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Post by goodkel on Jun 12, 2014 2:27:53 GMT -5
Wow, less than 3 wks away! I went to my 4 hr "NUT" class today. Followed by tons of blood work and a urine specimen. The guidelines given were 60-80 grams of protein, <60 grams carbs, <30 grams fat. They mentioned specifically that we actually had NO need to eat ANY fat at all but definitely not more than 30grams. At 6 months they will recalculate our protein need to 1 gram per lb of BMI weight... they were kind of hushhush about it... not 100% on understanding their calculations, 8but I got them to tell me at 5'8" mine would be 175 grams of protein. They were very specific about following "their" plan for success. Not to mention the one size fits all vitamin powder! So I waited for hours to get squeezed in to make sure my Dr and I were on the same page after I had many different tests. He said he wanted to do a 120cm CC. And when I brought up that we originally talked about an 80-100cm cc, he said he was only comfortable with a 100cm common channel for me. And when I ask how he measured, he said he doesn't stretch out the intestines....so do you think that will leave me with more like a 110-120cm cc? He will be removing my GB. And do to ongoing nausea and other issues with the barium swallow(barium covered chicken didn't move down my sleeve without drinking fluid), he is going to check for a hiatal hernia and look at the top of my stomach to make sure it was formed properly when my sleeve was originally done. If he doesn't find any abnormality, my sleeve will stay as is...and if he finds a hiatal hernia or other issue, he will repair it right then. I also learned today that they did find sleep apnea at my study last week, so I am scheduled for a second one to fit me with a cpap next week (the day before I have final meeting with nurse practitioner and get EKG and chest xray). So I am good with all the plans. I am gonna stay on top of the sleep study peeps and make sure that doesnt hang up my date, but we talked today and I emphasized that. I will smile and nod with the "nuts" and play a very active roll in my appropriate diet and vites. So any thoughts or imput? ;D VSG to DS 7-01-14/ Dr Boyce in Knoxville /Age 40/5'8"/HW 287/CW 282 Early out some people have issues if they eat too much fat (for them). It can increase how loose your stool is as well as the frequency. That is the only reason for restricting your intake temporarily. Some people just ride it out because things do calm down as you heal. If I had any problem with it, I just assumed it was par for the course in healing and I ignored it. You will have loose stools in the beginning, anyway. For me, it didn't didn't seem to be making anything noticeably worse. Now, I get constipated if I don't get enough. Gallladder out is a good thing. Rapid weight loss can cause problems with it and you don't need a second surgery so soon after your DS. Mine was taken out during my DS, too. When you are given the surgery authorization forms to sign, be sure to write in there "for a 100cm common channel DS." You don't want him to forget your agreement and have him give you a 120cm, if that is important to you. It sounds like you are doing great and everything is moving along smoothly. It won't be long now!
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Post by nursemelanie on Jun 12, 2014 15:50:00 GMT -5
Thanks Kelly! I'm definitely gonna make note of the 100cm cc.
VSG to DS 7-01-14/ Dr Boyce in Knoxville /Age 40/5'8"/HW 287/CW 282
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Post by Girlrocker on Jun 12, 2014 17:16:16 GMT -5
You sound SO good Melanie. You'll find your own 'happy medium' with fats and how to balance it all. And early recovery, the first 8-12 weeks it's really hard to sort because you're healing and everything can be wonky, I had crazy diarrhea or just an amazing um 'export' considering how little I was eating. My taste buds really changed, and eventually things 'settled'. And honestly, I was perfectly fine, as the REO Speedwagon song goes, rolling with the changes. I ate to live, did whatever I had to do to make it work. My major diets all failed me in the end, and so did my RNY, but I had learned a LOT, already went through the process of learning to eat protein focused, moderate carb, frequent meals; plus one malabsorptive procedure, and the psychological issues of learning how to live/cope/deal differently with food. So by my revision, none of this was new as it can be for many virgin DSers, or someone going from a sleeve/lapband to a DS. Believe me, I still had my freakouts, and I was an emotional wrecking ball, I cried daily for two weeks after my surgery.
