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Tanya - has this only been since you decided to go back to basics or did it start before? IMHO, you're not drinking nearly enough water. You should get a MINIMUM of 64 ounces of water a day. Is this new or has this been your water consumption for the last 11 years?
How's your fat intake? That could be a major cause of constipation - you need fat to keep things moving along. No lean proteins - go full fat. 100 grams of protein should be the minimum amount.
Add fiber to your diet - I add one scoop of organic fiber to my drink in the morning when I take my vitamins.
Have you changed your vitamins at all? Added iron? Upped your calcium?
Janet in Leesburg
DS 2/25/03
Hazem Elariny
-175
So I am 11 yrs post op and decided recently to go back to basics after a 30 lb weight regain. I keep a food log and aim for 100 for of protein per day and limit my net carbs to 20-30 per day. I get about 32-40 oz of water a day and am trying to increase that number.
My issue is that for the first time since my surgery I am experiencing constipation. Before lowering my carbs I was super regular. 3-4 times a day. Now I struggle to go once a day. I have gone 3-4 days without pooping. This has me very worried. I take colace every day now. And I was told to try MCT oil. Your thoughts?
Tanya B. 
SUCCESS IS ONLY A STEP AWAY
I was advised to get skin removal at 350 pounds (my highest weight was around/over 750) and they would remove a lot of skin. Even then it'd not be anywhere near like 40 pounds, though, without liposuction. They also told me that I'd have had close to a 100% wound failure rate and that I had to be on bedrest for at least 6-8 weeks to minimize it. She would have done it, but she said to expect it would be extremely difficult recovery wise. That's something to keep in mind. I weigh significantly less now and still am waiting to drop more weight.
I would still consult with Dr. K even if she made her decision. Even though I loved my surgeon I still got a second opinion. I mean, I never buy a car from the first car salesman. If I'm going to spend 30k, I'm going to get other opinions... especially being self-pay. The problem with hybrid surgeries is that this phrase isn't very specific. I would clarify what makes it a hybrid and get it documented so she has records of what was done in the event of other complications. He's one of the best, and he will be extremely honest with her regardless of whether he does the procedure or not.
I follow a ketogenic diet post-op. I also have a diagnosis of binge eating disorder. Feel free to ask me about either!
It is not that we have so little time but that we lose so much...the life we receive is not short but we make it so; we are not ill provided but use what we have wastefully. -- Seneca, On the Shortness of Life
Some absorption can increase but some can also decrease. It really depends on the individual medication, because they are not all metabolized or absorbed the same. There aren't many studies about the duodenal switch and absorption. Studies with the RNY do show decreases in plasma concentrations for some drugs (Cymbalta is a big one), but with the RNY contact with the duodenum is lost which isn't the case for the DS.
It's a good question to ask a bariatrician, actually, as they probably know the most about how malabsorption affects pharmacokinetics.
I follow a ketogenic diet post-op. I also have a diagnosis of binge eating disorder. Feel free to ask me about either!
It is not that we have so little time but that we lose so much...the life we receive is not short but we make it so; we are not ill provided but use what we have wastefully. -- Seneca, On the Shortness of Life
Sorry but I'm having a hard time following your post. I guess I'm confused as why you're so concerned about whether you weigh 273 or 278. I would recommend stop worrying about how much you weigh and start tracking what you're eating. I think from your signature block it appears you started with the sleeve and then got the switch done. Technical not a revision (revision would be RNY to DS, or DS to RNY). Many people have the same issue because you don't have restriction anymore (only malabsorption).
Go back to basics - you already said you need to start writing down what you eat. Focus on high protein, low carbs, and lots of water. If you get hungry, snack on protein - nuts, jerky, deli meats/cheeses, etc.
Janet in Leesburg
DS 2/25/03
Hazem Elariny
-175
I graze all day, but try to focus on protein snacks - nuts, cheese, deli meat, yogurt, tuna, jerky, etc. Stinky gas is definitely a sign of too many carbs.
Start keeping a journal and you'll find out pretty quickly what helped you add those 50 pounds. Ideally your DS still works and once you get back on track (high protein, low carbs, lots of water) you should drop those extra pounds.
Eating post-DS is all about balance - eating what you want but making sure you get your protein in. Also eating just enough carbs to keep from losing too much but not gaining.
Janet in Leesburg
DS 2/25/03
Hazem Elariny
-175
Donna SW- 363 CW- 326 GW- 230 VS 04/25/2013 Dr. M. Jawad
Donna SW- 363 CW- 326 GW- 230 VS 04/25/2013 Dr. M. Jawad
I recently had to increase the dose of Lamictal XR from 200 mg to 300 mg after many years of the 200 mg dose for seizures. My neurologist checks blood levels at every visit and I take it on an empty stomach. It has been extended release since I had a seizure with the non extended release formula. (I think that was a generic vs brand name issue which can happen with anyone). Testing blood levels of critical drugs is recommended.
No issues with outpatient antibiotics or pain killers in effectiveness at the standard doses, but antibiotics cause killer diarrhea.
It takes 48 hrs to a week to stop craving sugar/carbs when I get back on track.
Carbs cause so much of a gas problem when I overdo that it is impossible to be around anyone. It's a good deterrent. I do crave them but once I'm off and stick to my routine the bathroom issues are resolved.
I try to not let my weight go past 10 lbs.up. In my head, I can lose 10 lbs. I find 25 lbs or more very daunting.
I still struggle with just doing a little carb that eventually goes to a carb binge. It's the same crazy routine. You would think you would not expect different results. It's like my brain forgets after a few weeks and I start the bad habit. I am much better at catching myself before I go too far.
Good luck. Go back to what worked before. It's our only hope but at least we have a reliable tool and plan.
RNY revision to Lap DS Feb, 2016, Dr. Ayoola.
HW 235/SW 184/CW 127
