ds revision/reversal for malnutrition?

micheleladendorf
on 12/8/12 8:15 pm

hi, i had my ds in 2007. i have done pretty well until this past july. i began to experience severe nausea, weakness, rapid weight loss, bloating, anemia and generally very sick. i had mri's, catscans etc to rule out internal issues. tests came back normal. saw my bariartric dr, as well and he did not believe what i was experiencing required surgical intervention (this was back in july). so, i kept moving forward, hospitalized 8x for nausea, weakness, exhaustion, dehydration and excessive bloating. i began then to work with the top gastro in our area.

about 6 weeks ago i was advised to see a hematologist which revealed an extreme iron deficiency dilemma. i have undergone 2 iron infusions this past month and have a followup visit next week.

this last week, i saw my gastro dr, and he believes i am in malnutrition  mode and recommended a reversal. i would like to know if anyone was in this state and got well with out having a reversal/and or revision? i had so many complications with my ds surgery the idea of having another surgery would have to be at the bottom of my list,

can this malabsorbtion/malnutrition issue be cured through dietary and supplement changes? that is my question.has anyone had success with issue i am experiencing?

096
on 12/8/12 11:51 pm

I have read a couple of individuals do a revision because of malnutrition though not common. Just have to ask what is your common channel? If it is too short, it can cause that problem. Hope you can better. Some of the vets here can answer your question. 

                      VSG TO DS REVISION 

        

    

    

        
NoMore B.
on 12/9/12 3:22 am

When were your last labs?

What have you been doing for supplements - what vites do you take?

 

micheleladendorf
on 12/9/12 10:56 am

here is a list of my vitamins

centrum 1x day

calcium 1800 3xday

mag 450 3xday

vit. a 60,000 per day

vit. d3 4800 per day

bcomplex 1 per day

iron.325 ferrous sulfate 3xday

glucosomine.chond, 3x day

probiotics 3x day

enzymes 6 per day

protein shake 22gr 1x per day

Kerry J.
on 12/9/12 8:24 pm - Santa Clara, UT

 

 

If this is the supplement schedule your "bari Dr." has you on I don't think he know what he's doing. First thing that jumps out at me is that there's no dry D; which is almost always something a DSer needs a bunch of; I need 100.000 IU a day to keep my labs where they should be. The next thing is that the Iron you're taking doesn't look right to me; none of the ferrous irons I can think of did anything for me; I found I needed to take Elemental Carbonyl Iron and Heme Iron to my Iron numbers up. Here's my list of supplements I take and no Dr told me what to do; I read my labs and adjust my supplements according to what I need.

Without exception; I've never seen a DSer who just did what their Dr told them to do well. If you want to be healthy, you have to take charge of your health YOURSELF you have to read your labs, YOURSELF, you have to discover which supplements you need, YOURSELF. It's good to have a Dr. to talk to and help you, but YOU have to be the expert on you and YOU have to know what's going on inside your body so YOU can make the correct decisions about your health.

 

  Current Supplements          
             
  5:00 AM Dose Iron          
3 Tender Iron Caps 60MG Elemental Carbonyl Iron 400 MG Vit. C  
1 Glucosamine HCL w MSM 1500mg Glucosamine 1500mg MSM    
1 Magnesium Citrate 500mg Magnesium Citrate      
             
  7:00 AM Dose Vitamins          
1 Chelated Zinc 50 mg Zinc        
             
  Noon Dose Vitamins          
2 Cal-Mag-D3 500MG Cal Citrate, 125MG Mag Citrate, 125MG Mag Oxide, 250iu D3
1 Kirtland Daily Multi Whole bunch O vitamins      
1 Tri Boron 1.5 MG Boron etc.      
1 Strontium 680 MG Strontium      
1 Tender D3 50,000 iu D3        
1 B-12 Dot 500 mcg B-12        
1 Tender E-400 400 iu Vitamine E      
1 B-1 100 mg B-1        
1 DHC Heme Iron 150g Heme Iron      
             
  Evening Dose Iron          
3 Tender Iron Caps 60MG Elemental Carbonyl Iron 400 MG Vit. C  
1 Glucosamine HCL w MSM 1500mg Glucosamine 1500mg MSM    
1 Magnesium Citrate 500mg Magnesium Citrate      
             
