My 3yr surgiversary..
Sax,
Not unlike RnY folks, our supplement regime varies by individual, and SOP for a DSer is to base these decisions on lab results.
However, the basics are that we get in 100g of protein per day, via food or supplementation. Why 100g? Because the standard for non-WLS folks is 50g, and as a DSer, we malabsorb 50% of our protein, thus we need to get double the RDA. For me, I get in more than 100g. It is a personal choice, based on labs, listening to my body, and that I am very conscientious about muscle mass. I eat protein first, complex carbs next, and then whatever I want if there is room left (note: this is not me saying that I in anyway gorge, encourage people to gorge, or brag that I can -- it is simply my reality). Protein, 64oz of water, and supplementation as dictated by labs. It is really simple!
In addition, we mababsorb 80%+ of fat, so fat soluble vitamins (A/D/E/K) need to be especially monitored, and many of us supplement these. Again, personally, my labs only dictate that I supplement A & D right now, and while I watch the others closely, almost one year out my multi-vitamin seems to be covering it. Along with these, because of the close association with D & Calcium, Calcium Citrate is a high priority.
With the 80%+ malabsorption of fat, we *need* to make sure that fat is a daily part of our diet. Fat is not only necessary for the body to function, it is really nice not to have to deal with constipation. For some reason, many people consider what we eat and label us with not taking care of ourselves, deciding on this surgery choice so we can continue to feed our addiction to fat, gorging on fat, bragging about what we eat, etc... I have been the brunt of a lot of that the last couple of days by this very *support* forum. Like any other sub-set of the population, there are those of us that are compliant, those of us that aren't, and most of us somewhere in between. Bottom line is, I eat what I need to now to fuel my body and obtain the best possible overall health, and the way I feel and my labs are the proof -- this is a HUGE change for me, and my WLS made it all possible.
For me, I take: dry A, dry D, a multi, a prenatal, Calcium Citrate, Magnesium, and Zinc. What I anticipate may need to be added based upon other DSer's experiences: Iron, Copper, Potassium, E, and K. But, like I said, I watch my labs closely, and they are fantastic. Actually, much better than they were pre-op. I didn't get sliced open and have my anatomy re-arranged not to take care of myself now that I have been given this new opportunity.
For more information on the DS, here are some really great sources:
www.dsfacts.com
www.duodenalswitch.com
www.dshess.com
Not unlike RnY folks, our supplement regime varies by individual, and SOP for a DSer is to base these decisions on lab results.
However, the basics are that we get in 100g of protein per day, via food or supplementation. Why 100g? Because the standard for non-WLS folks is 50g, and as a DSer, we malabsorb 50% of our protein, thus we need to get double the RDA. For me, I get in more than 100g. It is a personal choice, based on labs, listening to my body, and that I am very conscientious about muscle mass. I eat protein first, complex carbs next, and then whatever I want if there is room left (note: this is not me saying that I in anyway gorge, encourage people to gorge, or brag that I can -- it is simply my reality). Protein, 64oz of water, and supplementation as dictated by labs. It is really simple!
In addition, we mababsorb 80%+ of fat, so fat soluble vitamins (A/D/E/K) need to be especially monitored, and many of us supplement these. Again, personally, my labs only dictate that I supplement A & D right now, and while I watch the others closely, almost one year out my multi-vitamin seems to be covering it. Along with these, because of the close association with D & Calcium, Calcium Citrate is a high priority.
With the 80%+ malabsorption of fat, we *need* to make sure that fat is a daily part of our diet. Fat is not only necessary for the body to function, it is really nice not to have to deal with constipation. For some reason, many people consider what we eat and label us with not taking care of ourselves, deciding on this surgery choice so we can continue to feed our addiction to fat, gorging on fat, bragging about what we eat, etc... I have been the brunt of a lot of that the last couple of days by this very *support* forum. Like any other sub-set of the population, there are those of us that are compliant, those of us that aren't, and most of us somewhere in between. Bottom line is, I eat what I need to now to fuel my body and obtain the best possible overall health, and the way I feel and my labs are the proof -- this is a HUGE change for me, and my WLS made it all possible.
For me, I take: dry A, dry D, a multi, a prenatal, Calcium Citrate, Magnesium, and Zinc. What I anticipate may need to be added based upon other DSer's experiences: Iron, Copper, Potassium, E, and K. But, like I said, I watch my labs closely, and they are fantastic. Actually, much better than they were pre-op. I didn't get sliced open and have my anatomy re-arranged not to take care of myself now that I have been given this new opportunity.
For more information on the DS, here are some really great sources:
www.dsfacts.com
www.duodenalswitch.com
www.dshess.com
~ I am the proud wife of a Guatemalan, but most people call me Kimberley
Highest Known Weight = 370# / 59.7 bmi @ 5'6"
Current Weight = 168# / 26.4 bmi : fluctuates 5# either way @ 5'7" / more than 90% EWL
Normal BMI (24.9) = 159#: would have to compromise my muscle mass to get here without plastics, so this is not a goal.
I 
my DS. Don't go into WLS without knowing ALL of your options: DSFacts.com
Sorry it took me so long to answer. Had to go to work..
Kim has pretty much answered your questions. One thing I would liek to point out is it is not a matter of ingesting more caleroies. Instead it is a matter of eating more protein. Like everyone else our bodies become more efficient with managing this and we can gain if we overdue it. Anyone can beat any WLS if they try hard enough. Part of the post-op process is to relearn to eat properly. The tool of WLS enables us to lose and have time to do this. But again anyone can outsmart it if they want to.