I literally was grossed out for awhile by things I now love and are staples. Dr. K told me ahead of time he was taking my gallbladder and appendix too, and I was like, fine by me, less to worry about later!
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Post by nursemelanie on Jun 21, 2014 2:02:10 GMT -5
This last week has been a tough one. I have been quite ill, very fatigued with more dizzy spells and headaches than normal.
I went to my second sleep study because they did find I have sleep apnea. The whole cpap thing freaked me out. The following day(Wednesday) I had my final appointment before surgery with the new nurse practitioner at my surgeon's office. That didn't go well. She was foreign and hard to understand and she couldn't answer ANY of my questions and seemed to be totally lost! My surgeon was out of town so she couldn't even check with him on anything she was unsure about. Several of my labs weren't good(I will see about filling in a template and posting tomorrow). The most concerning one was my iron saturation, which was already very low in February at "13" and has now dropped to only "9". Which definitely explains my shortness of breath, fatigue, and dizziness with headaches.
Even with those results I had to INSIST to her that I must have the iron infusions set up while I'm impatient postop. She thought that we would just wait till one month postop to address it!!! She finally agreed to ask the office manager, who quickly explained to the NP that she could write the order. My surgeon and I had discussed this previously but the NP said she could find no notes about it. She also was clueless when I told her that I would not sign the surgery papers without including "100cm common channel length".
**Important question** Since I am already sleeved and am just having the DS part, I asked my surgeon 2 wks ago, why all my paperwork said "BPD w/ DS". He said it was the same thing. Is this correct?
So Monday morning I have to call their office and try to sort out the ridiculous appt I had with the NP and try to get some questions answered. There was a lot more absurdity to it but it tires me just to think of it.
I hope to have it all straightened out so I can try to de-stress and refocus. Feeling very down and scared about my health at the moment.
VSG to DS 7-01-14/ Dr Boyce, Knoxville, TN /Age 40/5'8"/HW 287/CW 273.2
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Post by Girlrocker on Jun 21, 2014 10:31:53 GMT -5
Melanie, I'm so sorry you're struggling and feeling so bad, especially this close to your surgery date. You clearly had a very annoying nurse practitioner, would drive me crazy that they don't speak English that well, besides her lack of understanding about the surgery her boss performs. Glad the office manager was able to step in; when is he back? Sounds to me like you could have the infusions now, no need to wait. And as weird as the cpap must be, I'm just glad they caught the sleep apnea before surgery so you could be treated. And with good chance, it will be short and sweet, the sleep apnea will go away with surgery! As for the BPD with DS, here's a good explanation I found that should help ease your mind, you're having the 'full boat': www.newlifebariatricsurgery.com/weight-loss-options/biliary-pancreatic-diversion-duodenal-swith-knoxville-tn/Biliopancreatic Diversion (BPD)BPD removes approximately 3/4 of the stomach to produce both restriction of food intake and reduction of acid output. Leaving enough upper stomach is important to maintain proper nutrition. The small intestine is then divided with one end attached to the stomach pouch to create what is called an “alimentary limb.” All the food moves through this segment, however, not much is absorbed. The bile and pancreatic juices move through the “biliopancreatic limb,” which is connected to the side of the intestine close to the end. This supplies digestive juice in the section of the intestine now called the “common limb.” The surgeon is able to vary the length of the common limb to regulate the amount of absorption of protein, fat and fat-soluble vitamins. Biliopancreatic Diversion with “Duodenal Switch”This procedure is a variation of BPD in which stomach removal is restricted to the outer margin, leaving a sleeve of stomach with the pylorus and the beginning of the duodenum at its end. The duodenum, the first portion of the small intestine, is divided so that pancreatic and bile drainage is bypassed. The near end of the “alimentary limb” is then attached to the beginning of the duodenum, while the “common limb” is created in the same way as described above. Also, sometimes it's best to post more pressing questions like this as an independent post than on the personal blogs, so the responses are more targeted to your issue at hand. HANG in there Melanie, you will go the distance with this, I know it!
