ChunkCat

The SADI and the Duodenal Switch (they are different) are the two surgeries with the highest percentage of excess weight loss, the lowest rate of regain and the best reputation for significant weight loss in people with high BMIs. You can read studies about this. That said there are plenty of people with high BMIs that go with Gastric Bypass instead and plenty of them do keep the weight off. Both surgeries have restrictive and malabsorptive components, though their malabsorption is rather different. The bypass tends to be better for people with GERD issues but has a higher risk of ulcers and strictures. The SADI-S tends to be better for people at risk of developing ulcers, for those that smoke or vape and plan on going back to it after surgery healing is complete, and for those that may need to take NSAIDS in the future. The bypass involves a modified stomach with smaller capacity (about that of an egg) while the SADI has a sleeve stomach (banana shaped) so will eat bigger portions. Both still restrict enough calories for weight loss. The SADI is pylorus sparing so the stomach still has the valve in it that keeps food in so digestion happens in a more normal way, the bypass has no pyloric valve so you have to be extra mindful to chew thoroughly as things pass through the stomach differently. Both have to supplement vitamins but do so in a different way--but they are not optional. If you stop taking the vitamins you run a high risk of nutritional deficiencies. The diets are a bit different for the two. I believe bypass patients need to be mindful of seeds, skins, and meat that is overly dry. They need to be more particular with lean protein as they don't have malabsorption of fats to the same degree a SADI patient will. There is some conflicting data that suggests fat absorption in SADI-S patients normalize in the second year post surgery so they need to be careful about not eating too much fat, but the studies are by no means conclusive at this point. SADI patients need a bit more protein than bypass patients since the SADI bypasses a larger amount of the small intestine. Dumping syndrome is more common with bypass. Diarrhea may be more common with SADI-S though I've been told most tend towards constipation like with the bypass. SADI people may have more gut issues with carb consumption but don't tend to have dumping syndrome. SADI-S is a much newer procedure and we don't know as much about it as the bypass. That doesn't mean it is bad and it isn't considered experimental by many insurances anymore, but the fact remains we still don't understand as much about it as we do the Gastric Bypass or Duodenal Switch. In the end it is very much a matter of preference and which patient profile you fit best. You have to pick the surgery that works best for you! I wish you much luck in deciding, I'm debating the sleeve vs DS myself. ETA: The SADI has a bit better chance of resolving metabolic conditions like diabetes and other co-morbidities. Though the bypass does a good job of resolving those too compared to the sleeve!

I've heard of it but I haven't had it done. Hopefully someone else will chime in. Just wanted to wish you much luck on your procedure! Do you have to do the whole liquid diet again?

I don't have any experience with this insurance provider, hopefully someone else has. Have you called your insurance to ask what specific forms need to be submitted for the referral? Sometimes doctors think a blanket referral will cover things when it won't. Someone at the insurance company should be able to give you the specific info needed to get the ball rolling. Then you can take the form in to your doctor or send it on your portal and get things handled properly. It is so frustrating, navigating the various insurers. Each one is different, even between regions in the same state! And they ALL make it SO hard to get the proper care. I wish you lots of luck in figuring this out. I'm really thankful my GP was happy to refer me, she has a sister who had bariatric surgery and did well so she's a huge fan!

I'm having a lot of the feels about things and I don't even have a date yet! I think that's normal. Navigating the changes with other humans around is hard. My partner is diabetic too and very, very emotionally attached to food. And while they are very supportive of my choices and willing to change things around a bit, I think there may be some rough spots because food is a control issue and a comfort issue for them. I've had so many problems with food over the years that I'm pretty detached about it now. But I'm still sure these upcoming changes will be hard on us all. I did manage to quit vaping by just packing it all away. Out of sight, out of mind actually works for me for most things. I tend to eat out of boredom or vape out of boredom so putting things away and substituting other habits has been effective. But having conversations with my head hunger is still pretty hard. I'm not looking forward to the liquid phases of this experience. LOL I've fasted on liquids for days before for other procedures and the first few days are always the hardest, but I have never had to sustain it for weeks! I bet most of us are afraid of screwing things up. I had this whole panic thing the other day about possibly having the DS and then a world catastrophe happening and me not being able to get my vitamins and me dying of malnourishment---when my brain panics it does so EPICALLY! I finally reassured myself I could stockpile vitamins for a year once I find what works, you know, kind of like preppers do? I could be a vitamin prepper! 😂😂😂

I take that Spoiled Child collagen, it is a mango flavored liquid. I got tired of trying to mix powders! I put it in sugar free fruit drinks or tea but you have to dissolve the other drink powder first if you use one or the collagen will make it clump for some weird reason. So far I like it... But your waffle looked seriously delicious!

