Tuesday, July 8, 2008
Wednesday, July 2, 2008
almost 20 months out
Food Intolerance doesn't mean forever me with the DS
At being almost 20 months out, I am FINALLY able to drink some carbonated soda. I thought I would never be able to enjoy having a refreshing drink. Ok, I still am unable to deal with drinking any carbonated soda with caramel such as Diet Coke or Diet Pepsi. I am able to drink Diet Fanta Zero. I think this is considered a WOW moment. One of the beauty with having the DS is that your stomach does NOT stretch from the carbonation of soda. There is no such thing. You do have your real stomach that is intact. Only the bottom curvature of the stomach is removed. The upper portion of the stomach has been untouched. In addition, you have your plyoric valve that does make a huge impact to how food and liquid is process and the gases of the carbonated soda since it moves it along, not have it sit or hang out in your stomach. We have a stomach, not a stoma.
For those that don't about my journey, I went through hell with food intolerance from almost everything I ate. My food selection was extremely limited during my 1st year post-op, since almost everything I try to eat made me sick. It as not due or contributed to the DS. It was after surgery and my intestinal tracts taking a little longer than normal to heal. It actually took 12 months to recover anf function correctly, but NEVER had any complications. I was a very slow healer. After I was a year out, I continued to try to reintroduced food that was on my list that caused me severe negative symptoms from intolerance and am now able to eat it with no negative effect whatsoever.
One of these intolerance I had was to carbonated drinks that cause horrible cramps and pain in my belly. Not anymore. Although, I have tried out some Diet Pepsi, still have cramps from it. Tried out Diet Coke same thing. It must be the caramel, I am sure. I drank Fanta Zero and wow, no cramps, pain or feeling awful. So, I guess this orange drink is a choice for me and don't even have to let it get flat. Just pour it or right out of the can when I open it. FIZZZZZZ. Yup, I can drink it with all the sizzle and bubbles it has.
Fanta Zero has zero calories, zero carbs and even zero caffeine. The caffeine being zero is what interest me to buy it and taste test it. I know we are all different when it comes to intolerance and other issues, but hell, this is a huge thing to me because it tells me that having the DS you are able to eat and drink almost anything. Just need to have patience and give it some time, like me it took almost 20 months. It's all good....
At being almost 20 months out, I am FINALLY able to drink some carbonated soda. I thought I would never be able to enjoy having a refreshing drink. Ok, I still am unable to deal with drinking any carbonated soda with caramel such as Diet Coke or Diet Pepsi. I am able to drink Diet Fanta Zero. I think this is considered a WOW moment. One of the beauty with having the DS is that your stomach does NOT stretch from the carbonation of soda. There is no such thing. You do have your real stomach that is intact. Only the bottom curvature of the stomach is removed. The upper portion of the stomach has been untouched. In addition, you have your plyoric valve that does make a huge impact to how food and liquid is process and the gases of the carbonated soda since it moves it along, not have it sit or hang out in your stomach. We have a stomach, not a stoma.
For those that don't about my journey, I went through hell with food intolerance from almost everything I ate. My food selection was extremely limited during my 1st year post-op, since almost everything I try to eat made me sick. It as not due or contributed to the DS. It was after surgery and my intestinal tracts taking a little longer than normal to heal. It actually took 12 months to recover anf function correctly, but NEVER had any complications. I was a very slow healer. After I was a year out, I continued to try to reintroduced food that was on my list that caused me severe negative symptoms from intolerance and am now able to eat it with no negative effect whatsoever.
One of these intolerance I had was to carbonated drinks that cause horrible cramps and pain in my belly. Not anymore. Although, I have tried out some Diet Pepsi, still have cramps from it. Tried out Diet Coke same thing. It must be the caramel, I am sure. I drank Fanta Zero and wow, no cramps, pain or feeling awful. So, I guess this orange drink is a choice for me and don't even have to let it get flat. Just pour it or right out of the can when I open it. FIZZZZZZ. Yup, I can drink it with all the sizzle and bubbles it has.
Fanta Zero has zero calories, zero carbs and even zero caffeine. The caffeine being zero is what interest me to buy it and taste test it. I know we are all different when it comes to intolerance and other issues, but hell, this is a huge thing to me because it tells me that having the DS you are able to eat and drink almost anything. Just need to have patience and give it some time, like me it took almost 20 months. It's all good....
Wednesday, June 25, 2008
Saturday, June 14, 2008
19 months postop
I am 19 months postop. Time flies. I have been extremely busy with life and enjoying it. I live as though I never had bariatric surgery since I do not have to watch what I eat. I see many postops from other sugeries speaking alot about calories in versus calories out. But, that just does not apply to the DSer. I eat because I want to and not freak out or worry if I will gain weight, especially at times the amount or frequency. I am still not able to eat much. But, then there are times, I am able to eat a medium size portioned plate of food. I make sure most of my protein and nutritional value is obtained from bulk food. I know I have to live on using protein powder for life, since I am unable to eat that much to get my protein that way. I usually eat either cereal, grilled ham & cheese, western omelet with cheese , grilled salmon or even a cheeseburger for breakfast. I make sure my first meal is high in protein. I also noticed that I have to eat 5-6 meals a day. I will not able to get over 80gms of protein using the 3 meals, 2-3 snack per day plan. I make sure my snack time is a meal that consist of some sort of protein that is at least the minimum 24gms per serving.
I sit back and realized one of the beauty of having the DS is I never exercised and still lost weight and have no saggy or loose skin. I am 44 yrs old and expect some sort of skin issue, but I don't. My highest weight was 305 lbs. I am right now at 139 lbs. Other than that, I like to readjust my vitamins and supplement as often as needed and according to my schedule and agendas. My bloodwork at 19 months postop is STILL great and within range. I have not once or ever had any deficiencies. I did have vitamin D deficiency prior to surgery and was placed on Drisdol therapy for it. But, since having surgery, all my vitamins, iron, panels and other levels have been amazingly good. I have not once since after being 12 months postop, had any reactions to eating food as I did prior to that. I am still unable to have certain sugar subsitutes and had to observe sugar alcohol amount or suffer severe stomach cramps.
I get A LOT of PM from members here that are pre-ops and especially post-ops. Many are interested and even drawn to know more about the DS surgery and how it works. I do get RNY post-ops asking about vitamins and supplements and even food choices and even help them with their vitamins and supplements. Many post-ops from the Texas board private message me regarding my food log and do like reading what I post. They find it very informative. I am a bit taken back because there are some who write to me that don't want the other members to know they are struggling with their RNY, there are others who just don't want others to know they are dealing with weight gain and there are others who are beginning to have a hard time dealing with certain issues that they didn't expect. To each their own how they want to reach out to someone and who they want to know about what they are going through. But, they are struggling with their weight and disappointed they have to subject themselves to having to use the 5 day pouch test or the liquid protein test or whatever they call it. They are tired having to still worry about what they eat and food being their enemy. All I can do is provide them support and guide them to help them out. They know I am discreet and won't disclose what we speak of. Many are ashame to post about their struggles on the board. I can understand. Paying it forward doesn't mean to just help those get surgery. Paying it forward also mean and MANY forget that it is to help those who are post-op as well.
There are some RNY postops who are struggling with their health and bloodwork. They ask me a lot of questions about vitamins, proteins and supplements. They appreciate that I take the time to listen to them vent and that I post and share info that may help them with their struggles and post-op life. I may not have the RnY, but these postop who do have the RNY look up to me and know I am sincere to help them. They just don't see the support or help from others on the board that they need. They tell me their peers are struggling as well and can't see how they can help them, if they can't help themselves. I think those on the TMB would be surprised who I have been helping with their RNY struggle and work with them to sort solutions to their problems. I may not have RNY, but they rather reach out to me than to their fellow peers. Life is odd sometimes.
Some are also very disappointed in the way postops lower themselves to insult me when a person ask a question, seeking feedback and they come on in to post as though it is about them. I had a woman who wanted feedback regarding VSG vs RnY. The VSG is a part of the DS. Thing is we have been posting back and forth privately and she was offended by by a RNY postop who posted to not provide her with any answers or support, but to incite drama when there wasn't any. I told her, people like that I ignore because they are showing their true ignorancy and class level they are. She thanked me for posting all the info to her and to open her mind to other options to think about. She didn't appreciate what this postop posted, since she said they did not answer her question or helped her out at all. She said I was very straight forward and didn't see any bashing from me. She did said, the other RNY man was stirring the pot and to even insult instead of being polite to answer her question regarding what I wrote and if there was any misunderstanding or incorrect statement. She was disturb how he replied to me and with such degrade, it turned her off to post again to the TMB. I told her, I just ignore them because my reply was to help her and any pre-op out there. What matters to me is what she thinks and if my input helped her in her journey that is she taking to WLS.
Overall, I live a good life without much worry about dieting or having to obssess myself with the scale. I always invite members whether pre-ops or post-ops of various surgeries to visit and read the DS board. Many message me how different and easy going life is with the Ds since we don't care about calories or fat. They still find that amazing. Right now, I am helping out 4 postop RnYers who are longterm and struggling in one way or another.
One has reactive hypoglycemia and she was never diabetic. It has been hard on her and she thought those who have RNY are cure of diabetes. She learned it doesn't and can even develop diabetes (reactive hypoglycemia is a form of diabetes) when you never had a history of it pre-op.
Another RnYer is 5 yrs postop in dire need of support. Her health and emotional state is very messed up. I will be there for her and work with her to get her back on track.
Another RnYer is 3 years post-op and eventhough she exercise and eating right, she is regaining weight. She is now going from one diet after another and done the 5DPT that she says is a useless waste of time and gimmick. She has tried everything and nothing is working. Her carb is very low, she is eating high protein, low fat and low calories. Yet, there is no success. She wants a revision to the DS after reading all the success other RnY had with their revision to it. She is disappointed she wasted her time with having the RnY.
Another RNYer is a regular poster and well known to the TMB. She is struggling and don't want the others to know about it. She is ashame and see her friends are having problems with postop issues too. I have been communicating with her back and forth. She came to me to help her. Eventhough, I am not RnY, she feels comfortable talking to me about her issues and receiving help to get her back on track.
That is what paying forward is about, helping others without taking sides or feeling you need to belong or be accepted among others or to feel you need to be a part of their group just to fit in.
I sit back and realized one of the beauty of having the DS is I never exercised and still lost weight and have no saggy or loose skin. I am 44 yrs old and expect some sort of skin issue, but I don't. My highest weight was 305 lbs. I am right now at 139 lbs. Other than that, I like to readjust my vitamins and supplement as often as needed and according to my schedule and agendas. My bloodwork at 19 months postop is STILL great and within range. I have not once or ever had any deficiencies. I did have vitamin D deficiency prior to surgery and was placed on Drisdol therapy for it. But, since having surgery, all my vitamins, iron, panels and other levels have been amazingly good. I have not once since after being 12 months postop, had any reactions to eating food as I did prior to that. I am still unable to have certain sugar subsitutes and had to observe sugar alcohol amount or suffer severe stomach cramps.
I get A LOT of PM from members here that are pre-ops and especially post-ops. Many are interested and even drawn to know more about the DS surgery and how it works. I do get RNY post-ops asking about vitamins and supplements and even food choices and even help them with their vitamins and supplements. Many post-ops from the Texas board private message me regarding my food log and do like reading what I post. They find it very informative. I am a bit taken back because there are some who write to me that don't want the other members to know they are struggling with their RNY, there are others who just don't want others to know they are dealing with weight gain and there are others who are beginning to have a hard time dealing with certain issues that they didn't expect. To each their own how they want to reach out to someone and who they want to know about what they are going through. But, they are struggling with their weight and disappointed they have to subject themselves to having to use the 5 day pouch test or the liquid protein test or whatever they call it. They are tired having to still worry about what they eat and food being their enemy. All I can do is provide them support and guide them to help them out. They know I am discreet and won't disclose what we speak of. Many are ashame to post about their struggles on the board. I can understand. Paying it forward doesn't mean to just help those get surgery. Paying it forward also mean and MANY forget that it is to help those who are post-op as well.
There are some RNY postops who are struggling with their health and bloodwork. They ask me a lot of questions about vitamins, proteins and supplements. They appreciate that I take the time to listen to them vent and that I post and share info that may help them with their struggles and post-op life. I may not have the RnY, but these postop who do have the RNY look up to me and know I am sincere to help them. They just don't see the support or help from others on the board that they need. They tell me their peers are struggling as well and can't see how they can help them, if they can't help themselves. I think those on the TMB would be surprised who I have been helping with their RNY struggle and work with them to sort solutions to their problems. I may not have RNY, but they rather reach out to me than to their fellow peers. Life is odd sometimes.
