Postop

Best of luck.

I've been practicing DBT since 1999. It changed my life. As a matter of fact, I just began Skills classes again this past December. I find I need to refresh them every 5 years to keep myself sharp.

Just to amend one thing: I haven't told anyone (other than my immediate family). One caveat: I've told all physicians I see. I figure it's private & I believe they need to know.

Check with Dr. Esquerra in Mexicali. I'm unsure if he does revisions but I know many who had his/her DS with him. I've also sent you a PM.

I've told no one either. It is possible.

Sounds like a good idea. I had no scale in my apt. That way I couldn't weigh even if I wanted to. Remember, you had a DS. It's a mighty surgery. It would be very hard for it not to work. Also, about 3 months out, I was going into the shower & caught a glimpse of my reflection in the mirror. All of a sudden, I noticed my waist was curving inward. I knew right then & there things were changing. It was the start. There are many NSV to be had!

Maybe you want to stay away from the scale? I never knew about any stalls (or highs or lows) bc I only weighed at my surgeon's office during that first year. That was about every 3 months. Just a thought.

If you had the full DS, then eat. Not sure what your presecribed food list entails, but I would be eating Protein. Add more to meals, or Snacks (if it's protein). Part of the reason many of us have the DS is so we can eat very frequently. I eat every hour or two.

We do eat more fat than average people. Unfortunately, too many nutrit. provide standard weight loss surgery info. for everyone. We're not all the same. As DSers we eat very differently than sleeves, bands or bypassers. Esp. for DSers, fat is so impt. We need it to keep the internal wheels moving (so to speak).

At 11.5 years out, I eat a lot. For instance, 2 [6 oz. pre-cooked] hamburges w/cheese & catsup. Now, I don't eat them in 1 sitting. It takes 2, but I finish them. For breakfast: maybe a 3 egg omelette with cheese & bacon (some people add toast, too). Again, it takes 2-3 sittings to finish it. But I sure do. YMMV. This didn't happen overnight. I ate 1 tsp. of scrambled eggs [for a meal] the first couple of weeks. I got up to 1 or 2 scrambled eggs for Breakfast at a year or so. To supplement, I had 1 Protein shake per day (for the first year) bc I couldn't eat enough to get in the protein I needed. Once I could eat all my protein the shakes were no more (as they are for most full DSers). We eat!

Dr. K. is excellent.

For full DSers, we don't count calories. Ever. I haven't looked at a calorie since I had my DS in 2005. Just sugar and simple carb. grams (and, of course, Protein grams). Plus, you malabsorb. This renders a calorie count (e.g. say it's 1000 calories for a 10 oz. piece of steak [i made this up. I have no idea.]) incorrect. There are posts around regarding DS math, malabsorption & calories. I don't follow them bc I don't count calories. But I could direct you to them, if you want.

Good to hear.

I sent you a PM.

This was great advice. I don't know if I asked you this before, but did you have your ds surgery all at once or did they do the sleeve first, then six months later, the ds?When I had it done, they did many more in 1 surgery. I only knew a couple of people who had it done in 2 surgeries ( and they had very, very high BMIs). Nowadays, it's totally different. More are done in 2 steps. (I was done in a single pricedure).

Best of luck.

No longer. Many want to do the DS in 2 parts unless you're a super lightweight. The single part DS is generally 4 hours. Some maybe a bit less. Others more, depending what they find.

Very low carb.

Thanks so much for this. You don't know how reassuring it is to read someone who lost that much weight on a sleeve alone. I weighed in at 371 and want to lose 225 pounds--that's why he suggested the DS. Knock on wood, I've always been very healthy outside my sleep apnea and hypothyroidism--oh yeah, and cancer when I was 26 . I don't have diabetes or high blood pressure, so I guess that's why he said I'm a great candidate, I guess. He just feels a sleeve can only take me so far and it wouldn't have the lasting results that a ds would have. He hasn't gone into it further yet, but I'm guessing at six months in I'd have the second surgery. Not sure how that works if my bmi drops below 50, or hopefully maybe even 40. How would I qualify then? I look so young now, not even a single wrinkle on my face at 41, so yeah, I'm nervous. My plan of attack is low carb, high protein with very healthy veggies and berries. I want to work out six days a week to try and combat the loose skin as much as possible with a daily slather of Aquafor (best stuff for healing dry and cracked skin), and as much Water as I physically can get down, even if that means constant sipping all day. My insurance pays 85% for skin removal if deemed necessary--which they even said on the phone that losing that much weight will more than likely be necessary. I wonder how that works if the insurance covers skin removal but I'd want a lower body lift. I wonder if the surgeon gives an adjusted price for any work done above a skin removal --I know, I know...you don't have to say it. I'm getting my cart ahead of the horses You're lucky your ins. coverage will cover some skin surgery. Once you begin losing (or even now) start documenting everything with a doctor: rashes, yeast infections, etc. That will help the skin surgery approval process. As for 'shrinkles', many of us do get them. My face was stretched out much more when I was big. Now it's not. When it was stretched out, some acne scars from my cystic acne (when I was in my 20s) were big and wide. Now, they're much less visible. I'm not terribly wrinkled, but, in my 50s (now); yes, I do have some. I expect it as we all get them as we age. My mother looks great for her age. I use her as my template for what I'll look like. With me, though, health was the most impt. I already had some issues and I knew they were only going to get worse as I grew bigger and older. Let me give you a great positive: I eat every hour or two. Most of us do. Protein. A lot. I never feel deprived bc I can eat. Steak, hamburgers, chicken, fish, cheeses, cold cuts, nuts, etc., whatever you can think of. DSers don't count calories. Ever. We're only concerned with protein and sugar grams (including simple carbs.). When I'm hungry at 3pm at work, I can go down to McDonalds and get a triple cheeseburger. Do I eat the bread? Generally, no. Because, if I do, I can't get all the burger in and by the time I finish all the meat, I don't want it. Plus, if I want to knock off a pound or two, I'd pass on it. So while I will never push one WLS over another as I believe they all have tremendous good points, I just didn't want you to focus only on what could happen. I can tell you some of what does happen.

