I am pregnant again!
Hello everyone,i have not posted in a few months,last time i said i was pregnant,then shortly after i had a miscarriage,and i was DEVASTATED!Anyways its been about 3 months and i am pregnant again!I am praying that this time goes well,i am about 6 weeks,last time i was 8 weeks at miscarriage,but my levels are looking good so far and i am optamistic.I am having sort of an issue i wanted to ask about .Ever since my surgery(RNY) i have Not really ever had a constipation problem the last few weeks i have,i am trying to increase my fluids etc.,and asking my doctor what i can take if anything,IS this a hormone thing?Has anyone elso had this happen?Also did anyone find it difficult to get enough nourishment during thier pregnancies?I know this maybe shouldve gone on the post op pregnancy forum but i have always had more luck getting responses on this one.Thanks in advance for any advice or info.
Julie
Congratulations Julie! I hope things go smoothly ths time. I have had several miscarriages and even a stillborn birth so I know how devastating it is. My heart goes out to you! As far as the constipation, other than a high fiber diet and increasing your water intake and exercise, I would only take your OB docs advise on this considering your history. Do not take anything unless he/she says it's safe to do so.
Good luck to you! BTW, you look amazing! What a transformation you have gone through with this surgery!!!
Hugs,
Amy
Congrats to you, Julie!
Are you taking the prenatal vitamins yet? Although my babies are 18 and 16 years old, I still remember those huge vitamins. I think they have alot of iron in them which can lead to constipation, too. Maybe something like a few dried apricots would help.
Good luck on your wonderful journey,
Susan
Claire 
Julie:
Hello!
I have never been pregnant but here are links/sites/articles/group info I have on WLS/Pregnancy, followed by my info on constipation that is a real s/e of wls for me since early on....and possible remedies *make sure safe for you and baby ok!*.. Be well, keeping you in thoughts/prayers 
Now I would recommend seeing your WLS surgeon, clinical nutrition MD and a HIGH RISK OBGYN who has had RNY'ers as pts, if you can't find one ask other postops at support group your surgeon etc for a referral! Just my 2 coppers! LOL 
Here are a few groups for support if interested!
http://groups.yahoo.com/group/OSSG-pregnant/
http://health.groups.yahoo.com/group/OSSG-breastfeeding/
http://groups.yahoo.com/group/ossg-pregnancy-grads/
http://www.obesityhelp.com/forums/postop_pregnancy/
HERE IS A GOOD ARTICLE ON PREGNANCY AFTER WLS:Pregnancy Following Gastric Bypass for Morbid Obesity. Wittgrove AC, Jester L,
Wittgrove P & Clark GW. Obesity Surgery 8, 1998:461-464.
Found this at: http://www.gastricbypass.com/images/GBP%20-%20Pregnancy.pdf
******************
Worth the Weight Pregnancy After Gastric Bypass Surgery
from Advance Newsmagazine for Nurse Practitioners
Vol. 13 ?Issue 11 ? Page 45
Worth the Weight
Pregnancy After Gastric Bypass Surgery
By Joy Burt, NP
http://nurse-practitioners.advanceweb.com/common/EditorialSearch/printerfriendly.aspx?AN=N
P_05nov1_npp45.html&AD=11-01-2005
*******************
Is it Dangerous for the Bariatric Surgical Patient to Conceive?
Cynthia Buffington, Ph.D.
Beyond Change, January 2004
http://www.bbvitamins.com/research_Article_3.aspx
Patient Perspective:
Pregnancy After Bariatric Surgery--A Happy, Healthy Ending
- by Robin Roginski
http://www.bariatrictimes.com/displayArticle.cfm?articleID=article74
http://www.gastricbypass.com/Gastric%20Bypass-for%20Doctors%20Only.htm
(SNIP) Side Effects
Exclusion of the pylorus leads to increased symptoms of Dumping Syndrome, which are related to ingestion of foods with a high osmotic load, particularly sugars. Since these foods are undesirable in the weight-control patient, dumping provides negative feedback to limit undesired behavior, and is not considered to be a liability. The rare patient who exhibits dumping symptoms, or reactive hypoglycemia, with other foods should be carefully evaluated for insulinoma. Glucose Tolerance Testing is contra-indicated following Gastric Bypass: results will be spurious and uninterpretable, due to the altered anatomy and physiology, and dangerous hypoglycemic reactions, as well as severe dumping syndrome, can occur with ingestion of a large glucose meal. (SNIP)
~~~~~~~~~~~
CONSTIPATION
Constipation can be from so many things including BUT not limited to:
~1) FLUIDS: simply from not getting in enough fluids...