Some are also very disappointed in the way postops lower themselves to insult me when a person ask a question, seeking feedback and they come on in to post as though it is about them. I had a woman who wanted feedback regarding VSG vs RnY. The VSG is a part of the DS. Thing is we have been posting back and forth privately and she was offended by by a RNY postop who posted to not provide her with any answers or support, but to incite drama when there wasn't any. I told her, people like that I ignore because they are showing their true ignorancy and class level they are. She thanked me for posting all the info to her and to open her mind to other options to think about. She didn't appreciate what this postop posted, since she said they did not answer her question or helped her out at all. She said I was very straight forward and didn't see any bashing from me. She did said, the other RNY man was stirring the pot and to even insult instead of being polite to answer her question regarding what I wrote and if there was any misunderstanding or incorrect statement. She was disturb how he replied to me and with such degrade, it turned her off to post again to the TMB. I told her, I just ignore them because my reply was to help her and any pre-op out there. What matters to me is what she thinks and if my input helped her in her journey that is she taking to WLS.
Overall, I live a good life without much worry about dieting or having to obssess myself with the scale. I always invite members whether pre-ops or post-ops of various surgeries to visit and read the DS board. Many message me how different and easy going life is with the Ds since we don't care about calories or fat. They still find that amazing. Right now, I am helping out 4 postop RnYers who are longterm and struggling in one way or another.
One has reactive hypoglycemia and she was never diabetic. It has been hard on her and she thought those who have RNY are cure of diabetes. She learned it doesn't and can even develop diabetes (reactive hypoglycemia is a form of diabetes) when you never had a history of it pre-op.
Another RnYer is 5 yrs postop in dire need of support. Her health and emotional state is very messed up. I will be there for her and work with her to get her back on track.
Another RnYer is 3 years post-op and eventhough she exercise and eating right, she is regaining weight. She is now going from one diet after another and done the 5DPT that she says is a useless waste of time and gimmick. She has tried everything and nothing is working. Her carb is very low, she is eating high protein, low fat and low calories. Yet, there is no success. She wants a revision to the DS after reading all the success other RnY had with their revision to it. She is disappointed she wasted her time with having the RnY.
Another RNYer is a regular poster and well known to the TMB. She is struggling and don't want the others to know about it. She is ashame and see her friends are having problems with postop issues too. I have been communicating with her back and forth. She came to me to help her. Eventhough, I am not RnY, she feels comfortable talking to me about her issues and receiving help to get her back on track.
That is what paying forward is about, helping others without taking sides or feeling you need to belong or be accepted among others or to feel you need to be a part of their group just to fit in.
Wednesday, May 14, 2008
18 months postop
I am 18 months postop. I haven't been on OH much. Life moves on and I have a good and busy life that I love. I am at goal at 140 lbs. I wear a size 8 in clothes. I am not boney or skinny. I still have my curves and my skin looks great. At goal, I do not have saggy skin. I do have a slight flab here and there, but my body skin is overall firm. Due to WLS, one of the things I noticed is, it will not leave you perfectly toned or your skin looking very firm. Also, bear in mind, I am 44 yrs old. My upper inner thighs, you can see most of the flab. My stomach does not hang, sag or looks wrinkly. That is a good thing appearance wise, since, I will not need plastic surgery. My arms don't look bad either. I don't have batwings that needs concern or to hide. It is very slight and not significant that anyone can sees it. I do wear a lot of sleeveless shirts and halter tops that show my bare arms from all angles.
As I have written about in my previous blogs, I do readjust my vitamins and supplement alot to work with what is needed for the moment. I have stopped taking the Magnesium Oxide, extra multivitamins chewables from Bariatric Advantage and vitamin D3, as well as cut taking iron at night. I will see if it will cause any difference or decrease with my next bloodwork. I adjust my requirements as needed and according to my bloodwork. The minimum required is taking multivitamins and calcium citrate for life. Those are a must and taken seriously. This is my daily regimen at present:
Morning when I wake up:
1 BA iron chewable
Breakfast:
1 Centrum Performance
1 BA 400mg Calcium Citrate chewable
After Breakfast Snack:
1 Bariatric Advantage 400 mg Calcium chewable
Lunch:
1 Centrum Performance
1 BA 400mg Calcium Citrate chewable
After Lunch Snack:
1 BA 400mg Calcium Citrate chewable
Dinner:
1 Centrum Performance:
After Dinner Snack:
1 BA 400mg Calcium Citrate chewable
I am taking in total
elemental iron 1x a day
multivitamin 3x per day
calcium citrate 2000mg per day
Next month, I am sure it will change since I will add D3 again. RIght now, my bloodwork level are very good. For now, this is my regime.
One of the things that is taking up most of my personal time and interest is renovating my galley kitchen for the apt that I have in the city. I own a house in the suburbs, but love my city apt that is close to all and easy accessible to what the city has to offer. I am personally designing the style and working out the budget for it. My hubby is an architect and he is my critic to what I do in the drafting and designing stage. He even install Chief Architect program on my laptop. That is a professional 3D architectural design and drafting software that architect and interior designers use in their field for home designing from the foundation. The program cost $3000, then add the galleries of items that some you have to buy.
Most of the work will be done by my father who is an engineer and has is also a licensed contractor with a jouneyman license as an electrician and licensed plumber. He has over 40 years experience and who best to tackle my project than my dad. Besides, I will save over $10,000 in labor cost. I will assist in the construction as well as other family members. I have been carefully choosing the materials and appliances that is to my preference. I am demolishing, guttering and rebuilding the kitchen from scratch. I have been searching for what style I like and narrowed it down to Tuscan Style with Contemporary Look. I have a few things set in mind for my kitchen design. I was considering stainless steel appliances, but opted for black appliances to match the light maple or oak cabinets with Stonemark granite cinnamon sand countertop. For the wall, I am planning on having what is known as Vintage Layer in which is a glaze finish similar to smooth leather or soft suede causing a subtle and dramatic effect. My walls will be in a rich dark burgundy wine base coat with the top coat glaze effect of black. I need to take pics to show, when I have a chance. The ceiling, I plan to install ACP decorative thermoplastic panel that has a look of tin. This is very vintage and was used in the turn of the century. It will give another dramatic effect to the Tuscan style Vintage Layer effects for the walls. Not sure if I will use the same for the backsplash or something else for style.
I have already picked out
* side by side refrigerator with water/ice dispenser
* wall paint color with Vintage Layer style effects
* ceiling decorative paneling
* ceiling and undercabinet light fixture
* pull out spray faucet
* wall and base cabinets
* glass insert for wall cabinet
* granite countertop
Still comparing
* ranges
* dishwasher
* range hood
* sink
* flooring
* base and ceiling moulding
* 115v dryer
.
This project will take months to finalize before getting started on the actual work, since I want to make sure of my design and finalized it that I am satisfied with it longterm. I also want to make sure I budget correctly all my expenses for the materials and other stuff needed to complete this renovation in full and stay within budget.
As I have written about in my previous blogs, I do readjust my vitamins and supplement alot to work with what is needed for the moment. I have stopped taking the Magnesium Oxide, extra multivitamins chewables from Bariatric Advantage and vitamin D3, as well as cut taking iron at night. I will see if it will cause any difference or decrease with my next bloodwork. I adjust my requirements as needed and according to my bloodwork. The minimum required is taking multivitamins and calcium citrate for life. Those are a must and taken seriously. This is my daily regimen at present:
Morning when I wake up:
1 BA iron chewable
Breakfast:
1 Centrum Performance
1 BA 400mg Calcium Citrate chewable
After Breakfast Snack:
1 Bariatric Advantage 400 mg Calcium chewable
Lunch:
1 Centrum Performance
1 BA 400mg Calcium Citrate chewable
After Lunch Snack:
1 BA 400mg Calcium Citrate chewable
Dinner:
1 Centrum Performance:
After Dinner Snack:
1 BA 400mg Calcium Citrate chewable
I am taking in total
elemental iron 1x a day
multivitamin 3x per day
calcium citrate 2000mg per day
Next month, I am sure it will change since I will add D3 again. RIght now, my bloodwork level are very good. For now, this is my regime.
One of the things that is taking up most of my personal time and interest is renovating my galley kitchen for the apt that I have in the city. I own a house in the suburbs, but love my city apt that is close to all and easy accessible to what the city has to offer. I am personally designing the style and working out the budget for it. My hubby is an architect and he is my critic to what I do in the drafting and designing stage. He even install Chief Architect program on my laptop. That is a professional 3D architectural design and drafting software that architect and interior designers use in their field for home designing from the foundation. The program cost $3000, then add the galleries of items that some you have to buy.
Most of the work will be done by my father who is an engineer and has is also a licensed contractor with a jouneyman license as an electrician and licensed plumber. He has over 40 years experience and who best to tackle my project than my dad. Besides, I will save over $10,000 in labor cost. I will assist in the construction as well as other family members. I have been carefully choosing the materials and appliances that is to my preference. I am demolishing, guttering and rebuilding the kitchen from scratch. I have been searching for what style I like and narrowed it down to Tuscan Style with Contemporary Look. I have a few things set in mind for my kitchen design. I was considering stainless steel appliances, but opted for black appliances to match the light maple or oak cabinets with Stonemark granite cinnamon sand countertop. For the wall, I am planning on having what is known as Vintage Layer in which is a glaze finish similar to smooth leather or soft suede causing a subtle and dramatic effect. My walls will be in a rich dark burgundy wine base coat with the top coat glaze effect of black. I need to take pics to show, when I have a chance. The ceiling, I plan to install ACP decorative thermoplastic panel that has a look of tin. This is very vintage and was used in the turn of the century. It will give another dramatic effect to the Tuscan style Vintage Layer effects for the walls. Not sure if I will use the same for the backsplash or something else for style.
I have already picked out
* side by side refrigerator with water/ice dispenser
* wall paint color with Vintage Layer style effects
* ceiling decorative paneling
* ceiling and undercabinet light fixture
* pull out spray faucet
* wall and base cabinets
* glass insert for wall cabinet
* granite countertop
Still comparing
* ranges
* dishwasher
* range hood
* sink
* flooring
* base and ceiling moulding
* 115v dryer
.
This project will take months to finalize before getting started on the actual work, since I want to make sure of my design and finalized it that I am satisfied with it longterm. I also want to make sure I budget correctly all my expenses for the materials and other stuff needed to complete this renovation in full and stay within budget.
Thursday, May 8, 2008
DS is a modification of the BPD
The DS is a modification of the BPD. The DS works through an element of gastric restriction as well as malabsorption. The stomach is fashioned into a small tube, preserving the pylorus, transecting the duodenum and connecting the intestine to the duodenum above where digestive juices enter the intestine. Compared to the BPD, the DS leaves a much smaller stomach that creates a feeling of restriction. Anatomically, the main difference between the DS and the BPD is the shape of the stomach – the malabsorptive component is essentially identical to that of the BPD. Instead of cutting the stomach horizontally and removing the lower half (such as with the BPD), the DS cuts the stomach vertically and leaves a tube of stomach resembling a banana that empties into a very short segment of duodenum. The stomach portion of the DS (duodenal switch) surgical procedure reduces the size of the stomach. But, because it DOES retain the pyloric sphincter, it also retains NORMAL STOMACH FUNCTION. Hence:
* no dumping
* no stoma
* no marginal ulcers
* no strictures
* no 'getting something stuck'
* no reason NOT to drink with meals
* no need to chew food to mush
* no food or medication intolerances.
The bilio-pancreatic diversion with duodenal switch allows food to bypass part of the small intestine so that you absorb fewer calories and significantly reduces the absorption of fat. It also restricts the amount of food you may eat. Portions of the stomach is partially removed. The small pouch that remains is connected directly to the final segment of the small intestine, completely bypassing the duodenum and the jejunum which is known as a partial intestinal bypass and NOT a gastric bypass, since you DO have a functional working stomach and your pyloric valve is kept intact. A common channel remains in which bile and pancreatic digestive juices mix prior to entering the large intestine. Weight loss occurs since most of the calories and nutrients are routed into the colon where they are not absorbed. This procedure has 2 components. A limited gastrectomy is when your stomach is decrease from its orginal size to about 1/3 and similar to a banana (the RNY does not have a stomach, but a stoma hence gastric bypass due to pyloric sphincter removed). A smaller yet, portion of an intact stomach pouch and pyloric sphincter results in reduction of food intake while inducing weight loss. The second component of the operation is a construction of a long limb Roux-en-Y with a short common channel. This creates a significant malabsorptive component which acts to maintain weight loss long term. The length of the common channel may be adjusted in lengths from 50-175 cm for malasbsportion to take place. The results of these adjustments in length variant reportedly carries fewer complications and with comparable weight loss. The DS, also known as BPD-DS surgery is unique, since, it is the only current procedure that allows you to eat normal quantities of food and still achieve weight loss.
