Sleeve Veteran researching revision to SADI

[ShoppGirl 3,749]

26 minutes ago, apalm said:

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.

Yea insurance companies seem to have things backwards sometimes. I’m so glad you were able to get it though. I commend you for making this investment in your health!! Is there anything you have learned along the way that you wish you had known going in?

Edited March 29 by ShoppGirl

[apalm 20]

At 53, the age I was at my surgery, I had spent my entire life hating my body and being on some type of diet. I researched and educated myself on the types of bariatric surgeries. I scheduled the sleeve surgery and canceled telling myself I will try one more diet only to schedule the SIPS/SADI 3 months later. It is a scary step

[apalm 20]

But I knew I needed to do this for me, to save my life. So I guess to answer your question I knew all the risks, the rare complications the benefits that WLS entails. I just gave all my fears to a higher power and took the biggest step forward I have ever taken in my life!! Fortunately, I have had zero issues and have followed the Drs orders faithfully. It is the answer to my prayers, the help I needed. Now at 54 I am healthier than I have ever been!

[ShoppGirl 3,749]

14 minutes ago, apalm said:

At 53, the age I was at my surgery, I had spent my entire life hating my body and being on some type of diet. I researched and educated myself on the types of bariatric surgeries. I scheduled the sleeve surgery and canceled telling myself I will try one more diet only to schedule the SIPS/SADI 3 months later. It is a scary step

I believe that post came at the exact time I needed to hear it. Thank you. I am in a craft group and for some random reason they were talking about someone they knew that had bariatric surgery and how they gained it back. I told them I had the sleeve and I gained it back. That was kinda my way of testing the waters to see if I could confide in them I am considering it again.

Well that went over okay so I did and that’s when All the advice came of how I should try to lose it with this diet and that. I know that I can lose weight. I have lost probably over 1000 pounds in my life. It’s the keeping it off part I cannot do!!

Recently, I have been doing low carb trying out recipes that I think I can eat post op and I have lost a couple pounds. That’s when the little voice creeps in asking if I should try it the old fashioned way just one more time. Knowing good and well it will just be another year of dropping a few pounds then gaining that back plus some more soon after.

[ShoppGirl 3,749]

10 minutes ago, apalm said:

But I knew I needed to do this for me, to save my life. So I guess to answer your question I knew all the risks, the rare complications the benefits that WLS entails. I just gave all my fears to a higher power and took the biggest step forward I have ever taken in my life!! Fortunately, I have had zero issues and have followed the Drs orders faithfully. It is the answer to my prayers, the help I needed. Now at 54 I am healthier than I have ever been!

I am so happy to hear you are doing well. Thank you so much for sharing.

[apalm 20]

Some of us just need the “extra help” that bariatric surgery can give us. I was a total food addict. Always thinking about my next meal, feeling cheated if I did not have heaping portions and eating until I felt sick. Some of us are just wired like that. It’s not just “push the plate away” or having “will power” I believe it just how we are wired, an addiction. This surgery does change your brain, I’m serious, I don’t plan my day around food and I easily choose healthy foods. I don’t crave junk and sweets. The Hair loss is no joke but I knew that was going to happen. I’m 7mo post op and it has slowed down. As far as Vitamins .. I take 2 chewy Multivitamins and 2 calcium chews per day and a B12 every other week because my b12 level was really high. All other blood work was good. I’m happy to answer any questions you may have. I wish you the best of luck on whatever journey you decide to take.

[ShoppGirl 3,749]

29 minutes ago, apalm said:

Some of us just need the “extra help” that bariatric surgery can give us. I was a total food addict. Always thinking about my next meal, feeling cheated if I did not have heaping portions and eating until I felt sick. Some of us are just wired like that. It’s not just “push the plate away” or having “will power” I believe it just how we are wired, an addiction. This surgery does change your brain, I’m serious, I don’t plan my day around food and I easily choose healthy foods. I don’t crave junk and sweets. The Hair loss is no joke but I knew that was going to happen. I’m 7mo post op and it has slowed down. As far as Vitamins .. I take 2 chewy Multivitamins and 2 calcium chews per day and a B12 every other week because my B12 level was really high. All other blood work was good. I’m happy to answer any questions you may have. I wish you the best of luck on whatever journey you decide to take.