I don't see how taking more estrogen will help stop bleeding being caused by excess estrogen? But I'm not a doctor... Progesterone always helped my periods regulate but they weren't off for the same reasons yours are. I'm so sorry you are going through this. I once bled for a year straight so I can unfortunately empathize. I'm really surprised the surgeon isn't more help though, they should understand the shift in hormones post surgery better than your GYN. Are you on birth control pills? They might help. I'd talk to the GYN about progesterone if the estradiol didn't stop the bleeding... I hope it eases up soon!

You can do this!! I know it is scary. But weight is not worth dying over... I keep reminding myself that with the horror stories I've read about surgery, there are tenfold that never get told about obesity co-morbidities killing people. It is worth trading medications for vitamins. It is worth trading co-morbidities with some POSSIBLE side effects. It is worth trading physical dysfunction for wellness. Living like this is a life half lived and that is not something I want for myself or anyone else. So I will do the hard thing! I have done hard things before in the name of a well lived life. This will just be another on the list. People very, very rarely regret this surgery. The odds are overwhelmingly in our favor... Your life is worth doing scary things and being rewarded with health! ❤️

Ohhhh, you are in the UK! Then no, not insurance. But I'm assuming they have to adhere to treatment protocols like they did when I lived in NZ? They were quite fussy about them from what I remember... Or else the nurse was just plain rude, that happens everywhere. 🤣

Doctor's offices are often very particular about when they give vitamin/mineral shots/infusions because they don't want to overload the body and have strict protocols to adhere to. Also because often insurance will only pay for them at very specific intervals. A week early could be the difference between it being covered or not. But it is frustrating to go all the way there just to be turned away! I'd call and make them double check the timing next time.

Yay!! That's great news!! The body doesn't like to let go of weight when it is sick or traumatized (like with a surgery) so that stall was probably inevitable. I wish you smooth sailing now and some extra weight loss juju!

I can't answer what will sit well after surgery, but as for general shakes I've found that baby spinach, frozen cauliflower, zucchini, and avocado tend to disappear into most drinks I put them in. Not always the most appealing colorwise but they all work well taste wise. Especially with berries! Yesterday I saw someone on a WLS Instagram use frozen riced cauliflower in a smoothie with low calorie orange juice and a coconut cream protein powder for a tropical Orange Julius and now I'm intrigued to try it...

Good luck!! Crossing my fingers and toes for you!

Huh, that's so weird. Everywhere I've been catheters are used for surgeries expected to last an hour or more. I even had one placed for a 45 min surgery. I wonder if that's why you had bleeding? From pressure in your bladder during the time you were out? Either way hopefully they figure out what's up! Glad it seems to be abating...

Great job!! I'm sure you will make your goal by your follow up! Way to go back at it, making progress must feel really good. Keep going!!!

People at these places tend to forget they are providing you a service and taking your money for it, you deserve to be treated with kindness and respect! It sounds like the nurse at that practice has a God complex and way too much power over the patients there... Abusers will abuse no matter what job they find themselves in. Yes, don't give up hope!! I'm so glad you went to see your GP. I hope the new practice treats you much better. Please keep us posted, we are cheering you on! ❤️

I'm sorry things feel so rough right now. It seems most people regret these operations at first because recovery is so miserable. But eventually things even out and the feeling eases and the weight loss starts. Please be gentle with yourself right now. Anesthesia can cause depression and takes a long time to work its way out of the system. Plus, your hormones are all over the place and that alone can make you depressed and weepy! I agree with Lindsay, find someone you can talk to who can hear you out without being judgmental. Sometimes we need to get all that panic and fear out in the open so we can breathe a little. You feeling this way right now is perfectly normal... Take it one moment at a time and try to find something that will make you smile each day. When I had cancer I spent part of my recovery coloring in adult coloring books! Coloring in big, bold swear words was cathartic. 🤣

I'm glad you are out of the joint now!! They sure did keep you for a while... I've been in a local Alabama hospital before and it was not an experience I care to repeat. LOL I wish you much good healing and feel free to ask questions if you can't find what you are looking for, everyone around here is super helpful!

