This past Thursday marked one month since my DS procedure. It flew by a lot faster than I thought it would, but the first two weeks after a major surgery that alters how you eat, drink, move, and pretty much do EVERYTHING will make you feel like time is moving at a snail’s pace.
The first two weeks were the hardest because that was when I was in the most pain. Strangely, I did not have nearly as much pain as I did with my sleeve surgery. I had a few gut spasms about the 3rd and 4th days post-op, but nothing after that. I’ve really only had one day where I struggled with getting in enough fluids and protein so I consider myself pretty lucky. At my two-week follow-up appointment, my doctor advanced my diet a week ahead of schedule and moved me from liquids to soft solids which was a surprise. I fully expected to be on liquids for a full three weeks but I was so glad I was able to move to soft solids because I returned to work after three weeks of recovery at home. Teaching all day and moving around a classroom was definitely going to require more calories than I was getting on all liquids!
I’ve changed my approach to charting progress this time around. I learned a lot about what NOT to do when I had my sleeve surgery and documented EVERYTHING. In documenting everything, I developed some unhealthy behaviors centered around eating and measuring my progress that I did not want to repeat. I decided this time, I would only step on the scale at my doctor’s office when required, and once a month otherwise. I also decided I’d snap progress photos once monthly rather than weekly since the changes would be more obvious that way.
I tend to lose weight like a snowman melts: from the top down. My face and neck have thinned out a little, and my arms are more narrow (even though it may not be obvious from these pictures). I wore a pair of pants and a pair of jeans this past week that are embarrassingly large on me now so it will be time soon to take them to be tailored to fit. I learned the hard way last time not to buy clothes so often since I didn’t stay in a size range long enough to get enough wear out of what I purchased. I know some folks say “you can thrift, or go to Goodwill while you’re in between sizes” and my response is “no thanks.” I’d rather choose something new I really enjoy wearing that makes me feel good and that I chose with intention than wear something used because I had to. I spent most of my life wearing stuff I didn’t really want to wear because I HAD to–clothes for plus-sized women were hard to come by when I was growing up, and what was available was neither stylish or age appropriate so I always HATED clothes shopping. Now that there are more choices for plus-sized women (which I will likely always be), I choose pieces for my wardrobe that are classically styled, flattering, and brightly colored. Life is too short for a boring, drab wardrobe. 🙂
My blood sugars are still running a little higher than my PCP or I would like so I was told to resume taking Mounjaro. I’m not gonna lie, the fact that it quiets the “food noise” in my brain is a lovely bonus that comes with being on the medication so I am glad she is having me resume it. It did drive my a1c down a point and a half but as of last month, it was still in the prediabetes range which is not where I want it to be. I’d like it to be in the low 5s if possible so that is something I hope will change over the next couple of months as more weight comes off. My a1c measurement is one of the ways I’m measuring progress so it is important to me that it drops into a normal range.
I also went back to the gym for the first time in months Friday night. I’d been working with a trainer up until October when she moved abroad. Then because I was in the midst of my principal internship, I did the thing I did not want to do and let my health take a backseat to everything else. I asked my doc at my 2-week follow-up when I’d be able to go back to the gym, and he indicated that I could go back then, because as he said “You’re not going to do anything to cause yourself a hernia.” In my head, I laughed because I thought, have you seen me deadlift? I decided I’d wait until a full 8 weeks have passed before I attempt to start deadlifting again. I’m going to try and make getting into the gym a habit again because I know from past experience, I know purposeful movement accelerates my weight loss. And this time I don’t want to lose muscle mass because of the malabsorption I’m experiencing due to my DS.
Life with my remodeled digestive system has been interesting to navigate so far. Because my common channel is a little longer than most folks who have a traditional DS (200 cm vs 100-150 cm), I have to be more conscious of my fat intake. I haven’t been given a set of guidelines for my daily macros yet as I was told that would come at my 6-week follow-up. I’ve been trying to consume 100-120 grams of protein daily, 50-70 grams of fat (to keep things moving through my colon and to prevent dry skin and brittle hair), and between 40-60 grams of carbs a day. I also aim for 96 oz of water daily.
On the days I eat on the high side of my fat goals, I definitely feel it. I have only eaten one thing that has caused me great GI distress, and that was instant mashed potatoes that I made here at home. Because I’m on soft foods, I’ve eaten a TON of salmon and catfish, both of which I enjoy (thankfully). I cook the catfish in foil packets with veggies–I am allowed soft-cooked vegetables–and I roast the salmon. Soft foods have presented me with a bit of a challenge in that because they are not so dense, my capacity to eat them is greater than I feel it will be once I’m released to eat more dense proteins like chicken breast. I’ve eaten ground chicken thighs and ground sirloin, neither of which have caused me any discomfort but I don’t feel the same restriction with them as I feel I will once I am able to eat a whole chicken thigh or steak. I guess I’ll have to wait and see here in a couple of weeks once I’m released to eat such things.
Something else that should be noted is the vitamin supplementation that has to happen once you’ve had a DS. The malabsorptive component to the surgery (the “switch”) all but makes it so you HAVE to take a whole host of vitamin supplements in order to maintain good health.
My vitamin regimen (as of right now) consists of:
Bari-Life Just One multivitamin with iron x 1
5000 mcg B12 sublingual
500 mg Vitamin C chewable x 2 daily
ADEK x 2 daily sublingual
100 mg B1
1500 mg calcium citrate chews (500 mg x 3 daily)
400 mg magnesium chewable
1 prebiotic/probiotic capsule
Potassium gluconate 595 mg x 1
I’ll do this until May to see what my labs look like and adjust from there. Right now I feel like I have everything covered but we’ll see what shows up in my labs in a couple of months.
I’ll try to update more often than once a month–life has been pretty busy as it’s spring semester and the school year is winding down. I’m looking forward to what month 2 post-op brings.