Aspercreme contains a topical salicylate, trolamine salicylate, making it a NSAID of sorts.

Here's an article from www.sportsinjurybulletin.com; it doesn't address post-RNY users, of course.  It's likely that the blood levels of salicylate are much lower than those seen after taking aspirin or sodium salicylate orally.  Does this make it safe for RNYers?  I have no idea.

/Steve

Trolamine salicylate: The ‘Deep-Heat’ debate

Trolamine salicylate is the key ingredient to most creams that claim when applied directly to the skin can cure muscular aches and pains. Until recently however, the validity of trolamine salicylate as a sound tool for curing muscle-pain has been highly contested.

The First Test

Just over ten years ago, researchers at a Veterinarians Medical Center in Philadelphia applied trolamine salicylate skin cream on to the knees of both dogs and humans. The canines with trolamine rubbed into their knees had 20 times as much salicylate in the underlying muscles; compared to those who were taking aspirin orally (salicylate is the active ingredient in aspirin).

The research documented one very important fact: even though pill-popping pooches had higher BLOOD levels of salicylate, animals using skin cream had much more of the drug in their tendons, ligaments, cartilage, and joint cavities, where it really mattered, and where the chemical could actually relieve pain and inflammation.

In the Philadelphia research, results with humans were similar, with ample amount of salicylate building up in joint cavities. Actual pain relief was just as good with the salicylate skin cream, compared to ingesting aspirin orally. Plus, the researchers noted one special cream advantage: the ointment rapidly penetrated the skin and then lingered in the underlying muscles and connective tissues for long periods of time, only slowly drifting into the blood stream to be carried away. Overall, the skin cream removed discomfort with none of the side effects or the oral medicine.

The Second Findings

In a more recent test of trolamine salicylate, packaged in a commercial product called Aspercreme, scientists at the Mount Sinai Medical Center in Miami asked 22 males and 12 females to perform three sets of 20 repetitions of biceps curls each day for five consecutive days in order to induce significant muscle soreness. Four times each day, the study subjects rubbed one-half ounce of cream onto the skin directly over the biceps muscles. Half of the subjects rubbed in Aspercreme, the other half employed a placebo cream. Unaware of which cream they were actually using, subjects rated biceps soreness on a O to 10 scale several times a day.

As it turned out, the Aspercreme provided three main benefits:

   1. Muscle soreness appeared within 12 hours after initial exercise for the placebo users but took 24 hours to appear for Aspercreme appliers.
   2. The amount of pain experienced was significantly lower for Aspercreme users.
   3. Pain persisted for one day less with Aspercreme.

Concluding the trolamine debate

Analgesic creams containing 10 per cent trolamine salicylate really do work. There's also the intriguing possibility that a bit of skin cream rubbed on one of your body's 'hot spots' BEFORE a workout may actually reduce the amount of inflammation and pain which may be experienced after the session is over.

This is an uncommon, but not unheard-of, side effect of gallbladder removal.  It may get better with time.  It's often the result of a post-op increase in the amount of bile acids entering the small intestine continuously (b/c of no more gallbladder) and causing cramps and diarrhea

Your surgeon should order some additional tests to identify exactly what is the matter with you.  If it's due to bile acids, taking oral bile acid sequestrant powders or tablets (Questran, Colestid or Welchol) will bind the bile acids when they encounter them in the gut, reducing their irritant effects.

/Steve

My own opinion is that it's damn hard (not to mention expensive) to eat 100 grams of protein daily, so I've never ever tried.  I aim for 70-75 grams a day.  Some days I get in 60 or so, others somewhat more than 75: it all evens out.

/Steve

You can count your ALL of your coffee (caffeinated or not) as part of your fluid intake for the day.  Habitual coffee drinkers develop a tolerance to the mild diuretic effect of the caffeine.  It's simply not going to affect your hydration adversely.

/Steve

Are "dumping" and this hypoglycemia the SAME thing?

I believe that dumping and reactive hypoglycemia share many of the same symptoms, but during a "dumping episode" the blood sugar usually stays within normal limits (i.e., the syndrome is not necessarily associated with insulin release).  It wouldn't surprise me if one syndrome were confused with the other in any one particular individual without closer investigation, and I'm sure that both could be going on simultaneously.

How strict are you with food choices at this point?

Well, I try to watch what I eat, but I'm lucky (or unlucky?) in that I've never dumped, and seem to be able to eat just about any kind of food, including sugars.

/Steve

You've only "failed" if you make a regular habit of this, and even then you can take back control.  An occasional splurge isn't going to make or break you.  I usually treat the uncomfortable feeling as a "teaching moment".  Think of it this way: you might have eaten more than you typically do, but it's probably a lot less than you used to eat.  Just don't make this a daily/weekly habit.  Recriminations are only useful when they remind you how you should behave, and not a way of running yourself down.

