Road to DS continues...RNY to DS with Dr. Boyce Knoxville

[kmarlee76]

Contacted by my surgeons office today; approval granted by my insurance for revision of RNY to DS, probable mid June surgery date. Welcome any words of wisdom from Vet DSers! I have put in hours, days, weeks of research since my doc recommended revision to DS for me on March 22 of this year. Give me "pearls" from any subject matter, would be a great help to me in organizing my million and one thoughts regarding my life altering decision to have this surgery. Thanks in advance!

[newyorkbitch]

Have you spent hours reading this board?

[caprice]

Yes, what NYB said. There have been some good discussions on the boards since you last posted. Look through that. Then, if you read back through the older threads, here are some of the things you'll see, over and over again:
- the utter futility of counting calories
- the unnecessary frustration you can cause yourself by weighing daily, and (needlessly) worrying that you won't lose any more weight, because you didn't lose any from one day to the next
- the extreme importance of proper hydration, especially immediately post op. You get dehydrated, you'll get sick and eating will be even more difficult. And, you'll pretty much HAVE to get to a hospital to get rehydrated.
- The importance of tracking your own bloodwork, and adjusting your supplements accordingly.

As an example, have you read enough history here to know what 30,60,90 refers to? Not gonna tell you, you find it. It's kind of important, too.

There was also a great thread on here since you last posted here, about the things one could do for oneself as a pre-op, to be in the best possible place going in to surgery. Have you read it?

Happy reading!

[bboop]

After you read, PLEASE come back with questions. We love questions. Seriously, reading will really help you to understand your surgery, what to expect afterwards plus you vitamin requirements, hydration necessity, food immediately post op and then for the rest of your life, and so much more. Besides you will fine the 30, 60, 90 answer while reading.

I don't think there's a soul on here that didn't read, and then read some more.

Welcome.

[kmarlee76]

I have spent a great deal of time reading these boards. This thread was mainly an update as I was asked to contribute my journey being that I am the only RNY to DS with Boyce known on here. Getting opinions was just another way for me to condense some of what I have already learned. 30/60/90 is protein mg =/> the first, second, and third 30 day post op period. I am also taking ISOPURE protein shakes daily now to build my stores for rebuild of tissue after surgery, and to help keep stores to avoid hair loss if possible.

[caprice]

I see. Well, thank you for clearing that up.

[west4thavenue]

Apr 11, 2015 13:51:14 GMT -5 kmarlee76 said:

I have spent a great deal of time reading these boards. This thread was mainly an update as I was asked to contribute my journey being that I am the only RNY to DS with Boyce known on here. Getting opinions was just another way for me to condense some of what I have already learned. 30/60/90 is protein mg =/> the first, second, and third 30 day post op period. I am also taking ISOPURE protein shakes daily now to build my stores for rebuild of tissue after surgery, and to help keep stores to avoid hair loss if possible.

Hi, kmarlee, and welcome.

Disappointment is a function of the difference between expectations and reality. It seems that hair loss is a concern for you, and you have obviously read enough to realize that this is an issue. So let me help you out with this.

Our bodies do not store amino acids, the building blocks of protein. I'm certainly not saying that the protein shakes pre-surgery are a bad idea. I just don't want you to go into this thinking you can avoid something that happens to nearly all DS patients beginning at about 6-8 months post surgery. It happens. For most of us it is temporary. For some of us who had nice, thick heads of hair, it's not so bad.  For those of us who sort of lived all of our lives with a little bit of "frog fuzz" (like me), the loss meant a trip to the wig shop.

My hair is beginning to grow back now at 12+ months post surgery and I am donating the wigs to a local oncology center. Temporary issues are not something to get hung up about. There is really no way to have our insides surgically rearranged in such a drastic way and not expect our bodies to respond to the change.  Hair loss is only temporary for the majority of us and it happens at a time when your weight is dropping steadily and you are beginning to realize a quality of life you did not have as an MO person.  It is a yin-yang thing, my friend.

Focusing on the positives of this surgery and the improvements in your health will make a big difference throughout your journey.

Are there other things you are worried about as well as hair loss?

 

[bboop]

Yeah, what else concerns you. We are here, so ask away.

I've lost my hair...no, I'm not glad but definitely major thinning and it hasn't grown back. I think my hair loss is also heredity...I'm much older than most on this board, so factor that in. I think if you have hair loss you will have to live with it and then like most people, it will grow back.