Thank you so much. oh how I really hope I am like you and it’s easier to make healthy choices at 7 months. Post sleeve my hunger came roaring back and I had already started to eat small portions of less than healthy foods because calorie wise they were okay in small portions before but with that hunger I ate more or more often and you see how that ended up.

I do have two questions off the top of my head. Other than the really scary medical stuff my biggest fear are the bathroom issues (diarrhea and smelly gas). A couple DS people have said that it’s mostly just if you eat bad though. If you don’t mind me asking Is that the case for you? Also, I am trying to work out what the macros will be so I can get started now. Currently I’m trying to keep carbs below 40 but I have no clue what fat, sugar and calories I would be allowed. What are your macro requirements now. Ooh and finally when you look at carbs on the back of the package do you have to count total carbs or just the net carbs which are much lower?

[apalm 20]

I don’t count carbs or calories. I just focus on Protein and Water. The SIPS/SADI is a malabsorption surgery. What you eat goes through your system “faster” than other surgeries. I have not had any issues with dumping syndrome. I usually have 1 bm a day . If I do eat something that may be fried or higher carb I do get gas, which is unpleasant smelling. Lol. So I focus on high protein foods, at least 60 grams a day.

[ShoppGirl 3,749]

42 minutes ago, apalm said:

I don’t count carbs or calories. I just focus on Protein and Water. The SIPS/SADI is a malabsorption surgery. What you eat goes through your system “faster” than other surgeries. I have not had any issues with dumping syndrome. I usually have 1 bm a day . If I do eat something that may be fried or higher carb I do get gas, which is unpleasant smelling. Lol. So I focus on high Protein foods, at least 60 grams a day.

I guess that’s why it’s been so difficult for me to find the macros listed anywhere. I think the idea of smelly gas may just be enough to keep me from eating alot of carbs. At least when I’m out which is when I usually am tempted to make bad choices.

[ChunkCat 722]

I'm so glad you tried the muffins and liked them!! I really enjoyed mine, they kept well in the fridge and warmed up really well with a quick zap in the microwave.

Regarding the nutritional needs of a SADI patient. We don't really know, honestly. The SADI is too new to have some of the longer term studies that have been done on the sleeve, bypass, and DS. But it is commonly thought by most surgeons that the dietary needs of a SADI are more than with the bypass because SADI patients are thought to malabsorb more than a bypass patient. And their needs are most likely a little less than a traditional DS.

That said, I attended nutrition classes with all the different surgeries in one group, so we had to learn everybody's requirements!! Most good surgeons recommend that SADI patients follow the dietary requirements of a DS patient to be on the safe side. That means 80-120 grams of Protein, less than 50 TOTAL carbs while in the active weight loss phase (the dietician said "net carbs" is not an official measurement, but if you want to follow net carbs you'd need to keep under 30 net carbs since they get counted differently, most DS patients introduce a bit more complex carbs into their diets once they reach maintenance weight) and the fat grams recommended by the ASMBS is 60 grams of fat by 1 year post op.

However, SADI and DS patients malabsorb a good amount of fat, so veterans of the surgeries will tell you that you need more fat than that. I seem to feel best around 80-100 grams of fat a day, but there are veterans of the DS surgeries that eat closer to 150 grams, or whatever alleviates their Constipation and eases their symptoms of low fat like dry eyes and dry skin.

According to most studies, a DS patient only absorbs about 20-30% of the fat they consume, around 60% of the protein they consume, 60-80% of the complex carbs, and every single calorie of simple carbs!! That's why simple carbs are so important to restrict post surgery (besides the digestive drama), you can eat your way around any surgery with simple carbs... And this is why counting calories is pretty useless for DS and SADI patients.

We don't yet know exactly what the percentage of absorptions is for SADI patients as they haven't done a breakdown study (as far as I know) but it is safe to assume SADI patients absorb a little more fat and protein than a traditional DS patient would. The best way to find your own perfect macros post surgery IMO is to aim for 80-120 grams of protein and then watch your protein labs. They will tell you if you need more protein or if you can back off a little. And for me at least, I find my skin, hair and eyes are highly sensitive to when I have too little fat in my diet.

Edited March 31 by ChunkCat