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Post by nursemelanie on Jun 21, 2014 15:07:55 GMT -5
Thank you Sharyl
VSG to DS 7-01-14/ Dr Boyce, Knoxville, TN /Age 40/5'8"/HW 287/CW 273.2
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Post by nursemelanie on Jun 26, 2014 14:48:21 GMT -5
*****copied from different post just to have my story in one place************
I finally got the call back from surgeon's office and they said (since he was out of town when I went for my final preop with the NP last week) he wants to see me himself and evaluate me to decide if surgery should go as planned for Tuesday July 1st or if it will be postponed. So I'm feeling quite frustrated and stressed, but what good would it do me to throw a fit and freak out?! So I will be robbing peter to pay Paul to make another 5 hr drive there and 5 hr drive back in my SUV. I know he's just making sure I'm healthy enough to proceed, but the circumstances surrounding it are maddening.
The reason for all the concern is due to the new NP's concern over my preop labs. Without getting into all the range #'s here's the short version:
Prealbumin - low, 19 MG/DL T4 - high, 13.9 UG/DL TSH - high, 6.480 uU/ML Iron - low, 27 MCG/DL Iron saturation - low, 9% Chloride blood - low, 96 MMOL/L Sodium - low, 133 MMOL/L C-reactive protein - high, 25.9 MG/L Vitamin D - low, 18.9 NG/ML WBC - high, 16.9 MM3 PTH - high, 99 PG/ML Vitamin K1 - low, 0.24
All other labs were normal. The RN(been with him for years) in his office that I talked to explain what she thought of my labs... that my parathyroid was high due to my low vit D so I need a 2nd injection, infusion would take care of iron saturation, wbc would be taken care if with the antibiotic my pcp gave me for my tooth infection, regular thyroid and inflammation are up due to the my suspected thyroid condition.....so I guess. I'll see what he says tomorrow afternoon.
****copied from different post just to have my story in one place********
VSG to DS 7-01-14/ Dr Boyce, Knoxville, TN /Age 40/5'8"/HW 287/CW 273.2
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Post by nursemelanie on Jun 26, 2014 14:50:46 GMT -5
Saw Dr Boyce today and everything is a go for Tuesday morning July 1st!!!!'
VSG to DS 7-01-14/ Dr Boyce, Knoxville, TN /Age 40/5'8"/HW 287/CW 273.2
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Misty
Junior Member
Posts: 60
Surgery Type: DS
Surgery Date: 07/22/2014
Surgeon: Dr. Hazem Elariny
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Post by Misty on Jun 26, 2014 16:38:45 GMT -5
Yay! Great news! I'll keep you in my prayers.
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Post by Girlrocker on Jun 26, 2014 17:55:46 GMT -5
Saw Dr Boyce today and everything is a go for Tuesday morning July 1st!!!!' VSG to DS 7-01-14/ Dr Boyce, Knoxville, TN /Age 40/5'8"/HW 287/CW 273.2 MORE yayyyyyy!
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Post by west4thavenue on Jun 26, 2014 19:55:13 GMT -5
I am excited for you! I'll be thinking of you Tuesday morning!
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Post by nursemelanie on Jun 30, 2014 0:27:23 GMT -5
Sitting in bed on my last night at home (will be traveling to Knoxville late tomorrow night) , trying to whined down from the day. My head swirling with a million thoughts and emotions. Trying to grasp that this is really happening in 30 hrs.
My loved ones are quite scared of the worst case scenario. And my spouse ask tonight if I was really ready for all this. I had to stop and think for a minute, but my reply was that I don't think anyone is "ready" for the type of recovery the DS involves. Particularly with my conservative surgeons regimen of a solid month each of liquids, pureed, then soft foods....combined with pain, affects of anesthesia, drains, catheters, healing, crazy bowels, etc. But I am ready to stop existing and start LIVING!
