Pre-DS Surgery Baseline Testing Questions?

[Deleted]

OK….Though I am still in the “Surgeon shopping” pre-DS stage, I am trying to learn as much as possible and have another question. Will they do a “BASELINE” test for all these vitamins & minerals that you guys take BEFORE I have surgery?? Or...should I ask my PCP?? I am especially concerned because for the last TEN years or so, I have limited my caloric intake to between 500-800 calories a day (any more than that and I will gain weight), and after reading everything about the DS…There is no way in hell my numbers can be in the normal range??? I only recently (after all this DS reading), started taking a protein shake and a multi- vitamin drink, but I think I really need a baseline on these numbers? Also, are these the things to have tested for? I pulled it off some .pdf I saw?

CBC
COMPREHENSIVE METABOLIC PANEL
COPPER
CERULOPLASMIN
FASTING LIPID PANEL
FERRITIN
FOLATE
IRON
MAGNESIUM
NIACIN (Vitamin B3)
PHOSPHORUS
PTH, intact with Calcium
THIAMINE (Vitamin B1)
TSH
SELENIUM, SERUM
VITAMIN A
VITAMIN B6
VITAMIN B12
VITAMIN D, 25 HYDROXY
ZINC, PLASM

[newyorkbitch]

Rob how tall are you and what do you weigh? How old are you?

If you have eaten only 500-800 calories per day for years and you are still obese….something is very, very wrong and you need to be very fully evaluated before you even contemplate surgery.

When was the last time you had bloodwork done of any kind?

[Deleted]

Sept 10, 2014 8:22:45 GMT -5 newyorkbitch said:

Rob how tall are you and what do you weigh? How old are you?

If you have eaten only 500-800 calories per day for years and you are still obese….something is very, very wrong and you need to be very fully evaluated before you even contemplate surgery.

When was the last time you had bloodwork done of any kind?

I am 5'11" (used to be 6')...lol, 360 lbs and am 56 yrs old. I had an Executive Health Exam last November and there were no red flags. I am a FREAK...lol and no one believes me except my family and friends because they see what I DONT eat! I eat only vegetables and meat, grilled, NO high fat and almost NO carbs. My highest weight was 390...IF I go over 800-100 calories a day, I will get back up to 390 within a month. I take Thyroid meds, but only because my PCP was trying to help me figure it out. No matter what my dose is, my reading are always the same which means I wont absorb the T4-T3 conversion, which is in the same family as being insulin resistance. The only good news, is all my blood is thin,(bleed easy), and all my cholesterol numbers are good. I also have a very active job, a lot of walking etc and before I hurt my back a couple months ago, worked out 2-3 days per week. So...where does my energy come from? I live on border line starvation and believe it or not, that is somewhat healthy (google Dean Cornish starvation)... and having the almost normal blood levels is probably the only reason I haven't had a stroke or heart attack.

[newyorkbitch]

Have you seen an endocrinologist?

[Deleted]

Sept 10, 2014 8:42:05 GMT -5 newyorkbitch said:

Have you seen an endocrinologist?

LOL....every year or two for the last 35 years, in the perennial hope that I could actually find someone proficient. I apologize in advance, but I absolutely hate endocrines, they are completely useless! (at least the plethora I've been through), I know more about how the Human endocrine system works than anyone of them I've ever met....and...to make matters worse, they have all been very arrogant and condescending as though it is my fault.  I did luck out with the last guy I seen and he finally admitted that there are over 80 different human hormones that they have been able to recognize or isolate, but they only know how 5 or 6 of them work and interact with each other. I recently seen a WLS surgeon whom said they didn't even know about ghrelin when he was in med school and he was in his mid 30's. So, it's not their fault per se, they just don't know how everything works yet. At least when I get the DS, my "Super absorption" of everything should diminish significantly, at least that's what I hope.

[newyorkbitch]

You need a competent endocrinologist.

There is no way on earth you should contemplate bariatric surgery until you understand what your current situation is.

Why do you think your "super absorption" will change with the DS when you don't even know why it exists now?