Food normally moves along the digestive tract, digestive juices and enzymes digest and absorb calories and nutrients. After we chew and swallow our food, it moves down the esophagus to the stomach, where a strong acid continues the digestive process. The stomach can hold about 3 pints of food at one time. When the stomach contents move to the duodenum, the first segment of the small intestine, bile and pancreatic juice speed up digestion. Most of the iron and calcium in the foods we eat is absorbed in the duodenum. The jejunum and ileum, the remaining two segments of the nearly 20 feet of small intestine, complete the absorption of almost all calories and nutrients. The food particles that cannot be digested in the small intestine are stored in the large intestine until eliminated.
BPD-DS alters the digestive process. The surgery causes a combination of restrictive and malabsorptive process. The restrictive limits food intake by creating a narrow passage from the upper part of the stomach into the larger lower part, reducing the amount of food the stomach can hold and slowing the passage of food through the stomach. The malabsorptive do not limit food intake, but instead partially bypass the small intestine from the digestive tract so fewer calories and nutrients are absorbed. The surgery hencefore, creates a Y shaped intestinal tract for the purpose of separating the biliopancreatic secretions from the food for a certain portion of the passage of food down the alimentary limb. This introduces an element of deliberate malabsorption (the bile acids and pancreatic enzymes are needed to solublize and break down fats, complex carbohydrates and protein, in order of decreasing malabsorption) and is for the purpose of enabling and maintaining weight loss by creating malaborption of those calorie sources. Biliopancreatic diversion with duodenal switch are complex surgeries that should only be done by a very experienced surgeon.
The DS was first reported by Dr. Doug Hess in 1986. This type of surgical procedure was declared a beneficial and effective form of bariatric surgery for the treatment of morbid obesity disease by the Federal Government under the Medicare program on February 2006. It was endorsed by the ASBS (American Society of Bariatric Surgeons) back in 2003. Any medical insurance carrier who claims or still calling the DS 'experimental' is not up to date with current approved medical procedures. Another reason may be that they do not have a qualified DS bariatric surgeon listed on their database roster to accept for assignment and approval for medical service render. Hence appeals are set for motion and the medical insurance carrier will have to pay for surgical and bariatric services OUTSIDE their network since they do not provide and lack of it within their network coverage.
* no dumping
* no stoma
* no marginal ulcers
* no strictures
* no 'getting something stuck'
* no reason NOT to drink with meals
* no need to chew food to mush
* no food or medication intolerances.
The bilio-pancreatic diversion with duodenal switch allows food to bypass part of the small intestine so that you absorb fewer calories and significantly reduces the absorption of fat. It also restricts the amount of food you may eat. Portions of the stomach is partially removed. The small pouch that remains is connected directly to the final segment of the small intestine, completely bypassing the duodenum and the jejunum which is known as a partial intestinal bypass and NOT a gastric bypass, since you DO have a functional working stomach and your pyloric valve is kept intact. A common channel remains in which bile and pancreatic digestive juices mix prior to entering the large intestine. Weight loss occurs since most of the calories and nutrients are routed into the colon where they are not absorbed. This procedure has 2 components. A limited gastrectomy is when your stomach is decrease from its orginal size to about 1/3 and similar to a banana (the RNY does not have a stomach, but a stoma hence gastric bypass due to pyloric sphincter removed). A smaller yet, portion of an intact stomach pouch and pyloric sphincter results in reduction of food intake while inducing weight loss. The second component of the operation is a construction of a long limb Roux-en-Y with a short common channel. This creates a significant malabsorptive component which acts to maintain weight loss long term. The length of the common channel may be adjusted in lengths from 50-175 cm for malasbsportion to take place. The results of these adjustments in length variant reportedly carries fewer complications and with comparable weight loss. The DS, also known as BPD-DS surgery is unique, since, it is the only current procedure that allows you to eat normal quantities of food and still achieve weight loss.
Food normally moves along the digestive tract, digestive juices and enzymes digest and absorb calories and nutrients. After we chew and swallow our food, it moves down the esophagus to the stomach, where a strong acid continues the digestive process. The stomach can hold about 3 pints of food at one time. When the stomach contents move to the duodenum, the first segment of the small intestine, bile and pancreatic juice speed up digestion. Most of the iron and calcium in the foods we eat is absorbed in the duodenum. The jejunum and ileum, the remaining two segments of the nearly 20 feet of small intestine, complete the absorption of almost all calories and nutrients. The food particles that cannot be digested in the small intestine are stored in the large intestine until eliminated.
BPD-DS alters the digestive process. The surgery causes a combination of restrictive and malabsorptive process. The restrictive limits food intake by creating a narrow passage from the upper part of the stomach into the larger lower part, reducing the amount of food the stomach can hold and slowing the passage of food through the stomach. The malabsorptive do not limit food intake, but instead partially bypass the small intestine from the digestive tract so fewer calories and nutrients are absorbed. The surgery hencefore, creates a Y shaped intestinal tract for the purpose of separating the biliopancreatic secretions from the food for a certain portion of the passage of food down the alimentary limb. This introduces an element of deliberate malabsorption (the bile acids and pancreatic enzymes are needed to solublize and break down fats, complex carbohydrates and protein, in order of decreasing malabsorption) and is for the purpose of enabling and maintaining weight loss by creating malaborption of those calorie sources. Biliopancreatic diversion with duodenal switch are complex surgeries that should only be done by a very experienced surgeon.
The DS was first reported by Dr. Doug Hess in 1986. This type of surgical procedure was declared a beneficial and effective form of bariatric surgery for the treatment of morbid obesity disease by the Federal Government under the Medicare program on February 2006. It was endorsed by the ASBS (American Society of Bariatric Surgeons) back in 2003. Any medical insurance carrier who claims or still calling the DS 'experimental' is not up to date with current approved medical procedures. Another reason may be that they do not have a qualified DS bariatric surgeon listed on their database roster to accept for assignment and approval for medical service render. Hence appeals are set for motion and the medical insurance carrier will have to pay for surgical and bariatric services OUTSIDE their network since they do not provide and lack of it within their network coverage.
Monday, April 14, 2008
17 months post-op
I am 17 months post-op. The month of April has been extremely busy with various agendas and projects going on. So far, everything is going well and life is back to where it was prior to the fiasco of becoming and being imprisoned by morbid obesity. I am wearing size 7/8 and think I like this weight and clothes size. I am bouncing between 145 and 150 lbs. I have gotten down as low as 143 lbs. I am not sure, I want to lose anymore weight. Overall, I feel comfortable where I am at and the weight looks good on me since I do have curves on my body.
Below is my current regime of vitamins and supplement. It varies as time goes by, being constantly readjusted as needed:
When I wake up:
1 Bariatic Advantage Iron Chewable (29mgs)
Breakfast time:
1 Centrum Performance multivitamin
2 Bariatric Advantage Calcium Citrate (800mgs)
After Breakfast Snack:
1 Bariatric Advantage High ADEK Multivitamin Chewable
Lunch:
1 Centrum Performance multivitamin
2 Bariatric Advantage Calicum Citrate Chewables (800mgs)
Dinner:
1 Centrum Performance multivitamin
2 Bariatric Advantage Calcium Citrate Chewables (800mg)
After Dinner Snack:
1 Bariatric Advantage High ADEK Mulitivitamin Chewable
Before Bedtime:
1 Bariatric Advantage Iron Chewable (29mgs)
2x a week:
Solaray Dry Vitamin E (400 IU per serving)
Jarrow Formulas Biotin 5mg
1x a week:
Drisdol, Calciferol Vitamin D2 (50,000 IU)
The following regime is working very well for my current situation. My blood work has not shown any deficiencies and my body is not showing any signs or symptoms of deficiencies either. If there are any signs, symptoms or results of deficiencies, it will be reevaluated and adjusted accordingly.
I get many private messages about this, is what do i eat mainly on a daily basis. Instead of answering each person, let me just post it here on my blog.
Top 5 breakfast I eat:
1. 4oz grilled salmon, seasoned with Goya adobo, cooked in alittle olive oil and butter (35gms protein)
2. western omelet with milk, onions, red & green peppers, ham, mushrooms, american or cheddar cheese (21gms protein)
3. 1 cup Special K with red berries cereal with 4 oz Lactaid fat free milk with 3 tbsp Champion Nutrition 100% Pure Whey Protein Stack vanilla flavor (20gms protein)
4. grilled cheese with ham and tomatoes or bacon and tomatoes (16-21gms protein)
5. Optimum Nutrition 100% Whey Gold Standard Rocky Road protein with 12oz milk (36gms protein)
Top 5 lunches:
1. grilled salmon
2. Chef Boyardee spaghetti and meatballs
3. chili made with Goya chorizo, Nathan's hot dog, black bean, Bush baked beans, canned tomatoes, ground beef with cheddar cheese, sour cream and cilantro
4. chicken breast (grilled, fried, stuffed or saute)
5. tuna sandwich made with mayo, Miracle Whip, onions, scallion, pickles, lemon, mustard on white bread
Top 5 dinners:
1. filet mignon or ribeye steak, coleslaw, with either baked potato, butter and sour cream or white rice with cuban style black beans, grilled or steamed vegetables (zucchini, squash, pumpkin, sweet white potatoes, yams, onion and/or portabello mushrooms), canned mexicorn
2. salisbury steak, mashed or baked potato, butter and sour cream or potato salad or macaroni salad, coleslaw, canned mexicorn
3. crabcakes, rice pilaf with shrimp and spinach, coleslaw
4. chicken either grilled, stuffed, stewed, fried with baked potato, sour cream and butter or Stovetop stuffing or steamed, grilled or saute vegetable medley, macaroni salad or coleslaw
5. meat, spinach or eggplant lasagna or stuffed shells made with spinach, ground beef, ricotta and mozarrella cheese
Top 10 food I occasionally eat (no particular order):
1. Jamaican beef patty with melted cheddar or mozzarella cheese
2. monfongo with pork crackling, lots of garlic and mojo sauce
3. roast beef sandwich with mayo, salt and pepper on white bread
4. corned beef hash made with tomato sauce and onions, white rice and canned mexicorn
5. beef negamaki with a house salad with avocado, crab legs and Japanese ginger dressing, miso soup
6. Nathan's hot dog with cheddar cheese, grain mustard, onion sauce, sauerkraft on warmed bun
7. cheeseburger with bacon and mushroom, 2 White Castle cheeseburgers or 1 small Burger King Whopper Jr. with cheese
8. Homemade broiled tilapia parmesan, crabmeat stuffed mushroom, coconut shrimps with pina colada sauce or grilled, fried, saute, breaded shrimps, lobster, crab, fish
9. gyro with onion, tomatoes, lots of tsatziki on pita bread
10. breaded mozzarella sticks with marinara sauce, chicken parmesan with mozarrella and marinara sauce or those Tyson bbq chicken tenders
Top 5 daily drinks:
1. Lactaid fat free milk (I don't like the taste of skim, lowfat or whole milk)
2. Tropicana Light & Healthy orange juice
3. Tang orange drink
4. Kool Aid tropical punch with splenda
5. Nestle water
I do drink sweetened ice tea (but have limited it, to only when I go out to eat)
Current food intolerance:
1.Anything made with asparatame, acesulfame-k or saccharine such as Nutrasweet, Sweet & Low, Equal, Spoonful, Sunette or Sweet One
2. Anything with certain amount of sugar alcohol in it
3. Any carbonated drink or soda (including diet) and even if left to be flat
4. Any diet drink such as Crystal Light, diet ice tea, etc
5. ??? (I have no other food intolerance that I am aware of)
5 leisure snacks I will indulge in, every once and awhile:
1. Smart Food white cheddar popcorm
2. Entenmann's chocolate chips cookies
3. Haagen Dazs strawberry cheesecake ice cream
4. homemade cream cheese sugar cookies made with Splenda
5. brownies, pumpkin pie with graham crust or pecan pie
I can only eat:
1. 1/2 NY style thin pizza with heavy toppings
2. 3 to 4oz of beef or poultry
3. 1/2 to 3/4 cup of rice any style
4. 1/2 small or 1/4 medium potato with sour cream and butter or cheese, chives and bacon bits or cheddar cheese, chili and cilantro
5. 1/2-3/4 c pasta with meat marinara or seafood(able to digest fresh pasta better than dry pasta)
Basically, at 17 months post-op, I do not eat much in portion. Another thing that people inquire about is gas and bowel movements. With the DS, all is controllable and a person knows what will trigger then to have food that will make them gassy. There are some DS post-op who eat high calorie and high fat food. That is an option if you want to eat such and not mandatory. My average calorie intake is about 1200 and I am not much into eating fatty food. But, the option is there if I want it. With the DS, calories and fat is not of concern since most is not absorbed. That is why most DSers do not gain weight, worry or focus on counting calories or how much fat they are eating. With the DS, you also malabsorb complex carbs, as high as 50%. But, it depends on the DSer internal length of various limb and common channel. I know I do not malabsorb 50%. I malabsorb about 30-40% of the complex carbs. We have to take focus on simple carbs which is sugar since it is what will cause a DSer to gain weight.
