I am contemplating a revision surgery from sleeve to SADI. I am in the research process now. I asked my doctor what I could do to get started and he said to keep my carbs below 40 for now. Well I have questions what about net carbs? I am looking at a package of wraps and it’s only four net carbs but it’s 32 g of total carbs. I understand that it has a lot of fiber, and that you subtract the fiber from the carbs to get net carbs, but does the post surgical body care that you’re getting the fiber as well.

in other words, if my post surgical plan was 40 carbs a day could I have this tortilla and would it count for 4 g of carbs or 32 g of carbs towards my goal??

also, I think I read somewhere that too much fiber may cause an issue post surgery as well- will 28 g of fiber be too much??

Edited March 24, 20242 yr by ShoppGirl

I can't speak to the question of fiber, but I can share with you what my dietician said about net carbs. She told me to ignore net carb count and focus on total carbs. So on my tracking journey, I would count the tortilla as ingesting 32g of carbohydrates.

12 minutes ago, BeanitoDiego said:

I can't speak to the question of Fiber, but I can share with you what my dietician said about net carbs. She told me to ignore net carb count and focus on total carbs. So on my tracking journey, I would count the tortilla as ingesting 32g of carbohydrates.

So basically no, I can’t have the tortilla. lol. Thanks for your help.

2 minutes ago, ShoppGirl said:

So basically no, I can’t have the tortilla. lol. Thanks for your help.

Not necessarily. You need to find out if your doctor is following that same guideline, or if he follows net carbs. Just send his office a message and ask for clarification. If you have a healthcare portal, this should be super easy to do.

Just now, NickelChip said:

Not necessarily. You need to find out if your doctor is following that same guideline, or if he follows net carbs. Just send his office a message and ask for clarification. If you have a healthcare portal, this should be super easy to do.

Right now I am not getting a great deal of help from his team. I am trying to decide between SADI and bypass but I honestly think I may be one of the first patients to get the SADI with him. A fact that if it is true scares me a bit but the possibility of greater weight loss has kept me interested. I do have an appointment tomorrow with his PA and in two weeks with the dietician to help in my decision. I hope I get quite a few answers between the two. I am just really trying to figure things out so I can eat that way now to see what I am possibly getting myself into. Lol

I don't follow a low carb but I had asked something similar to my team, and basically they said that you count only Net carbs. So if it were up to my team, you can definitely have that tortilla lol. ^^

2 hours ago, Tomo said:

I don't follow a low carb but I had asked something similar to my team, and basically they said that you count only Net carbs. So if it were up to my team, you can definitely have that tortilla lol. ^^

Hummm….i wonder if the difference is because our anatomies vary post surgery so we will process carb differently?! I can’t wait until my appointment with the dietician to learn the answer to this question per my surgeons reccomendations. A life without ever being able to have another wrap, at least on occasion, is going to take a second to “wrap” my mind around. Haha. I couldn’t resist.

you'll have to check with the clinic - I know carbs are more of an issue for DS patients than they are for sleeve/RNY, but I don't know about SADI. I've read carbs can give DS patients a lot of G/I distress, but I don't know if it's all carbs or just certain ones (and again, SADI might be different than DS when it comes to carbs)

Edited March 26, 20242 yr by catwoman7

My understanding was that the "Net Carb" count was more for Keto / Atkins carb counting to be a guide for staying in Ketosis. Then it became a way for marketing to say its lower carb to sell more stuff. Both my primary care doctor and my surgeon told me to measure total carbs and disregard net carbs if I'm not doing either of those diets.

20 minutes ago, SomeBigGuy said:

My understanding was that the "Net Carb" count was more for Keto / Atkins carb counting to be a guide for staying in Ketosis. Then it became a way for marketing to say its lower carb to sell more stuff. Both my primary care doctor and my surgeon told me to measure total carbs and disregard net carbs if I'm not doing either of those diets.

it’s interesting to hear the differnt responses from differnt teams. I think which surgery we had plays a part in it too. I’m meeting with the PA in a couple hours in hopes of getting some of these questions answered. I’m really curious to see the response.

Well I met with the PA who did not know a lot about SADI at all. I asked several of my questions and he said ALOT if words that actually said nothing to answer my questions. I guess I just need to sit tight and see what the surgeon has to say. I am not a very patient person though. It’s killing my to wait a whole month for answers. ?

hiya @ShoppGirl!

ive been reading all your posts about your decision making process on your decided SADI revision! i commend you for your quest in educating yourself around the whole thing.

i realize im just a stranger on the internet with just a two cent opinion, but here it is anyway:

from the sounds of it, your surgical team sounds ill-prepared to provide any meaningful assistance to you post surgery. at least not the kind of assistance it sounds like YOU are seeking. this may be a problem for you as i gather (from your posts) that you would greatly benefit from more structured guidance vs being left to your own devices.

while posing your questions to a whole slew of strangers on the internet (i.e., us! lol) could definitely help, i feel like there are just too many variances in responses that can add unnecessary stress and confusion.

would you consider having your procedure with an establishment who has more working knowledge with the SADI?

while, in my opinion, a capable surgeon is a capable surgeon is a capable surgeon whose skill with a knife and needle is easily transferrable across procedures IF EVERYTHING GOES WELL (experience is golden when the unexpected arises) your surgeons seemingly lack of knowledge on SADI overall gives me pause. the fact that he/she seemingly isn't researching is at least half as much as YOU are also makes me go hmmmmmm.

your dietician on the other hand is completely useless (though i have thoughts on hospital provided dieticians/nutritionists on the whole, which is beyond the scope of this post...but i digress...) with zero knowledge on how to advise SADI patients.

personally i navigated my post surgery nutrition without the help on my nutritionist. i listened to her and told her what i was doing but i basically did my own thing by researching and reading (more medical journals vs anecdotal text) and doing good old personal data collection with trial end error. BUT that is just my nature AND there is a wealth of info on my sleeve out there. and while i didn't adhere to much of my NUTs recommendations, at least she HAD advice to give me.

would you consider moving to a team with more (any!) experience with SADI and who are better equipped to guide u and answer your questions? you seem like a gentle-ish soul would benefit from a more hands on, knowledgeable team.

of course you could also be a bee-yatch and i am waaaay off in my assessment of what i think you need from a team based on your posts! ????? in which case please ignore the ramblings of this old woman hahahahha!

