w/ insurance. 

1. Bowel movements are more frequent since our food travels a much shorter distance. I wouldn't call this an "issue", but I do have a giant poo every morning if that's what you're asking.  If I eat certain simple carbs, I can also get quite gassy.  There's a period of trial and error, but 8-9 years into this, I feel pretty mu*****ontrol and report no "issues".

2. I eat all fats without issues, healthy and not.  I avoid all food labeled "low fat", and focus on marbeled, untrimmed meats.

3. DSers take many more pills.  I take 12 daily, but some take twice as much.  It depends on what our bodies need vs, what it absorbs from foods.  If you are unwilling to get into a habit of taking vitamins, then do NOT consider the DS another minute.  Keep in mind, though, that you will also need vitamins with sleeve, but in normal dosages.  Either way, you will no longer be able to consume enough nutrients to sustain good health, so supplementation is necessary.

4. If you got no results with the band, then I wouldn't expect much better with the sleeve.  

5. The major difference with the sleeve (from your band) is that you will have more satiety with the sleeve because of the lack of grehlin production, so think to yourself....did the band fail you - or did you simply out eat it?  Was it restriction or compliance that was the downfall?

6. I chew quite normally - no need to chew to mush

7. For me the most annoying part is some of the new food intolerances I have.  It's not a show-stopper, but annoying.

Well  explained

The sleeve is restrictive only.  As is the band.  If the band didn't work for you, the sleeve won't either.  Life post DS is pretty normal once you get by the first year or so.  Life post sleeve is pretty much a forever starvation diet.  Just like the band.  600 to 800 calories a day.

And honestly, if you won't take the supplements post DS you will not be healthy or have a good life.  The DS is not for you if you won't do the supplements and get enough protein.  You need to see if you can make it a habit to take pills a couple times a day.  Start now!

I eat normally and chew normally.  You would never know I had WLS unless I told you.  I take vites twice a day, around 15 pills each time.  I usually poop 2 or 3 times a day.  Twice in the am and sometimes once in the evening.  Diarrhea is common in the beginning but should be treated and over time you figure out what causes it.  I CAN eat absolutely anything but it's always protein first.  I can eat a normal sized meal.  Protein and fat are free food.  What you avoid like crazy are carbs and sugar.

You did not FAIL with the band.  The band failed you!  Band results are dismal at best.  I have been in the WLS community for more than a decade and I know ONE person who was significantly overweight who has done well with the band over a long period of time.  Why do we buy in to the idea that we deserve to be miserable to be thin?  And living on a starvation diet forever is not my idea of success regardless of the number on the scale.  JMHO.

I had NO IDEA that I would need to eat 800 - 1,000 calories for the rest of my life on Sleeve, until in maintenance it became clear that I would gain my weight back at 1200 calories. DS would have been the better choice, but Thank God, I am still able to convert to DS, 4 years out...!

This is simply not true. There are plenty of people in the VSG forum that are maintaining on more than 600-800 calories per day. I am eating 2000 calories per day to maintain my weight - it just depends on the person. Are there some that have to keep calories incredibly low? Sure.... but your post above just makes it sound like a "given" which it is not. I wouldn't even say it is the norm.

I think Valeries is spot on with her answers. I'm 16 months out so I'm not an expert.

The majority of DS'rs settle down to  one or two BM's a day but a lot depends on what you eat. There are people 
at the far end of the spectrum that can have more BM's than that. Not many but it does happen. I do 1 or 2 a day
but sometimes 3 or 4, that doesn't happen very often now. 

I too no longer eat low fat or look for lean cuts of meat. That doesn't mean that if I have something 
extraordinarily fatty I won't pay for it later. 

I came out of the surgery lactose intolerant. For me this only hits me when drinking milk straight not
triggered by yogurt, cheese, or anything like that. Lactaid takes care of any yen for milk. Less of an issue the
further out I get.

Between iron, calcium, and everything else I am closer to 25 pills/tablets/capsules a day. I used to be overwhelmed
by it. Now I just fill my organizer every month and don't really see it as a problem.

You will have to chew well immediately post-op but I was chewing normally after 2 months.

Most annoying thing. My BM's can really smell bad abour 3/4 of the time.
I use a lot of air freshener and you will see plenty of threads about what to use to dissipate the smell.
There are also plenty of ways to try and get rid of the smell at the source. Strong pro-biotics, or products
like Devrom. this is an annoyance. I'll live with it for the upside of my DS - down 220 lbs.

Pete

I failed the lap band as well and although some have success I feel it should not be offered......... personal opinion only.

The better I am with my protein the better I poop.  Meaning if I do get backed up I find if I drink a protein shake in the morning without fail I will be in the  bathroom.  At first I had several small stools per day and there was some cramping not the case now. 

If I eat more carbs I have more gas and I am bloated.  Easy enough avoid the simple carbs in particular.

Most annoying taking vitamins / supplements and being told by every doctor I do not need them all.  Honestly I have had issue in which I was not taking in enough protein and I started seeing white lines in my toe nails.  The DS is no game and personally I do not want to be a little low in any thing so I take the vitamins as I was advised by individuals on this site.  That said and I wi**** was not the case I do make excuses some times and do not take them and there is zero excuses for this.  My legs are very dry so I know for sure I am low in fat hence my DS is working and I need to be aware of this so I do not cause my body to be deficient in other vitamins and minerals.  I think this is hard because after awhile it like as if you never had any thing done and you would like to be like your old teenage thin self and simply not supplement but we are not the same nor do I want to be as I am very pleased with who I am today with my DS.

