Sleeve Veteran researching revision to SADI

[NickelChip 812]

I'm not sure a PCP would have too detailed an understanding of complications from any bariatric surgery, even a more common one. At least I wouldn't rely on that. Although I have a feeling if she has a patient who gets a certain procedure, she might be more likely to read up on it. Is your surgeon attached to a weight loss center of some kind? Mine is, and I'm expected to go for a follow up at the center yearly, basically forever, so I'll always be in close contact for questions. Honestly, I think you need to choose your surgery based on which one will work best for you, which could very well be the SADI. A long term complication is going to be rare, but also you'll know to bring it up if something happens. You don't have to rely on your doctor to think of it, and any doctor will know how to find out more of needed, even if they don't really know much about it now.

[ShoppGirl 3,428]

1 minute ago, NickelChip said:

I'm not sure a PCP would have too detailed an understanding of complications from any bariatric surgery, even a more common one. At least I wouldn't rely on that. Although I have a feeling if she has a patient who gets a certain procedure, she might be more likely to read up on it. Is your surgeon attached to a weight loss center of some kind? Mine is, and I'm expected to go for a follow up at the center yearly, basically forever, so I'll always be in close contact for questions. Honestly, I think you need to choose your surgery based on which one will work best for you, which could very well be the SADI. A long term complication is going to be rare, but also you'll know to bring it up if something happens. You don't have to rely on your doctor to think of it, and any doctor will know how to find out more of needed, even if they don't really know much about it now.

That’s very true. Even as we spoke today she was researching it a bit. Perhaps it peaked her interest and she will search it a bit more. My surgeon is not at a weight loss center but he does have a NP and I am expected to do follow up appointments with her. Post sleeve I stopped going as soon as they said I could get my labs at my pcp but that’s just because I was so ashamed about my regain. I know that the malnourishment is a lot bigger of a deal with this procedure though so I will be more diligent this time around if I choose to go with the SADI.

[ChunkCat 711]

I agree with NickelChip, your PCP not knowing about the surgery is not a big deal IMO. What is most important is that YOU understand your surgery and whatever anatomy you end up with, and that you are able to communicate that to emergency responders and ER doctors in an emergency. Everyone close to me knows what surgery I've had done, knows the technical term for it, and it is in my phone's health info that emergency responders can access. A lot of SADI and DS patients carry a card illustration of their surgery in their wallets or on their phones.

When I was considering the SADI and two surgeons recommended I do the DS instead I had reservations. I live in North Carolina and we have some really stellar bariatric surgeons here in Raleigh. But I plan on moving back to New Zealand in the next few years and DS surgery is really rare there, there are only 2 surgeons I know of in the country who can perform it and they are both in Auckland. My surgeon here told me as long as I planned on having the first few years locally here in Raleigh, and as long as there was one surgeon that could be consulted about my care in the area I move to, I should be fine with the DS... The same applies to the SADI. What we tend to forget is that people have surgery on their small intestines for a variety of reasons besides bariatric surgery. Cancer, Crohn's, etc... Many people have designer insides and while not every gastro doc is trained to do a DS or SADI, they have the technical skill to find a surgeon to consult with about your surgery should they need it.

In terms of your PCP what she most needs to know is that it is vital to order a FULL panel of bariatric labs for you at least once a year, as well as at any point if you start having symptoms of a Vitamin deficiency or Protein deficiency. She'll also need to watch your Iron levels. These are things a PCP can do. She also needs to be in good communication with your surgeon if she has any questions. Doctors act like they can't talk to each other, but they can. I have an autoimmune GI condition that causes ulcerations sometimes (like Crohn's) and my bariatric surgeon actually called and consulted with my GI doctor to ensure they were on the same page about the surgery and to ensure it was a safe surgical option for me. That made me feel SO well cared for!

My PCP has a sister who had the sleeve done so she's familiar with the bariatric surgery options. She is well read, researches what she needs to, knows how to consult when she needs more info, and trusts me to tell her what I need when I need it. For me, that's the perfect PCP. I don't need her to understand the complexities of my surgery. I just need her to know when she's out of her depth and needs to refer out to a GI doctor, my bariatric surgeon, or the ER.

