Hello all - some golden advice please

At my heaviest I was 518lbs. In 2010 I had the Gastric Sleeve and things went really well and I lost loads of weight - to date 216lbs.  At my lowest I was 298lbs but recently since a diagnosis of Rheumatoid arthritis and the concoction of drugs I'm on to get that under control I've seen my appetite increase and my weight do the same, the massive exercise I was doing had had to be called into check because of the disease - and old demons return. My BMI at my heaviest was 78.8 now it is 45.9. As my BMI was so high my surgeon recommended to have the Op is stages and he said the DS would be the best for me.  I've now reached the stage of the second part of the Op and I have the following questions:

1. There's a raft of information "out there" on this option but could the post-op lovelies share with me the *most* important information/lesson you learnt. I'm doing all the reaserch on vitamins/minerals and bloods.

2. Is there anybody out there who's got RA and has had the DS - how has it affected you?

3. Is there somewhere I can get a table of the levels of vitamins and minerals a *typical* person needs?

thanks so much in advance! 

Some websites you should visit include www.dsfacts.com, www.bariatricfacts.org, www.vitalady.com, and various DS-oriented FB groups.

Thanks!

My mom had severe RA and I know she was on Humira.  I don't know how that affects all of the vitamins and supplements you need to take.  I wonder if your Rheumatologist and Bariatric Surgeon could discuss the best option for you.

I would think that obesity itself can't help any disease and that it would just make you more uncomfortable overall.  I take a lot of vitamins in 4-5 batches a day.  My best advice for anyone considering the DS is that you can and will take all of the supplements needed for life, can afford them and all of the protein requirements, can and will eat animal meat, will be diligent on lab work, be able to advocate for yourself and your health, be ok mentally with the possibility of complications, and that you are having surgery more for survival and health than vanity reasons.  I added that last part because once I had complications (bowel obstruction surgery), I realized how serious this decision was and continues to be.  I would have died had I not had the DS so I never regret that decision.  If I had only done it for vanity reasons I would have been kicking myself.  Good luck on your decision and I hope you get some advice with someone with RA.  You might ask your DS doctor if he/she has other patients with RA and if they would be willing to arrange contact for you. 

Thank you so much for your detailed reply. My reasons are for my continued improvement in my health and to enable me to have babies (in time of course!)

Others have already provided the right resources for you, so I'll just mention that it's great that your surgeon has recommended DS and not gastric bypass, because with DS you can still take NSAIDs for your arthritis if they help you, but with gastric bypass they are contraindicated for the rest of your life. I realize that RA is not the same as osteoarthritis and that other drugs are often used, but it's best to have every possible weapon available to you.

Larra

Thanks Larra x

I'm not quite sure what caused me to "learn" this lesson but before the DS I couldn't separate the urge to eat caused by
hunger and the urge to eat caused by emotion/mind games. Since the DS I find it much easier to tell one from the other.
It gives me a whole different perspective on eating. I don't know if it was the operation, the resultant loss of weight, or
just the focus on eating to be healthy - tracking liquids and proteins - I'm just glad it happened.

You probably won't find a list for a typical DS needs. Surgeons are all over on what they suggest and a great many of them 
are just wrong on their advice. A base list would be calcium, iron, multi, B12, and the fat solubles vitamins A,D,E, and K are
a particular problem for DS'rs. Not everyone needs to suplement vitamin E for some reason. 

I take 5 doses a day. Everyone finds a starting point and then you adjust according to your labs. 

There are two ways to go when figuring out your starting point (mostly a philosophical
difference since everybody adjusts based on labs). You will eventually run into the vitalady list which lets you start high and go down
from there or you can look at the individual lists people have posted and see what makes sens to you - that would be more 
along the lines of starting minimally and adding from there. I started low and added but a great many people start with the Vitalady 
suggestions and then reduce if they need to. While some people have issues with a particular vitamin formulation I've never seen
anyone have a problem with the vitalady list except for a few [people very sensitive to vitamin A.

Here is a sample of what I take after 19 months.
1500-200mg calcium split into 3 doses 
Magnesium oxide - 400mg with each calcium dose
magnesium glycinate - 100mg
2 centrum-like multi vitamins - one at a time with 2 of the calcium doses
Vitamin A - biotech dry 25K
Vitamin D- Biotech 50k capsues - 2 a day
Vitamin E - 400mg
Vitamin K - 100mcg
Iron in a dose by itself with vitamin C (approx 180mg)
Iron - proferrin - heme iron with 4th vitamin dose - 12mg
Zinc - 90mg
copper - 900mcg
Potassium-otc-99mg-every other day
B12-500mg sub lingual - every other day

Good luck.  Search the archives here and there is a great vitamin section at the pro boards DS site.
http://weightlosssurgery.proboards.com/board/43 along with extensive archives.

WOW! Thank you so much for such an amazingly detailed reply!

The biggest lessons I've learned about living with the DS (9yrs out) are that:

Most gas and other digestive effects are usually from what you eat, and it takes years to find triggers, and they can be strange.

The medical staff at the surgeon, and even Nutritionists, have no idea about long-term DS nutrition, so nod & smile, and consult those of us who have been-there-done-that.