Questions, Rambling, Ranting

Sorry had to remove this due to too much personal identifying info. Sorry.

Welcome.  I'm not sure that anyone goes into the DS without some major concerns. It turned out very well for me and for the vast majority of us. So just a b road overview of some of your concerns and as you look for more specific info people can chime in on particular issues..

Office staff can suck. No doubt about it.

First on the VSG with possibly the switch later. In my mind it really depends on your weight loss history. My biggest fear was weight regain. I could usually lose a large amount of weigh by restricting or changing what I ate but I always gained it back. While weight regain is possible with any WLS it is less likely with the DS because of the malabsorption. I think the full DS is the best way to go overall. You can always do the DS in 2 steps - VSG then the Switch part but personally I would rather have a single surgery. 

For the smell. I know some people have that problem early on because of the ketosis and the rapid weight loss. It never happened to me, at least no one ever said but it seems to go away after a while. Maybe some of the other people will have some work arounds for that. I just think if you have that problem it will be temporary.

Vitamin. In the end you pick a starting point and then change it based on your labs. A lot of people use a list from Vitalady that has been around a long time. I've never seen anyone have a problem starting there. It was a little daunting to me at the start so I took that and my Doc's recommendations, ASMBS recommendations, along with other peoples lists (search the archives here) to come up with a starting point that made sense to me and then modified over time based on my labs. Vitamins are a lot to begin with but at 3 years it is just something I do and don't think about it much except as it interests me.

Specifically on ADEK. Most people don't need E for some reason so I wouldn't worry about that. While some people seem to do OK on Bariatric Advantage most of us think it is not a long term solution. Maybe OK for the first couple of months while you are getting used to everything but in the long run the dosages are wrong and way too expensive. What we usually take are the Biotech versions of these vitamins because they are "dry" and come in good sizes. "Dry" means it is not suspended in a gel and is water miscible (dissolves in water). Standard doses are 50k vitamin D, 25K vitamin A, and 1k Vitamin K. Some people take a lot more of the vitamin D. Most nutritionists will initially think the vitamin D and A doses are too high depending on their experience and background but the proof is in people's labs. I spent the first 6 months upping my D by 10K here and 5K there but I didn't stabilize until I started just doing 1 50k capsule and didn't gain ground until I went to twice a day.

It's too bad your family isn't more supportive but you are right. No one can really understand how hard it can be to live with the weight.  I think it's good you talk about the changes with your boyfriend. You do tend to still be you and sometimes much more as you interact with people differently and they react differently to you. Always hard to say how much that will really change you. It may look to other people like you are changing and not seem that way to you at all.  Just something to keep in mind. HEalthy and happy are the goals for all of us.

Pretty rambling myself here.  Never a bother though even if responses take a wile. :)

Pete

Wow!  Thank you so much for replying! I'm glad you are so positive about it all, and took the time to answer my questions.

I will look for the post on vitamins, that will help squish my biggest fears right now. I think just taking to people that have had surgery helps. 

Thank you again Pete! 

I think you've made a great decision to have the DS and improve your health and quality of life. Many people go into bariatric surgery without the support of family and friends, sad but true. Most of the time they mean well and are just afraid for you. They don't understand that the risks of this major surgery, while real and not to be minimized, have fallen over the years as surgeons and anesthesiologists have gained so much experience working with MO and SMO people for all sorts of surgeries. They also forget that you have very real risks if you remain as you are now, the risks just seem less immediate to them.

The DS has the best statistics of any bariatric surgery for percentage excess weight loss, for maintaining that weight loss, and for resolution of almost all comorbidities. It is suitable for anyone who qualifies for bariatric surgery, but especially useful for people with higher bmi's. And while, as you know, it doesn't mean eat anything and everything, it does allow for much more normal and varied meals than any other bariatric surgery.

Note that I'm calling it bariatric surgery and not "weight loss surgery" because this is about more than the number on the scale. The DS creates metabolic changes that will help people resolve permanently diseases like type 2 diabetes, and that will help you to keep the weight off and stay healthy for the rest of your life.