How about your vitamin routine? What are you going to eat immediately post op, and then later on? You may have all of this figured out. Just let us know what you need info wise. We will help you.

[kmarlee76]

Oh yes!  I worry constantly!  That's why I'm all over the place with my threads. Trying to hit topics as they come if I can't find enough info on my own to truly understand it. I have VERY fine hair, and I lost a lot with my RNY which is why I'm concerned now with The DS. Truly hair loss is not that big of a deal, as you said...its temporary. My hair grew back after RNY, still fine, but thicker actually!  

Honestly, the vitamins have me wrecked. To the point im still not 100% ready to say yes to having this procedure. I have two teenage boys that still need me, I'm scared if I don't know enough about aftercare that I can really go down a bad road...and I don't want them affected by my health struggle. BUT clearly my health is already a struggle, otherwise I wouldn't have sought out a doc to discuss revision in the first place. I'm day and night researching (when I'm not playing mom of course) and driving people crazy on boards like this one!  I'm a registered nurse, have worked in the field almost 20 years (primarily ICU), and I have never had a DS patient. So my skills as a nurse are on high alert as I feel I'm back in school trying to learn every aspect of this procedure that I can possibly find out. 

If you've made it this far, maybe I can take you a little further?!!  I had a barium swallow last week to check the anatomy of my RNY, and my pouch is VERY dilated, stoma is blown, everything goes straight down and my proximal bypass length is a joke. Knowing all of this, revision now feels even more of a necessity for me.  I have to do something and, I have learned by researching revisions that DS by far is my best choice. If I can just get passed being so scared of it. You would think my knowledge as a nurse would help, BUT oh boy it does NOT!  I know enough to fear it. I think, "what if I get lazy" or "what if I can't get used to a new way of thinking after 14 years as a RNYer". I bet you're glad you asked if I had any other concerns!  Thank you all for your support!  It means so much to me as this is my life we're talking about!  Lol. Also a BIG issue is my dear hubby isn't on board. I can usually calm his fears by explaining medical procedures to him; but since I am concerned, he rightfully is concerned too. So much to work through, and I am supposed to call this week to schedule my surgery as I have already been approved. For those of you that have read my life story,THANK YOU, and bless your heart for helping me!

[kmarlee76]

Just a quick add in I forgot to touch on...diet. I plan to do post op diets ordered by my surgeon for appropriate healing, and of course, protein supplements and hydration. I also have learned to sharpen my knowledge on LCHF living, as fat is so important with DS, to follow months after my surgery when I'm cleared from all post op plans. AND I have been fortunate to be able to be a stay at home mom the past couple of years; however, my activity is so sedentary now. No longer do I run 12-14 hour shifts 3-5 days a week as a nurse, so quite frankly my activity level is horrendously low compared to when I was working outside of my home.  Thanks for letting me add this in!

[west4thavenue]

You've brought up some pretty steep concerns in these last two posts, kmarlee.

Some comments in the order you presented:

Vitamins. You will be married to them and you will have to be dedicated to monitoring your bloodwork and adjusting those supplements FOR THE REST OF YOUR LIFE. You must advocate for yourself and you will probably wind up educating your doctors on the way your system works post-surgery. If you can't get past this concept, please do not have this surgery. The vitamins are not negotiable. Read about diseases caused by vitamin deficiencies and you will understand why vitamins are a must for DS patients. I cannot stress this enough. If you have any idea that you can do the one without the other, this surgery is NOT an option for you.

Your husband is not on board. What does he believe you should do instead? If you are an MO person with the hope of living a healthy life, you must change. The DS is the most effective documented tool available, but it's not easy. My husband was worried, too, when I went for the surgery, as was I, but the fact of the matter was that I was dying, and we both knew the DS was my best shot at circumventing a premature death from all the comorbidities I had. Remember that courage does not mean you do not feel fear. Courage means you move forward in the face of fear and do what must be done.

LCHF. Well, that's not it and I recommend you do more reading on the post-DS lifestyle. The point of everything is the heavy consumption of protein, mostly animal protein. In so doing, you will consume fat, about which you need not concern yourself. You will need some fat in your diet, of course. However, the pursuit of fat? HF? No, that is not correct. This should not be considered a "high fat" diet. It's all about high protein and low carbs. So let's redo your acronym to HPLC, very much like Atkins. Eat your protein first before you eat anything else and the rest will fall into place.