  Evening Dose Vitamins          
2 Cal-Mag-D3 500MG Cal Citrate, 125MG Mag Citrate, 125MG Mag Oxide, 250iu D3
1 Kirtland Daily Multi Whole bunch O vitamins      
1 Tri Boron 1.5 MG Boron etc.      
1 Strontium 680 MG Strontium      
1 Tender D3 50,000 iu D3        
1 Tender Dry K2 150 mch K2        
1 Tender Dry K1-1000 1000 mcg K11        
1 Tender A-25 25,000 iu Vitamin A      
1 Proferrin ES 12m Heme Iron      
1 Primal Defense Ultra          

Your labs (not the numbers, but the things your testing for) should looks something like this:

 

Lab Results   6 Month 12 Month 18 Month 24 Month 36 Month
  Normal Range 4-Feb-09 26-Aug-09 8-Feb-10 21-Sep-10 22-Sep-10
Comprehensive Metobolic Panel          
Sodium {137 - 146} 146 139 140 140 140
Potassium {3.5 - 5.0} 4.1 4 4.2 4.2 3.5
Chloride {98 - 109} 112 - H 109 105 106 109
CO2 {19 - 30} 23 22 25 26 23
Anion Gap {3 - 16} 11 8 10 8 8
Glucose {65 - 99} 89 82 72 82 78
BUN {6 - 21} 18 23 23 20 18
Creatinine {.71 - 1.18} 1.06 1.11 1.36 1.18 1.15
GFR by MDRD eq. {>60} >60 >60 54 >60 >60
Calcium {8.4 - 10.2} 9 8.9 9.5 9.2 8.9
Protein, Total {6.0 - 8.4} 6.8 6.8 7.2 6.8 7.5
Albumin {3.3 - 4.8} 4 4.3 4.5 4.1 4.5
Bilirubin, Total {.2 - 1.3} 0.7 0.6 0.4 0.7 0.9
Alkaline Phosphates {40 - 120} 92 156 114 122-H 108
ALT (SGPT) {12 - 61} 48 33 35 45 18
AST (SGOT) {16 - 50} 41 33 32 36 22
Ferritin {20 - 300}   16 - L 32 83 237
Folate {3 - 21}   >24 - H 17.5 24 - H 24 - H
Iron, Total Serum {49 - 181}   110 167 85 81
Magnesium {1.6 - 2.3}         2.2
Phosphorus {2.5 - 4.6}   3.3 3.2 3.2 3.5
Thyroid Stim Hormone {.45 - 4.67}   1.72 1.62 1.26 1
Cholesterol, Total {158 - 199}   117 - L 123 - L 109-L 114-L
Triglycerides {58 - 149}   100 142 110 108
HDL Cholesterol {40 - 75}   27 - L 29 - L 27 - L 29- L
VLDL Cholesterol (Calc.) {12 - 29}   20 28 22 22
LDL Cholesterol (Calc.) {
micheleladendorf
on 12/10/12 12:57 pm

interersted in the excell spreadsheetl; my email is: [email protected]

tks!

determineddanni
on 12/10/12 6:45 am

wow that is so little.... i honestly would try to order vitalady asap and maybe even ask her what she would suggest. i think she has a packet or something for people 'really' trying to get their numbers up.

 

also i am going to link my vit schedule just so you can get an idea of what you should be taking. (this is modified from vitalady's plan) each 3 months i have labs and also tweak

Morning:

@ 5:15am

1 Levothyroxine (generic Synthroid)-.112mg

@8am

2 Calcium-300mg each

1 E-400IU each

1 Multi Vitamin/Mineral

1 Zinc-50 mg each

1 K1-1,000mcg each

1 D3-50,000IU each

1 B9 (folic Acid) -1,200mcg sublingual each (exclude weekends)

1 B12-5,000mcg sublingual each (exclude weekends)

@9am

2 A-25,000IU each

 

Morning Total:

Levothyroxine (generic Synthroid) =.112mg

Calcium=600mg

E=400IU

Multi=1

Zinc=50mg

K1=1000mcg

D3=50,000IU

B9 (folic acid) =1,200mcg sublingual (exclude weekends)

B12=5,000mcg sublingual (exclude weekends)

A=50,000IU

 

Noon:

@11am

1 E-400IU each

2 Calcium-300mg each

1 Multi Vitamin/Mineral

2 D3-5,000IU each

1 Zinc-50 mg each

1 B Complex w/out B6 (exclude weekends)

@12pm

2 A-25,000IU each

 

Noon Total:

E=400IU

Calcium=600mg

Multi =1

D3-10,000IU

Zinc=50mg

B Complex (exclude weekends)

A=50,000IU

 

Evening:

@3pm

1 B1 (thiamin)-100mg sublingual each

2 C-500mg chewable each

1 K1-1,000 each

1 Copper-2mg each

1 E-400IU each

@4pm

2 A-25,000IU each

 

