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Batesville, AR. VSG 1/24/19 at Blossom Bariatric in Las Vegas. Dr. Matt Apel.

I don't know the answer to your last question, but just so you know, not many bariatric surgeons perform the DS, and it's not a common surgery, so that's probably why you're not finding much. Check out that dsfacts site that an above poster mentioned - I was on that site once and found it very helpful.

My "I've had it" moment was when I had to get my annual physical that my employer requires. It took 3 scales before they found one that would weigh me. The very next day I went to a Bariatric Info Session, and I signed up to meet with the surgeon.

@Postop I wanted to follow up on your comment about chewables. What's the issue there? Gummy vs non-gummy? I ask because I'm taking the Bariatric Advantage chewables now. The things are specifically designed for bariatric patients, but are you saying they're no good for DS'ers? thanks

According to one surgeon, the term roux en y just means an incision. So any of the surgeries like DS, Loop DS and MGB all use roux en y incisions. But in bariatric circles, the RNY pertains to the regular GB. All I know about the MGB is that it can be revised and is less invasive. As is the case with all of us, my biggest concern was/is weight regain over time. I chose the Loop DS because it seemed to be more effective with weight loss than the GB and MGB and equally as effective as the tradition DS with one less incision and less intestinal bypass, diarrhea, etc. As far as the DS vs the Loop DS (SADI), I am concerned about weight regain because of the significant difference in the amount of longer intestinal tract that is left with the Loop DS. But I also have to take into consideration the side effects of having that much shorter intestinal tract with the malabsorption issue.

Did you find a PS? I’ve been shopping around also- need a slew of things tightened. I found that some PS’s do not have experience with bariatric patients, many have different strategies, they all charge differently, some do procedures in a hospital and others in a surgical-center. Some have better bedside manners than others. Tummy tuck hurts as if you did a zillion sit ups- hurts to laugh, cough and sneeze. Breast lift/implants - I was sooo prepared for the pain before surgery and was fine. Let us know where you’re at.

I take bariatric melts (vitamins and calcium citrate). Had to start a zinc supplement, because I was a little deficient. My meals always consist of a protein (seafood, ground turkey, chicken or beans) and vegetables. I don't eat any bread, rice or regular pasta (I do zucchini noodles) and absolutely no sweets, caffeine or carbonated drinks. Starting out my exercise was just walking about a mile a day. I still walk, but do low impact strength training and will begin jogging soon. I do still have an occasional protein shake after I have finished exercising

If you’re looking for a low-cost option without having to travel outside of the U.S., you should definitely check out Blossom Bariatrics out of Las Vegas. I was sleeved there on 1/24/19 and they were very thorough. The whole process was very smooth.

Hey guys, I'm at the 10 month mark and just got my third round of blood tests for vitamins done. Consistently, I am low in vitamin D3, which I have a hard time understanding. After it came up low last time (about 3 months ago) they gave me a prescription for 50,000UI to take for 12 days, and ever since then I've been taking three 5,000ui caplets EVERY DAY.... according to the bottle, one 5k caplet is 1250% of daily requirements, so I'm taking 3750% of my daily requirement every day! Seems like overkill. But my blood test showed my D3 was LOWER than it was 3 months ago. NOTE: I live in San Diego, so even though it's winter, I get more sun than most. I'm asking the question here because the bariatric department for my medical plan mostly deals with sleeve and bypass, and doesn't have much experience with DS, SADis or SIPS, so they can't really tell me if this is normal or weird or what. They're response is to have me do another round of the 50,000 ui prescription. So, do any of you DS'ers have any knowledge around D3 deficiency? Is this a common thing? or is this just specific to me?

I agree with Danny that you should find a support group that you feel comfortable with. I was required to go to the support group at my hospital for 3 months before and after. I really wanted it to be useful, but (like Danny's therapist's group), people just yell over each other and there are several conversations going on at once. It stressed me out so much I actually threw up once. Now i go to one offered by my therapist (who specializes in weight loss/bariatrics). It's new, but so far, great. We share our experiences, fears, emotional issues with foods. She prepares a topic to discuss if we don't have anything specific to talk about. I'm also looking into seeing if one of the other hospitals has a convenient group. My therapist's group is pretty small, and I'd like to meet a larger community of WLS patients. Most hospitals will let you attend even if you had surgery elsewhere.

I had my last nutrition appointment yesterday. I’m doing my best not to keep bothering Rica. She was waiting on one clearance from pulmonology and my last nutrition to submit. She called about 11 this morning. I’ve been submitted to insurance!! This is real people. I have my preop appointment on 2/20. Surgery exactly 4 weeks from today. She said it can take up to 4 weeks to get an answer. I told her my only worry is that at the initial appointment they measured me in shoes and my BMI looks like it went up even though my weight went down. I was 282.8 and I’m now 273.4. Nutrition gave me some more papers to read about the food stages and said to get bariatric vitamins with iron and that I should be on vitamin d because mine is so low (level is 9) She said once I get my vitamin d up I should feel a lot better. So now I wait. 2 weeks. May as well be two months. I’m not good with patience. Fingers crossed guys.