Supplements do vary by doc and patient but my own regime consists of twice a day.. A daily vitamin, Omega 3, Dry Vit D 10,000 mgs (Bariatric Advantage) Dry Vit A&D (Twin Labs) B Complex, 3 Citricals, & B-Sublingual (my B was low even pre-op)
For the most part my labs have been fine but we tweaked the D once and the Dry A&D. In March I was diagnosed with Rheumatoid arthritis and that has affected some of my labs due to the meds I have to take to manage the pain.
Before spmeone jumps in about the arthritis be careful as there are several types of arthritis. Osteo-arthritis being the most common and then there's rheumatoid. It is known that many WLS post-op patients if not compliant -even sometimes even if they are- will develop ostearthritis. The proof of that is seen on the following Yahoo group:
[email protected]
So far the same correlation has not been made with Rheumatoid Arthritis. SO I am just one of the lucky ones to get this disease.
Kim has pretty much answered your questions. One thing I would liek to point out is it is not a matter of ingesting more caleroies. Instead it is a matter of eating more protein. Like everyone else our bodies become more efficient with managing this and we can gain if we overdue it. Anyone can beat any WLS if they try hard enough. Part of the post-op process is to relearn to eat properly. The tool of WLS enables us to lose and have time to do this. But again anyone can outsmart it if they want to.
Supplements do vary by doc and patient but my own regime consists of twice a day.. A daily vitamin, Omega 3, Dry Vit D 10,000 mgs (Bariatric Advantage) Dry Vit A&D (Twin Labs) B Complex, 3 Citricals, & B-Sublingual (my B was low even pre-op)
For the most part my labs have been fine but we tweaked the D once and the Dry A&D. In March I was diagnosed with Rheumatoid arthritis and that has affected some of my labs due to the meds I have to take to manage the pain.
Before spmeone jumps in about the arthritis be careful as there are several types of arthritis. Osteo-arthritis being the most common and then there's rheumatoid. It is known that many WLS post-op patients if not compliant -even sometimes even if they are- will develop ostearthritis. The proof of that is seen on the following Yahoo group:
[email protected]
So far the same correlation has not been made with Rheumatoid Arthritis. SO I am just one of the lucky ones to get this disease.
sorry to hear about the rheumatoid arthritis. I have psoriatic arthritis, somewhat similar to rheumatoid as its an autoimmune disease. I don't know where I'd be without the biologics they have now. I was on enbrell for 7 years and just switched to humira. Are you doing methotrexate, a biologic, comboination or something else? I've just never had issues with my blood work from those two. With the biologics I have kept everything in check, that was probably one of my biggest pre-op fears, "what if I flare up." Always worry about that -- did you have to do any steroid treatments to calm things down after that first diagnosis? Maybe a conversation more appropriate for pm's rather than the board, sorry if it is
--Sax
--Sax
Sorry I didn't answer sooner. I had to do some dumb thing like go to work 
If you read Pam's last post you pretty much have your answer. However I will say it is not so much a matter of eating more calories as it is maintaining the protein levels. In fact Dr Hares support group often discusses how we should not over due it in the fats department. Nor the carbs as our bodies become more efficient, the further post-op we are, we can like anyone else gain. However for the most part it is minimal and less. All these procedures are a tool. They are not the answer. We need to use our tools properly.
As far as supplements/vitamins go again Pam said it right as it depends on our labs but to begin with Dr Hares reccommends taking twice a day 10,000 mgs of Dry Vita D, (Bariatric Advantage) a multiple vitamin, Citrical, and Dry A&D from Twin Labs, B-Complex also Omega 3 ( I take 3 1200 units but I forget what the original reccommended amt was.) From there your labs will determine any modifications needed.
My labs have been in normal range all along. The only adjustments have been to up my D and also add B-sublingual as my B was low even prior to surgery .
Unfortunately this past March I became afflicted with rheumatoid arthritis and the meds are now affecting my iron (just found that out last month) so it is looking like I may need an iron infusion. BUT this is not WLS related. My arthritis doc says it is normal with this chronic disease. I hate to imagine how much more diffuicult managing this would be if I were at my pre-surgical weight.
Now before everyone jumps in about the arthritis .. Yes I have seen and in fact there is a Yahoo board about how osteo-arthritis is sometimes a part of post-op WLS. Osteo & Rheumatoid arthritis are 2 very different creatures.
If you read Pam's last post you pretty much have your answer. However I will say it is not so much a matter of eating more calories as it is maintaining the protein levels. In fact Dr Hares support group often discusses how we should not over due it in the fats department. Nor the carbs as our bodies become more efficient, the further post-op we are, we can like anyone else gain. However for the most part it is minimal and less. All these procedures are a tool. They are not the answer. We need to use our tools properly.As far as supplements/vitamins go again Pam said it right as it depends on our labs but to begin with Dr Hares reccommends taking twice a day 10,000 mgs of Dry Vita D, (Bariatric Advantage) a multiple vitamin, Citrical, and Dry A&D from Twin Labs, B-Complex also Omega 3 ( I take 3 1200 units but I forget what the original reccommended amt was.) From there your labs will determine any modifications needed.
My labs have been in normal range all along. The only adjustments have been to up my D and also add B-sublingual as my B was low even prior to surgery .
Unfortunately this past March I became afflicted with rheumatoid arthritis and the meds are now affecting my iron (just found that out last month) so it is looking like I may need an iron infusion. BUT this is not WLS related. My arthritis doc says it is normal with this chronic disease. I hate to imagine how much more diffuicult managing this would be if I were at my pre-surgical weight.
Now before everyone jumps in about the arthritis .. Yes I have seen and in fact there is a Yahoo board about how osteo-arthritis is sometimes a part of post-op WLS. Osteo & Rheumatoid arthritis are 2 very different creatures.
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