Missed my post on my 3mnth as I have been feeling great. Never home and having lots of fun. I am down 72 lbs and go to see Dr. L for my blood work and check up on Aug 22nd. Wearing size 20 jeans and 1X shirts.

Well I am finally feeling better and able to eat just about anything. I have been having some oil slicks. Too much oil makes Brenda a oil spewing maniac. Oh well I will soon get that under control. Trying to lower the carbs and oils and focus on protiens. Its hard because I am not a meat lover. Love beans and lentals so I am making more receipts with them in it. Love chili but don't want to get sick of it. Another favourite is fajita. With out the wrap. So lots of onions and peppers and chicken and the spice. I make a big batch and then freeze it and take it out and warm it up with cheese on top. I am still off work and plan to go back and another couple of months. Enjoying my summer and my DS. Have lost 52lbs in 8 weeks.

Julie called yesterday with my date for surgery. I was in shock. It was so fast. When I had my consult dr L. said mild to end of April but I some how had my self believing that it wouldn't be till May. So its about a month. I thought that I would kick into gear once I got my date and get prepared. Only problem is that I am so hyper that I don't know what I should do. Yippy. Looks like I will be walking the halls with Kim she is the next day.

Well I went for my consultation with Dr. L. and he was really nice. Informative and had lots of  time for questions. He went over the operation and explained how it worked. Asked me about what weight that I wanted to be. He also asked when I wanted the surgery. He wrote ASAP on my chart and said it would be the later part of April. He wants me to lose 15 lbs between now and then. Has me on hopefully the the last diet of my life. Its going to be rough. All the veggies and meat I want. No carbs. No crystal light. Up to 2 slices of either pumpernikle or whole grain bread per day. One potato plain or 1 cup plain white rice. Salad with vinigar or lemon juice. Up to 2 peices of fruit per day. 1 small coffee in morning with breakfast black only or tea. Only water to drink. No juice or crystal light. Oh boy. It will be rough. Oh ya I can have 1 glass of milk a day but I don't like milk or meat. So its veggies and fruit for me. I have 6-8 weeks to loose 15lbs. It is easier for him to do the surgery if I loose the weight. He gave me the persicptions for my DR to write for pain meds. Also gave me a list of tests to be done. EKG, bone density, fasting blood surgar, gulbladder ultra sound. Also gave me a list of products to avoid between now and surgery. Because I live so close I am going to my pre-op about 10 days before surgery. Then go down day before. Do bowel prep. When I am released I can go home I don't have to stay in michagan. I will just return for next appt. I said I could stay if he thought that I should and he said it wasn't necessary. He also stated that I could come to the support meetings because I am so close. He really recommends the support. So I will try and for sure try and get appts on days where I can stay and go to the meeting that night.

I was put on metformin. My sugar is not up but my hormones are out of wack and specialist I seen thinks that if I lower my insulin level my hormones will straighten up. So I just started taking it and so far so good.

Well it didn't take long to get my ohip approval for my consultation for my DS surgery. Now I just need a EGD scope for Dr. Lu to beable to see if he can do a revision for me. I sent me papers on the Monday and OHIP faxed my DR for more info on Tuesday and they heard back on Thursday that I was approved. I did not find out until the following Monday Feb 11th when Dr. Lu nurse called to tell me. My Dr. office didn't call me because the paper work said that it was sent to me too so they assumed that I already knew. I was so shocked. I really thought that I wouldn't get approved. I have a high bmi but when I called Dr Hunts office to find out about wait time I was told that he is nolong going to be doing the DS surgery. He is currently getting set up for the lap RNY. I figured that OHIP knew and would nolonger approve because the surgery is nolonger available in Ontario. I didn't let on to them that this was the case. But I got my approval. So I am so excited and can hardly wait to meet Dr. Lu.

Found this interesting info on a memebers site: ) thought I would post it for my friends to look over.


RNY compared to the DS

RNY – expected weight loss

• 50-65% expected excess weight loss (percentage varies in opinion – this is the most commonly seen estimate)
  • Results may vary
• Regain
  • Possible regain: more prevalent after 5 years
  • 50-100% regain of weight has been recorded
  • Results may vary
  • Must follow “pouch rules” in an attempt to not regain

DS – expected weight loss

• 85% expected excess weight loss
  • Results may vary
• Regain
  • Studies show little to no regain (20 pounds recorded)
  • Results may vary
  • Highest success rate over 10 year study (78% avg. Excess Weight Loss – EWL)

 RNY – have a stoma (stomach made into a pouch – size of an egg)