VSG to DS 7-01-14/ Dr Boyce, Knoxville, TN /Age 40/5'8"/HW 287/CW 271
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Post by Girlrocker on Jun 30, 2014 1:36:07 GMT -5
So much the thoughts the hours before surgery! I was on a very conservative progression regimen too, feeding tube for 6 weeks! The first week is the worst but I think you are similar to how I felt, I was so glad for a second chance, to start living, I didn't care what I had to do! I do understand how scared your family is for you, I've been single so I only had me. But I know you're also doing this for them, and I am wishing for you a smoooooooth easy surgery and complication free recovery!
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Post by west4thavenue on Jun 30, 2014 9:50:39 GMT -5
I've been single so I only had me. Well, you may not have a spouse, but you mustn't consider yourself alone. As giving and compassionate as you are, there are people everywhere who love you and to whom you matter greatly! That we don't share blood or names and addresses notwithstanding!
Melanie. Bon voyage, my friend. Holler at us ASAP!
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Post by Girlrocker on Jun 30, 2014 19:40:02 GMT -5
I've been single so I only had me. Well, you may not have a spouse, but you mustn't consider yourself alone. As giving and compassionate as you are, there are people everywhere who love you and to whom you matter greatly! That we don't share blood or names and addresses notwithstanding!
Melanie. Bon voyage, my friend. Holler at us ASAP!
Oh my dear, bless your heart, you are SO kind! Melanie, you gotta be packed up, as you are hittin' the road SOON. Thinking of you, rooting for you, drive safe, and wishing you an easy, smooth uneventful trip to the DS side!
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Post by nursemelanie on Jun 30, 2014 21:44:25 GMT -5
Thanks you guys. We decided to leave early so we are close to Nashville now. Gonna make a short stop there and then be back on the road to Knoxville (another 2 1/2hrs). Our 15 yr old had a total meltdown before we left. She was crying her eyes out with worry. It broke my heart!! Even though this isn't a pleasure trip, Sharon and I are trying to enjoy our first alone moments. She will post as soon as I'm out of surgery. VSG to DS 7-01-14/ Dr Boyce, Knoxville, TN /Age 40/5'8"/HW 287/CW 271
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Post by nursemelanie on Jul 1, 2014 9:08:25 GMT -5
Melanie is out of surgery and in recovery. Her doctor said that everything went great. Thank you all for supporting my wife in her life changing journey and helping her to make the best decisions to improve health .
Sharon.
VSG to DS 7-01-14/ Dr Boyce, Knoxville, TN /Age 40/5'8"/HW 287/CW 270
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Post by Girlrocker on Jul 1, 2014 9:55:33 GMT -5
Melanie is out of surgery and in recovery. Her doctor said that everything went great. Thank you all for supporting my wife in her life changing journey and helping her to make the best decisions to improve health . Sharon. VSG to DS 7-01-14/ Dr Boyce, Knoxville, TN /Age 40/5'8"/HW 287/CW 270 YAYYYYYY!!!! Sharon I'm so glad to hear the good news, for Melanie and all of you. She couldn't have a more loving, supportive partner in you! Wishing her an equally uneventful recovery. Tell her we are thinking of her!
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Post by nursemelanie on Jul 1, 2014 9:57:06 GMT -5
Will do.
VSG to DS 7-01-14/ Dr Boyce, Knoxville, TN /Age 40/5'8"/HW 287/CW 270
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Post by amydroe on Jul 1, 2014 10:23:03 GMT -5
YAYAYAY!!!! Welcome Melanie!!!! Thanks for the update Sharon! Take good care of her
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Post by west4thavenue on Jul 1, 2014 10:55:33 GMT -5
WONDERFUL! Rest well, Melanie! See you back here soon!