[ShoppGirl 3,428]

38 minutes ago, ChunkCat said:

I agree with NickelChip, your PCP not knowing about the surgery is not a big deal IMO. What is most important is that YOU understand your surgery and whatever anatomy you end up with, and that you are able to communicate that to emergency responders and ER doctors in an emergency. Everyone close to me knows what surgery I've had done, knows the technical term for it, and it is in my phone's health info that emergency responders can access. A lot of SADI and DS patients carry a card illustration of their surgery in their wallets or on their phones.

When I was considering the SADI and two surgeons recommended I do the DS instead I had reservations. I live in North Carolina and we have some really stellar bariatric surgeons here in Raleigh. But I plan on moving back to New Zealand in the next few years and DS surgery is really rare there, there are only 2 surgeons I know of in the country who can perform it and they are both in Auckland. My surgeon here told me as long as I planned on having the first few years locally here in Raleigh, and as long as there was one surgeon that could be consulted about my care in the area I move to, I should be fine with the DS... The same applies to the SADI. What we tend to forget is that people have surgery on their small intestines for a variety of reasons besides bariatric surgery. Cancer, Crohn's, etc... Many people have designer insides and while not every gastro doc is trained to do a DS or SADI, they have the technical skill to find a surgeon to consult with about your surgery should they need it.

In terms of your PCP what she most needs to know is that it is vital to order a FULL panel of bariatric labs for you at least once a year, as well as at any point if you start having symptoms of a Vitamin deficiency or Protein deficiency. She'll also need to watch your Iron levels. These are things a PCP can do. She also needs to be in good communication with your surgeon if she has any questions. Doctors act like they can't talk to each other, but they can. I have an autoimmune GI condition that causes ulcerations sometimes (like Crohn's) and my bariatric surgeon actually called and consulted with my GI doctor to ensure they were on the same page about the surgery and to ensure it was a safe surgical option for me. That made me feel SO well cared for!

My PCP has a sister who had the sleeve done so she's familiar with the bariatric surgery options. She is well read, researches what she needs to, knows how to consult when she needs more info, and trusts me to tell her what I need when I need it. For me, that's the perfect PCP. I don't need her to understand the complexities of my surgery. I just need her to know when she's out of her depth and needs to refer out to a GI doctor, my bariatric surgeon, or the ER.

That makes a lot of sense. Thank you. I guess I need to go with my gut too which says that she is a very qualified provider that has done right by me thus far and I like that she didn’t even pretend to know about it. I usually say that I would rather have someone who can admit what they don’t know and know how to find the answer when they need it than someone who tries to pretend to be experts at everything but really doesn’t have a clue. I suppose i was overthinking it a bit. She asked me to get a list of labs from him and said she will order them for me with my regular ones. I think for the first year they will probably want me to do them at the surgeons office, though. They did with the sleeve.

[ShoppGirl 3,428]

ChunkCat. I seen on another post where to listed out your daily food log and it was super helpful. I can’t find it now but i took a screenshot and I was just looking at it. I’m hoping my log will be somewhat similar. I am wondering about the Keto muffins. You said homemade. Do you mean from a box or scratch. If scratch do you have a link to the recipe by chance?!

Since my appt I have been eating lower carb and I am quickly recalling that if I don’t have carbs for a few days I don’t crave them nearly as strongly. I have since told two close friends, my husband and my aunt that apparently no i can’t have just one brownie or one slice of pizza or one piece of cake even if I have this surgery and I’m doing great and please try to remember not to tempt me because it’s hard enough on my own not to have it.

I honestly think I’m addicted to carbs and I have to go cold Turkey to be able to do it. I mean I had a wrap the other day and that was okay because it was still low amount I think but if I have a lot. My body screams out for them again for several days afterwards. Maybe most of you know this or maybe I’m weird but I’m hoping that if people who love me understand this about me then maybe I will have better success this time around. Ooh and my point to telling you all that is that I would love to try your muffin recipe because I am basically doing low carb now. Lol

[NickelChip 812]

1 hour ago, ShoppGirl said:

have since told two close friends, my husband and my aunt that apparently no i can’t have just one brownie or one slice of pizza or one piece of cake even if I have this surgery and I’m doing great and please try to remember not to tempt me because it’s hard enough on my own not to have it.