Protein is very important and it is what is focused first when eating. After that, is carbs. I also focus on vitamins that I can get from food. One other important daily thing is fluids. I try to aim for more than 64oz, but I don't always meet that amount. I am still struggling with no desire to eat and when I do eat, it is very small amount usually 5 teaspoon max or 1/4 to 1/2 cup worth of food per meal serving. Due to that, I rely heavily on my protein supplements and mixing it always with milk to get alittle more protein out of it. 1oz of milk is equal to 1 gm protein. I do drink a lot of milk and it is my preference of choice to drink. But, only Lactaid fat free milk.
I like to eat these whenever the mood fits:
1. Lay's or Wise potato chips plain, bbq or sour cream and chives or onions flavors
2. Dorito's corn chips with sour cream
3. soft ice cream with melted marshmallow
4. cheesecake, cinnamon raisin, pecan or cheese danish or buns, corn bread, blueberry muffins, banana nut bread
5. General Tso chicken or Kung Po chicken or shrmps
On a daily basis:
I will drink multiple times, Optimum Nutrition Gold Standard Rocky Road Protein with 8, 10 or 12oz of milk that ranges from 32 to 36 grams of protein. I usually drink this as my snack. This will also provide me with meeting my protein quota for the day, since there are many times and days that I have no desire to eat or even feel hungry to need to eat.
As I have written before, with the DS you malasbsorb 80% of the fat you eat and malabsorb a ballpark between 30-60% of the calories and 20-50% of the complex carbs. With any WLS, the DS also does not malabsorb any simple carbs, BUT do malabsorb complex carbs. Therefore, calories and fat are not focused much upon, only carbs and the most important thing protein. With the DS, you can malabsorb from 25-40% of the protein. The calories, carbs and protein malasorption varies from DS post-op to post-op according to length of their common channel, small bowel, alimentary and biliopancreatic limbs. The only way to actually determine how much a DSer malabsorbs is through a control study in which the same amount of calories, carbs, protein and fat is given during a set period of time, then it is calculated through their waste (excrement) to determine how much is being absorbed and malabsorbed through their system. The only fact that is known is a DSer is able to malabsorb 80% of the fats and 0% of the simple carbs (sugar).
Below is my current regime of vitamins and supplement. It varies as time goes by, being constantly readjusted as needed:
When I wake up:
1 Bariatic Advantage Iron Chewable (29mgs)
Breakfast time:
1 Centrum Performance multivitamin
2 Bariatric Advantage Calcium Citrate (800mgs)
After Breakfast Snack:
1 Bariatric Advantage High ADEK Multivitamin Chewable
Lunch:
1 Centrum Performance multivitamin
2 Bariatric Advantage Calicum Citrate Chewables (800mgs)
Dinner:
1 Centrum Performance multivitamin
2 Bariatric Advantage Calcium Citrate Chewables (800mg)
After Dinner Snack:
1 Bariatric Advantage High ADEK Mulitivitamin Chewable
Before Bedtime:
1 Bariatric Advantage Iron Chewable (29mgs)
2x a week:
Solaray Dry Vitamin E (400 IU per serving)
Jarrow Formulas Biotin 5mg
1x a week:
Drisdol, Calciferol Vitamin D2 (50,000 IU)
The following regime is working very well for my current situation. My blood work has not shown any deficiencies and my body is not showing any signs or symptoms of deficiencies either. If there are any signs, symptoms or results of deficiencies, it will be reevaluated and adjusted accordingly.
I get many private messages about this, is what do i eat mainly on a daily basis. Instead of answering each person, let me just post it here on my blog.
Top 5 breakfast I eat:
1. 4oz grilled salmon, seasoned with Goya adobo, cooked in alittle olive oil and butter (35gms protein)
2. western omelet with milk, onions, red & green peppers, ham, mushrooms, american or cheddar cheese (21gms protein)
3. 1 cup Special K with red berries cereal with 4 oz Lactaid fat free milk with 3 tbsp Champion Nutrition 100% Pure Whey Protein Stack vanilla flavor (20gms protein)
4. grilled cheese with ham and tomatoes or bacon and tomatoes (16-21gms protein)
5. Optimum Nutrition 100% Whey Gold Standard Rocky Road protein with 12oz milk (36gms protein)
Top 5 lunches:
1. grilled salmon
2. Chef Boyardee spaghetti and meatballs
3. chili made with Goya chorizo, Nathan's hot dog, black bean, Bush baked beans, canned tomatoes, ground beef with cheddar cheese, sour cream and cilantro
4. chicken breast (grilled, fried, stuffed or saute)
5. tuna sandwich made with mayo, Miracle Whip, onions, scallion, pickles, lemon, mustard on white bread
Top 5 dinners:
1. filet mignon or ribeye steak, coleslaw, with either baked potato, butter and sour cream or white rice with cuban style black beans, grilled or steamed vegetables (zucchini, squash, pumpkin, sweet white potatoes, yams, onion and/or portabello mushrooms), canned mexicorn
2. salisbury steak, mashed or baked potato, butter and sour cream or potato salad or macaroni salad, coleslaw, canned mexicorn
3. crabcakes, rice pilaf with shrimp and spinach, coleslaw
4. chicken either grilled, stuffed, stewed, fried with baked potato, sour cream and butter or Stovetop stuffing or steamed, grilled or saute vegetable medley, macaroni salad or coleslaw
5. meat, spinach or eggplant lasagna or stuffed shells made with spinach, ground beef, ricotta and mozarrella cheese
Top 10 food I occasionally eat (no particular order):
1. Jamaican beef patty with melted cheddar or mozzarella cheese
2. monfongo with pork crackling, lots of garlic and mojo sauce
3. roast beef sandwich with mayo, salt and pepper on white bread
4. corned beef hash made with tomato sauce and onions, white rice and canned mexicorn
5. beef negamaki with a house salad with avocado, crab legs and Japanese ginger dressing, miso soup
6. Nathan's hot dog with cheddar cheese, grain mustard, onion sauce, sauerkraft on warmed bun
7. cheeseburger with bacon and mushroom, 2 White Castle cheeseburgers or 1 small Burger King Whopper Jr. with cheese
8. Homemade broiled tilapia parmesan, crabmeat stuffed mushroom, coconut shrimps with pina colada sauce or grilled, fried, saute, breaded shrimps, lobster, crab, fish
9. gyro with onion, tomatoes, lots of tsatziki on pita bread
10. breaded mozzarella sticks with marinara sauce, chicken parmesan with mozarrella and marinara sauce or those Tyson bbq chicken tenders
Top 5 daily drinks:
1. Lactaid fat free milk (I don't like the taste of skim, lowfat or whole milk)
2. Tropicana Light & Healthy orange juice
3. Tang orange drink
4. Kool Aid tropical punch with splenda
5. Nestle water
I do drink sweetened ice tea (but have limited it, to only when I go out to eat)
Current food intolerance:
1.Anything made with asparatame, acesulfame-k or saccharine such as Nutrasweet, Sweet & Low, Equal, Spoonful, Sunette or Sweet One
2. Anything with certain amount of sugar alcohol in it
3. Any carbonated drink or soda (including diet) and even if left to be flat
4. Any diet drink such as Crystal Light, diet ice tea, etc
5. ??? (I have no other food intolerance that I am aware of)
5 leisure snacks I will indulge in, every once and awhile:
1. Smart Food white cheddar popcorm
2. Entenmann's chocolate chips cookies
3. Haagen Dazs strawberry cheesecake ice cream
4. homemade cream cheese sugar cookies made with Splenda
5. brownies, pumpkin pie with graham crust or pecan pie
I can only eat:
1. 1/2 NY style thin pizza with heavy toppings
2. 3 to 4oz of beef or poultry
3. 1/2 to 3/4 cup of rice any style
4. 1/2 small or 1/4 medium potato with sour cream and butter or cheese, chives and bacon bits or cheddar cheese, chili and cilantro
5. 1/2-3/4 c pasta with meat marinara or seafood(able to digest fresh pasta better than dry pasta)
Basically, at 17 months post-op, I do not eat much in portion. Another thing that people inquire about is gas and bowel movements. With the DS, all is controllable and a person knows what will trigger then to have food that will make them gassy. There are some DS post-op who eat high calorie and high fat food. That is an option if you want to eat such and not mandatory. My average calorie intake is about 1200 and I am not much into eating fatty food. But, the option is there if I want it. With the DS, calories and fat is not of concern since most is not absorbed. That is why most DSers do not gain weight, worry or focus on counting calories or how much fat they are eating. With the DS, you also malabsorb complex carbs, as high as 50%. But, it depends on the DSer internal length of various limb and common channel. I know I do not malabsorb 50%. I malabsorb about 30-40% of the complex carbs. We have to take focus on simple carbs which is sugar since it is what will cause a DSer to gain weight.
Protein is very important and it is what is focused first when eating. After that, is carbs. I also focus on vitamins that I can get from food. One other important daily thing is fluids. I try to aim for more than 64oz, but I don't always meet that amount. I am still struggling with no desire to eat and when I do eat, it is very small amount usually 5 teaspoon max or 1/4 to 1/2 cup worth of food per meal serving. Due to that, I rely heavily on my protein supplements and mixing it always with milk to get alittle more protein out of it. 1oz of milk is equal to 1 gm protein. I do drink a lot of milk and it is my preference of choice to drink. But, only Lactaid fat free milk.
I like to eat these whenever the mood fits:
1. Lay's or Wise potato chips plain, bbq or sour cream and chives or onions flavors
2. Dorito's corn chips with sour cream
3. soft ice cream with melted marshmallow
4. cheesecake, cinnamon raisin, pecan or cheese danish or buns, corn bread, blueberry muffins, banana nut bread
5. General Tso chicken or Kung Po chicken or shrmps
On a daily basis:
I will drink multiple times, Optimum Nutrition Gold Standard Rocky Road Protein with 8, 10 or 12oz of milk that ranges from 32 to 36 grams of protein. I usually drink this as my snack. This will also provide me with meeting my protein quota for the day, since there are many times and days that I have no desire to eat or even feel hungry to need to eat.
As I have written before, with the DS you malasbsorb 80% of the fat you eat and malabsorb a ballpark between 30-60% of the calories and 20-50% of the complex carbs. With any WLS, the DS also does not malabsorb any simple carbs, BUT do malabsorb complex carbs. Therefore, calories and fat are not focused much upon, only carbs and the most important thing protein. With the DS, you can malabsorb from 25-40% of the protein. The calories, carbs and protein malasorption varies from DS post-op to post-op according to length of their common channel, small bowel, alimentary and biliopancreatic limbs. The only way to actually determine how much a DSer malabsorbs is through a control study in which the same amount of calories, carbs, protein and fat is given during a set period of time, then it is calculated through their waste (excrement) to determine how much is being absorbed and malabsorbed through their system. The only fact that is known is a DSer is able to malabsorb 80% of the fats and 0% of the simple carbs (sugar).
Sunday, April 13, 2008
people interested and inquisitive about the DS
I get lots of private messages on this OH site with people interested and inquisitive about the DS. Not only pre-ops, but a lot of post-ops of other surgery types. They are amazed with my food choices and what I am able to eat and not get sick, negative side effects or gain weight.