[goodkel]

No, Robert, I have never heard of surgeons running a complete set of labs prior to surgery. That is something that you should request from your pcp early enough to address any deficiencies before surgery.

I was just like you for most of my adult life. I did 1.5 hours of aerobics four times a week and ate less than 1,000 calories a day just to stay a slightly chubby size 9. But, I aimed to be a size 5. If I stopped exercising or ate more, the weight gain was rapid. It was a constant struggle. I was always hungry, but I trained myself to ignore it. Hunger just wanted to make me fat.

I am sure that I blew out my metabolism early on from extreme dieting. I managed to keep my weight down until 2001 when metastatic thyroid cancer hit me. The year and a half of steroids and being off thyroid meds after the thyroid had been removed made me gain 100 pounds during that time. Afterwards, my tried and true dieting methods only added more weight. And here I am.

I was furious with my endo, too. It didn't occur to me that thyroid meds wouldn't at least give me the same metabolism that I had before. Of course, they didn't. I, too, was treated as if it was all my fault and the only advice they gave me was the usual diet and exercise. They did not believe me when I told them that that didn't work.

I am now a steady size 6 and I am never hungry.

I think that the DS will work wonders for you, too.

[Deleted]

Sept 10, 2014 10:32:10 GMT -5 newyorkbitch said:

You need a competent endocrinologist.

There is no way on earth you should contemplate bariatric surgery until you understand what your current situation is.

Why do you think your "super absorption" will change with the DS when you don't even know why it exists now?

I have been living in my torturous situation for over 35 years and I do understand what my situation is better than anyone, including any Scientist, (at least any I have met)...Just doing the math...50% less absorption (avg) = 50% less absorption = 50% less calories, (I know, except carbs), plus, as said, there are a host of other reasons, especially for what I am calling a "Super absorber" other than diminished caloric availability. There are "triggers" in our body that say store every single GD thing you eat and not burn real time. Those triggers and hormones we've yet to understand are survival mechanisms that were designed as preservation mechanisms when food was not plentiful and are changed with WLS, even with just the VSG. That's why type II diabetes (which I have if I eat) is significantly diminished within a day or two of WLS. VSG numbers are about 81%, the DS 98%. The VSG is purely a restrictive procedure and not malabsorbtive, yet it changes the dynamics of the endocrine system enough to stop type II diabetes and  insulin resistance. In theory, based on current "Science"...that shouldn't be happening either. As I said earlier, I am also not absorbing enough thyroid medication, i.e. T4-T3 conversion. IMHO, as a lay person, I think that those are similar all mechanisms in our cells we have yet to understand. Why do you think that NO Dr. or scientist can explain why type II diabetes goes away almost immediately following WLS. So yes, for me, the malabsorption part of the DS is only a part of the overall dynamic.

[Deleted]

Ms. goodkel….You totally Rock!! Thxs for your encouraging words. I’m so happy you fixed yourself too…..Exactly, I was told I have “Metabolic Syndrome” and YES, I have played a role in completely destroying what little metabolism I had by not eating. I realize that, and I still am…BUT…IF I EAT more that the 1K or so…MAX…I gain weight and VERY quickly would be one of those 600 lb men, I have no doubt…of course, …their answer…swear to God was just what you said, I should “workout more, that I should be working out 5-6 days per week”. My answer to them…OK, so PLEASE explain to me that if I am in a 12K calorie deficit per week, then WHY am I not losing 3-4 pounds a week based on the LAWS OF THERMODYNAMICS which says 3500 calories = one pound (avg person). I am an Engineer, so that is kind of in my world and have always sought scientific answers. I LOVE science and live my life observing the basic principles of “Cause and Effect”…

The DS will work for me, I know it will from a science standpoint and I know it in my heart. It’s my only option left and am running out of time. I/we have been raising our Granddaughter as her only parents for the last 10 yrs and she is 11. I have to figure this out so I have a chance to be here for her and I’m already not young.