I hope talking to them about it will help! It's funny because everyone knows right now I can barely eat anything, but they all catch themselves offering me food because it's "polite." I'm eating dessert, want some? I made this big meal full of stuff you can't even look at right now, can I get you a plate? And then I see it on their faces, it's like oh, wait...

But since you're dealing with regain, it's good that you are figuring out your triggers and asking others to help you avoid them now so you can have the best chance for success the second time around.

[ShoppGirl 3,428]

1 minute ago, NickelChip said:

I hope talking to them about it will help! It's funny because everyone knows right now I can barely eat anything, but they all catch themselves offering me food because it's "polite." I'm eating dessert, want some? I made this big meal full of stuff you can't even look at right now, can I get you a plate? And then I see it on their faces, it's like oh, wait...

But since you're dealing with regain, it's good that you are figuring out your triggers and asking others to help you avoid them now so you can have the best chance for success the second time around.

Yea I’ve told them all I know they are just being polite and I know it’s not their job to help but yet I’m still asking them to please help. Last time it was always you doing so good, one slice of pizza won’t kill or one whatever. But I have enough of a fight inside myself without them tempting me too.

i told my husband tonight I sit here and think about this time vs last time and I am starting to think maybe last time I really just wasn’t really ready. Last time at this point I was out eating everything I could trying to get my last hoorah in. This time I’m eating healthy as I can trying to lose some now to make it easier. I can’t say for sure but I hope that’s a good sign.

[ChunkCat 711]

On 3/21/2024 at 8:04 PM, ShoppGirl said:

ChunkCat. I seen on another post where to listed out your daily food log and it was super helpful. I can’t find it now but i took a screenshot and I was just looking at it. I’m hoping my log will be somewhat similar. I am wondering about the Keto muffins. You said homemade. Do you mean from a box or scratch. If scratch do you have a link to the recipe by chance?!

Yes! Happy to share! It's this one: https://www.wholesomeyum.com/keto-banana-muffins-recipe/ I doubled the banana flavoring emulsion (I got mine from Amazon) and I added vanilla. None of the box mixes were low carb enough for me and I used to be a chef so I have a bias towards homemade things. 😂

I can empathize with the carb cravings. When I eat carbs I crave them intensely for days afterwards. There are a lot of people who make judgments about those of us who use artificial sweeteners, and though I prefer the real thing, I simply cannot have it. My body HATES carbs, it just doesn't know what to do with them and whether it's a piece of cake or a bagel, it will bloat me and I'll want 3 times as much the next meal. It is just not worth it. And now with the surgery and my designer insides, it isn't worth the gas and such either... The only exception I seem to be able to make is a small amount of very dark chocolate. I think the reason it doesn't cause the carb cravings is because my craving for the minerals in it is stronger. LOL And even with that I can't have it two days in a row without cravings kicking in stronger...

I think it is perfectly reasonable to ask those close to you to support you with limitations around what they offer you. I asked the same thing of those close to me and they were happy to do so because it gave them a tangible way to help me with my goal. We don't gain weight in isolation. food is a social thing. We ask our social circle for support around other goals like going to school or raising our children, we should be able to ask for support with this too. It increases our chances of success!! The head game will do you in every time. Having people close to you wise to that helps tremendously in my experience... As long as they don't turn into food police. 😂

Edited March 24 by ChunkCat

[ShoppGirl 3,428]

26 minutes ago, ChunkCat said:

Yes! Happy to share! It's this one: https://www.wholesomeyum.com/keto-banana-muffins-recipe/ I doubled the banana flavoring emulsion (I got mine from Amazon) and I added vanilla. None of the box mixes were low carb enough for me and I used to be a chef so I have a bias towards homemade things. 😂

I can empathize with the carb cravings. When I eat carbs I crave them intensely for days afterwards. There are a lot of people who make judgments about those of us who use artificial sweeteners, and though I prefer the real thing, I simply cannot have it. My body HATES carbs, it just doesn't know what to do with them and whether it's a piece of cake or a bagel, it will bloat me and I'll want 3 times as much the next meal. It is just not worth it. And now with the surgery and my designer insides, it isn't worth the gas and such either... The only exception I seem to be able to make is a small amount of very dark chocolate. I think the reason it doesn't cause the carb cravings is because my craving for the minerals in it is stronger. LOL And even with that I can't have it two days in a row without cravings kicking in stronger...