It's a little difficult to aim well in making comments to you, since I know little about you other than you are sedentary and you've had an RNY. I don't know your weight now or what, if any, comorbities you have. This information would help us help you. Are you diabetic? Do you have heart disease, osteoarthritis, etc.? What is your age?

[kmarlee76]

HW 260 CW 240 after RNY LW 128. I am 38 have high blood pressure (140's/80's) and elevated cholesterol at 153

[bboop]

Yeah, you need to research the vitamin thing. I have a 30 pill organizer and use it faithfully. I basically take calcium, AKE and LOTS of D. I also take vitamin B-12. My labs are great, but I'm way out from surgery. Calcium will also help your bowel movements, too. Meaning to contain them. I take a multi vitamin cause I can't take vitamin C by itself...gives me terrible heartburn. Trust me, as time goes by you will want to trash the vitamins, but you just can't...they are for life. This is a non-negotiable issue. Calcium must be citrate not carbonate.

Immediately after surgery, you must - I repeat you MUST keep yourself hydrated. That means at least 64 oz of liquid, as soon as you can...yes you can count your protein drinks. Before she closes, I would order some of Vitalady's sampler packs to find out which ones you like. I personally just use chocolate and buy it at CVS or Walmart, but there are zillions of kinds of protein out there. There are different kinds so make sure you buy the correct protein.

Right after surgery, I suggest you learn to smash up your food. I did mine in a blender in small portions. I ate things that I normally don't eat because it was easier to get them down. Like beans...they are high in protein, but really high in carbs, too. There are all kinds of soups out there, smashed up they are fine but only in the beginning. Yogurt, eggs (more about eggs later), SF puddings and so forth. Eggs are totally an individual thing. In the beginning I couldn't do eggs...up they would come. So I suggest you take that one slow and easy till you learn. I eat them almost daily now.

Get yourself a carb counter...aim for low carbs and high protein. Those are the rules. Like west4ave said, fat won't be an issue unless you end up having a constipation problem and then we suggest you add more fat to your diet. Initially after surgery and for a few weeks, maybe longer you will want to stay near a bathroom...remember liquid in liquid out and sometimes you don't have but a moment to get there. This will change as your diet changes. You will get to eat solid food...I promise. You may feel good pretty soon after surgery, but for me, being near a bathroom, made all the difference in the world, initially. Sometimes revisions lose more slowly, you may or may not be one of those. I'm one of those. But I'm so much better than I was.

That's all I can think of for now. Ask questions.

[Joanne]

Hi,
Everyone gave you good advice. I might pick a few of your topics and add a few things.

I was really glad to see Monica give her opinion on high fat. IMHO too many DS'ers push that high fat is "necessary". I would encourage you to think of fat more as a "free" food. There's no reason to limit it - you shouldn't. Don't eat the fat free or low fat version of anything, of course. I just eat fat to taste. Honestly, when I read some stories of the amount of fat people add to their food it would make me gag. Now, if they like to eat that way and are eating to taste, that's one thing. But I do think there are people who go beyond what tastes good because they think they need to. If you're not getting enough fat, you would become constipated and perhaps have dry skin, but in my experience using olive oil, butter, and other liberal fats would avoid that.

Switching topics - your husband. You said he's not onboard, but then I also read where you said he's worried. To me there's a big difference. Is his hesitation because he's worried about you? Or does he not want to see you succeed? Does he have other reservations? What is going on? Of course you are an adult and entitled to do whatever you want to do, but since he is your husband it's going to make it so much easier to have his support. Is this a matter of educating him and helping to calm his fear, or is there a deeper issue at hand?

[west4thavenue]

Apr 12, 2015 11:12:31 GMT -5 kmarlee76 said:

HW 260 CW 240 after RNY LW 128. I am 38 have high blood pressure (140's/80's) and elevated cholesterol at 153

You don't mention joint pain or similar issues.  Why are you sedentary at this point, kmarlee?  Is walking an option for you?

[kmarlee76]

Thank you all for your wonderful advice! My husband is concerned. He just needs to learn along side of me. He knows I will do this the right way, he just doesn't want anything bad to happen to me, pre-during- post operative. Heck, he may not want me to succeed. This is quite personal, but I did file for separation after I lost weight with RNY. That's a whole different story, we worked through and have been fine for the last 7 years. I'm very happy with him, I wasn't before. We had a lot of growing up to do honesty.

I don't have pain issues, I am just inactive. I'm home most of the time, I don't work and walk like I used to, but I do exercise every day. I don't haven't anything physically wrong, just not super active day to day.