They also ask me about the vitamins I have to take and if I am required to take 50,000 IU of vitamin D3 daily as the other DSers do. I tell them honestly, that even with the RnY, you still have to take certain and various vitamins for life. I usually tell them it is not the quantity, but the type you need to take and it is adjusted accordingly with each blood result as needed. I also inform them that each DSer take different type of vitamins and nutrients since we are all not alike. But, there is 2 basic vitamins and supplements that is a must and minimum requirement to survive and be healthy as a DSer, which are multivitamins and calcium citrate. As long as those 2 are the core to the daily regime, anything else taken is based according to each's health and blood test. The requirement needed may change with time or if there are any deficiencies or high value that may be considered excessive or out of range.
One thing, that must be taken into consideration is the use of taking megadoses of certain vitamins and/or nutritients that may cause toxicity, adverse reaction and allergies to either food or your surroundings. The megadoses usage also includes post-ops with malabsorption issues. Some DSers take 50,000 IU of vitamin D3 every single day. That is an option and not required or considered mandatory. I do not need to take such amount daily. Taking 50,000 IU once a week or 2-3 times a week is suffice and safe for the body. Taking it every single day and for a long time is questionable and if longterm use causes any effects to the health that may not be positive. It should be done with observation to monitor diligently, take awareness at the amount and length of time and have knowledge that such extremely high and excessive amount taken every single day for a long period of time may affect your health in a negative manner.
I take Drisdol which is vitamin D2 calciferol. Vitamin D3 is Cholecalciferol. Although, it is D2 ergocalicerol, its main purpose is for my body to absorb the calcium from the stomach and to help with the functioning of calcium in the body. It is what is meant for my condition and what is being monitored. Ergocalciferol is for treatment of vitamin D deficiency osteomalacia, hypoparathyroidism and hypophosphatemia, which is an electrolyte imbalance.
There are those who take D3 at 50,000 IU daily. That is fine for them as long as they know how to monitor the amount they are consuming safely, that is suitable for their needs and how it improves their health. It all comes down to your current medical health, what your blood results are saying, what disorders or deficencies you have and what are the proper treatment of medication and nutrients for your body as well as health needs. Vitamins and nutritients are revised as needed per person and according to deficiency or current values of interest.
For those who want to take solely to whoever is on the net giving advise regarding vitamins, etc, should know, it is NOT on a professional level to dispense, but personal views and opinions, To each their own. I prefer to work with my medical staff who are medically trained and licensed in medicine and health care. I will not place my life or health to rely on a person I don't know of their background, if they have licensure in healthcare or nutritional education from any salesperson with a pitch because they say so and so works for them or others. The job of a salesperson is to make that sell using whatever tactic they can to convince you and make that profit. It may work for some, but with other factors in our health should be considered and what is the longterm effects taking such, I work with what is needed for my current health and adjust as needed. If I need to take D3, it will show in my blood results and will work with adding it, if needed to improve my health.
People can take megadoses of 50,000 IU vitamin D3 daily for a short set time. But, NOT for a prolong period or even permanently as for the rest of your life on a daily basis. You have to be realistic and truely understand what you are doing and how it actually works and affects you when taking it longterm. Your body is not meant to take megadoses every single day for months or even years. Just like medications, vitamins and nutrients have to be adjusted with time. People have to ask questions to the medical professionals, physicians, research it online or even verify the source indepth that taking extreme amount known as megadoses of D3 at 50,000 IU daily for a prolong amount of time might cause vitamin D toxicity. You are able to take vitamin D in high doses, for a temporary amount of time and be safe and healthy for you, but not for too long amount of time. Take it for certain amount of weeks will not cause harm to your health. Taking it for a prolong period or even permanently will cause toxicity from calcium formation that will harm your organs, such as your kidneys, heart and lungs. This is permanent damage to your organs.
Buyer beware and do your background inestigation, research and homework. Don't rely, depend or take a person's recommendation to sell you stuff as being the sure thing at face value. Salesperson's job is to convince you to buy their product and on a regular basis as you become a recurring client to their sales. Taking megadoses of vitamin D3 for short period is OK. But for prolong period or to take it permanently, you have to be aware of its consequences to your health. Below is my current regime of vitamins and supplement. It varies as time goes by, being constantly readjusted:
When I wake up:
1 Bariatic Advantage Iron Chewable (29mgs)
Breakfast time:
1 Centrum Performance multivitamin
2 Bariatric Advantage Calcium Citrate (800mgs)
After Breakfast Snack:
1 Bariatric Advantage High ADEK Multivitamin Chewable
Lunch:
1 Centrum Performance multivitamin
2 Bariatric Advantage Calicum Citrate Chewables (800mgs)
Dinner:
1 Centrum Performance multivitamin
2 Bariatric Advantage Calcium Citrate Chewables (800mg)
After Dinner Snack:
1 Bariatric Advantage High ADEK Mulitivitamin Chewable
Before Bedtime:
1 Bariatric Advantage Iron Chewable (29mgs)
2x a week:
Solaray Dry Vitamin E (400 IU per serving)
Jarrow Formulas Biotin 5mg
1x a week:
Drisdol, Calciferol Vitamin D2 (50,000 IU)
The following regime is working very well for my current situation. My blood work has not shown any deficiencies and my body is not showing any signs or symptoms of deficiencies either. If there are any signs, symptoms or results of deficiencies, it will be reevaluated and adjusted accordingly.
They also ask me about the vitamins I have to take and if I am required to take 50,000 IU of vitamin D3 daily as the other DSers do. I tell them honestly, that even with the RnY, you still have to take certain and various vitamins for life. I usually tell them it is not the quantity, but the type you need to take and it is adjusted accordingly with each blood result as needed. I also inform them that each DSer take different type of vitamins and nutrients since we are all not alike. But, there is 2 basic vitamins and supplements that is a must and minimum requirement to survive and be healthy as a DSer, which are multivitamins and calcium citrate. As long as those 2 are the core to the daily regime, anything else taken is based according to each's health and blood test. The requirement needed may change with time or if there are any deficiencies or high value that may be considered excessive or out of range.
One thing, that must be taken into consideration is the use of taking megadoses of certain vitamins and/or nutritients that may cause toxicity, adverse reaction and allergies to either food or your surroundings. The megadoses usage also includes post-ops with malabsorption issues. Some DSers take 50,000 IU of vitamin D3 every single day. That is an option and not required or considered mandatory. I do not need to take such amount daily. Taking 50,000 IU once a week or 2-3 times a week is suffice and safe for the body. Taking it every single day and for a long time is questionable and if longterm use causes any effects to the health that may not be positive. It should be done with observation to monitor diligently, take awareness at the amount and length of time and have knowledge that such extremely high and excessive amount taken every single day for a long period of time may affect your health in a negative manner.
I take Drisdol which is vitamin D2 calciferol. Vitamin D3 is Cholecalciferol. Although, it is D2 ergocalicerol, its main purpose is for my body to absorb the calcium from the stomach and to help with the functioning of calcium in the body. It is what is meant for my condition and what is being monitored. Ergocalciferol is for treatment of vitamin D deficiency osteomalacia, hypoparathyroidism and hypophosphatemia, which is an electrolyte imbalance.
There are those who take D3 at 50,000 IU daily. That is fine for them as long as they know how to monitor the amount they are consuming safely, that is suitable for their needs and how it improves their health. It all comes down to your current medical health, what your blood results are saying, what disorders or deficencies you have and what are the proper treatment of medication and nutrients for your body as well as health needs. Vitamins and nutritients are revised as needed per person and according to deficiency or current values of interest.
For those who want to take solely to whoever is on the net giving advise regarding vitamins, etc, should know, it is NOT on a professional level to dispense, but personal views and opinions, To each their own. I prefer to work with my medical staff who are medically trained and licensed in medicine and health care. I will not place my life or health to rely on a person I don't know of their background, if they have licensure in healthcare or nutritional education from any salesperson with a pitch because they say so and so works for them or others. The job of a salesperson is to make that sell using whatever tactic they can to convince you and make that profit. It may work for some, but with other factors in our health should be considered and what is the longterm effects taking such, I work with what is needed for my current health and adjust as needed. If I need to take D3, it will show in my blood results and will work with adding it, if needed to improve my health.
People can take megadoses of 50,000 IU vitamin D3 daily for a short set time. But, NOT for a prolong period or even permanently as for the rest of your life on a daily basis. You have to be realistic and truely understand what you are doing and how it actually works and affects you when taking it longterm. Your body is not meant to take megadoses every single day for months or even years. Just like medications, vitamins and nutrients have to be adjusted with time. People have to ask questions to the medical professionals, physicians, research it online or even verify the source indepth that taking extreme amount known as megadoses of D3 at 50,000 IU daily for a prolong amount of time might cause vitamin D toxicity. You are able to take vitamin D in high doses, for a temporary amount of time and be safe and healthy for you, but not for too long amount of time. Take it for certain amount of weeks will not cause harm to your health. Taking it for a prolong period or even permanently will cause toxicity from calcium formation that will harm your organs, such as your kidneys, heart and lungs. This is permanent damage to your organs.
Buyer beware and do your background inestigation, research and homework. Don't rely, depend or take a person's recommendation to sell you stuff as being the sure thing at face value. Salesperson's job is to convince you to buy their product and on a regular basis as you become a recurring client to their sales. Taking megadoses of vitamin D3 for short period is OK. But for prolong period or to take it permanently, you have to be aware of its consequences to your health. Below is my current regime of vitamins and supplement. It varies as time goes by, being constantly readjusted:
When I wake up:
1 Bariatic Advantage Iron Chewable (29mgs)
Breakfast time:
1 Centrum Performance multivitamin
2 Bariatric Advantage Calcium Citrate (800mgs)
After Breakfast Snack:
1 Bariatric Advantage High ADEK Multivitamin Chewable
Lunch:
1 Centrum Performance multivitamin
2 Bariatric Advantage Calicum Citrate Chewables (800mgs)
Dinner:
1 Centrum Performance multivitamin
2 Bariatric Advantage Calcium Citrate Chewables (800mg)
After Dinner Snack:
1 Bariatric Advantage High ADEK Mulitivitamin Chewable
Before Bedtime:
1 Bariatric Advantage Iron Chewable (29mgs)
2x a week:
Solaray Dry Vitamin E (400 IU per serving)
Jarrow Formulas Biotin 5mg
1x a week:
Drisdol, Calciferol Vitamin D2 (50,000 IU)
The following regime is working very well for my current situation. My blood work has not shown any deficiencies and my body is not showing any signs or symptoms of deficiencies either. If there are any signs, symptoms or results of deficiencies, it will be reevaluated and adjusted accordingly.
Tuesday, April 8, 2008
Readjusting my vitamins
I will readjust my vitamins and supplements this weekend and remove the extra BA vitamins chewables during snack time and take the magnesium oxide with my vitamins and calcium citrate during my meals. I do not need to take the extra 2 multivitamins (it was an option), since I am using Centrum Performance now. Therefore, no more supplements during my snack times, since I am readjusting it and moving what is needed. In the morning iron, during breakfast the Centrum, calcium citrate chewables and magnesium oxide, lunch the same , dinner - ditto and bedtime iron. These are my essentials now:
daily regime
1 iron chewables 2x daily (total 58mg)
1 Centrum Performance 3x daily
2 calcium citrate chewables 3x daily (total 2400mg)
1 magnesium oxide 2x daily (total 800mg)
Morning when I wake up:
1 Bariatric Aadvantage iron chewable (29mg)
Breakfast:
1 Centrum Performance
2 Bariatric Advantage Calcium Citrate chewable (total 800mg)
1 Magnesium Oxide 400mg
Lunch:
1 Centrum Performance
2 Bariatric Advantage Calcium Citrate chewable (total 800mg)
Dinner:
1 Centrum Performance
2 Bariatric Advantage Calcium Citrate chewbles (total 800mg)
1 Magnesium Oxide 400mg
Bedtime:
1 Bariatric Advantage iron chewable 29mg
every other day to 3x a week
serving taken separately throughout the day
1 dry vitamin D3 10,000 IU (2x for the day, total 20,000 IU)
I am planning on having more home cooked meals done. At least, I know what ingredients go into the preparation, instead buying the ready made ones or going to the restaurants and trying to decipher each ingredient or how fresh it is. I am beginning to enjoy making restaurant type of food at home and it keeps me busy as a hobby. I feel like a gourmet chef and have fun entertaining with it once set at the table. I do make enough food to last for a few days and give me a break cooking every day.
daily regime
1 iron chewables 2x daily (total 58mg)
1 Centrum Performance 3x daily
2 calcium citrate chewables 3x daily (total 2400mg)
1 magnesium oxide 2x daily (total 800mg)
Morning when I wake up:
1 Bariatric Aadvantage iron chewable (29mg)
Breakfast:
1 Centrum Performance
2 Bariatric Advantage Calcium Citrate chewable (total 800mg)
1 Magnesium Oxide 400mg
Lunch:
1 Centrum Performance
2 Bariatric Advantage Calcium Citrate chewable (total 800mg)
Dinner:
1 Centrum Performance
2 Bariatric Advantage Calcium Citrate chewbles (total 800mg)
1 Magnesium Oxide 400mg
Bedtime:
1 Bariatric Advantage iron chewable 29mg
every other day to 3x a week
serving taken separately throughout the day
1 dry vitamin D3 10,000 IU (2x for the day, total 20,000 IU)
I am planning on having more home cooked meals done. At least, I know what ingredients go into the preparation, instead buying the ready made ones or going to the restaurants and trying to decipher each ingredient or how fresh it is. I am beginning to enjoy making restaurant type of food at home and it keeps me busy as a hobby. I feel like a gourmet chef and have fun entertaining with it once set at the table. I do make enough food to last for a few days and give me a break cooking every day.
