Long Post

I am the one they warn the newbies about! My DS was with Dr. Ungson in Jan.2006.  I loved him and got great care there.  When I got home, I did great for awhile.  The bad thing about surgery out of the country is no surgeon to see and no support group.  At the time, no surgeons in Houston did the DS.  There were cir****tances that led me to where I am now, but I only blame myself.  I have atrial fibrulation and I think my lack of adequate vitamins and protein has made it worse.  I lost my job 7 months ago and because of money (or lack of), I have been taking Walmart vitamins.  I am to the point where I'm really scared!  I have an appt with my pcp on 1/14 and have a list of labs I need her to do.  I may have to do battle but she will do them or I will find someone else.  What is the code for malnutrition?  Does anyone know if any of the surgeons in Houston who now do the DS will take on a patient who has already had surgery?  Please don't flame me!  I have done that so much to myself!  I also deal with depression and that has made me have a "who cares" attitude.  Well, I do care now and I hope it's not too late to turn this around.   Thanks in advance for any advise or help you have.  Ann

Hi, as I'm not in the US the only thing I can suggest is you take a look at this thread re getting vitamins on script http://www.obesityhelp.com/forums/DS/4439535/Getting-a-quots criptquot-for-your-vites-to-pay-from/#36710329

All the best.

Welcome Ann, Nothing there to be flamed about. That usually doesn't happen around here any more as far as I can tell. It sounds like you are on the right track to turn this around. You should consider this part of your support group. I had my DS in Cleveland, Ohio and very few Docs here do the DS (Actually only one that I know of) so there are very few people to talk to in real life and no specific DS support groups.

I've seen the code your talking about but don't remember it. You might look at vitalady.com or search for Dina McBrides web site. I think I saw some codes there once. It may have been worded something along the line of checking for vitamin deficiency and not strictly malnutrition.

Are you tracking your daily protein? It might be a good idea to post a few days in the vites and bites posting by MajorMom. She does a post every day. You can get a lot of good ideas about increasing protein. The same with your current level of vitamins. If you post what you are taking people can give you suggestions about how to prioritize adding things to your daily schedule. Hey, the worst they can say is that you need to add some things and I think you know that already. People may have ideas about lower cost viatamins or better vitamins than what you are currently taking.

I hope the labs turn out well but no matter what they will give you a starting point to work with.

Happy New Year,

Pete

My surgeon was useless for nutritional health, so you've come to the right place.  You can get the majority of your vitamins (Multi, Calcium Citrate, B, Zinc, C)  from Walmart.  You just need to know how much to take.  By all means, shop around town and find the BOGO deals.  My grocery store is best for those.  The dry versions of A, D, E and K are the pricier ones, but definitely essential.  I slide my annual labs in with my annual checkup and it's covered with zero copay with insurance, so if you're due for the annual physical, try that.  Your labs will help you get a start on how to guage what you want to take.

Val, I slide my labs in with my annual physical yearly too. My PCP is excellent about ordering what I want ordered. 

Walmart vutamins are ok you are probably not taking large enough doses many times a day not all at once. A lot of ppl use wakmarts calcium citrate 500 3 times a day. 

I have heard wonderful things about Dr. Adam Weinstein as a PCPO familiar with bariatric patients, but he now charges a yearly fee to use his practice. not sure how that works, but you may want to contact him.

http://www.primehcp.com/

Did you contact The Davis Clinic? If they will not take you on as a patient, ask them for for a referral.

There are many groups here that allow everyone in. You do not need to be a patient. What part of Houston are you in?? I'm sure you could go to the ones at the Davis Clinic if they are close to you. I'd like to start going again.

Pam has a lot of good information on her blog. Here is one on labs and codes:

http://pamtremble.blogspot.com/2008/10/labwork-recommendatio ns-after-wls.html

You won't really know where you're at until you get your labs back, though it sounds like you are expecting deficiencies. I agree with others about buying what you can locally. You should be able to find calcium citrate at places like Walmart and Costco and also at drug stores. B12 and zinc are also readily available (I get zinc really cheap at Grocery Outlet, just for example).

The really mportant vits to spend you limited funds on are the "dry" forms of the fat soluble vitamins, esp D, A, and K. Vitamin E deficiency is uncommon and less likely. It is difficult to find these locally, though I have seen post about buying them at places like GNC. Most of us order them from Vitalady, with her brand being slightly less expensive than the manufacturer's brand. Amazon might also be a good place to look. Just be sure to get the "dry" form, and remember that prescription Vitamin D, which your pcp might try to order for you meaning to be helpful, is packaged in oil and you won't absorb it well.

the other really important thing is protein. If you are protein deficient, it will be difficult, if not impossible, to correct any vitamin deficiencies until you get your protein back up to normal. So start taking protein supplements if you haven't already. You should be able to find protein products at any health product place, plus Walmart, Costco, all the usual places. Trader Joes has a protein drink with 35 gms of protein that isn't half bad (not great, but not half bad either).

And see if your pcp would also give you something for the depression, or refer you to someone who can help with that. The fact that you care now is a good sign, but depression is mierable and being emotionally stronger will help you to deal successfully with everything else.

Larra

Thank you to everyone *****plied with great information!  I will see my pcp on the 14th with a list of labs I need done and my daughter looked up the codes for malnutrition for me.  She is a registrar at a local hospital and she has an app on her iphone to look them up. For severe malnutrition NOS it is 261 and for malnutrition due to GI surgery it is 579.3.  Which one do I need to use?  And Laura, I am in Alvin, south of Houston.  I will call the Davis group and see what they say. Thank you.  I even was going to try Overeaters Anonymous just to have a support group, but the one in Alvin stopped meeting over a year ago!