As far as doing VSG first and seeing how it goes, I would not recommend this, both because, at your present weight, VSG is very unlikely to get you anywhere close to where you need to be, and also because you will probably have trouble getting insurance to pay for a second bariatric surgery. Most policies have different requrements for revisions even if you are still MO, and some even have "one wls per lifetime" clauses.

More info coming to you in a pm, so look out for it!

Larra

I don't stink.  And I had the DS more than a decade ago.  We do have stinky poop but you already know there are products to deal with that.  And no one has poop that smells like roses.

Agree with Larra about the sleeve.  You will have no chance with the sleeve alone.  Sorry.  And guess what, odds are you won't be constipated anymore either!

In the beginning, the DS does sort of takes over your life.  Over time it just becomes normal and you don't even have to think about it.  It's just life.  What's your future look like if you do nothing?  I can tell you for sure that you are missing out on life.  You don't realize it because as you said, you have been over 200 since you were 7.  Almost everyone who has the surgery says they wish they had done it sooner!

You have a metabolic disease and the DS is your best shot to fix the problem.  Good for you!

The docs office...meh.  Most of them are questionable.  And don't take their supplement advice either.  Surgeons are good cutters and most of them know nothing about post-op nutrition.  Take a look at vitalady's DS regimen.  What you will need is close to this.  Start there and tweak later when you get labs done.

In the beginning, your job is to drink, walk, and heal.  Then you need to cut the carbs and lose as much as possible as fast as possible.  I don't want you to run out of DS before you run out of fat!  Don't fall into the trap of thinking you are losing too fast/too much.  Guess what...the people who speak this stuff are usually back in a year or so needing to lose the rest of their weight.  Just lose the weight!  The only good carb is the one you don't eat.  Unless your BMI goes under 20 don't even think about it.  Bounceback is real and it happens to almost everyone.  If you have a goal weight, it's good to lose to 10% less to account for the bounce!

It's likely, with your history, that you are a superabsorber.  Even the DS will be work for you.  Make the most of that first chunk of time where the weight comes off pretty effortlessly.

I've never heard of a superabsorber.  What is that?

I'm all right with busting my booty to lose weight, I'll just be grateful for more results this time!

The more people that tell me about their life, the less scared I am getting.  VitaLady's spreadsheet was super helpful! 

There are people who are fat because they eat too much for all the wrong reason.  There are also people who were fat before they ever made a food choice.  Most of their family is fat.  And they eat pretty normally.  These folks are superabsorbers.  Normal people poop out calories, superabsorbers use more of what they take in.  We are the individuals who would survive the apocalypse.  We look at food and gain.  Out whole lives have been 1 diet after another, many starting at a very young age.

You know you and you have to be honest with yourself.  Many people who are very heavy when they are young are superabsorbers.  Their obesity is a metabolic disease.  The DS is the best option because of the malabsorbtion.  But if you are a superabsorber, it's not a free ride.  That's why I said lose as much as possible as fast as possible!

I live in Turlock, California and had my DS in Jan in Modesto and memorial with Dr. Corian, he got a new PA at the end of the year and she is really nice have had no problems the last guy was a little pushy.  I have heard lots of the girls in modesto complain and the other Dr office as far as staff lately and they lost a PA too now.  Best decision I have ever done, we have a support group in Modesto next wed if you would like to go huge group up to 75 people some times.  There is probably about 15 of us are DS'ers.  I was 318 and now I am down to 226 in about 5 months, I have been in a stall the last 3 weeks but they happen to all of us.  I get help with my vitamins list and any needed ds info from bariatricfacts site those people are the best with any ds, because at the beginning I too felt lost and not as informed.  My insurance only allows for 1 bariatric surgery so I did the DS I too had wanted to do the sleeve first and then that but my PA told me it would be hard to push them to let me do the second surgery.