What is the surgery I had all about?
The Duodenal Switch, although a bariatric surgical procedure for weight loss, is NOT a gastric bypass.
This type of method keeps a portion of the duodenum in the food stream. The preservation of the pylorus means that food is digested normally in the stomach before being excreted into the small intestine. The outer curvature of the stomach pouch is removed known as partial gastrectomy that restricts food to be consumed as well as limit the amount of food intake, especially fat to be absorbed into the body which is caused by the intestinal switch. This effectively restricts its capacity while maintaining its normal functionality. The BPD-DS procedure keeps the pyloric valve intact in which helps eliminate the possiblity of dumping syndrome, ulcers as well as stoma closures and blockage known as strictures. The intestinal tract is divided into 2 limb sections (the food limb and the biliopancreatic limb) that are reconnected and meet together to what is known as the common channel (the end limb portion of the small intestinal tract) and moves on to the large intestine. The food limb is also known as the alimentary limb, where the food is digested. The biliopancreatic limb basically processes the digestive juices. When both meet at the common channel at the bottom of the small intestines, the food and digestive juices mixes together and moves further on to the rest of the digestive tract system.
In plain English, with the BPD-DS, you have 2 intestinal tracts, one tract is to digest the food and the other tract is to digest the gastric juices in which both tracts known as limbs meet together again at the end of the small intestines. This is what a Duodenal Switch function is primarily about and explained in the simplest and generic form without getting in depth, if the above synopsis is too technical to comprehend.
The advantages of having the Duodenal Switch procedure are:
You have a more normal stomach that allows for better eating quality
You can drink with meals
There are no dumping syndrome since the pylorus is not removed
There is a minimal risk of having ulcers
There are no strictures that will occur
The intestinal bypass is partially reversible for those having malabsorptive complications
Carbs can be well absorbed, yet must be careful
The disadvantages of having the Duodenal Switch procedure are:
There is a chance of chronic diarrhea and possibly smelling stools and gas. This can be contributed to your dietary intake and can be controlled to avoid occurring
Malabsorption can lead to anemia, protein deficiency and metabolic bone disease in up to 5% of patients
You must keep a regime for daily intake of vitamins supplements for life, especially calcium, vitamin A, D, E and K
This type of method keeps a portion of the duodenum in the food stream. The preservation of the pylorus means that food is digested normally in the stomach before being excreted into the small intestine. The outer curvature of the stomach pouch is removed known as partial gastrectomy that restricts food to be consumed as well as limit the amount of food intake, especially fat to be absorbed into the body which is caused by the intestinal switch. This effectively restricts its capacity while maintaining its normal functionality. The BPD-DS procedure keeps the pyloric valve intact in which helps eliminate the possiblity of dumping syndrome, ulcers as well as stoma closures and blockage known as strictures. The intestinal tract is divided into 2 limb sections (the food limb and the biliopancreatic limb) that are reconnected and meet together to what is known as the common channel (the end limb portion of the small intestinal tract) and moves on to the large intestine. The food limb is also known as the alimentary limb, where the food is digested. The biliopancreatic limb basically processes the digestive juices. When both meet at the common channel at the bottom of the small intestines, the food and digestive juices mixes together and moves further on to the rest of the digestive tract system.
In plain English, with the BPD-DS, you have 2 intestinal tracts, one tract is to digest the food and the other tract is to digest the gastric juices in which both tracts known as limbs meet together again at the end of the small intestines. This is what a Duodenal Switch function is primarily about and explained in the simplest and generic form without getting in depth, if the above synopsis is too technical to comprehend.
The advantages of having the Duodenal Switch procedure are:
You have a more normal stomach that allows for better eating quality
You can drink with meals
There are no dumping syndrome since the pylorus is not removed
There is a minimal risk of having ulcers
There are no strictures that will occur
The intestinal bypass is partially reversible for those having malabsorptive complications
Carbs can be well absorbed, yet must be careful
The disadvantages of having the Duodenal Switch procedure are:
There is a chance of chronic diarrhea and possibly smelling stools and gas. This can be contributed to your dietary intake and can be controlled to avoid occurring
Malabsorption can lead to anemia, protein deficiency and metabolic bone disease in up to 5% of patients
You must keep a regime for daily intake of vitamins supplements for life, especially calcium, vitamin A, D, E and K
Thursday, March 13, 2008
16 months post-op
Tomorrow, I will be 16 months post-op. I haven't been updating my blog here, since I have been busy with life that does go on and moves on. I have other things in my life to keep me busy than to be online. I did spend a lot of my time and even hours being online prior to having bariatric surgery. I even was popping online alot, for the first year after having surgery. Now, I am hardly online. The reason I log onto OH is from email alerts I receive from private messages here. If I don't have any alert, i don't visit OH. I get a lot of people inquiring about my surgery and asking about how it is to live with the DS. I know how important it is when you are researching your options and want to know about different surgeries. Many people have interest in the DS and its benefit. I explain the facts about it, the pro and cons, but mostly reply to threads based on my personal experience living as a post-op DSer. Although, there are some that have the same type of surgery, everyone's journey is different and that is important to alway let people know about. I don't really have much to say except, I am doing well in health and life. No risk or complications and haven't experienced any negative side effects since hitting my 1 year mark. I live as though I never had surgery and that is amazing.
With the DS, there is high malasborption. I am waiting word from my surgeon to validate information in regards to the actual amount of malabsorption that a DS has from calories and protein. I know as a fact per Dr. Rabkin, the DS malabsorbs 80% of the fat and 40% of the complex carbs. DSers does absorb 100% of the simple carbs. Once I get the facts, I will post it here about calories and protein malabsorption. I just want it validated by my surgeon who is also a well known researcher whose work been published on various WLS. He does LapBand, RnY, DS and VSG. I have received info that DS malabsorbs 80% of the calories and others say its 60%. My surgeon will provide me with the correct info on that. I've also requested on what is the actual protein absorption for a postop RnY that can be use as an average, as well as the difference for the distal and proximal. I am interested to know how it compares with the DS. Protein intake is very important for a post-op and it is very important the actual amount your body can/does absorb. RnY and DS do not absorb 100% protein. I know many list their food charts. But, the protein consumed that is entered, in reality, are not adjusted for a person with WLS. The charts are meant for a person who is non-op, not WLS.
I am still unable to drink any carbonated drinks (soda). I tried some and it just gives me an instant bellyache. Although, I was a diet pepsi vanilla addict. I don't miss it or think of it. I was speaking to my PCP about this and was told that caramel based sodas, whether diet or regular does causes kidney stones and can be seen by elevated red blood cells. My bloodwork are within excellent ranges. I was inquiring about diet soda. I found this fact about sodas and kidney stones quite interesting. There are sugar substitute such as aspartame (Nutrasweet and Equal) and saccharine (Sweet N Low), when I ingest it, makes me ill to my stomach. This also goes for sugar alcohols. Most sugar alcohol gives me terrible bellyaches. Sucralose (Splenda) is the only sugar subsitute I am able to ingest and cause no negative side effect. Kinda weird, but it is all based on its molecular formula that affects me.
Sucralose has C12H19Cl3O8, apartame has C14H18N2O5, saccharine has C7H5NO3S as their compoud. The general formula for sugar alcohol is H(HCHO)n+1H. I've noticed sucralose does not have any nitrogen element. Yet, it is found in both apartame and saccharin formula. This might be the cause to my negative reaction of severe bellyache and cramps to certain sugar substitute. Regarding sugar alcohol, I need to do further research on it.
I have gone from size 8 shoes, to size 7 shoes. I wear a size 10 in some clothes and size 8 in other clothes. I haven't lost the butt and still have breast mass that has not deflated, sag or droop with WLS. I do not have any saggy, loose or fabby skin on me at 16 months post. The only exception that is noticeable happened to be my thighs. My batwings are hardly noticeable. I will NOT need a tummy tuck, arm reduction, breast or body lift, which is great news for me. If I ever have any type of surgery that related to my WLS, it would be to tighten my inner thighs. But, it isn't that noticeable either.
Hubby bought me a bikini and it is beautiful. The best thing about this bikini is that it will camoflauge certains scars (not stretchmarks) I have that are not WLS related. I do have a lot of scars along my pelvic area. It is very noticeable and obvious upclose. I am extremely light skin and the scars have faded to my skin color. But, you can tell, if you are observant they are scars. There is nothing I can do about that. No plastic surgery can cut those away. I just learned to live with it. The bikini bottom has enough coverage to cover the scars that go mostly around my lower hip area and front. I was thinking wearing a bathing suit, but this year I will wear a bikini in which I haven't done in over 10 years. I need to take an umbrella with me since I cannot let the peak sun touch me. I suffer from severe sunstrokes. We used to go to the beach at sunset. This year, we will be at the beach while the sun is up in the sky. It's a big deal for me to wear a bikini after all these years, to have lost all the weight to look good in a bikini and to actually be at the beach wearing a bikini and have the sun beaming. Life is good.
With the DS, there is high malasborption. I am waiting word from my surgeon to validate information in regards to the actual amount of malabsorption that a DS has from calories and protein. I know as a fact per Dr. Rabkin, the DS malabsorbs 80% of the fat and 40% of the complex carbs. DSers does absorb 100% of the simple carbs. Once I get the facts, I will post it here about calories and protein malabsorption. I just want it validated by my surgeon who is also a well known researcher whose work been published on various WLS. He does LapBand, RnY, DS and VSG. I have received info that DS malabsorbs 80% of the calories and others say its 60%. My surgeon will provide me with the correct info on that. I've also requested on what is the actual protein absorption for a postop RnY that can be use as an average, as well as the difference for the distal and proximal. I am interested to know how it compares with the DS. Protein intake is very important for a post-op and it is very important the actual amount your body can/does absorb. RnY and DS do not absorb 100% protein. I know many list their food charts. But, the protein consumed that is entered, in reality, are not adjusted for a person with WLS. The charts are meant for a person who is non-op, not WLS.
I am still unable to drink any carbonated drinks (soda). I tried some and it just gives me an instant bellyache. Although, I was a diet pepsi vanilla addict. I don't miss it or think of it. I was speaking to my PCP about this and was told that caramel based sodas, whether diet or regular does causes kidney stones and can be seen by elevated red blood cells. My bloodwork are within excellent ranges. I was inquiring about diet soda. I found this fact about sodas and kidney stones quite interesting. There are sugar substitute such as aspartame (Nutrasweet and Equal) and saccharine (Sweet N Low), when I ingest it, makes me ill to my stomach. This also goes for sugar alcohols. Most sugar alcohol gives me terrible bellyaches. Sucralose (Splenda) is the only sugar subsitute I am able to ingest and cause no negative side effect. Kinda weird, but it is all based on its molecular formula that affects me.
Sucralose has C12H19Cl3O8, apartame has C14H18N2O5, saccharine has C7H5NO3S as their compoud. The general formula for sugar alcohol is H(HCHO)n+1H. I've noticed sucralose does not have any nitrogen element. Yet, it is found in both apartame and saccharin formula. This might be the cause to my negative reaction of severe bellyache and cramps to certain sugar substitute. Regarding sugar alcohol, I need to do further research on it.