Evening Total:

B1 (thiamin) =100mg sublingual

C=1,000mg chewable

K1=1000mcg

Copper=2mg

E-400IU

A=50,000IU

 

Bedtime:

@6pm

2 A-25,000IU each

@10pm

2 Magnesium Citrate-150mg each

2 Calcium-300mg each

 

Bedtime Total:

A=50,000IU

Magnesium Citrate=300mg

Calcium=600mg

 

Total Daily:                                                                            

A (Vitalady Tender A [small yellowish capsule])                                                                       200,000UI            8 of 25k IU

D3 (Vitalady Tender D3 [white capsule])                                                                                 50,000UI              1 of 50k IU          

D3 (Vitalady Tender D3 [white capsule])                                                                                  10,000UI              2 of 5k IU

E (Vitalady Tender E [white capsule {feels gritty}])                                                                   1200IU                  3 of 400IU

K (Vitalady Tender K1 [small white/cream capsule])                                                               2000mcg              2 of 1000mcg

Calcium (Vitalady Tender Calcium elemental [blue capsule])                                               1800mg                6 of 300mg

Magnesium Citrate (Vitalady Tender Mag Cit elemental [white & green capsules])        300mg                   2 of 150mg

Zinc (Puritans Pride Zinc [white tablet])                                                                                      100mg                   2 of 50mg

Copper (Puritans Pride Copper [white/gray tablet])                                                                  2mg                       1 of 2mg

B-1 thiamin (Superior Source B1 [white round tablet-sublingual])                                        100mg                   1 of 100mg

B-9 folic acid (Superior Source B9 [small yellow tablet-sublingual]) (exclude weekends)1,200mcg             1 of 1,200mcg

B-12 (Superior Source B12 [small red tablet-sublingual]) (exclude weekends)                 5,000mcg             1 of 5,000mcg

B Complex (Desert Harvest B Complex w/out B6 [orange tablet]) (exclude weekends)    B’s 50mg              1 of B’s 50mg

C (Kirkland Vitamin C [chewable orange])                                                                                  1000mg                2 pill of 500mg

Multi Vitamin (Kirkland Multi Vitamin/Mineral-[large cream tablet])                                      MULTI                   2 of MULTI

HW 259          SW 256          CW 141       GW 150
             

micheleladendorf
on 12/10/12 12:54 pm

ty so much for taking the time to list your vit's and especially including brand names! i will know in the next 10 days what my numbers are. so little>? gosh i gag to get these all in and then i look at what others are taking and i feel like i am under supplemented for sure! dear lord, help me!

JazzyOne9254
on 12/11/12 8:07 am, edited 12/11/12 8:08 am

This is more like the RNY schedule I've seen from my program, but even they take more than what you're taking. and you are getting nowhere nearly enough protein -  your capacity is reduced, you can't eat enough and you're only drinking one shake a day?  Just from looking at your list, and knowing how the DS works, I would say your issues are symptoms of severe malnutrition.

Who did your surgery, and what hospital program are you in?  Don't mean to insult your surgeon, but he seems like one of those that I call  "cut and run" type of surgeons - they give you the surgery without any instruction on what you need to do to stay healthy.

Most Bariatric Centers of Excellence have a multidisciplinary program that goes along with their bariatric surgery patients - dietitians, PA's, support groups, free or discounted gym use, etc. Even though sometimes the dietitians don't have a clue... there's the vets on this board who can help you.

Vitalady has a package put together for bariatric patients who struggle with deficiencies.  It might seem pricey, but it will last you at least a couple months.  Once you learn what you need, you can shop around for the same vitamin at a lower price. I use a combination of Vitalady and what I've found in the same potency, but lower price elsewhere.

At this point, IMHO, you probably need to be on TPN and IV  vitamin and mineral therapy to build your body back up.

HW 405/SW 397/CW 138/GW 160  Do the research!  Check the stats!
The DS is *THE* solution to Severe Morbid Obesity!

    

Valerie G.
on 12/9/12 4:22 am - Northwest Mountains, GA

The first step is determining what all you're deficient in and address accordingly.  Are you taking all of the supplements your body requires, or have you been skating along and not paying attention?  If you've not been paying attention, then some schooling on what you need is necessary and some diligent effort, that may take up to a year to get you where you want to be.    Revisions are risky, so before you go that route, it should be considered a last resort.  Try a digestive enzyme to increase absorption first.  Many get the results they're looking for that way.  It's also important to learn how NOT to let this happen again.

Valerie
DS 2005

There is room on this earth for all of God's creatures..
next to the mashed potatoes

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