Newbie Needs Help!!

[lilwashu]

Ok, so I was sleeved on Tuesday the 12th, and so far so good....pain is minimal, and I'm walking and keeping hydrated, etc. The issue is, I was supposed to have been a DS'er. My Surgeon couldn't complete the DS because of intestinal issues that I was born with, so I only have the Sleeve....and I've done no research on the sleeve. Can you guys tell me:

1. What are the vitamin & mineral requirements for Sleever's?

2. What does a typical daily diet look like?

3. What are some typical weight loss numbers with the sleeve...what should I be expecting?

4. How hard is it to fight regain?



I had got in all of the vitamins I'd need for the DS, and now I'm wondering which ones to keep, and which ones to send back. I need all the help I can get, since I was totally unprepared for this outcome....so Please Help Me!

[Deleted]

HI,
I am sorry your surgeon was unable to complete the DS. Did you purchase your Vitamins from VitaLady? If so shoot them an email explain the situation and I am sure they will send you a list of what to send back. Their customer service is fantastic.

I can not answer any of your other questions but someody will chime in.

Keep your head up you will do fine.
Best,
Whitney

[kyal]

I took nothing more than a Multi vitamin and B12 with my sleeve. Since there is no surgically induced malabsorption you should be able to get most nutrients from food.

Have your PCP or surgeon run some labs and work from there.

You daily diet should be along the same lines as a DS, hydration and then protein first before anything else. The difference will be that you will want to stay well away from fat and carbs to loose the maximum amount of weight.

The weight loss from the sleeve isn't terrible and can be quiet dramatic in it self. The problem is the longevity of the loss and how sustainable it is. Regains are commonly seen from 2-5 years post op as the sleeve stretches.


Who was your surgeon? It may be a legitimate excuse as to why you didn't get the DS but knowing who did the surgery will tell us more. Depending on who did your surgery you may be able to look at a revision with some one more competent down that track.

[Leonie]

Hugs, surgery recovery is tough at best, and now you have to handle this curveball too!

Just focus on recovery for now.

[Deleted]

Aw what a bummer . It must have sucked a bunch to wake up to that news. Who is your surgeon? Perhaps sometime down the road, if you need it, you can consider moving forward with a different surgeon. Plus, as time passes, new options will be "invented," so one day, again IF NEEDED, you might be able to benefit from something new and different. Don't give up hope.

There are a goodly number of people who do quite well with the VSG. I'm currently doing a literature review of outcomes for a research project (undergraduate honors thesis in psychology), so comparisons of different surgeries are pretty fresh in my mind. Now that there is a good decade of VSG information out there getting published (maybe a little more than ten years now, but close), it's looking like the total EWL and maintained EWL statistics are similar to RNY, give or take a few percentage points. That's not shabby--not as good as DS, but still perfectly respectable.

A bit of REALLY GOOD news is that the late term complications of RNY, like reactive hypoglycemia, certain micronutrient deficiencies and of course all the pouch-stoma related issues are nonexistent or dramatically less in the VSG. For that, there is a higher incidence of GERD type symptoms in VSG than in RNY.

(But remember, these are statistics and not experiences. You could fall anywhere in that range.)

With the VSG, your main supplementation issues will be related to your extremely limited food intake. Hence you must supplement because you cannot take in sufficient nutrition from food (micronutrients). But you need not megadose to accomodate malabsorption. You should get labs done to see how you're doing and adjust accordingly. Every WLSer should do that.

The VSG diet is going to be very similar to any other balanced, calorie restricted plan. You will want to eat more protein than a normie because of the rapid weight loss, to protect your lean muscle mass. You will need to do weight bearing, muscle building type exercise for the same reason. Rapid weight loss = muscle mass loss = Bad Thing. (For lots of reasons, one of which is that your heart is a muscle and you can lose mass there too.)

You don't have to mega restrict carbs to maximize malabsorption. But the idea of high protein, lower carb, medium fat is what you'll want to follow, kind of like South Beach or something like that. Getting the fast acting carbs (meaning sweet and processed things and the very vast majority of fruit) out of your diet will help a lot. Your plant foods should be primarily veggies.

For now, the ONLY thing you need is hydration. Don't let ANYTHING get in the way of fluids, k?

[Deleted]

You've gotten great advice re: vites & HYDRATION (biggie!) So I won't cover that other than to say I take only what I seem to need- a good multi & b complex, d3, cal/Mg and an occasional B12 once in a while and my labs have been pretty stellar. If you track your own labs and eat well, your supplement needs are close to if not what any other person w/o altered guts needs.. just that first year or so, you won't be eating a varied diet- so vites are important moreso than usual during that time.

Since the sleeve is basically a restrictive only surgery, though there is a hormonal aspect from removing the greater curvature of the stomach- your results are directly linked to what you intake (same for any WLS really.) The downfall for any is an overabundance of carbohydrates.. I didn't do low-fat anything unless I preferred the taste, but my fats were pretty low by default the first year for cal restriction purposes.. now- not so much.