I have gone from size 8 shoes, to size 7 shoes. I wear a size 10 in some clothes and size 8 in other clothes. I haven't lost the butt and still have breast mass that has not deflated, sag or droop with WLS. I do not have any saggy, loose or fabby skin on me at 16 months post. The only exception that is noticeable happened to be my thighs. My batwings are hardly noticeable. I will NOT need a tummy tuck, arm reduction, breast or body lift, which is great news for me. If I ever have any type of surgery that related to my WLS, it would be to tighten my inner thighs. But, it isn't that noticeable either.
Hubby bought me a bikini and it is beautiful. The best thing about this bikini is that it will camoflauge certains scars (not stretchmarks) I have that are not WLS related. I do have a lot of scars along my pelvic area. It is very noticeable and obvious upclose. I am extremely light skin and the scars have faded to my skin color. But, you can tell, if you are observant they are scars. There is nothing I can do about that. No plastic surgery can cut those away. I just learned to live with it. The bikini bottom has enough coverage to cover the scars that go mostly around my lower hip area and front. I was thinking wearing a bathing suit, but this year I will wear a bikini in which I haven't done in over 10 years. I need to take an umbrella with me since I cannot let the peak sun touch me. I suffer from severe sunstrokes. We used to go to the beach at sunset. This year, we will be at the beach while the sun is up in the sky. It's a big deal for me to wear a bikini after all these years, to have lost all the weight to look good in a bikini and to actually be at the beach wearing a bikini and have the sun beaming. Life is good.
Tuesday, March 11, 2008
20,000 postop follow-up for 13 years
20,000 postop patient of various surgeries were compared to each other. The key word is cure and reduction to provide a control to the disease of diabetes. From data finalized in this research of 13 years follow-up of postops, there was a 98.9% improvement with the contribution of the DS, compared with 83.7% with RnY and 47.9% with Lapband.
Bariatric Surgery
A Systematic Review and Meta-analysis
Henry Buchwald MD
JAMA
October 13, 2004
Vol 292, No. 14
source where I obtained info from:
http://jama.ama-assn.org/cgi/content/abstract/292/14/1724
http://jama.ama-assn.org/cgi/reprint/292/24/3040.pdf
http://jama.ama-assn.org/cgi/content/full/jama;293/14/1728-b
Below is a chart outlining the differences following weight loss surgery in the cure and or reduction of diabetes and other serious morbid obesity related diseases reported by Harvey Buchwald, M.D. in his meta analysis published in 2004. In this study over 20,000 postoperative bariatric patients were followed for up to 13 years.
Obesity Related Illnesses that Improved/Resolved Following Weight Loss Surgery:
Gastric Band RNY DS
Diabetes Mellitus 47.9% 83.7% 98.9%
Hyperlipidemia 58.9% 96.9% 99.1%
Hypertension 43.2% 67.5% 83.4%
Sleep Apnea 95% 80.4% 92%
From Page 7
Cormorbidity Outcomes
Diabetes. When defined as the ability to discontinue all diabetes-related medications and maintain blood glucose levels within the normal range, strong evidence for improvement in type 2 diabetes and impaired glucose tolerance was found across all surgery types. Within studies reporting resolution of diabetes, 1417 (76.8% [meta-analytic mean, 76.8%; 95% CI, 70.7%-82.9%]) of 1846 patients experienced complete resolution. Within studies reporting both resolution and improvement or only improvement of diabetes, 414 (85.4% [meta-analytic mean, 86.0%;95% CI, 78.4%-93.7%]) of 485 (mean change, 71.53 mg/dL; 95% CI, 49.37%-93.69 mg/dL [3.97 mmol/L; 95% CI, 2.74-5.2 mmol/L]; n=296 by meta-analysis) compared with unselected populations (means change, 13.33 mg/dL; 95% CI, 10.81-15.86 mg/dL [0.74 mmol/L; 95% CI, 0.60-0.88 mmol/L]; n-2092 by meta-analysis.
There was a difference in diabetes outcomes analyzed according to the 4 categories of operative procedures. With respect to diabetes resolution, there was a gradation of effect from
98.9% (95% CI, 96.8%-100%) for bioliopancreatic diversion or duodenal switch to
83.7% (95% CI, 77.3%-90.1%) for gastric bypass to
71.6% (95%CI; 55.1%-88.2%) for gastroplasty, and to
47.9 (95% CI, 29.1%-66.7%) for gastric banding.
The percentage of patients with diabetes resolved or improved showed different results (Table 5 [page 9]); this variation from the trend solely for diabetes resolved may be due to the far greater number of patients assessed for this variable (n=85) in the total population.
From Page 10
Resolution of diabetes often occurred days following bariatric surgery, even before marked weight loss was achieved. Resolution of diabetes was more prevalent following the predominantly malabsorptive procedures (bioliopancreatic diversion or duodenal switch) and the mixed/restrictive gastric bypass in contrast to the purely restrictive gastroplasty and gastric banding procedures. In addition, there appeared to be a gradation of diabetes resolution as a function of the operative procedure itself.
98.9% for bioliopancreatic diversion or duodenal switch
83.7% for gastric bypass
71.6% for gastroplasty, and
47.9% for gastric banding.
The putative extent and time relationship of the different operative procedures to diabetes resolution or improvement after bariatric surgery may be related to some of the changes in the gut related hormones. The hormonal milieu, or the relative balance of forgut mediators, is differently affected when the distal stomach is bypass, or a partial gastrectomy is performed, and the enteric contents are separated from the bioliopancreatic stream in the upper small intestinal tract. The study of the impact of the various bariatric procedures on leptin, grehlin, resistin, acylation-stimulating protein, adiponectin, entro-glucagon, cholecystokin, and other gastrointestinal satiety mediators receiving increasing attention.
Bariatric Surgery
A Systematic Review and Meta-analysis
Henry Buchwald MD
JAMA
October 13, 2004
Vol 292, No. 14
source where I obtained info from:
http://jama.ama-assn.org/cgi/content/abstract/292/14/1724
http://jama.ama-assn.org/cgi/reprint/292/24/3040.pdf
http://jama.ama-assn.org/cgi/content/full/jama;293/14/1728-b
Below is a chart outlining the differences following weight loss surgery in the cure and or reduction of diabetes and other serious morbid obesity related diseases reported by Harvey Buchwald, M.D. in his meta analysis published in 2004. In this study over 20,000 postoperative bariatric patients were followed for up to 13 years.
Obesity Related Illnesses that Improved/Resolved Following Weight Loss Surgery:
Gastric Band RNY DS
Diabetes Mellitus 47.9% 83.7% 98.9%
Hyperlipidemia 58.9% 96.9% 99.1%
Hypertension 43.2% 67.5% 83.4%
Sleep Apnea 95% 80.4% 92%
From Page 7
Cormorbidity Outcomes
Diabetes. When defined as the ability to discontinue all diabetes-related medications and maintain blood glucose levels within the normal range, strong evidence for improvement in type 2 diabetes and impaired glucose tolerance was found across all surgery types. Within studies reporting resolution of diabetes, 1417 (76.8% [meta-analytic mean, 76.8%; 95% CI, 70.7%-82.9%]) of 1846 patients experienced complete resolution. Within studies reporting both resolution and improvement or only improvement of diabetes, 414 (85.4% [meta-analytic mean, 86.0%;95% CI, 78.4%-93.7%]) of 485 (mean change, 71.53 mg/dL; 95% CI, 49.37%-93.69 mg/dL [3.97 mmol/L; 95% CI, 2.74-5.2 mmol/L]; n=296 by meta-analysis) compared with unselected populations (means change, 13.33 mg/dL; 95% CI, 10.81-15.86 mg/dL [0.74 mmol/L; 95% CI, 0.60-0.88 mmol/L]; n-2092 by meta-analysis.
There was a difference in diabetes outcomes analyzed according to the 4 categories of operative procedures. With respect to diabetes resolution, there was a gradation of effect from
98.9% (95% CI, 96.8%-100%) for bioliopancreatic diversion or duodenal switch to
83.7% (95% CI, 77.3%-90.1%) for gastric bypass to
71.6% (95%CI; 55.1%-88.2%) for gastroplasty, and to
47.9 (95% CI, 29.1%-66.7%) for gastric banding.
The percentage of patients with diabetes resolved or improved showed different results (Table 5 [page 9]); this variation from the trend solely for diabetes resolved may be due to the far greater number of patients assessed for this variable (n=85) in the total population.
From Page 10
Resolution of diabetes often occurred days following bariatric surgery, even before marked weight loss was achieved. Resolution of diabetes was more prevalent following the predominantly malabsorptive procedures (bioliopancreatic diversion or duodenal switch) and the mixed/restrictive gastric bypass in contrast to the purely restrictive gastroplasty and gastric banding procedures. In addition, there appeared to be a gradation of diabetes resolution as a function of the operative procedure itself.
98.9% for bioliopancreatic diversion or duodenal switch
83.7% for gastric bypass
71.6% for gastroplasty, and
47.9% for gastric banding.
The putative extent and time relationship of the different operative procedures to diabetes resolution or improvement after bariatric surgery may be related to some of the changes in the gut related hormones. The hormonal milieu, or the relative balance of forgut mediators, is differently affected when the distal stomach is bypass, or a partial gastrectomy is performed, and the enteric contents are separated from the bioliopancreatic stream in the upper small intestinal tract. The study of the impact of the various bariatric procedures on leptin, grehlin, resistin, acylation-stimulating protein, adiponectin, entro-glucagon, cholecystokin, and other gastrointestinal satiety mediators receiving increasing attention.
Saturday, March 8, 2008
William B. Inabnet, MD
Positions and Appointments
2003-present Associate Professor
Clinical Surgery
Columbia University College of
Physicians & Surgeons
New York, NY
2003-present Associate
Attending Surgeon
New York-Presbyterian Hospital
Columbia University Medical Center
New York, NY
2003-present Chief
Endocrine Surgery Section
New York-Presbyterian Hospital
Columbia University Medical Center
New York, NY
2003-present Co-Director
New York Thyroid
Parathyroid Center
New York-Presbyterian Hospital
Columbia University Medical Center
New York, NY
Clinical Specialties
Minimally invasive thyroid and parathyroid surgery
Laparoscopic adrenal and pancreatic surgery
Laparoscopic bariatric surgery
* Appendectomy
* Bariatric Surgery (DS, LapBand, RnY, VSG, Revision)
* Colon Resection Surgery
* Gastrectomy
* Gastroesophageal Reflux Surgery
* Hemorrhoidectomy
* Laparoscopic Cholecystectomy
* Liver Biopsy
* Lumpectomy (Partial Mastectomy)
* Lung Biopsy
* Radical Mastectomy (Total)
* Splenectomy
Education and Training
Nov 1996-Oct 1997 Fellowship
Surgical Endocrinology
Cochin Hospital
Paris, France
Pr Yves Chapuis
July 1992-June 1996 Resident
General Surgery
Rush-Presbyterian -
St. Luke's Medical Center
Chicago, IL
July 1991-June 1992 Intern
General Surgery
Rush-Presbyterian -
St. Luke's Medical Center
Chicago, IL
1991 MD
University of North Carolina
at Chapel Hill
Chapel Hill, NC
1987 BS
University of North Carolina
at Chapel Hill
Chapel Hill, NC
Board Certifications
American Board of Surgery
Professional Experience
1998-2003 Assistant Professor of Surgery
Mount Sinai School of Medicine
New York, NY
1994-1996 Instructor of Surgery
Rush Medical College
Chicago, IL
Professional Honors
Strathmore's Who's Who
2003 Edition
American Registry
Top American Surgical Specialists
2002 & 2003
NY Magazine
Top 100 Laparoscopic Surgeons
2002
SAGES Video Achievement Award
2001
SAGES Video Achievement Award
2000
General Surgery Department Award
Chief Resident of the Year
1996
Chief Administrative Resident
1995-1996
Surgical Sciences Research Award
1994
Surgical Sciences Award
Intern of the Year
1992
Professional Societies
and Committees
Societies
American Association of Endocrine Surgeons
American Association of Tissue Banks
American College of Surgeons
American Society for Bariatric Surgery
American Society of General Surgeons
American Thyroid Association
Association for Academic Surgery
Association Francophone de Chirurgie Endocrinienne
French National Academy of Surgery
French Surgical Association
International Association of Endocrine Surgeons
International Federation for the Surgery of Obesity
International Society of Surgery
New York Surgical Society
Society for Surgery of the Alimentary Tract
Society of American Gastrointestinal Endoscopic Surgeons
Society of Laparoendoscopic Surgeons
Comittees
Chair
American Society for Metabolic and
Bariatric Surgery Research Committee
(ASBS)
Society for Metabolic and
Bariatric Surgery Program Committee
(ASBS)
Executive Council
American College of Surgeons Committee
for Video-Based Education
Selected Publications
Costen E, Gagner M, Pomp A, Inabnet WB.
