Quick questions from a DS newbie -- NSAIDS and (current) opinions on Garth Davis

Welcome!!!

I just had the DS with Dr. Garth Davis 2 weeks ago.  He and his staff are really great.  I have absolutely no complaints.  Jamie is the DS expert in his office and can answer all of your questions.  Dr. Davis does try to push a more vegetarian approach with his patients.  I can see where he is coming from, though.  Animal protein has very little vitamin nutrients and there are loads of vegetables that have protein as well as vitamins.  He says the more vitamins you can get through your diet, the less pills and supplements you might need later down the road.  I will not go vegetarian, but I am researching more vegetables to add to my diet to increase my protein and vitamin levels (in addition to taking my vitamins).  I like a good steak every once and a while.  =)

I always use Aleve for aches and pains.  I was told after surgery to use extra strength Tylenol for a while if I needed anything for pain.  It hasn't been too bad.  As I lose weight, my normal pains aren't hurting so bad and I'm finding that I really don't need to take anything anymore.

Keep us posted!!!

Yes, veggies do contain some important vitamins, but the sheer bulk of veggies required to get in enough protein to remain healthy, and with the right variety of different amino acids, would be far too much bulk for our small post-op stomachs. This advice may be fine for someone who has a normal sized stomach, but frankly, it's scary for someone with a DS or RNY or sleeve. Esp with the DS, we only absorb roughly half of the protein we consume, so we need to consume very generous amounts of protein, and there just won't be space in our stomachs to do this primarily with vegetable sources of protein.

Larra

    

Because my sleeve is 5+ years old, I've got a bit more room than a freshly post-op DSer.  I only agree with adding additional veggies to my animal protein because I've got the extra room and I'm trying to stay away from carbs.  If I'm full of proteins and the right kind of veggies then hopefully that'll help me 2 fold...  no room for carbs and extra vitamins...  LOL! 

There's no flipping way I could go vegetarian!  I need meat!  =)

That sounds like a very reasonable approach. But I bet if you tried, even with a 5 year old sleeve, to get all your protein from veggie sources, you sould end up with protein deficiency, or with deficiency of specific amino acids. My sleeve is 6 years old, and I also have much less restriction than I started with, but I do still have restriction, and hope I always will. There is no way I could maintain proper protein nutrition without meat/fish/poultry/eggs, etc.

 

Larra

It's helpful to understand why RNYers can't have NSAIDs as I had to explain to my PCP why I could. A good explanation is here: http://www.obesityhelp.com/forums/rny/4020919/Why-cant-RNYers-take-NSAIDS/

"We [RNYers] do not have a normal stomach anymore, as a normal stomach's most inner layer is a mucosa layer, which secrets mucus protecting the stomach from gastric acid and is much thicker towards the bottom of the stomach and thinner towards the top, which the top portion is what makes up our pouch. As well the top portion of the small intestine where it meets the stomach, the duodenum, as well has an inner mucosa layer that as well protects it from gastric acids that are mixed with half digested food, otherwise known as chyme. As you know, the duodenum is also a portion that is bypassed, being left attached to the old portion of our stomach and attached down lower to be mixed with food farther down in the small intestines. In the duodenum of a normal person, chyme is mixed with alkaline bile from the gall bladder & liver and sodium bicarbonate from the pancreas, thus neutralizing the chyme so that in can pass through the rest of the small intestines which do not have a mucus coating to protect them from acids. With our pouches we have no stomach acid like in a normal stomach, our food does not meet with the digestive enzymes and stomach acid until farther down in the small intestines, thus leaving our pouch, stoma and small intestines open to irritation from highly acidic foods and medicines until they reach that portion to be mixed with the digestive enzymes that would neutralize them.

So with that understanding, our pouches would have a problem that could eventually lead to an ulcer by taking NSAIDs that are a weak acid, other things that we've all been told to avoid that are also acidic and can irritate our pouches if consumed in large amounts over time are carbonated beverages (ph of about 2.5) and beer (ph of about 4.2) and even smoking and even lead to ulcers."

Prior to my DS, I would take 4 motrin whenever I had a headache, which was a couple times a month. Now, I find I get relief with one or two motrin when I need it. I've never had a problem. Just keep in mind your dosage may change when you lose weight!

Prior to my DS, I was on a high dose (as high as allowed) of Celebrex (an NSAID). The surgeon I first went to wanted to do the RNY and told me no more Celebrex...so I went hunting for a surgeon that would do a DS for me. My first surgeon ONLY does them on those over a 50 BMI and I was/am a lightweight at 35.2. I did find a surgeon willing to do a DS on a lightweight.

However, I had to temporarily come off the Celebrex for two weeks pre-op and then for an entire month afterward. When I went back on it, I found I only needed a minimal amount. About a year later, I was able to stop all Celebrex. I still take NSAID's on occasion but only on a very occasional basis.

Liz

Thank you so much for all of the comments, everyone! I appreciate the wealth of information. :)