Post by Deleted on Jan 28, 2016 18:49:00 GMT -5
This is my first post here so be kind. On December 29, 2015, I had a revision of the gastric sleeve, the SA-DS & an hiatal hernia repair.
My starting weight was 303 on my scale. I had the gastric sleeve done on 8-22-2013. My weight the day before surgery was 259, a loss of 44 pounds in 4 months pre-op. Over the next 5 months or so I lost about 33 pounds & then I stalled. Nothing would break the stall although I did lose another 5 pounds over the next 10 months. On 12-8-2014 I had a panniculectomy where my surgeon removed 15 pounds (!) of excess skin & fat. This was covered by insurance since I had documentation of recurring severe rashes under the "apron."
I did hit a low of 198 pounds about two months after the panniculectomy but that was very briefly & I gradually regained to a weight of 218. My BMI was still just over 35 & I still had the co-morbidities, although markedly improved, that I did when I started. My last hemoglobin A1c was 5.9, my cholesterol is near normal & my blood pressures are good. But, keeping them there required Metformin plus 4 insulin injections a day, generic Lipitor 80 mg a day (actually an increase), & 3 blood pressure meds. I can’t say the sleeve didn’t work. After all, I was down 84 pounds from my starting weight & 95 pounds from my highest weight. When they say patients lose an average of 65% of their excess weight, there are many on both sides of that average. I’m just one of the lower percentage people.
So, after much consideration I decided to have the duodenal switch as my surgeon originally suggested. As a nurse the major malabsorption of the classic duodenal switch still scares me so I had decided to ask Dr Srikanth if he would do a longer common channel when I learned of the single anastomosis duodenal switch, AKA SA-DS or SIPS, which has an even longer common channel. He & I agreed on a 300 cm common channel which I am comfortable with. I got insurance approval one week after I completed the pre-op testing.
Recovery has been a bit rocky. Two & a half weeks post op I spent the afternoon & early evening in the ER getting IV fluids & a CT scan because I was having difficulty getting my fluids & protein in & was vomiting quite a bit - four times just that morning. Two days later I had a repeat upper endoscopy & my surgeon dilated two strictures in my sleeve. There was still a lot of edema in the stomach. I continue to have difficulty getting in my protein & fluids. I do wish there was a way to speed up resolution of the edema.
I still feel a lot more restriction, especially in the afternoon & evening, than I ever did with the initial sleeve. In reading the operative reports, I found that he used a size 26 fr bougie which I think is very tight. But that is the same size he used on the first sleeve & I didn’t have the same issues. At least I know my stomach should eventually dilate some.
In reading what other programs require for supplements for the SA-DS & even the classic DS with 50-100 cm common channel, I think my surgeon’s requirements are excessive. I am supposed to take five 30-gram protein shakes, 12 (yes, twelve!) multivitamins, 4500 mg calcium citrate, 50,000 u vitamin D & 3 iron tablets at day. The requirements after the initial sleeve weren’t quite so bad, but it took over a year of lab tests to get them to drop all supplements except one multivitamin a day. I worry about hypervitaminosis with toxic levels of some vitamins, especially vitamin D. Also, my surgeon is very, very strict on the post-op diet for all of his patients no matter what procedure & I was just allowed to start pureed foods at 4 weeks.
My starting weight was 303 on my scale. I had the gastric sleeve done on 8-22-2013. My weight the day before surgery was 259, a loss of 44 pounds in 4 months pre-op. Over the next 5 months or so I lost about 33 pounds & then I stalled. Nothing would break the stall although I did lose another 5 pounds over the next 10 months. On 12-8-2014 I had a panniculectomy where my surgeon removed 15 pounds (!) of excess skin & fat. This was covered by insurance since I had documentation of recurring severe rashes under the "apron."
I did hit a low of 198 pounds about two months after the panniculectomy but that was very briefly & I gradually regained to a weight of 218. My BMI was still just over 35 & I still had the co-morbidities, although markedly improved, that I did when I started. My last hemoglobin A1c was 5.9, my cholesterol is near normal & my blood pressures are good. But, keeping them there required Metformin plus 4 insulin injections a day, generic Lipitor 80 mg a day (actually an increase), & 3 blood pressure meds. I can’t say the sleeve didn’t work. After all, I was down 84 pounds from my starting weight & 95 pounds from my highest weight. When they say patients lose an average of 65% of their excess weight, there are many on both sides of that average. I’m just one of the lower percentage people.
So, after much consideration I decided to have the duodenal switch as my surgeon originally suggested. As a nurse the major malabsorption of the classic duodenal switch still scares me so I had decided to ask Dr Srikanth if he would do a longer common channel when I learned of the single anastomosis duodenal switch, AKA SA-DS or SIPS, which has an even longer common channel. He & I agreed on a 300 cm common channel which I am comfortable with. I got insurance approval one week after I completed the pre-op testing.
Recovery has been a bit rocky. Two & a half weeks post op I spent the afternoon & early evening in the ER getting IV fluids & a CT scan because I was having difficulty getting my fluids & protein in & was vomiting quite a bit - four times just that morning. Two days later I had a repeat upper endoscopy & my surgeon dilated two strictures in my sleeve. There was still a lot of edema in the stomach. I continue to have difficulty getting in my protein & fluids. I do wish there was a way to speed up resolution of the edema.
I still feel a lot more restriction, especially in the afternoon & evening, than I ever did with the initial sleeve. In reading the operative reports, I found that he used a size 26 fr bougie which I think is very tight. But that is the same size he used on the first sleeve & I didn’t have the same issues. At least I know my stomach should eventually dilate some.
In reading what other programs require for supplements for the SA-DS & even the classic DS with 50-100 cm common channel, I think my surgeon’s requirements are excessive. I am supposed to take five 30-gram protein shakes, 12 (yes, twelve!) multivitamins, 4500 mg calcium citrate, 50,000 u vitamin D & 3 iron tablets at day. The requirements after the initial sleeve weren’t quite so bad, but it took over a year of lab tests to get them to drop all supplements except one multivitamin a day. I worry about hypervitaminosis with toxic levels of some vitamins, especially vitamin D. Also, my surgeon is very, very strict on the post-op diet for all of his patients no matter what procedure & I was just allowed to start pureed foods at 4 weeks.