• Size: 2 oz
  • Stretch to average size of 6 oz in 2 years  (possible to stretch up to 9-10 oz)
  • You can eat more as time goes by
  • Average after 1 year is 1-1.5 cups of food
• No Endoscopes on blind stomach/remnant stomach that is bypassed
  • Doctor evaluation: cannot use an endoscope (to find ulcers and tumors)
  • RYGBP construction makes the large bypassed distal stomach inaccessible to standard non-invasive diagnostic modalities. Neither x-ray contrast studies nor endoscopy can assess this potentially important but hidden area.
• Stoma: pouch
  • Should not take Nonsteroidal Anti-Inflammatory drugs (NSAID).
• NSAIDs are: Advil, Alka Seltzer, Aleve, Anacin, Ascription, Aspirin, Bufferin, Coricidin, Cortisone, Dolobid, Empirin, Excedrin, Feldene, Fiorinol, Ibuprofen, Meclomen, Motrin, Nalfon, Naprosyn, Norgesic, Tolectin, Vanquish
  • NSAIDs are used for arthritis, bursitis, tendonitis, back pain, headaches, and general aches and pains.
  • Taking NSAIDs could develop into a bleeding ulcer and interfere with kidney function.
• Possible Problems
  • Ulcers (Some doctors recommend taking prilosec for 6 months to 1/2 years in an attempt to prevent the ulcers)
  • Possibility of a staple line failure
  • Noncompliance: simply do not lose enough (even with following the rules)
  • Vitamin Deficiencies
  • Narrowing/blockage of the stoma
  • Vomiting if food is not properly chewed or if food is eaten to quickly
  • Dumping syndrome, NIPHS, Hypoglycemia
    • No Valve (pyloric valve that opens and closes to let food enter intestines is bypassed) which means food empties directly into the small intestines and causes dumping and/or can cause NIPHS or Hypoglycemia
• Dumping: food (most commonly sugar but not necessarily “just” sugar) enters/dumps directly into small intestines and causes physical pain (some people believe this pain enforces good eating habits)
  • Dumping varies in degree of occurrence and discomfort
  • Dumping symptoms:
    • Nausea
    • Vomiting
    • Bloated stomach
    • Diarrhea
    • Excessive sweating
    • Increased bowel sounds
    • Dizziness
    • “Emotional” reactions
• NIPHS (insulin over production): “the body overproduces insulin in response to food entering the intestines at a point where food would normally be more digested already - this part of the intestine is not used to coping with metabolizing glucose in the condition it arrives after RNY, and it is suspected that the intestine signals the pancreas for more insulin to aid digestion, causing a MASSIVE overproduction.  The change occurs on a cellular level, hard to diagnose.  Treatment: Removal of half the pancreas.”
  • RNY stoma that is created allows food to go straight through the stomach into the small intestine unrestricted so it does not control the flow.  Because of that the body reads that it needs more insulin because the food is moving through so quickly and it thinks there's going to be a lot more food.  With the DS, the normal peristalsis works because the pyloric valve is in place and can control the movement of food into the small intestines.  
  • NIPHS, Hypoglycemia is deadly if not corrected

 DS – whole stomach (size of banana)

• “Whole working stomach” - meaning the stomach’s outer curvature is removed as opposed to making a pouch/stoma.
  • Part of the stomach removed is where most of the hormone called Grehlin is produced.
  • Grehlin gives the sensation of hunger so by removing most of that section of the stomach a DSer is not as hungry as before.
• Whole working stomach: no blind stomach.  Endoscope can be used.
• Can take NSAIDs
• Do not need to take Prilosec to prevent ulcers.
• Valves are in tack: no Dumping Syndrome or NIPHS

 RNY – Eating

• Eat protein first
  • 60g of protein a day
• Recommended to chew food to liquid consistency (pureed, soft, thoroughly chewed)
  • This is more important for people early out (new pouch stomach will stretch out with time).
  • Food is thoroughly chewed to prevent blockage (the hole/path leaving the stomach and into the intestine is roughly the size of a dime).
  • To get food unstuck, patients drink meat tenderizer mixed with water.
• Low carbohydrates
  • Carbohydrates can slow weight loss and lead to possible regain
  • Avoid sugars in particular (to prevent dumping syndrome)
• Low fat
  • Foods high in fat may cause Dumping Syndrome
  • Fatty foods can lead to slow weight loss or possible regain
• 64 oz of water
  • Stop drinking within 15-30 minutes of a meal
  • Do not begin drinking after a meal for 1-1.5 hours
  • Some doctors do not encourage the use of a straw (pushes food too quickly through the stomach and can cause gas/discomfort)
• Water Loading
  • 15 minutes before the next meal, drink as much as possible as fast as possible. 
  • Water loading will not work if you haven’t been drinking over the last few hours.
  • You can water load at any time 2-3 hours before your next meal if you get hungry, which will cause a strong feeling of fullness.
    • Disclaimer: this is a practice some people use to feel “full” and lose weight. Not a requirement.