So first before you do anything ask yourself? Am I drinking at least 64 oz a day (8 cups)...If not try increasing and see if this helps. Look at this neat hydration calculator! It may open your eyes! It says I need 117.5 oz day (I do get that too still not enough for me!) http://nutrition.about.com/library/blwatercalculator.htm
~2) EXERCISE: Get moving! I do 30-60 min cardio a day + wts. Yes it helps! Start somewhere! Something is better than nothing!
~3) FIBER: We get constipated because our diet is now volume in general & lower in fiber especially due to lack of tolerance also (less fruits and veggies).
So many try increasing fiber by using benefiber (non swelling/no taste) or some like liquifiber at Vitalady: http://tinyurl.com/5edxn I have used Metamucil caps in past but I DO NOT RECOMMEND it is a SWELLING FIBER & may NOT be good for pouchie! ***We do not want to stretch it!!!
I swear by Flax Seed ground. I get mine here: http://www24.netrition.com/now_flaxseeds_page.html
I started with 1T ground a day (in yogurt, shakes or on my salad it has slightly nutty flavor) now I am up to 1T three times a day. The benefits of flax are so much more than just for fiber!!! Read for more info! http://www.flaxcouncil.ca/flaxnut10.htm (A lower risk for heart disease, Prevention of some forms of cancer, Treatment of immune disorders, Diabetes helps in stabilizing Blood Sugars, Relief from constipation) http://www.flaxcouncil.ca/faq.htm You can also buy it in GNC, health food stores, Wal-Mart has it in vitamin aisle and baking aisle. KEEP refrigerated for longest shelf life and so it doesn't go rancid! It has to be ground (bought that way or ground in Magic Bullet or a small coffee grinder for the benefit ok!)
~4) OTHER NUTRITIONAL/SUPPLIMENT CAUSES: Higher protein (in diet and shakes), Calcium Citrate (form we need to absorb after bypass), Iron supplementation can all add to the constipation scenario postop (things we need!).
Different forms of Iron are more constipating than others (Ferrous sulfate for instance AVOID!!! Many feel carbonyl iron like vitalady's tender iron http://tinyurl.com/3ve5x , ferrous gluconate *I get OTC at Wal-Mart just ask pharmacist, ferrous fumarate, polysaccharide iron are less constipating).
Another solution Magnesium: HERE IS JULIA Z's recommendation: Magnesium as magnesium citrate or amino acid chelate 400-1000 mg a day. OK to take with calcium but not with iron. Can be taken all at once or throughout the day. Start out with 200 mg and increase dosage every few days until the desired level is reached; decrease dosage slightly if loose stools result. Preferred dosage is 1 part elemental magnesium to 2 parts elemental calcium or 1000 mg magnesium to 2000 mg calcium, but this ratio is not accurate for each person. Increasing the dosage until you get loose stool and than backing off a little seems to work best for most people.
IF still NO GO: my surgeon recommended Colace. It is an over-the-counter stool softener. Try it once a day and increase to 2-3x if needed. (It is cheap too, buy the generic brand, docusate sodium)...
If this is ineffective, my surgeon said I could use a gentle suppository (such as glycerin, ducolax or the generic form)....only to get things going, they can get habit forming so be careful. It is always best to ask your surgeon or MD about his but this is what I have been told. I use Colace 2x a day, it does help (with my flaxseed)
I also have used Milk OF Magnesia a few times week if needed.
My Clinical Nutrition/Bariatric MD prescribed Miralax (generic is glycolax) works great also (I used a few times in severe cases w/ some bloating but no taste!, it is a powder mixes in water great!) They say can be used long-term! (BUT I am cheap rather find a non prescription way!)
Many swear by Smooth move tea, it is just senna in a tea (you can buy senna tabs OTC also called SENOKOT Tablets: Each tablet contains 8.6 mg sennosides.). Or ingredient in: PERI-COLACE® TABLETS (Purdue Products)
docusate sodium and standardized senna concentrate (so is a stool softener and laxative in one!) http://www.tealand.com/SmoothMove.asp BY: Traditional Medicines in Health food, Wal-Mart of many health food aisles of grocery stores!
Contents: Active Ingredient: 20mg. Sennosides A & B per cup from senna leaf. Other herbal ingredients: Licorice root, fennel seed, orange peel, cinnamon bark, coriander seed, ginger rhizome, natural orange flavor. Directions for use: Pour 8 oz. of boiling water over one tea bag and steep, covered, for 10-15 minutes. Adults and children over 12 years: Drink 1 cup before bedtime. If necessary, repeat the next day not to exceed 4 cups in 24 hours.
