Surgery date set...nervous & excited!

My surgery date is set for 3/10!  My WLS journey began in July and now it's quickly approaching. I'm getting so nervous mainly about recovery & possible complications.  I choose the DS for various reasons but my main reason was the overall results and less likely than other surgeries for weight regain. From what I have read, you seem to be able to maintain a somewhat normal diet with less restrictions (compared to other WLS) & less complications as long as you maintain your vitamin regimen & check labs every 6 months. Which luckily my surgeon has a multivitamin specially for bariatric patients in switch I will take 8 tablets per day or 3 scoops of the powder version. I am currently on the "liver shrinking" diet, 800 calorie VLCD, which I'm having a hard time with but trying to stick to it due the fact it will pose less complications during surgery.  I want to shake the nervousness & get past the difficulty of the pre op diet.  Any advice is greatly appreciated!

Congrats on your decision and your upcoming date!

Unfortunately, the vitamin regimen recommended by many DS surgeons is not adequate, esp when they are selling a product to you themselves. I say this without even knowing who your surgeon is because it is so rare that the regimen gets it right. Surgeons may be excellent in the OR but most fall far short on the nutrition end of things, and combination products such as the "powder version" generally contain some of the necessary vitamins but not enough of anything. You would be better served to buy separate dry D, A, and K, and also your calcium citrate (which needs to be in divided doses throughout the day) and adjust each as needed going by your lab results. Anything with just 8 tablets/day isn't going to keep your vitamin and mineral levels healthy, and it's much, much harder to catch up after levels tank than it is to maintain good levels.

Larra

Thank you, Lara!   What I'm taking is called BariLife. The dietician actually did comparison to other products which is refreshing about the care of their patients.  No doubt I will have to tweak levels with additional vitamins and not solely rely on the powder form.  Thank you so much for the advice!

I take 1-50k dry D, 1-25k dry A, 1-400iu dry E and sometimes 1-K.  I've supplemented this way adding more then taking away when labs come up.  You are only going to be getting 9k of D, 15k of A taking the powder 3x/day and it's going to cost you a bundle at $30 for 60 servings that's for 20 days, and tablets are $30 for 22 days taking 8.  My 100 Vit D 50k is $25 for over 3 mo.  The 25k A is around $8.  I do supplement with over 50 women's multivitamins and take 3/day.  At one point I was taking 3 Vit D a day to bring my D up - that's 150,000 iu. I've found it's cheaper to supplement what I need, I take 20 different vitamins a day and calicum 6x/day.  I tweak from there.  I think it sounds very easy ordering this way, but very costly, in the long run, when it doesn't have to be. 

Here's the info from BariLife on the powder and tablets:

One scoop of powder contains : Vitamin A: 5,000 IU, Vitamin C: 60mg, Vitamin D: 3,000 IU, Vitamin E: 100 IU, Vitamin K: 120mcg, Thiamine: 3mg, Riboflavin: 4mg, Niacin: 20mg, Vitamin B6: 4mg, Folic Acid: 200mcg, Vitamin B12: 500mcg, Biotin: 300mcg, Pantothenic Acid: 20mg, Calcium: 1000mg, Iron: 22.5mg, Iodine: 150mcg, Magnesium: 400mg, Zinc: 15mg, Selenium: 70 mcg, Copper: 1mg, Manganese: 2mg, Chromium: 120mcg, Molybdenum: 100mcg   Three tablets contains:

Vitamin A: 5,000 IU, Vitamin C: 60mg, Vitamin D: 3,000 IU, Vitamin E: 100 IU, Vitamin K: 120mcg, Thiamine: 3mg, Riboflavin: 4mg, Niacin: 20mg, Vitamin B6: 4mg, Folic Acid: 200mcg, Vitamin B12: 500mcg, Biotin: 300mcg, Pantothenic Acid: 20mg, Calcium: 1000mg, Iron: 22.5mg, Iodine: 150mcg, Magnesium: 400mg, Zinc: 15mg, Selenium: 70 mcg, Copper: 1mg, Manganese: 2mg, Chromium: 120mcg, Molybdenum: 100mcg

Thank you for the info.  I may try your suggestion.  I'm currently doing 3 scoops of powder per day which contains 60 scoops and cost around $35.  Eventually, I may switch to the tablets which I would take 8 per day if I do not go with just taking individual vitamins.  