Hi everyone, I'm new to the Bariatric Pal community, but wanted to jump on this thread as I was sleeved 1/16/19 and would love to share my journey with others!

You're gonna need to get a referral to a therapist who specializes in bariatric food issues. If it were me, I'd dial back the amount of exercise. Walk daily, do some HIIT stuff. Drop ALL bad carbs to the curb for now. Only eat dense, dry protein to whatever quantity your doctor specifies. Get all your water in (no sweet waters). Drink decaff coffee and decaff green tea and matcha. Keep fully hydrated. Drink as much water as you can about 15minutes prior to eating. Then eat slowly as you can for 20 minutes. Then don't drink for 1-2 hours afterward. The only thing I would eat right now until my hunger comes into control is: 1. Lean dense (very) protein=dry grilled chicken breasts, pork chops (lean), turkey burgers, lean ground beef burgers. Lean steak, salmon, hard boiled eggs, hard scrambled eggs, hard fried eggs (no runny yolks, they make the egg a slider protein at that point). (Only grill it or pan sear it or air fry it. NO MEAT LUBES, SAUCES, GRAVIES, or CASSEROLES!!!!) 2. 1 oz of al dente veggies: broccoli, cauliflower, wilted greens and garlic, wilted cabbage, brussels sprouts, broccoli rabe 3. 1/2oz avocado or up to 1 tsp of healthy oil per meal: olive, avocado, grassfed butter, lard, tallow. Use spices but no artificial sweeteners. Nothing sweet! No fruit, no mashed anything, no potatoes, rice, grains, beans, nothing til your hunger is assuaged. Meet your protein needs if you can from solid lean dense protein: 60-80g/day. That's what I do. Of course I can't tell you to do it. I'm not an RD or a doc!!! It takes about 4 solid days of behaving and doing this for your hunger to come into control...then I'd see what I needed to do after that. I would probably just continue on like that...cuz um, lol, that's what I already do!

You won’t be dependent on protein shakes long term. You will use them in your first food stages after surgery because your sleeve restriction is tight. Real food phase, you will be able to hit your protein goal (60-100grams) without shakes. Your first food stages liquids, puree and soft foods won’t be very exciting. Easy to shop for. Something to try pre-surgery. Make a grocery list with foods allowed on your real food dieticians plan. Keep it simple. No processed foods. What is the cost to purchase protein sources? (eggs, dairy, beans, sea food/fish, poultry, pork, beef, soy) How expensive is it to buy fresh or frozen fruits and vegies in small amounts? How expensive are spices, olive oil, marinades? Cook meals at home. Keeps cost down with no hidden calories. Freeze left overs in small bags/containers for meals later Look up bariatric friendly recipes. (make sure they fit your plan and calories and macros for the day) Use a food log app. Bariatastic or myfitnesspal. https://www.bariatriccookery.com/recipes-2 https://insidekarenskitchen.com/recipes/bariatric-friendly-recipes/ https://www.pinterest.com/bariatricfoodie/pins/

You got sleeved over a month after me and I just started hitting 1000 calories. It was through adding bariatric snacks I bought on here and Amazon.

Bariatric fusion has vitamins you will need for about $30.00 monthly Sent from my SM-G950U using BariatricPal mobile app

Hiding your surgery from your trainer because you're afraid of how they my judge you is a really bad decision. Your trainer needs to know about your physical condition---and what surgeries, injuries, physical issues you have had that may effect his or her decisions about how best to approach your training. If the trainer makes a stupid comment or acts less than 100% professional, get a different trainer. We can't hide our surgery from everyone for fear of judgment--if they don't like it, f--k them. I don't work with a personal trainer, but the trainers in my gym know about my surgery and they have been very supportive of my decision. I have had one tell me not to take her abs class yet because it was too soon after surgery and she suggested how long I should wait (which ended being around the same amount of time as my doctor suggested I would be ready). If they have been in the profession for a while, they have probably worked with bariatric patients in the past--but you won't know that until you talk to them.

Can't wait to renew mine...I lied the last time and grossly under-reported my weight (I was 225 ish and said 165) 😐 So now it says 165 and I'm 123 July '19 come onnnnnn renewal!