My diet early out, and for basically the first year was a steady increase in protein forward foods- progressing of course from liquids to solids as tolerated that first month.. I aimed for a min of 70g of protein, which left very little room for much else for quite some time.. I did keep carbs very low, sub 40g a day- which helped with fat loss and appetite, plus again, no room early out.. Now in "maintenance" I am usually under 100g carbs, and about 25g or more of that is fiber.. I eat about 1400-1800cal a day, sometimes much more.. (600-800 that first year, sounds tiny, but you may struggle to eat close to 800 cals for a while!) About half my daily cals is from fat now, and about 80-100g protein.

I lost more than all my excess weight if you go by a "normal BMI goal" in a year fairly easily- went from about 280 to a maintenance range of the high 130's to low 140's (5'6.5") with no real crazy working out at all.. and still none. I do like to lift weights on occasion, and walk.. that's my activity.. no issues maintaining, but I also changed up my eating style as a happy permanent shift away from simple carbs (mostly grain free, sugar free now.. unless I'm having a treat which I do on occasion, I still like pizza, and chocolate- thanks.) I still eat my meat first, a healthy amount of fat, and veggies round out the remainder (with a little fat, butter makes everything better) and then have fruits & nuts as nibbles.. I had a friend send a link to a blog saying "hey, is this what you are doing?" - It was Mark's Daily Apple, a "primal" site.. I had no clue, but in reality- it's pretty much a ringer for what I eat and do activity wise. Who knew it had a name? Btw, for weight-loss maint, he advocates keeping carbs under 150g a day, and grain free.. pretty spot on I think. Much over 150g a day, count on a slow weight increase, under 50-75g a day, a slow decrease.. it's all up to you. Diet is more than 80% of loss/maint, so eat well=lose & maintain, eat more than you need, esp carbs=gain.

Not too sure about stretching the sleeve- mine has remained fairly constant in capacity since the initial healing was over- I'm about what I was capacity-wise at around 6-8mo out, and I have eaten to full frequently- I do not "undereat my sleeve" as some post about elsewhere.. For the majority of those that are years out- most do not report stretching much past that first year, however all report that early feeling of fullness you may have gotten for carby easily broken-down foods passes.. I used to feel full nibbling on stuff like that - now I do not.. but give me some chicken breast and I reach full/overfull on about 3oz still.. Ymmv, anatomy and surgical technique can vary your end capacity a bit for sure.

Good luck! Sorry to hear you didn't get what you planned on- but the sleeve is a very good surgical choice regardless of not choosing it directly in this case.

[lilwashu]

Thanks everyone for the great advice, and words of encouragement. My Surgeon is Dr. Roslin @ Lenox Hill. I have no doubt in my mind that he made the best call he could make, and put my health first when he decided to not give me the DS portion. If there is an option down the road that will help, I'll be all over it...but for now I'm trying to adjust to having the Sleeve.

On the up-side every day has been better than the last, and I'm down to only needing Tylenol 1x a day. I've been walking and sipping, although I can only manage a quart of water, and some tea at this point. Haven't started adding protein, but I've tried yoghurt...too filling right now. I Hate the feeling of fullness.

More than anything, I just want to lose this weight!!! I am praying this helps me, as I really believed it would take the DS to keep me at a healthy BMI from here on out. Thank you all again, and I'll be asking for help at every opportunity.

[Peggy]

I am so glad you posted your story. I am in the same exact boat as you. Thought I was going to be a DSer but for now, Sleeve is what I got. I am so back and forth an emotional roller coaster I have bean on since the 6th! My issue was in 2005, I was 10 days out from having RNY and I had appendicitis. Which lead to 3 total surgeries, wound vac for years and a big pain in my bazoka!

Well last Thursday, when they did surgery because of my past history she was worried about doing the whole procedure because of so much scar tissue. I felt sad and devastated. Luckily, when I was dismissed she told me she would re-evaluate this in the future after I lost more weight and got healthier. So there is chance for me but that doesn't help me right now!

[Peggy]

just realized this post is a year old...

[Taterweight]

Oh Peggy, I'm sorry that you are having to rearrange yourself mentally to a sleeve after surgery! Don't despair, there are many successful folks rock in' the sleeve, too! Ultimately you may have to watch the carbs more, but you also won't have to worry about deficiencies as much. Each of us has a journey...there are no guarantees with either of these paths, but there are successes with both! Be determined to be one of them! I wish you all the best!

[Butterfly]

Hi!
My story is very similar.
I had surgery last Wednesday assuming I'd come out with the DS but woke up to find that I had only the sleeve as my surgeon nicked my spleen just as he finished the sleeve. He had a lot of trouble stopping the bleeding and by the time he did, he judged it unsafe to continue. Fortunately, he said I could have it done later.

I had prepared myself for months for the DS and suddenly find myself unprepared.

Right now I just need to heal and get my head around this new reality.

Since this is my third bariatric surgery (lap band placement, band slip reposition and now sleeve), I don't know if I'm up to doing fourth surgery.

So for now I'm I the same boat as you and need to get educated quickly.

Lisa

[johndean]

Hello, I'm also in the same situation, I had sleeve gastrectomy 2 weeks ago..

[OnMyWay2Thin]

Johndean,

Sorry to hear you went in for one surgery and got another. I've seen a lot of success with the sleeve so don't be discouraged. I wish you the best of luck and a speedy recovery!

Kelly