I am working on an articl...

I am working on an article that will target the wide range of advice and opinions that we receive from our surgeons about our gastric bypass surgery post-op care. It is my belief that we would ALL benefit from a consistent standard from which we all begin our post-surgery journey. I am specifically thinking about recommendations for vitamins and minerals, lab work that is done, frequency of the lab work, post-surgery food introduction stages, how to best get protein, and who is really helping us take care of our bodies once the technical part of our surgery is completed. Below are some questions that will help me put together an informed article about what is being experienced by gastric bypass patients in the variety of programs available. 1. What supplements were recommended for you post-op? Were these considered short-term or permanent supplements? 2. What types of post-op lab work does your surgeon have you do? Specifically, names of the tests because "the works" does not define anything and likely is not all inclusive? 3. How often does your surgeon have you do this lab work? 4. How long does your surgeon follow up on your care: first year, for life, etc? 5. What type of post-op diet were you told to follow (i.e. clear for one week, 2 weeks of full liquids, 2 weeks of pureed and 1 week of soft)? 6. Does your surgeon believe in the value of high quality protein shakes (i.e. Champion Pure Whey Stack, Proplete Gold, Nectar, etc.)? If not, what does he/she say is your best way to get in adequate amounts of protein for a healthy post-gastric bypass body? 7. Have you had any specific problems related to the post-surgery nutritional care advice that you received (i.e. mineral or vitamin deficiencies)? How did you discover these? Are they being resolved? 8. Does your surgeon's program prefer that you defer to your PCP for your medical needs when it comes to post-surgery issues that are related to the malabsorption process? 9. Is your PCP prepared to deal with a gastric bypass patient? What is his/her knowledge and experience level with gastric bypass? Is your PCP willing to learn from what you have been able to gather from other gastric bypass patients so that you can improve the quality of your evaluations? 10. Any other observations that you think might prove helpful? 11. When did you have your surgery? 12. If you feel like sharing, what is the name of your surgeon and clinic? (I will not be naming clinics or surgeons, but this might be of value to me if someone were to ask). If I feel the need to quote someone I will contact you for permission. Sandra McDaniel (I have a new online name)

Hi Sandra, I found your questions to be very pointed , and definitely pointing in the right direction. I have a whole book full of info on what to do for the first couple of months after surgery, but virtually nothing on how to continue my care and labs, etc. into the long term future. I'm currently picking a lot of brains to try and gather that info before I find myself lacking in some nutrient and feeling rough. My doctor is Juarez. I haven't been to my 8 week appt. yet, so just to give the benefit of the doubt, maybe that's when he gives out that info.... I took the liberty of posting your post along with a link to get bback here to the Tucson WLS group. Maybe you'll get some hits from some who are farther out and can give their takes on what they've experienced. Good luck with the article. I'd love to see it when it's finished. - Stephanie J

If I am unable to get a WLS magazine to publish this I will definitely be making it available through frequent publishings on OH and the various other support groups. I believe it is a topic that has much value to each of us. Please keep in touch after you have your next appointment and let me know if you will be getting information about some of the areas I am inquiring about. My list might give you some ideas of what to ask Dr. Juarez so that you know what to expect ahead of you. Sandra

I'm sure he'll have adequate answers to all my questions - and I definitely will have a list of them - but the question is does he give that advice out as a matter of course. As far as different doctors having different recommendations, it does seem that it's about time a definitive set of best practices achieved some professional agreement. Until research based rules come into existence, you get the feeling the existing protocols reflect a bunch of rules that really are just arbitrarily landed on. - Stephanie

1. vitamins, calcium, B-12, biotin 2. protein levels, sugar levels, cholestoral levels, mineral levels and many many more. 3. at 6 weeks, 3 months, 6 months, 1 year. after there I don't know. 4. Dr. Chiasson says in his seminars that we are his patient for life. He will follow up always. He is keeping track of all of his patients and will probably write a book someday. 5. clear liquids for 2 weeks, add an egg on day 14, add puried foods at 3 weeks, 7 weeks add chicken, turkey, vegetables, and fruits. 6 months all other foods but be careful of those that are hard to digest (breads, rice, pasta, etc.) 6. yes, I was able to find an egg protein that is sweetened with Splenda after about 4 months out that I could tolerate. I did Isopure before that. You see I was lactose intolerant, and also became soy intolerant, and was allergic to Nutrasweet. 7. Gout from too rapid weight loss. Potassium, am taking supliments. and every once in a while I don't get enough fluids. this was all found out thru blood work along the way. 8. Our PCP should always be the primary one taking care of you and he can call Dr. Chiasson for consultations anytime. 9. My PCP has only had one other WLS patient and he is learning from me. I am always willing to talk with him about my concerns and if he doesn't know the answer, he will find them for me. 10. I have had a few problems, that thanks to my PCP, I have been able to deal with. Because of my rapid weight loss, I experienced very sever back problems which he sent me to PT for and also my knee problem flared up and he sent me to PT on that also. I am thankful for this support and suggest it to anyone who has these problems, to get the proper help to be able to learn to live with this thru proper exercises and brace support. 11. October 28, 2003 12 Dr. Patrick Chiasson, Northwest Medical Center, Tucson, Az. Sandra, thank you for this wonderful way of expressing our thoughts about this surgery. I am so thankful for being able to share my experience with you. But I would also like to say that I have been a member of the TUSWLS support group for 25 months now. And thru all that I have learned thru this group, I saved my husband's life. As I have become healthy, I wanted him to be as healthy as possible also and took him to my doctor and he had sleepapnia, and thru our Pul. , he was sent for a stress test. Which we found out that he had had a heart attack, and had to have a stent inserted. He has also been thru many others test that I would not have understood what was going on except that thru the education that my Surgeon gave us. So I thank God everyday for the wonderful things that I have learned thru this surgeryl Clara Jo Wogstad Dr. Patrick Chiasson lap Oct. 28, 2003 303/ 190/ 160 (healthier) pre/ now/ goal