DS – Eating

• Eat protein first
  • 80-100g of protein
  • DS patients can on average eat more food than any other type of weight loss surgery.
• Low carbohydrates
  • Carbohydrates can slow the weight loss and lead to possible regain
  • No dumping syndrome from eating sugar (or fat)
• Eat high in fat
  • DS only absorb 20% of fat (do not need to eat low fat)
    • If a taco has 20g of fat, a DSer only absorbs 4g while a person without surgery or RNY absorbs ALL 20g. (this is just an example, measuring absorption is not an exact science)
    • When experiencing a “stall” (slowed weight loss/plateau) a DS patient commonly increases fat consumption to resolve
• 64 oz of water
  • Can drink with meals
  • Can use a straw

RNY – Possible Issues

• Vitamin deficiencies: Must follow a vitamin regime for the rest of your life
  • Common vitamin deficiencies found in vitamins B12, iron, and zinc
  • Calcium must be supplemented for the rest of your life
• Bathroom issues
  • Gas
  • Constipation
  • Dumping in the form of loose stools
• Reversible procedure (Reversals of any surgery is very complicated)
  • Revision often performed instead of reversal
  • Revising to a different type of surgery is possible.

 DS – Possible Issues

• Vitamin deficiencies: Must follow a vitamin regime for the rest of your life
  • Common vitamin deficiencies found in vitamins A, D, and iron
  • “Water soluble”/ “water miscible” / “dry” vitamins absorb best (in other words get vitamins that are not fat/oil based)
  • Calcium must be supplemented for the rest of your life
• Bathroom issues
  • Gas
  • Loose stool (Most common in the first few weeks of surgery. Generally food related)
• Reversible procedure
  • The intestinal bypass is reversible for those having absorption complications
    • revision: lengthening common channel (to stop losing weight and/or to absorb vitamins)
  • Stomach is obviously not reversible (part of stomach was removed)

 

RNY - Diabetes

• 85% cure rate
  • RNY can put diabetes in remission.
  • Diabetes may come back in two or three years--even if the
    patient maintains most of their weight loss.
  • Even a small amount of weight gain, long-term, can cause a diabetes
    relapse.

 DS – Diabetes

• 98 % cure rate for type II diabetes.

 

DS – Myth or Fact

The DS is only recommended for the super morbid obese (BMI over 60) = Myth / Not True

• To be eligble for ANY type of weight loss surgery, a person has to be 100 lbs. over weight or have a body mass index (BMI) of 40 or more.
• BMI’s under 40 have also been approved (usually require a comorbidy/health problem - an example is sleep apnea).

The DS is “experimental and investigational” = Myth / Not True

• Medicare approves the DS
• Many insurance companies are starting to cover the DS.
• DS has been performed since the 1970s

DSer will have a problem when they become old = Not True

• We wont need to eat as much when we are older b/c our bodies will adapt
• The little hair-like villa located in the intestines grows longer to adjust to the new digestive system (grows longer to increase absorbtion).

DSer’s gas stink = true

• The gas does smell. (This is true for the DS and RNY)
• There are products called air fresheners that a person can use.
• May take Flagyl or fish zole

DSers may need to wear a diaper = Myth / Not True

• That is silly

Skin color turns yellow or pallor = Myth / Not True

• Patients who follow their regular vitamin regime (keep up with blood work) do not turn pallor
• If someone looks pallor, they could have a vitamin deficiency.  This applies to any type of weight loss surgery. For both RNY and the DS.
• Vitamins and blood work must be monitored for life. For both RNY and the DS.

DSers will have a heart attack from all the fatty food they eat = Myth / Not True

• Cholesterol levels lower after having the DS. 
• 80% of the fatty food is not absorbed – the fatty food is healthier to eat as a DSer than a person without surgery.
• If a taco has 20g of fat, a DSer only absorbs 4g while a person without surgery or a person with the RNY will absorb ALL 20g.  Good meal for the DSer. (this is just an example, measuring absorption is not an exact science)

Dsers don’t need to exercise = Myth / Not true

• DSer’s are aware of the benefits of exercise (body and soul).
• Exercise helps in losing weight and maintaining goal weight 

 *Some practices may not be used by all patients. Some recommendations will differ depending on a person’s surgeon.  Possible issues are just that, “possible,” and may or may not occur.  

Not every surgery will be right for everyone. Not every surgery will be covered by insurance. Good luck to everyone and thank you for reading my comparison chart. Hayley F.

Just waiting too hear. Hope it doesn't take to long to hear one way or another. Wish me luck cause I want to be a Switch Sista   

Guess when it comes right down to it I am sure and my mind has not changed but my husbands has. Now I need to try and convince him that this is really what I want. Wish me luck.

Thought that I was sure. Need to take some time and rethink things. I know that DS is what I would like but I am scared. Worried about complications. My husband is really against me having it due to the resent events. Time will tell. I know that I have to make the decision on my own. I also know that my husband is scared that something will go wrong and he will lose me. I also know that I am having issues with my weight and I know that it is just a matter of time till my body breaks down and I start having major health issues. Scared and Confused.