Thank you so much, Post Op! I totally missed this post earlier somehow. It was packed with some really great information. I will ask him about the length of the channel. I will admit, when he strongly urged me to do this procedure, I was completely unprepared (even though I knew it was a possibility) and shocked on the inside, but trying not to show it on the outside. After a couple of days have passed, I'm feeling better about it. More so because I will get a bunch of weight off with the sleeve first, which means I'll have more absorption time to build up on my minerals and vitamins. I guess I just saw some videos on Youtube that freaked me out. I'm not kidding. One woman looked like she was doing a side of crack cocaine along with a healthy dose of meth on a daily basis. She started the procedure looking like she was in her mid thirties and a year later she looked like she belongs to AARP. I honestly felt nauseous watching her, scared that was going to be me. But soon, I came to the realization this probably isn't the best sample size of this procedure. Who knows why she looked like that. It's hard telling. Maybe she didn't take her daily vitamins or maybe she really does do a healthy side of crack cocaine after her two bites of fish--I don't know. But really, good job with all the weight loss. It says you had the surgery in 2004-05? Have you had any regain and how do you feel? Do you ever get nauseous taking that many vitamins? No, no regain. But most DSers do have some. It's generally good as many get too low during the initial weight loss phase. I don't have any problems with my vits/minerals. But I take them constantly throughout the day. It isn't as if you can just take them all at once. It has become second nature to me. I'd feel very weird if I didn't take them. As a matter of fact when I had to have my gb out in 2008, I couldn't take them for 5 days. I was nuts. It just didn't feel right not to take them, lol. I feel good. No question, I've had challenges. It took a long time till I felt like myself after the surgery. Things have come up in the ensuing years. (That's why it's so impt. to have a good team that will help throughout the rest of your life). But I weighed them against the things I knew were coming if I kept gaining.

Stacy, it's a single vs. double anastomosis.

Sure thing. Sounds as if you're getting the SIPS/SADI. That's generallly the WLS with the longer cc.

Due to the malabsorption DSers need tons of vits/minerals. We don't absorb them well. Same with Protein. We need 100+ grams/day. I eat closer to 150. A Dexa bone scan is a quick easy test. It shows how your bones are doing. Age and malabsorption can make one (more so a woman) more prone to osteoporosis. So it's great to have a preop baseline so you can see (as the years go by) if there's any change. My common channel is 100. It was pretty much the standard at that time. But some did have longer and some shorter.

Lots of people need something for the nausea. Hopefully, it'll lessen soon.

Hi. I'm 11+ years out from a full DS. I've heard of doctors mentioning the DS (as the second procedure) as something to think about if you don't do well enough with the sleeve (and keep it off) but yours does seems a bit more insistent. I guess he really thinks it will be necessary in your case given what you want to lose. But remember, the decision is ultimately yours. You'll do what your comfortable with. As for the insurance, I know many DSers who want to have that 2nd stage of the surgery within about 6 mos. The reason being is they may lose enough weight that their ins. co. might balk at another procedure & that sleever wants the switch to add the lifetime malabsorptive component. Today most DSers have it done in 2 steps. Especially if you have a high BMI, it's just safer to keep you on the operating table for a shorter period of time. I'd ask the doctor what length he makes the common channel. Does he use a standard length of: 75, 100, 150? Or does he measure each patient individually? The length will also determine what (if any) types of side effects you may experience. The DS is more extreme. There is potential for more side effects. Most are manageable if you're careful about what you eat and when. That doesn't mean I don't eat junk. I just had half a brownie. I'm at home now as I wouldn't eat something like that in public. I don't want to deal with the gas and/or stool issues that might occur. But...there is also the benefit of your odds regarding losing & keeping it off. As for Vitamins, I don't know many DSers who have luck with the Patches. It's just something I want you to think about. You must be committed to a lifetime of vitamins (I take 40+ per day) and blood tests (every 6 mos. or yearly depending on your surgeon). You should also probably have a Dexa Bone Scan (preop) so you'll have a baseline to be compared to as you age and as your malabsorption kicks in. While the amount of my vit/minerals may have shocked you (others do take fewer, but we all take a good amount) there's no diabetes issues, cholesterol issues, CPAP, etc. You might want to make a pros/cons list to figure out what you can live with and what you can't. Look, I didn't run to the DS. I was told in 2003, I had to have WLS. I ignored that for 1 year. I told no one. Then in 2004, I realized I had to do something (as my cholesterol was 302 and everyone in my family dies of heart issues). I was also a touch below diabetic. I went to 3 hospital programs and at one of them, I learned about the DS. Once I realized I just couldn't lose/keep the weight off on my own; I decided the DS was probably the right one for me. It's a very personal decision as all of the WLS have good & bad points.