BUT if i am even partly right, pls consider your choice of team and if u are setting yourself up for success (which u totally deserve) by aligning yourself with them.

good luck! ❤️

Edited March 27, 20242 yr by ms.sss

29 minutes ago, ms.sss said:

hiya @ShoppGirl!

ive been reading all your posts about your decision making process on your decided SADI revision! i commend you for your Quest in educating yourself around the whole thing.

i realize im just a stranger on the internet with just a two cent opinion, but here it is anyway:

from the sounds of it, your surgical team sounds ill-prepared to provide any meaningful assistance to you post surgery. at least not the kind of assistance it sounds like YOU are seeking. this may be a problem for you as i gather (from your posts) that you would greatly benefit from more structured guidance vs being left to your own devices.

while posing your questions to a whole slew of strangers on the internet (i.e., us! lol) could definitely help, i feel like there are just too many variances in responses that can add unnecessary stress and confusion.

would you consider having your procedure with an establishment who has more working knowledge with the SADI?

while, in my opinion, a capable surgeon is a capable surgeon is a capable surgeon whose skill with a knife and needle is easily transferrable across procedures IF EVERYTHING GOES WELL (experience is golden when the unexpected arises) your surgeons seemingly lack of knowledge on SADI overall gives me pause. the fact that he/she seemingly isn't researching is at least half as much as YOU are also makes me go hmmmmmm.

your dietician on the other hand is completely useless (though i have thoughts on hospital provided dieticians/nutritionists on the whole, which is beyond the scope of this post...but i digress...) with zero knowledge on how to advise SADI patients.

personally i navigated my post surgery nutrition without the help on my nutritionist. i listened to her and told her what i was doing but i basically did my own thing by researching and reading (more medical journals vs anecdotal text) and doing good old personal data collection with trial end error. BUT that is just my nature AND there is a wealth of info on my sleeve out there. and while i didn't adhere to much of my NUTs recommendations, at least she HAD advice to give me.

would you consider moving to a team with more (any!) experience with SADI and who are better equipped to guide u and answer your questions? you seem like a gentle-ish soul would benefit from a more hands on, knowledgeable team.

of course you could also be a bee-yatch and i am waaaay off in my assessment of what i think you need from a team based on your posts! ????? in which case please ignore the ramblings of this old woman hahahahha!

BUT if i am even partly right, pls consider your choice of team and if u are setting yourself up for success (which u totally deserve) by aligning yourself with them.

good luck! ❤️

Hello @ms.sss

I actually really do appreciate your response. You are pretty accurate in your assessment, lol, I definitely have my moments but for the most part I tend to be pretty agreeable and sometimes that bites me. i have taken A little breather after yesterday’s meeting with my surgeons’ PA and waking up to a stranger taking their time to say I should too makes me realize I’m not just being overly anxious. Thank you!!

I did make a call just now to see if the only other surgeon I would consider does this procedure and he does not So I guess the most obvious options at this point are to just go with the bypass instead or to ask ALOT of questions and pose some really uncomfortable ones about the surgein and that team that I may not like the answers too. Regardless I realize I need to slow this bus down a great deal and really think this one through.

My thoughts so far are, when the surgeon sits down with me and my list of questions IF I feel better that HE has done his research and both he and I are confident he has this, then I just need to worry about the aftercare. I need to be bold and require that he gives a way to get HIM, post op if I have any urgent concerns. And I need to know who he turns to if he doesn’t know the answer.

I know for my first post op appointment I will see him but maybe I can see him ever so often past that. Especially if I am feeling lost. The PA said yesterday that I may get him or the surgeon if I called with questions immediately post op and he claimed he wouldn’t just give me an answer to give me an answer but it sorta felt like what he did for a half hour with my questions.

I am just going to have to go out of my comfort zone a bit and bluntly say that I don’t feel like the rest of the team is prepared to handle my care with this particular procedure. I must get the point across that the PA just can’t answer all my questions at this point and I wouldn’t feel confident in his advice about any post op questions.

Or, Perhaps he could just make the PA do the research now? I mean he is practically a doctor. They know how to learn things. I just don’t think he has tried with this procedure yet. He did seem to know alot about the DS, Just not this modified version. I can ask to meet with him again after he has had a chance to prepare and see how I feel with him. My gut has gotten me this far??

As far as the dietician goes. I think I just need a list of what macros he wants me to stick to and to know what type of carbs really count and I think I can take it from there at least witb the help of this community. I also think I can shop around for a different dietician once I have the requirements If I feel like I even need one. I’m hoping that the dietician gets the exact requirements from the surgeon in preparation for our meeting in two weeks. If not I will need to ask him that when I meet with him as well.

I guess the skinny about the surgeon, though is that I am going to have to pump the brakes a bit and put on my big girl panties. I need to have some awkward conversations and just mentally prepare myself that the result could be that I don’t get exactly what I thought I wanted.