At the start I did tend to clog the toilet regularly although I installed new toilets.  A quick fix to avoid a plumber call at the price of 90 dollars each time...........I try and flush in between portions of my bowel movement and I have the auger (8.00) near, one can purchase at home depot and it is much better then any plunger I have ever bought!!!  That said I live in AZ and they are big on saving water so my toilets do not work like the ones I used in Chicago.........

Flatus, Farts do smell and smell more if I eat carbs but I can control this as to avoid any thing embarrassing.  Oh other worthwhile comment is there are drops you can purchase if you need to cover the odor up of your stool if you work in an office as I do on occasion and 8 drops do the trick and AMAZON will ship them to your door. 

The worst complaint and I think it is only when I have not been good about eating simple carbs and which is the scenario of not completely emptying ones bowel so that you keep wiping and there is still a small amount of stool on the toilet paper............ no matter how many times you wipe or how raw you have become.  There has been times the only way to get rid of it was to get in the shower and use the hose:)........... TMI  Again this is a problem when I have been bad to many snacks in a row not a common occurrence and not if I eat carbs once.

Now after hearing from me you are probably wondering why on earth any one would do this.  The fact is I would do it again in a second.  I am a precert nurse and the trend at this time is sleeve and I have approved more sleeve then any other gastric procedures in the last 6 months.  Personally I am wondering either when they will be back or if they will need an adjustment or if they will stretch their stomachs out and will need to have another sleeve once again to get to a healthy weight.  I have not witnessed any of the above after a sleeve so do not think I am stating for a fact that will happen I am merrily speculation.   I only see subsequent gastric procedure if in fact the individual did not succeed with the first gastric procedure they sought......obviously other wise I would never hear from the members or the providers/surgeons as I would hope they would be like me and maintaining their desired weight.  I absolutely love my job and gastric is only about 10 %  of what I do and I process around 200 precert a month which range from cardiac bypass to gastric bypass.  I have been doing this type of nursing for around 8 years or so but specifically in my position at his particular insurance company going on 2 years in just a matter of a few days Aug 11!!!!  Any way in the 2 years I have not had one failed DS.....  I am not saying they do not exist but I have not had one.  In my research as being a prior failed lap band that is what made my decision hands down if there was any failures I was not going to invest the time and money once again to be disappointed.  I have never regretted my decision.  Logically I would think with a sleeve one would need supplement any way so why not just take a little extra plus there is not the risk of stretching out the stomach.  At this point I seem to have more room in my stomach in the first part of the day so that is when I have my shake and try to max my protein early in the day.  Dinner I am full at 5 bites and either need to put it up or drag it out as I am full and have zero desire for a single bite.

You may disagree but I do think most of us with weight issue there is a psychological aspect of comfort foods.  I know I stress eat and use food for comfort which will never be fixed by the DS and needs to be dealt with on an individual level as what would set me off to eat unhealthy may not be what would set you off.

Hope this helps

Donna

Keep on learning!!!

I had my DS in Mexico and supposedly the surgeon I have following my laps said not even 1 % of his post DS patients ever followed up on their yearly labs which surprises me and I find frightening.  I think it is the best thing I have ever had but if you do not think you are going to follow up with your labs and the responsibility of taking vitamins then this is not the answer for you. 

Honestly I would have said any thing to get rid of the extra weight and not be so short of breath and participate in my daughters life more.  I am not the thinnest DS'er and I know I could do better if I followed the zero simple carbs portion of the diet however I am by far over weight and very comfortable in my skin which is something I have not been able to say until I did have the DS.  At this particular time I am about 160 and I wear a size 12.  I was as low as 148 and in a size 8. 

The DS was for me as I paid out of pocket for both and I simply was not interested in one more gimmick or quick weight loss.  The DS helped me get my weight into a more reasonable parameter now if I want work with my DS I know how to work with it and get smaller.  That said I am told it is easier in the beginning and I am only a few years out go****hink it was 2011 where has the time gone?  If I can be of any assistance please reach out.  I am direct and I may give you more information then you desire but if it is info you need and I have it I will give it.  Please note yes I am a nurse my expertise does not lie in DS and there ware far more educated individuals on this site with regard to the DS.  My past is ICU and recovery so far from gastric procedures.  I can only answer questions from my personal experience not as an expert by any means............  Takes a lot for me to claim I am an expert at something...........  the older I get the less I feel comfortable with that word!!!! such as life thank God we are forever learning!!!

Donna

I forgot to add I do not tolerate fatty meat have no idea if it is because I do not have a gallbladder but it is not an option for me..........  truly any thing greasy does not sit well on my stomach.  I do have very low cholesterol as in under 70 the machine could not read it so I am increasing all my fats.

I do not have to over chew my food.  The signal for being full happens very fast for me in about 5 bites.  I tend to snack all day on cold cuts and cheese and to be honest bad carbs which I know is a no no and I am always updating and removing them from my diet.  Remember the doc changes your physical make up not your psychological make up you will still need to deal with those hang ups for the rest of your life just like any one....  There is no free ride out of that one I found out:)  If you are a stress eater you will continue to do it.  I have to break the habit and go for a walk and some days I am successful and some days I am not.  I am a work in progress as a man told me around ten years or so go:)

You are probably aware but what has been a life saver for me is buying a handheld sprayer for my toilet.  I got it on Ebay for about $10 and installed it myself easily.  In fact, I have one in both my bathrooms.  

I tend towards constipation and take Miralax daily, which makes my stool very soft and difficult to clean.  The handheld sprayer, also called a diaper sprayer, works like the one I have in the shower except it is attached to my toilet so I don't have to remove all my clothes to get clean.

A lot of people have bidets, which are also a good option if you have problems getting completely clean.

At one point, years ago, I gave myself an anal fissure due to aggressive wiping with a washcloth after every bowel movement.  Not a good idea.