As many of us are aware, it is common for us post-ops to order Flagyl (Metronidazole) from reliable online suppliers of fish antibiotics to treat our occasional bacterial c. difficile ("c. diff.") intestinal infections b/c it is cheap(er) (well, used to be ) than from "people" pharmacies. More importantly, no prescription is required . I myself have always ordered from a major particular supplier of fish and bird antibiotics located in Utah.

Very unfortunately, we customers of the supplier in Utah recently received a group email from the company informing us that, until further notice, their company will not be able to fill any orders for any fish antibiotics. After further inquiry, turns out that our F.D.A. has sent warnings letters out to the manufacturers of fish antibiotics ordering them to cease and desist in doing so. Although I have not been able to ascertain the precise reason for the letters (nor seen a copy of the actual letter) I have a hunch the motivation behind the F.D.A.'s action is that such "veterinary" antibiotics are, for the most part, being ordered and used by persons for "human consumption" rather than for fish (or birds, etc.), in contravention of the instructions on the bottles of such products. If so, then sounds like that route is now foreclosed to those of us who are in need of Flagyl. This basically means that whenever we need the med in the future we will need to present to our doctors to get a script for same, assuming we can convince them why we need it. A DS surgeon would understand the need, but I'm not sure a non-WLS doc would.

Anyway, has anyone else heard about this matter, or can shed some more light on what is going on here?

I already posted this over in one of the gastric bypass forums, but you all tend to have such good advice that I thought I would post here too.

My mom had gastric bypass a few months ago. Her doctor wanted her to have it because she was Type 2 diabetic and in danger of a lot of other health issues that would be solved by losing weight. She is 69 years old. Things were going well at first - she felt well, she was able to eat as needed, and was losing the weight. She is about 5'5" and I'm not sure about her current weight, but she's lost quite a bit and can now fit into like size large in women's (she was at a 2XL or 3XL before).

But recently she has become very weak and has fallen several times (which is dangerous at her age). She went in to the doctor and they were initially convinced based on scans and blood work that she she had fatty liver that had advanced to cirrhosis, and they said it was Stage 3 cirrhosis (and that her only hope for survival would be a liver transplant). The doctor also told her that she was severely malnourished, comparing her to starving kids in other countries. He said that was the cause of her weakness, along with the liver issues.

A biopsy was done on her liver and she's Stage 1 of fatty liver, which means she can turn it around with diet and exercise, and we're all very happy about that. However, she is still extremely malnourished. The doctor's solution was that she eat more protein. She has been focused on doing so ever since her surgery; now she is trying to up her intake even further. And despite trying to get as much protein as she can, her last blood work showed that her protein is at a 2, which is apparently really bad.

So a couple of questions for you - Have you heard of anyone going through something similar to this? What did they do to improve their nutrition and overall health? (Because at this point the doctor is now recommending undoing the surgery so that she can absorb protein better, but I don't want my elderly mother to undergo surgery again.)

How can she up her protein? She is already eating large amounts of protein at every meal and snacking on it throughout the day. She is also eating plenty of vegetables. I know you're not supposed to get your protein from drinking, but would that be helpful here? Just to make sure that she's getting enough? And how many grams of protein should she be eating a day?

What kind of vitamins should she be taking, and at what dosage? She is very low on like Vitamin D and B, and assures me that she's taking OTC vitamins that her doctor recommended. I know that's not good enough if you have absorption issues and gastric bypass, and I also know that doctors' recommendations (especially those who don't focus on bariatrics) often recommend way below what is needed. (Her vitamin levels are bad enough that the doctor wrote her a prescription for vitamins to take once a week.)

Any and all advice/help/suggestions would be most welcome. Thank you!

suggest eating normal fat intake, don't drink the stuff, but don't go low fat. When DSers consume drastic high fats the potential for enteric hyperoxaluria is pretty high. Unless you have 24 hr urine for stones as part of your yearly lab work.. those who don't won't know till they get stones or kidney disease

I've done a couple of ds surgeries. Now I want to start again. papa's games

Hi, I also had my surgery with Dr Lutryzkowski 02/11/2000 and I'm sorry to be the one to tell you, Doc passed away, I have been searching for another Dr that is familiar with this surgery. My vitamin levels are wayyy out of whack. 24 years ago he changed my life completely, for the absolute better. Just found this site and am hopeful for any help I can find.