I actually came on to ask the same question. I’m so burnt out on Protein Shakes that a single drink triggers a gag reflex at times. Unfortunately, I’m nowhere near the point of getting enough Protein with food alone. I just ate dinner and am only at 17g of protein for the day. I may try to get a little bit of milk down or some cottage cheese later this evening to push it a little higher, but it’s still nowhere near enough. I had egg for Breakfast, shrimp (the canned kind that are softer) for lunch, and diced chicken for dinner. I’m also still struggling to hit Water goals. I’m averaging about 20-30 oz of water a day. Another issue I’m having with protein shakes is that it takes me a solid 6 hrs to get an 8oz shake down. I’ve tried a few different brands and they all just seem to sit in my stomach like a brick. I did just order some unflavored Protein Powder and some bariatric friendly cocoa mix with 15g of protein per 6-8 oz serving. If I make the cocoa with fair life milk, it will add another 13g of protein per 8oz serving. I see several people mentioning protein chips, so I’ll look into those as well in the coming weeks. Any other suggestions for protein dense foods/beverages are certainly welcome. I’m just really struggling at this point to get much down at all (which is kind of the point, I guess). I’m about 3 weeks post-op. Just started soft Proteins on the 7th.

I notice a lot of people stop using shakes. I still have to have at least one 30 gram shake a day, and often some other form of supplement like 1/2 a protein bar, some protein chips or a bariatric cocoa to get to 60 grams. At what point did you stop using shakes and supplements and got your protein only from natural foods?

Another point to consider is if your insurance limits you to one bariatric surgery per lifetime. If that’s the case, you should consider RNY over VSG, cut once, as there are a number of people that are requiring revision surgery after VSG and you would hate to have to self-pay for a 2nd surgery. As well, weight loss is typically better with an original surgery than a revision surgery. Long term use of PPIs is also not recomneded as they cause risks for serious health issues/diseases.

My experience is the same as @chrissymcm08. I’ve lost 83 lbs and rarely have knee pain now. Before the sleeve, I was told I would benefit from knee replacement. I was referred to Bariatrics by an orthopedic surgeon because my BMI was over 40. My BMI is now 30 and still going down. Knee replacement is the last thing on my mind now. So much happier!

I heard I should be avoiding carbohydrates, is this true? This is 100% false! Carbohydrates are the body’s preferred source of fuel. Just as your car needs gas to run, your body and brain rely on carbohydrates to give you the physical and mental energy that you need to get through your day. What are carbohydrates actually? The majority of patients identify carbohydrates simply as grain products (e.g. bread, pasta, and rice). When dieters say they’re going on a low carb diet, they typically plan to eliminate or reduce their consumption of these grain products. In reality, carbohydrate sources include many other foods, like milk, yogurt, fruit, plenty of vegetables, and legumes. Did you know that one cup of milk has the same amount of grams of carbohydrates as a piece of toast? Or that a large apple has twice as many grams of carbohydrates as that same slice of toast? Or that a 1⁄2 cup of chickpeas has three times the amount of carbohydrates as the toast? Confused? This is why we challenge our patients in why they want to experiment with low-carbohydrate diets. What does that mean to them? And which foods are they planning on restricting? A lower carbohydrate diet is not necessarily a healthier one! In a world where our food apps can track everything, it’s sometimes hard to make sense of all of the numbers they give us. You shouldn’t be blindly trying to decrease your total grams of carbohydrates or total grams of fat per day without understanding how that translates into food choices and your overall health. The type of carbohydrate is more important than the amount of carbohydrate.Not all carbohydrates are created equal. The most common forms of carbohydrates are:  Fibre (for the purposes of this book, we will refer to fibre as a ‘complex carbohydrates’);  Sugar (for the purposes of this book, we will refer to them as ‘simple carbohydrates’).  Starch. Starch is calculated by taking the total carbohydrates and subtracting both the fibre and sugar from it (for the purposes of this book, we will refer to starches as ‘complex carbohydrates’). Foods that are high in carbohydrates but contain a fair amount of fibre and starch, and a low amount of sugar (i.e. high in complex carbohydrates and low in simple carbohydrates), are typically healthier choices. Complex carbohydrates take longer to digest, which is why they make you feel fuller longer. Examples include:  Barley;  Oats;  Quinoa;  Whole-grain products;  Legumes. Similarly, foods that are high in carbohydrates but contain high amounts of sugar and low amounts of fibre and starch (i.e. high in simple carbohydrates and low in complex carbohydrates) are typically less healthy choices. Simple carbohydrates are quickly digested, which is why they give you a quick boost of energy, but also why you don’t feel satisfied for very long. Examples include:  Pastries;  Donuts;  Chocolate;  Candy;  Juice;  Regular soda;  Sugary cereals. After WLS, protein should always be eaten first, followed by your vegetables and then your grain products (e.g. rice, quinoa, pasta) or starch (e.g. potato, sweet potato, squash). Eating in this order will naturally limit the amount of carbohydrates you consume at each meal because of the limited space in your stomach. Patients who restrict their carbohydrate intake, in our experience, typically have a harder time finding a healthy balance and joy in eating again. One of the biggest consequences of skipping out on carbohydrates at mealtime is that your blood sugar is less balanced, which can result in sugar cravings later on in the day. Remember: All foods fit, but it’s the portions of food that should be the focus in a healthy diet, post WLS. - Lisa & Monica

Bariatric Prayers ... And protect me from the haters that will surely arise ... Amen.