/Steve

Lookin' good, Shari!

/Steve

Ferritin is a blood protein that binds iron, its level is a measure of the iron stores in your body.  I don't think that a ferritin of 77 is anything to get worried about; it's still plenty high (just FYI, my ferritin was 57 two months before my RNY; in December 08 it was 76, and in May 09 it was 92.  For women, the "normal" range is 18-160 ng/mL)  I would discuss this with your doctor and ask for the results of your CBC, specifically your RBC, hemoglobin and hemocrit, to see if they're  in a normal range.  Otherwise, I suspect s/he will just recommend that you keep track of your lab values'  direction.

Similarly, your B12 is comfortably in the normal range.  There's really no effective difference between 950 and 744 pg/mL.

Megadoses of vitamin  B6 (pyridoxine) -- 100 or more mg/day -- can cause a peripheral neuropathy, including numbness of the extremities.  I've always taken a multivitamin that includes 100mg of B1 (thiamin) daily, though I suspect that this is just superstition on my part.

Of course, it's entirely possible that this numbness in your feet has no direct relation to your having had RNY surgery, and I would have your doctor follow up on this if it continues to bother you.

/Steve

All of the brands you mention are combo all-in-one cold medicines and contain acetaminophen as a pain reliever as well as an antihistamine and an oral decongestant (anything available off the shelf and not behind the pharmacist's bench contains phenylephrine, which really isn't effective orally.)

Anyhoo, if you're simply congested, taking any of these nostrums exposes you to drugs you don't need.  The only oral decongestant for sale in the US is pseudoephedrine (Sudafed), but as of a few years ago, any drug containing it requires a signature and is sold behind-the-counter (it's a precursor for the synthesis of methamphetamine).  Pseudoephedrine is fine if you don't have high blood pressure, but if you do, it should be avoided, since it can raise BP.

A better choice is a nasal inhaler or nasal spray.  Benzedrex (propylhexedrine) or Vicks Inhaler (levmetamphetamine aka levo-methamphetamine) both work well, and Afrin (oxymetazoline) nasal spray and its drug-store generic equivalents are also good choices.

/Steve

It seems to me that any sort of "carb intercept", if it truly worked, would cause a bad case of gas or diarrhea or both.

Think of it this way: the reason beans cause flatulence is because they contain a carbohydrate, stachyose, which your digestive enzymes can't break down.  In a sense, beans come with their own "carb intercept".  But that undigested carbohydrate has to go somewhere, and it enters the large intestine, where gut bacteria, which CAN "digest" stachyose, produce voluminous quantities of methane and CO2 when they chow down.  That gas has to go somewhere.

People with "lactose intolerance" lack adequate quantities of lactase, the enzyme which digests the milk sugar disaccharide lactose.  Undigested lactose, when it enters the large intestine, is also broken down by gut bacteria into methane, CO2 as well as short-chain fatty acids which draw water into the colon.  You end up with cramps, gas and diarrhea.

When you take any sort of substance which inhibits the digestion of disaccharides such as sucrose -- table sugar -- and complex carbs such as starch, you're artificially creating the equivalent of lactose intolerance, and you can expect similar kinds of unpleasant and anti-social reactions.

I have no idea whether these "carb blockers" such as the one you mention really work at all, but there are prescription drugs which act in the same way and which are used in some diabetics to blunt the after-meal increase in blood sugar.  There are two such drugs: acarbose (Precose) and miglitol (Glyset), and they both have cramps, flatulence and diarrhea as potential side effects.

Note, too, that "carb blockers" can only have effects on the digestion of disaccharides (sucrose) and starches; they don't affect the absorption and metabolism of the simplest sugars such as glucose and fructose.  Furthermore, they really don't have any effect on the caloric content of carbohydrates.

/Steve

It's a waste of your money.  It contains hydrolyzed collagen protein, an incomplete protein which your body cannout use to build its own proteins.

There may be 42 grams of inessential amino acids in a protein ***** of New Whey, but virtually all of if cannot be used by your body.

Think of your milk-based (or soy-based) (or egg-based) proteins as essential medicines.  And hunt around some will taste better than others.  But any of these are superior to what is, nothing more than liquid Jell-O.

/Steve

That something has a patent claim filed against it  says NOTHING WHATSOEVER that the claims made for that patent are true.

Don't waste your time slumming around patentstorm.us; it's full of would-be money makers provided that their wild guesses ever turn out to be true.  It is the worst possible source of legitimate medical information.

/Steve

I saw the opthamologist today. She confirmed what I suspected-- my vision may be permanently impaired-- we'll have to wait and see. My eyelids don't fully close and my eyes have to be lubricated hourly. I can't read on paper without lenses. I had perfect vision before.

Huh?  Have I missed something?  Are you saying that this was a consequence of your eyelid surgery?  Did the ophth explain the whys and wherefores of what you're experiencing?

/Steve