I think they are amazing medications for weight loss and certainly worth a good try! I just find it frustrating as a diabetic that there are shortages that affect my dosing schedule. I had a similar issue with Plaquenil, the arthritis med that everyone suddenly wanted when they thought it might be useful for Covid. I don't begrudge anyone else a go at the meds, I just think pharmacies should put aside a portion of their stock for their regular diabetic patients since it impacts us so much when we can't get our monthly supply...

I'm assuming you had a catheter in for surgery? UTIs after catheter use aren't unusual and sometimes you can have one without symptoms so you may want to have them check for that at some point. Congrats on your surgery!!

I've tried weight loss shots. I haven't had surgery yet. I had luck with Saxenda but the insurance did not think I was losing weight fast enough so they refused to cover more. Losers. LOL I had some nausea with it at first but no real issues otherwise. When I stopped the meds I gained the weight back plus extra, of course. I'm on Ozempic now but it is to treat diabetes. I have way more side effects with it as the dose goes up, but it usually evens out after a few weeks at the new dose. I don't love it though. The Saxenda was way easier on my body... I've lost 10 lbs on the Ozempic, then gained it back as I've had a hard time consistently getting the med since everyone is on it for weight loss, it is super frustrating. I have heard of it being used in conjunction with weight loss surgery and some people have a lot of luck with it! The ones I've followed have been using Mounjaro though. CarolinRNY on Youtube talks a bit about this in her more recent videos if you'd like a first hand account of it being used to boost weight loss that has slowed post surgery. My guess is if you pair it with behavior modification and taper off it slowly after you hit goal weight you might be able to maintain the results. If not you are stuck with a weekly shot until something new comes out. The shots themselves are easy to do and aren't usually painful, though they can sting a little. ETA: I think The Sleeved Dietitian is also using Mounjaro to lose weight with and has been successful with it. You can find her on Instagram.

It is sad how some women feel the need to tear other women down in order to feel better about themselves. Clearly she's got some **** going on somewhere. People like that used to hurt me until I really understood it is more about them than it was about me. I've been overweight most of my life. I've had people telling me how to fix that for most of my life too. As time has gone by and age has taught some wisdom I've come to understand that the only person's opinion that truly matters is mine. Everyone else can choke on it. Hahahahaha! But OMG does the advice mill get annoying!! I store up good one liners for this purpose, with a generous dose of sarcasm. I would have looked at her wide eyed and said "Wow, that's a really interesting perspective. I had no idea you think about me so much! I'm flattered!" 🤣I usually just deflect what people are saying and they get the hint, but for the stubborn ones I won't hesitate to make them as uncomfortable as they've just made me. <3

Woot!!! What a great accomplishment! And you look fabulous by the way and so happy! Good job!!

This is similar to what I wear to the pool. I'm pre-surgery and very self-conscious about how I look in a bathing suit. But I do aquatic therapy and it has been way more effective than land exercises! I wear a swim tank with an actual bra built into it and the capri pants along with water shoes. I can't wear the layered tops because they float up during therapy but the snug tank works well! The pool I go to has water aerobics where people of all ages are wearing similar outfits. I've seen people of all shapes, sizes and weights and it has helped me be much less self conscious about my own body in the pool. And the water feels so good!!

My gut says you have dodged a bullet. This is awful treatment and I would not feel safe letting those people have my care in their hands. You should have had your concerns validated and calmly discussed by a patient coordinator over the phone, not suddenly have your procedure cancelled simply because you voiced concerns. My worry here is if you were to go through with things with them, what happens if you have a complication, heaven forbid?? Will they treat you as a malingering patient instead of taking you seriously? That could go very badly, very quickly. I know this delay is devastating. I am so sorry you are experiencing this. My heart hurts for you! I would seek out another practice. You already meet all the pre-reqs. The process shouldn't take as long the second time and you deserve to be in good hands that will respect your time and your trust in them as a patient. This behavior from them is inexcusable. ETA: As an out of area patient they should have been taking that into consideration the whole time and should have been working hard to keep your schedule steady. This is NOT a big ask of an office doing this sort of care and is something the patient coordinator should have been advocating for you. Surgery practices are accustomed to needing to do this. Some will even schedule multiple appointments for you in a day and work with each other to ensure you get all your boxes ticked with minimal travel. I really want you to know that your expectations are not out of the norm, their behavior however IS.

Wow, that's incredible! What an awesome achievement! You really do look like a different person and I'm sure you feel like it too!