A few prunes (3) also have helped me in a pinch...few times a week (watch cal/carbs)...Some gain w/ carbs/sugar or get triggered hunger! It has been ok w/ me as it is seen as medicine and used accordingly!
Just my thoughts/ideas! I do Exercise/Water/Colace 2 day/Flaxseed 3T total a day and it generally is ok, only needing MOM 1x week or 3 prunes 1-2x week! J
~~~~~~~~~
Take Care,
Jamie
100cm proximal Lap RNY 10/9/02 Dr. Singh Albany, NY
320(preop)/163 (lowest)/174 (current) 5'9'' (lost 45# before surgery)
Plastics 6/9/04 & 11/11/2005 Dr. King www.albanyplasticsurgeons.com
http://www.obesityhelp.com/member/jamiecatlady5/
"Being happy doesn't mean everything's perfect, it just means you've decided to see beyond the imperfections!"
Hello!
I have never been pregnant but here are links/sites/articles/group info I have on WLS/Pregnancy, followed by my info on constipation that is a real s/e of wls for me since early on....and possible remedies *make sure safe for you and baby ok!*.. Be well, keeping you in thoughts/prayers
Now I would recommend seeing your WLS surgeon, clinical nutrition MD and a HIGH RISK OBGYN who has had RNY'ers as pts, if you can't find one ask other postops at support group your surgeon etc for a referral! Just my 2 coppers! LOL
Here are a few groups for support if interested!
http://groups.yahoo.com/group/OSSG-pregnant/
http://health.groups.yahoo.com/group/OSSG-breastfeeding/
http://groups.yahoo.com/group/ossg-pregnancy-grads/
http://www.obesityhelp.com/forums/postop_pregnancy/
HERE IS A GOOD ARTICLE ON PREGNANCY AFTER WLS:Pregnancy Following Gastric Bypass for Morbid Obesity. Wittgrove AC, Jester L,
Wittgrove P & Clark GW. Obesity Surgery 8, 1998:461-464.
Found this at: http://www.gastricbypass.com/images/GBP%20-%20Pregnancy.pdf
******************
Worth the Weight Pregnancy After Gastric Bypass Surgery
from Advance Newsmagazine for Nurse Practitioners
Vol. 13 ?Issue 11 ? Page 45
Worth the Weight
Pregnancy After Gastric Bypass Surgery
By Joy Burt, NP
http://nurse-practitioners.advanceweb.com/common/EditorialSearch/printerfriendly.aspx?AN=N
P_05nov1_npp45.html&AD=11-01-2005
*******************
Is it Dangerous for the Bariatric Surgical Patient to Conceive?
Cynthia Buffington, Ph.D.
Beyond Change, January 2004
http://www.bbvitamins.com/research_Article_3.aspx
Patient Perspective:
Pregnancy After Bariatric Surgery--A Happy, Healthy Ending
- by Robin Roginski
http://www.bariatrictimes.com/displayArticle.cfm?articleID=article74
http://www.gastricbypass.com/Gastric%20Bypass-for%20Doctors%20Only.htm
(SNIP) Side Effects
Exclusion of the pylorus leads to increased symptoms of Dumping Syndrome, which are related to ingestion of foods with a high osmotic load, particularly sugars. Since these foods are undesirable in the weight-control patient, dumping provides negative feedback to limit undesired behavior, and is not considered to be a liability. The rare patient who exhibits dumping symptoms, or reactive hypoglycemia, with other foods should be carefully evaluated for insulinoma. Glucose Tolerance Testing is contra-indicated following Gastric Bypass: results will be spurious and uninterpretable, due to the altered anatomy and physiology, and dangerous hypoglycemic reactions, as well as severe dumping syndrome, can occur with ingestion of a large glucose meal. (SNIP)
~~~~~~~~~~~
CONSTIPATION
Constipation can be from so many things including BUT not limited to:
~1) FLUIDS: simply from not getting in enough fluids...
So first before you do anything ask yourself? Am I drinking at least 64 oz a day (8 cups)...If not try increasing and see if this helps. Look at this neat hydration calculator! It may open your eyes! It says I need 117.5 oz day (I do get that too still not enough for me!) http://nutrition.about.com/library/blwatercalculator.htm
~2) EXERCISE: Get moving! I do 30-60 min cardio a day + wts. Yes it helps! Start somewhere! Something is better than nothing!
~3) FIBER: We get constipated because our diet is now volume in general & lower in fiber especially due to lack of tolerance also (less fruits and veggies).
So many try increasing fiber by using benefiber (non swelling/no taste) or some like liquifiber at Vitalady: http://tinyurl.com/5edxn I have used Metamucil caps in past but I DO NOT RECOMMEND it is a SWELLING FIBER & may NOT be good for pouchie! ***We do not want to stretch it!!!