Decreased bleeding after laparoscopic
sleeve gastrectomy with or without
duodenal switch.
Obesity Surg, in press
Inabnet WB, Quinn T, Gagner M, Urban M,
Pomp A.
Laparoscopic Roux-en-Y gastric bypass in
patients with BMI<50: A prospective randomized
trial comparing short and long limb lengths.
Obesity Surg, accepted.
DiGiorgio M, Daud A, Inabnet WB, Schrope B,
Urban-SkuroM, Restuccia N, Bessler M
Markers of Bone and Calcium Metabolism
Following Gastric Bypass and Laparoscopic
Adjustable Gastric Banding.
Books
Inabnet WB, Ikramuddin S, DeMaria E.
Laparoscopic Bariatric Surgery.
Lippincott, Williams, & Wilkins Sept, 2004
Gagner M, Inabnet WB.
Minimally Invasive Endocrine Surgery.
Lippincott, Williams, & Wilkins March, 2002.
Abstracts
Inabnet WB, Rogula T, Gagner M.
The safety and efficacy of alternative energy
sources in endoscopic thyroidectomy.
Surg Endoscopy 2003, 17:S304.
Comeau E, Gagner M, Inabnet WB, Herron D,
Quinn T, Pomp A.
Symptomatic internal hernias following
laparoscopic bariatric surgery.
Surg Endoscopy 2003, 17:S219.
Kim CK, Kim S, Eskandar Y, Krynyckyi BR,
Inabnet WB, Machac J.
The efficacy of dual-isotope substraction vs
dual phase parathyroid scintigraphy for directing
targeted surgery.
Radiology 2002
Kim CK, Kim S, Eskandar Y, Krynyckyi BR,
Inabnet WB, Machac J.
Any separation between abnormal foci and
the lower pole of thyroid on Pinhole Sestamibi
Parathyroid Imaging is highly suggestive of
Intrathymic/anterior mediastinal Parathyroid
Adenomas.
J Nucl Med 2002
Kim CK, Kim S, Eskandar Y, Krynyckyi BR, Zhang Z,
Knesaurek K, Inabnet WB, Machac J.
Appearance of Descended Superior Parathyroid
Adenoma on SPECT Parathyroid Imaging.
J Nucl Med 2002
Kim CK, Kim S, Eskandar Y, Krynyckyi BR, Haber R,
Machac J, Inabnet WB.
Efficacy of Parathyroid Scintigraphy (PS) vs
ltrasonography (U) for Directing Targeted
Surgery (DTS).
J Nucl Med 2002
Kini S, Gagner M, Gentileschi P, Nandkumar G,
Inabnet WB, Herron D, Pomp A.
Laparoscopic bariatric surgery for
super super obese patients (BMI>60):
a comparison of Roux-en-Y gastric bypass
and biliopancreatic diversion with duodenal switch.
Obes Surg 2001; 11:158.
Quinn T, de Csepel J, Kini S, Gentileschi P, Ren C,
Pomp A, Herron D, Inabnet WB, Gagner M.
Laparoscopic biliopancreatic diversion with
duodenal switch: the early experience.
Surg Endo 2001; 15(Suppl 1):S158.
Inabnet WB, Gagner M.
Endoscopic thyroidecomy: patient selection,
technique and preliminary results.
Surg Endosc 2001;.
Chapuis Y, Dousset B, Inabnet WB, Ozier Y,
Luton JP, Houssin D.
Facteurs prédictifs des complications opératoires
après surrénalectomie trans-péritoneale
vidéo-endoscopique.
Ann Chir 1999; 53:677.
Inabnet WB, Pitre J, Bernard D, Chapuis Y.
Comparison de paramètres hémodynamiques
à l'occasion de l'exérèse par vidéo-endoscopie
et voie traditionelle de phéochromocytomes.
Ann Chir 1999; 53:677.
Inabnet WB, Vogler RC, Arikan E, Sancar A.
Parasites are the most frequent pathogens of
acute gastroenteristis in southeastern Turkey.
Fax 1990; 5:77.
2003-present Associate Professor
Clinical Surgery
Columbia University College of
Physicians & Surgeons
New York, NY
2003-present Associate
Attending Surgeon
New York-Presbyterian Hospital
Columbia University Medical Center
New York, NY
2003-present Chief
Endocrine Surgery Section
New York-Presbyterian Hospital
Columbia University Medical Center
New York, NY
2003-present Co-Director
New York Thyroid
Parathyroid Center
New York-Presbyterian Hospital
Columbia University Medical Center
New York, NY
Clinical Specialties
Minimally invasive thyroid and parathyroid surgery
Laparoscopic adrenal and pancreatic surgery
Laparoscopic bariatric surgery
* Appendectomy
* Bariatric Surgery (DS, LapBand, RnY, VSG, Revision)
* Colon Resection Surgery
* Gastrectomy
* Gastroesophageal Reflux Surgery
* Hemorrhoidectomy
* Laparoscopic Cholecystectomy
* Liver Biopsy
* Lumpectomy (Partial Mastectomy)
* Lung Biopsy
* Radical Mastectomy (Total)
* Splenectomy
Education and Training
Nov 1996-Oct 1997 Fellowship
Surgical Endocrinology
Cochin Hospital
Paris, France
Pr Yves Chapuis
July 1992-June 1996 Resident
General Surgery
Rush-Presbyterian -
St. Luke's Medical Center
Chicago, IL
July 1991-June 1992 Intern
General Surgery
Rush-Presbyterian -
St. Luke's Medical Center
Chicago, IL
1991 MD
University of North Carolina
at Chapel Hill
Chapel Hill, NC
1987 BS
University of North Carolina
at Chapel Hill
Chapel Hill, NC
Board Certifications
American Board of Surgery
Professional Experience
1998-2003 Assistant Professor of Surgery
Mount Sinai School of Medicine
New York, NY
1994-1996 Instructor of Surgery
Rush Medical College
Chicago, IL
Professional Honors
Strathmore's Who's Who
2003 Edition
American Registry
Top American Surgical Specialists
2002 & 2003
NY Magazine
Top 100 Laparoscopic Surgeons
2002
SAGES Video Achievement Award
2001
SAGES Video Achievement Award
2000
General Surgery Department Award
Chief Resident of the Year
1996
Chief Administrative Resident
1995-1996
Surgical Sciences Research Award
1994
Surgical Sciences Award
Intern of the Year
1992
Professional Societies
and Committees
Societies
American Association of Endocrine Surgeons
American Association of Tissue Banks
American College of Surgeons
American Society for Bariatric Surgery
American Society of General Surgeons
American Thyroid Association
Association for Academic Surgery
Association Francophone de Chirurgie Endocrinienne
French National Academy of Surgery
French Surgical Association
International Association of Endocrine Surgeons
International Federation for the Surgery of Obesity
International Society of Surgery
New York Surgical Society
Society for Surgery of the Alimentary Tract
Society of American Gastrointestinal Endoscopic Surgeons
Society of Laparoendoscopic Surgeons
Comittees
Chair
American Society for Metabolic and
Bariatric Surgery Research Committee
(ASBS)
Society for Metabolic and
Bariatric Surgery Program Committee
(ASBS)
Executive Council
American College of Surgeons Committee
for Video-Based Education
Selected Publications
Costen E, Gagner M, Pomp A, Inabnet WB.
Decreased bleeding after laparoscopic
sleeve gastrectomy with or without
duodenal switch.
Obesity Surg, in press
Inabnet WB, Quinn T, Gagner M, Urban M,
Pomp A.
Laparoscopic Roux-en-Y gastric bypass in
patients with BMI<50: A prospective randomized
trial comparing short and long limb lengths.
Obesity Surg, accepted.
DiGiorgio M, Daud A, Inabnet WB, Schrope B,
Urban-SkuroM, Restuccia N, Bessler M
Markers of Bone and Calcium Metabolism
Following Gastric Bypass and Laparoscopic
Adjustable Gastric Banding.
Books
Inabnet WB, Ikramuddin S, DeMaria E.
Laparoscopic Bariatric Surgery.
Lippincott, Williams, & Wilkins Sept, 2004
Gagner M, Inabnet WB.
Minimally Invasive Endocrine Surgery.
Lippincott, Williams, & Wilkins March, 2002.
Abstracts
Inabnet WB, Rogula T, Gagner M.
The safety and efficacy of alternative energy
sources in endoscopic thyroidectomy.
Surg Endoscopy 2003, 17:S304.
Comeau E, Gagner M, Inabnet WB, Herron D,
Quinn T, Pomp A.
Symptomatic internal hernias following
laparoscopic bariatric surgery.
Surg Endoscopy 2003, 17:S219.
Kim CK, Kim S, Eskandar Y, Krynyckyi BR,
Inabnet WB, Machac J.
The efficacy of dual-isotope substraction vs
dual phase parathyroid scintigraphy for directing
targeted surgery.
Radiology 2002
Kim CK, Kim S, Eskandar Y, Krynyckyi BR,
Inabnet WB, Machac J.
Any separation between abnormal foci and
the lower pole of thyroid on Pinhole Sestamibi
Parathyroid Imaging is highly suggestive of
Intrathymic/anterior mediastinal Parathyroid
Adenomas.
J Nucl Med 2002
Kim CK, Kim S, Eskandar Y, Krynyckyi BR, Zhang Z,
Knesaurek K, Inabnet WB, Machac J.
Appearance of Descended Superior Parathyroid
Adenoma on SPECT Parathyroid Imaging.
J Nucl Med 2002
Kim CK, Kim S, Eskandar Y, Krynyckyi BR, Haber R,
Machac J, Inabnet WB.
Efficacy of Parathyroid Scintigraphy (PS) vs
ltrasonography (U) for Directing Targeted
Surgery (DTS).
J Nucl Med 2002
Kini S, Gagner M, Gentileschi P, Nandkumar G,
Inabnet WB, Herron D, Pomp A.
Laparoscopic bariatric surgery for
super super obese patients (BMI>60):
a comparison of Roux-en-Y gastric bypass
and biliopancreatic diversion with duodenal switch.
Obes Surg 2001; 11:158.
Quinn T, de Csepel J, Kini S, Gentileschi P, Ren C,
Pomp A, Herron D, Inabnet WB, Gagner M.
Laparoscopic biliopancreatic diversion with
duodenal switch: the early experience.
Surg Endo 2001; 15(Suppl 1):S158.
Inabnet WB, Gagner M.
Endoscopic thyroidecomy: patient selection,
technique and preliminary results.
Surg Endosc 2001;.
Chapuis Y, Dousset B, Inabnet WB, Ozier Y,
Luton JP, Houssin D.
Facteurs prédictifs des complications opératoires
après surrénalectomie trans-péritoneale
vidéo-endoscopique.
Ann Chir 1999; 53:677.
Inabnet WB, Pitre J, Bernard D, Chapuis Y.
Comparison de paramètres hémodynamiques
à l'occasion de l'exérèse par vidéo-endoscopie
et voie traditionelle de phéochromocytomes.
Ann Chir 1999; 53:677.
Inabnet WB, Vogler RC, Arikan E, Sancar A.
Parasites are the most frequent pathogens of
acute gastroenteristis in southeastern Turkey.
Fax 1990; 5:77.
Sunday, March 2, 2008
Otolaryngologist's office
I called my Otolaryngologist's office and ask the receptionist that I want him to return my call, that it is an emergency. Within an hour he called. I told him, I am choking in my sleep and awaken trying to grab my breath. My throat, my middle and right side of my chest (the lung and trachea area) hurts. I told him, I called the same day when I get out of the sleep study to make an appt to see him right away, but the receptionist told me it takes 2 weeks for the data to be analyzed by him and that I cannot see him before the 2 weeks. I told him, she refused to give me a date to see him this week and I cannot wait 2 weeks because of the severity I am suffering. He agreed and was bothered that the receptionist said such a thing. He told me to call Jackie, the senior receptionist an hour from our talk to get an appt for Wed Mar 3, 2004, 2 days away. I am glad, I can get thing done right away.
Tuesday, January 8, 2008
My kid brother, Joe, such a badass. Rides bikes like a cowboy rides a wild stallion. Need for speed...runs in the family. I used to jet 100 mph in my black decked out fully loaded black Honda Prelude Si. Those were the days, sighh. Never got a ticket and never been in an accident. This video was taken recently, so let me share. That is his son in the video with the black car.
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