I think it is perfectly reasonable to ask those close to you to support you with limitations around what they offer you. I asked the same thing of those close to me and they were happy to do so because it gave them a tangible way to help me with my goal. We don't gain weight in isolation. food is a social thing. We ask our social circle for support around other goals like going to school or raising our children, we should be able to ask for support with this too. It increases our chances of success!! The head game will do you in every time. Having people close to you wise to that helps tremendously in my experience... As long as they don't turn into food police. 😂

The food police. That’s cute. I have to admit when you said you used to be a chef I reluctantly opened the recipe thinking it was going to be really hard but that doesn’t look too difficult. I am adding the ingredients to my Amazon and Walmart carts now. Thanks!!

[ShoppGirl 3,428]

I finally have some appointments lined up. I am seeing the PA at the surgeons office tomorrow, the dietician in two weeks and I do a pre screening for a bariatric therapist this week. They don’t take my insurance and I THINk it said it’s $175 a session but I’m hoping I don’t need too many. None of this is mandatory for revision but I want to dive in this time 100% readh!! I am just excited that I should finally be getting answers and some help.

[ChunkCat 711]

Yay for progress!!

[apalm 18]

I had SADI on 8/15/23. I have had wonderful results. I was a type 2 diabetic with and A1C of 9.5 at the time of surgery, two weeks post op I was taken off meds my last A1C was 4.9. “Normal”! I have lost almost 100 LBS since surgery. I was also very nervous and scared of all the “what ifs” but I was also on a fast track to “what if’s” if I did not have the surgery. I agree with the above recommendation to follow Laura Fluschee on instagram. Wonderful account for SIPS/SADI patients. Best wishes!

[ShoppGirl 3,428]

31 minutes ago, apalm said:

I had SADI on 8/15/23. I have had wonderful results. I was a type 2 diabetic with and A1C of 9.5 at the time of surgery, two weeks post op I was taken off meds my last A1C was 4.9. “Normal”! I have lost almost 100 LBS since surgery. I was also very nervous and scared of all the “what ifs” but I was also on a fast track to “what if’s” if I did not have the surgery. I agree with the above recommendation to follow Laura Fluschee on instagram. Wonderful account for SIPS/SADI patients. Best wishes!

I am so glad to hear that you are doing so well. Congrats on your loss but even bigger congrats on the “normal” on your blood test for diabetes. That’s amazing!! May I ask if your Surgery was a virgin surgery or revision?

Edited March 29 by ShoppGirl

[ShoppGirl 3,428]

On 3/23/2024 at 10:27 PM, ChunkCat said:

Yes! Happy to share! It's this one: https://www.wholesomeyum.com/keto-banana-muffins-recipe/ I doubled the banana flavoring emulsion (I got mine from Amazon) and I added vanilla. None of the box mixes were low carb enough for me and I used to be a chef so I have a bias towards homemade things. 😂

I just made these and yummm. I made them according to directions except I added the vanilla you suggested but wanted to see if it was sweet enough with 1/2 cup and if I should double the banana and I will increase those next time but even as they are they are quite a little treat. And simple now that I realize it’s just mix together the dry stuff then add in the wet. I kept going back and forth on my phone to get the measurements. Anyways, pretty easy and super tasty too. thanks so much for sharing. 🙏🏼

[apalm 18]

My surgery was a “virgin” surgery. I did my research and felt the SIPS/SADI was the best surgery for me and my health. It was not covered by my insurance (it was around 16k) it is so frustrating that insurance won’t cover this surgery that will literally resolve T2D but will pay for metformin, insulin and dialysis.