I swear by Flax Seed ground. I get mine here: http://www24.netrition.com/now_flaxseeds_page.html
I started with 1T ground a day (in yogurt, shakes or on my salad it has slightly nutty flavor) now I am up to 1T three times a day. The benefits of flax are so much more than just for fiber!!! Read for more info! http://www.flaxcouncil.ca/flaxnut10.htm (A lower risk for heart disease, Prevention of some forms of cancer, Treatment of immune disorders, Diabetes helps in stabilizing Blood Sugars, Relief from constipation) http://www.flaxcouncil.ca/faq.htm You can also buy it in GNC, health food stores, Wal-Mart has it in vitamin aisle and baking aisle. KEEP refrigerated for longest shelf life and so it doesn't go rancid! It has to be ground (bought that way or ground in Magic Bullet or a small coffee grinder for the benefit ok!)
~4) OTHER NUTRITIONAL/SUPPLIMENT CAUSES: Higher protein (in diet and shakes), Calcium Citrate (form we need to absorb after bypass), Iron supplementation can all add to the constipation scenario postop (things we need!).
Different forms of Iron are more constipating than others (Ferrous sulfate for instance AVOID!!! Many feel carbonyl iron like vitalady's tender iron http://tinyurl.com/3ve5x , ferrous gluconate *I get OTC at Wal-Mart just ask pharmacist, ferrous fumarate, polysaccharide iron are less constipating).
Another solution Magnesium: HERE IS JULIA Z's recommendation: Magnesium as magnesium citrate or amino acid chelate 400-1000 mg a day. OK to take with calcium but not with iron. Can be taken all at once or throughout the day. Start out with 200 mg and increase dosage every few days until the desired level is reached; decrease dosage slightly if loose stools result. Preferred dosage is 1 part elemental magnesium to 2 parts elemental calcium or 1000 mg magnesium to 2000 mg calcium, but this ratio is not accurate for each person. Increasing the dosage until you get loose stool and than backing off a little seems to work best for most people.
IF still NO GO: my surgeon recommended Colace. It is an over-the-counter stool softener. Try it once a day and increase to 2-3x if needed. (It is cheap too, buy the generic brand, docusate sodium)...
If this is ineffective, my surgeon said I could use a gentle suppository (such as glycerin, ducolax or the generic form)....only to get things going, they can get habit forming so be careful. It is always best to ask your surgeon or MD about his but this is what I have been told. I use Colace 2x a day, it does help (with my flaxseed)
I also have used Milk OF Magnesia a few times week if needed.
My Clinical Nutrition/Bariatric MD prescribed Miralax (generic is glycolax) works great also (I used a few times in severe cases w/ some bloating but no taste!, it is a powder mixes in water great!) They say can be used long-term! (BUT I am cheap rather find a non prescription way!)
Many swear by Smooth move tea, it is just senna in a tea (you can buy senna tabs OTC also called SENOKOT Tablets: Each tablet contains 8.6 mg sennosides.). Or ingredient in: PERI-COLACE® TABLETS (Purdue Products)
docusate sodium and standardized senna concentrate (so is a stool softener and laxative in one!) http://www.tealand.com/SmoothMove.asp BY: Traditional Medicines in Health food, Wal-Mart of many health food aisles of grocery stores!
Contents: Active Ingredient: 20mg. Sennosides A & B per cup from senna leaf. Other herbal ingredients: Licorice root, fennel seed, orange peel, cinnamon bark, coriander seed, ginger rhizome, natural orange flavor. Directions for use: Pour 8 oz. of boiling water over one tea bag and steep, covered, for 10-15 minutes. Adults and children over 12 years: Drink 1 cup before bedtime. If necessary, repeat the next day not to exceed 4 cups in 24 hours.
A few prunes (3) also have helped me in a pinch...few times a week (watch cal/carbs)...Some gain w/ carbs/sugar or get triggered hunger! It has been ok w/ me as it is seen as medicine and used accordingly!
Just my thoughts/ideas! I do Exercise/Water/Colace 2 day/Flaxseed 3T total a day and it generally is ok, only needing MOM 1x week or 3 prunes 1-2x week! J
~~~~~~~~~
Take Care,
Jamie
100cm proximal Lap RNY 10/9/02 Dr. Singh Albany, NY
320(preop)/163 (lowest)/174 (current) 5'9'' (lost 45# before surgery)
Plastics 6/9/04 & 11/11/2005 Dr. King www.albanyplasticsurgeons.com
http://www.obesityhelp.com/member/jamiecatlady5/
"Being happy doesn't mean everything's perfect, it just means you've decided to see beyond the imperfections!" Most Active
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