[goodkel]

The DS will give you a normal metabolism. Once you are in maintenance you will still have to watch what you eat to not gain weight just like a normal person. Carbs will forever be our downfall, just like a normal person. But, it is a joy to be able to snack on cheese cubes or nuts whenever I feel hungry and not gain weight.

You will enjoy this life, too.

[PeteA]

Since you are still Dr. shopping I would ask your PCP to run the labs. I think the ones you listed are sufficient. I thought most surgeons
run pre-op labs, at least mine did. Sometimes they run them too close to surgery for you to take advantage of your pre-op absorption
to get your levels up.

It's hard to tell if you will show any real issues besides D. I'm guessing with the other Doctor's visits you have had they would have flagged
anything really unusual but sometimes low normal isn't just good enough so make sure you get a copy of the actual lab results instead of
just an OK from your PCP. I find I often disagree with my PCP about what levels are OK and what levels aren't.

Sounds like hell I hope this does hit reset on your metabolism, even though nothing is 100% for sure I think the DS is your best bet.

Good Luck,

Pete

[bboop]

Erick Wilson ran blood work prior to surgery...like after I was there for a pre op visit. So you may not need to have the blood work done somewhere else. Be sure to ask, it's always necessary to have a starting point.

[goodkel]

I had a a couple of tests, but definitely not the whole vitamin panel.

[bboop]

I'm pretty sure it was the entire enchilada. Now I could be wrong but I do remember the vitamin K vile being wrapped up and so forth. I actually ended up having it done here in Austin because there was a wait and I needed to catch a plane but I swear I had all or possibly most of my labs done pre op. And Erick Wilson ordered them.

[Deleted]

Sept 10, 2014 23:49:31 GMT -5 bboop said:

I'm pretty sure it was the entire enchilada. Now I could be wrong but I do remember the vitamin K vile being wrapped up and so forth. I actually ended up having it done here in Austin because there was a wait and I needed to catch a plane but I swear I had all or possibly most of my labs done pre op. And Erick Wilson ordered them.

I am seeing Dr. Eric on the 28th. I am SO ready to pick someone and so tired of interviewing surgeons. I hope he will finally be the one and I can get going. If not, i'm most probably off to Dallas.

[Deleted]

Sept 10, 2014 15:01:16 GMT -5 PeteA said:

Since you are still Dr. shopping I would ask your PCP to run the labs. I think the ones you listed are sufficient. I thought most surgeons
run pre-op labs, at least mine did. Sometimes they run them too close to surgery for you to take advantage of your pre-op absorption
to get your levels up.

It's hard to tell if you will show any real issues besides D. I'm guessing with the other Doctor's visits you have had they would have flagged
anything really unusual but sometimes low normal isn't just good enough so make sure you get a copy of the actual lab results instead of
just an OK from your PCP. I find I often disagree with my PCP about what levels are OK and what levels aren't.

Sounds like hell I hope this does hit reset on your metabolism, even though nothing is 100% for sure I think the DS is your best bet.

Good Luck,

Pete

Thank you Pete, all good advice!

[illinids2]

My Surgeon absolutely required labs prior to surgery to make sure I wasn't deficient in any area pre DS as he didn't want me starting out already deficient in any given area. My iron and D levels were low so I started supplementing probably 60 days pre surgery.

Regarding endo's I could not agree more. I saw one jack ass who told me I needed to do south beach diet because I was fat .. and that my wife and nutritionist who advised that I limit carbs to 50-75 per meal, we're probably fat as well. Needless to say I got up and left never to return. The next guy I saw wanted me to reduce carbs which was fine but he wanted to do an A1C every two freaking weeks...He was all about the billings ($$$$$).

In any case, the DS is a great procedure that sounds perfect you.

FYI - the VSG to my knowledge may show temporary diabetes improvement but it has not been shown to be long term effective for high weight loss or diabetes resolution. The DS has on both accounts.

Good luck and welcome to the board. I hope the ds allows you to eat more food (like a normal ds patient) and you see the results many of us have seen. I am only a year out but so far this has been "all that was advertised".

