Carafte, iron and food - on my!

I'm really just here to vent. I had an endoscopy and colonoscopy on friday as I was passing a sizable portion of blood for few days (yeah, that's scary thing). The good news is, it's nothing terribly serious, just an ulcer. Doctor isn't too worried, and gave me a regimen of pills to clear things up. That's the bad news.

I am almost 2 years post-op and have a pretty set schedule of food that has been quite effective for me to maintain my weight in maintenance, and this carafate is completely screwing that up. I tend to eat a number of small/meals and snacks throughout the day, but it's impossible with the carafate restrictions. I can't take it for an hour after my iron, which I like to take first thing in the morning, so I can get it in, then wait before I have my coffee so as not to mess with the iron absorption. But now I have to work the carafte in as well. So annoying.

I've actually gone to setting my alarm for the wee hours of the morning to take my carafate 2 hours before i get up, so I can still take my iron first thing, and still get in coffee and breakfast.

But then I tend to eat every 2-3 hours, which I am going to just have to abandon as the cafate 4x a time messes with that.

And I have to take all of this for like 2 months. Grrrr......

I probably shouldn't complain, I'm just 3 days in a frustrated.

Another interesting fact is that he noted that me opening for my RNY was really, really small, which we had sort of expected given some symptoms I'd had since surgery. He actually thinks I've had this ulcer for some time and clearing it up could actually give me some more space. He thinks I might feel better and put on a few pounds (which he is in support of - I am not!).

Interesting !

Sorry about the complication. Hopefully a speedy couple months for you. I hope you feel better and get used to your new routine without much disruption.

That does sound nightmarish.... and gaining weight? Nobody wants that.

That Carafate is a PITA with our usual eating schedule. My GI basically looked at my schedule and agreed that I should just take it overnight. Dropping some of the "extra" meals and trying to fit more in on fewer meals will probably lead you to some additional weight loss (assuming that you don't change things over to more crap!) which you may or may not need - I certainly didn't.

For the sake of curiousity, was the ulcer around the anastomosis as is common with the RNY, or elsewhere (though I guess that it can't be too far away with our small stomachs!)

That's exactly where it was.

Thats is pretty much my thought exactly - that I might end up losing more weight. I eat like 5-6 times a day (at least) in order to maintain my weight. I don't see hot I can get in more than about 4 meals maximum with the carafate.

Nobody will be pleased with me if I drop more weight (including myself). I like where I'm at. I'm a 5'8" male weighing 152 lbs (give or take daily fluctuations).

But maybe if i lose a couple pounds, I'll get it back after the ulcer heals given he thinks i might put on a few pounds.

And i i definitely won't be adding in any junk. I am really conscientious about what I eat. I eat a fair amount of it, but by focusing on highly nutritious food it keeps me satisfied and at maintenance weight. So no worries there. My version of eating junk food these days is the occasional splurge on a low calorie (100-130) and low sugar (5g) granola bar. Haha.

That's what I figured - the part of the intestine where the stomach pouch is joined isn't resistant to stomach acid like the duodenum is, so that anastomosis is sensitive to it - if an ulcer is going to happen, that's where it usually shows up.

At the risk of being overly trendy, you might want to try adding more fats to your diet relative to the veg - I know Dr. Weiner likes his veg first approach, and it works well for long term weight control (I have evolved toward something similar) but a higher caloric density of the higher fat/protein diet may allow you to get in the calories that you need with fewer meals. Clinically, the high fat/low carb type of diet (like Paleo or Keto) is what is often prescribed to gastrectomy patients looking to minimize weight loss and regain unwanted lost weight. It would only be for the couple of months that you are on the Carafate - we often have to temporarily adopt diets with undesirable nutritional consequences to address specific medical needs, but can often tailor them some to minimize the downsides.

It's a good suggestion. Dr. Weiner is actually super flexible about stuff, and is a huge proponent of healthy fats - especially nuts (raw, of course!). It's definitely an issue. Right now, eating just a few times a day, I've really been focusing on getting my protein in, unfortunately, that has a negative effect calorically. Dr. Weiner had asked me to start adding in oatmeal/brown rice (I went with oatmeal) when I hit maintenance to slow down the weight loss. I've now ditched the oatmeal in lieu of eggs for breakfast to get more protein. But then I'm stuffed, and have no room left for anything else (after about 150 calories worth of eggs). I can also consume VERY little meat/chicken/seafood as my stoma is so small that 1-2 ounces of meat or chicken makes me STUFFED. Shellfish (specifically scallops) go down a little easier.

But yeah, I gotta figure out something soon. It's amazing how fast the weight drops off when I can only eat a few times a day. My goal weight is 152, and I have been +-2 pounds of that for over a year in maintenance. After being on this regiment for less than 5 days, I am already down to 149 lbs. I know that's not a huge deviation, but the +-2 has mostly been in the + range (152-154). I have spent almost no time under 150 and am already there in less than a week.

Maybe I'll sub in some raw almonds or avocado instead of the Greek Yogurt. That has been the only "snack" I've been eating these last few days. Everything else has been protein based.

Maybe some liquid calories would help - going back to protein shakes in part (whole milk, etc. if needed). Sometimes going against some of the "rules" is what's needed to get the job done, as long as one doesn't make a habit of it - as long as there is a viable rationale for it then it's a reasonable thing to do. Weiner's approach is contrary to a lot of the WLS "rules", but there is some well thought out reasoning behind it.

Thanks. That's a great idea actually. I kind of can't stand protein powder or shakes, but I have a "Dr. Weiner Approved" shake I used a ton post-op. It a Peanut, banana, chocolate shake. And while i used to use peanut powder, i could go with a natural peanut butter for extra fat and calories (which the doc actually prefers over the powder). Good call. And they are delicious!

Thanks for taking the time to reply. It's been a big help. Not sure why I didn't think of this, but this is a great solve for my issue.