The pre-surgery diet was harder for me than the post surgery diet has ever been.  So, in many ways you are doing the hardest part right now.  I only got through it by telling myself "I can do anything for a month." about 200 times a day.  After the surgery your body will feel so differently about food that it will be a night and day experience. 

 

If you can, walk off the nervousness.  After the surgery, walking is the best thing to get your body booted up again, so any progress you make towards that pre-surgery is a bonus.  At least solve the walking shoes & clothes for exercise issues now. 

 

I think researching vitamins, supplements and laxatives is also something that should be done pre-surgery.  IMHO, you need to own this information.  If your surgeon says you need 10,000 iu amount of vitamin A and the DS Surgery Veterans says you need 107,000 iu vitamin A, I think you need to be able to describe why you choose the amount to take that you did, and what vitamin A is and does and what a shortage looks like.  BTW, I choose those two numbers because that is the range of the recommended dose by the DS experts.    Calcium, iron, D, K and Zinc are also good ones to understand in more detail. 

 

I'm a planner, so I spent hours planning for future things to calm my nerves.  Like what kinds of skinny clothes would I want?  Or where would I want to go on skinny vacations?  Or what ever, I'm not sure it mattered what I planned, as long as it kept my mind on the benefits coming my way post surgery. 

 

Reading DS forums was also a great way to calm down.  Giving back to others is always a great way to do good for yourself. 

 

Good luck! 

Thank you, Brandy!  I'm hoping the diet is the hardest part, too!  I have always been a pretty healthy eater but tend to over eat or emotionally eat.  I'm done with the yo-yo diets and the losing weight just to regain that and then some.  I'm a die hard planner, too.  Thank you for sharing your experiences and encouragement! 

Congratulations. You are in the final stages now. Moving from pure excitement to panic.  

Your reasons are some of the same reasons I got the DS so I'm with you on the yo-yo dieting and the weight regain. I also had diabetes and sleep apnea that were resolves with the DS.

I'm always a little unsure how to comment on the diet because while what you say is true at the maintenance level I found that for the first year or so my diet was pretty different because of restriction and the need to concentrate on protein. I'm going on 2 years and within 10 lbs of my goal weight so my menu is now a lot more varied but while actively losing I did high protein low carb to make the most out of what a lot of surgeons think of as a "honeymoon phase" where weight loss is the easiest. 

As for vitamins, as long as you tweak according to labs that isn't a bad place to start. There are always people that do well on those combo vitamins and many that don't seem too. Reacting to trends is your best bet in the long run. 

Once I started thinking about buying vitamins over the span of years I figured out that the buying vitamins separately was the best choice economically. While I do think Larra is right that it  is the better option health wise to separate them out it is by no means an absolute rule. 

I think D is the biggest culprit where DS vets and surgeon's offices disagree and your labs will tell you who is right. I started out at 10 - 20K the first couple of months but lost ground until I went to 50k I didn't move up until I went to 100k a day. But that was me and you can see on your own labs.
I did see the comment about Vitamin A. I think you will find most people between 10 and 25k. It is true that some people seem to have problems absorbing A and take larger quantities but I think they are the exception.

I found the first couple of days on the pre-op liquid diet to be the hardest. Just stick with it as best you can. Surgeons on this are all over the place but best to try to do what your surgeon wants as best you can.

So, things that you nutritionist may not have thought of but might be useful. Calcium can block you up and a lot of us take magnesium oxide to counter that, others rely on fiber, stool softeners, Miralax, whatever if they have that problem. 

Pete

Thank you!

I, too, will chime in on the vitamins.  They'll do 'okay' for about 3 months before your levels start staggering.  One thing I've noticed about DSers is that we are not your average bear.  One person is needing iron infusions while another never needs to supplement iron past the multivitamin.  Our needs are so variable, and these bariatric multivitamins are giving a little more than a normal non-patient needs, but rarely even enough iron, calcium (which should always be taken without iron) A or D.  That means it's about as good as a double-dose of Centrum, and you can get that much cheaper and in chwewable form.

If you really want a good shotgun approach to vitamins and NOT have to deal with deficiencies in the next six months, I highly reecommend the DS regimen at vitalady.com.  It's not a magical mutivitamin, but daily packets of the essentials at the dosages we need.

Just to give you an example, look at the Vitamin D3 levels in your surgeons' multivitamin.  Do they amount to 400, 1000, 5000 iu?  Take this into account that the average DS patient needs between 50,000 - 150,000 iu of D3 to account for malabsorption.