[Deleted]

Sept 11, 2014 9:59:10 GMT -5 illinids2 said:

FYI - the VSG to my knowledge may show temporary diabetes improvement but it has not been shown to be long term effective for high weight loss or diabetes resolution. The DS has on both accounts.

Good luck and welcome to the board. I hope the ds allows you to eat more food (like a normal ds patient) and you see the results many of us have seen. I am only a year out but so far this has been "all that was advertised".

Thxs for the reply and congratulations on your weight loss!! Regarding the VSG, yeah I know, what your saying is true and for me too, I wouldn't even consider just the VSG. My point I was trying to make though was that something happens almost immediately upon removal of 2/3 of the stomach when the ghrelin hormone is reduced which changes the dynamics and the interactions of other hormones (they have yet to identify) which turns on/off the triggers that say absorb, store or burn real time. I personally believe (and its not proven YET), that this same process that stops you from being insulin resistant i.e. type II diabetes, almost immediately, post surgery, is the same culprit, same components that caused the whole endocrine problem from the beginning, i.e., storing and not burning. Unfortunately, with the VSG, a lot of people do stretch their stomach back out in 2-3 yrs, produce more ghrelin (and all those other hormones not yet identified) which then starts the whole process of store not burn ALL over again which = weight gain. My whole point of bringing that up was the Malabsorbtive part of the DSS was NOT the only benefit I was hoping to get. I think there are the obvious Malabsorbtive benefits which are significant of course and most certainly have a short and long term benefit, but you also have endocrine benefits too which does alter your metabolism even if it is just in the short term.

[illinids2]

Sept 11, 2014 12:32:39 GMT -5 @robs477 said:

Sept 11, 2014 9:59:10 GMT -5 illinids2 said:

FYI - the VSG to my knowledge may show temporary diabetes improvement but it has not been shown to be long term effective for high weight loss or diabetes resolution. The DS has on both accounts.

Good luck and welcome to the board. I hope the ds allows you to eat more food (like a normal ds patient) and you see the results many of us have seen. I am only a year out but so far this has been "all that was advertised".

Thxs for the reply and congratulations on your weight loss!! Regarding the VSG, yeah I know, what your saying is true and for me too, I wouldn't even consider just the VSG. My point I was trying to make though was that something happens almost immediately upon removal of 2/3 of the stomach when the ghrelin hormone is reduced which changes the dynamics and the interactions of other hormones (they have yet to identify) which turns on/off the triggers that say absorb, store or burn real time. I personally believe (and its not proven YET), that this same process that stops you from being insulin resistant i.e. type II diabetes, almost immediately, post surgery, is the same culprit, same components that caused the whole endocrine problem from the beginning, i.e., storing and not burning. Unfortunately, with the VSG, a lot of people do stretch their stomach back out in 2-3 yrs, produce more ghrelin (and all those other hormones not yet identified) which then starts the whole process of store not burn ALL over again which = weight gain. My whole point of bringing that up was the Malabsorbtive part of the DSS was NOT the only benefit I was hoping to get. I think there are the obvious Malabsorbtive benefits which are significant of course and most certainly have a short and long term benefit, but you also have endocrine benefits too which does alter your metabolism even if it is just in the short term.

Good points Rob. You are obviously well educated and have done your research.....that in my humble opinion is a huge asset when it comes to post DS life.

And thank you...Wasn't an easy battle early on for me but I am very happy with the results so far.

[Deleted]

Sept 11, 2014 12:42:16 GMT -5 illinids2 said:

Sept 11, 2014 12:32:39 GMT -5 @robs477 said:

Good points Rob. You are obviously well educated and have done your research.....that in my humble opinion is a huge asset when it comes to post DS life.

And thank you...Wasn't an easy battle early on for me but I am very happy with the results so far.

Nice of you to say that thxs...I've been fighting this for 35+ years, learned a lot. Only in the last few months has the DS thing been in the equation. I can finally see a very dim light at the end of a very long tunnel!!