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Post by Taterweight on Jul 1, 2014 11:03:47 GMT -5
Welcome to the bench, Melanie!!! So happy to have you finally joining us after all your patient planning and preparations. Rest, sip, and walk laps! Wishing you a boring but speedy recovery! (Thanks Sharon for the update! )
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Post by Girlrocker on Jul 1, 2014 13:58:14 GMT -5
YAYYYY! From sleeve to DS, she's on the team! She will be so happy to see these responses. Sharon, let us know if we can help YOU too!
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Post by nursemelanie on Jul 1, 2014 17:51:04 GMT -5
Hey there. Dr Boyce, preop nurses, anesthesia, surgical team members, postop nurses and specialize bariatric floor nurses are all the bomb here!
Requested a PCA with dilaudid and got it. Been sipping 1oz fluid every 15 minutes and walking every 1-2 hrs. They took out Cath almost 3 hrs ago(their protocol after you can walk 150feet) and I haven't urinated yet, so they will bladder scan me soon to see if I need straight Cath. I would have preferred it stay in longer, due to my history of slooow bowel & bladder wake up.
I'll be getting 4 iron infusions. 9pm tonight, 2 tomorrow and 1 Thursday morning.
Will write more soon.
VSG to DS 7-01-14/ Dr Boyce, Knoxville, TN /Age 40/5'8"/HW 287/CW 270
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Post by west4thavenue on Jul 1, 2014 18:01:25 GMT -5
Go, Melanie! Have a good night!
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Post by meq815 on Jul 1, 2014 18:05:42 GMT -5
Amazing! Congrats!
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Post by goodkel on Jul 1, 2014 18:08:19 GMT -5
Melanie is out of surgery and in recovery. Her doctor said that everything went great. Thank you all for supporting my wife in her life changing journey and helping her to make the best decisions to improve health . Sharon. VSG to DS 7-01-14/ Dr Boyce, Knoxville, TN /Age 40/5'8"/HW 287/CW 270 YAY! Congratulations, Melanie! Thank you, Sharon for keeping us informed! We're here for you, too, if you have any questions.
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DSwitcher
Junior Member
Posts: 88
Surgery Type: Revision
Surgery Date: 08/26/2014
Surgeon: BOYCE
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Post by DSwitcher on Jul 1, 2014 18:27:19 GMT -5
Congrats on your conversion from VSG to DS with Dr Boyce in Knoxville!
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Post by nursemelanie on Jul 1, 2014 19:32:14 GMT -5
You are all so sweet and supportive! They did bladder scan and it showed 392....they straight cath'ed me and got 750! My body knew there was a lot more and fortunately I have an awesome nurse who listened to me. Iron infusion is ferric gluconate, takes one hour IV and they're giving it every 12 hours. Frequent updates are for my journey records and for you.;D VSG to DS 7-01-14/ Dr Boyce, Knoxville, TN /Age 40/5'8"/HW 287/CW 270
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Post by Girlrocker on Jul 1, 2014 19:39:04 GMT -5
Hey there. Dr Boyce, preop nurses, anesthesia, surgical team members, postop nurses and specialize bariatric floor nurses are all the bomb here! Requested a PCA with dilaudid and got it. Been sipping 1oz fluid every 15 minutes and walking every 1-2 hrs. They took out Cath almost 3 hrs ago(their protocol after you can walk 150feet) and I haven't urinated yet, so they will bladder scan me soon to see if I need straight Cath. I would have preferred it stay in longer, due to my history of slooow bowel & bladder wake up. I'll be getting 4 iron infusions. 9pm tonight, 2 tomorrow and 1 Thursday morning. Will write more soon. VSG to DS 7-01-14/ Dr Boyce, Knoxville, TN /Age 40/5'8"/HW 287/CW 270 YAYYYYYYYYYY! After ALL you have been through to get here, SO happy to here it! You let them take good care of you while you are there, don't leave until you're ready, get pumped up and refueled. So happy for you, welcome to the club sister!
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