I Finally did it!

Hi all! I finally had my DS surgery on 10/07/2014!!! The recovery hasnt been a breeze but much easier than I imagined :) I've been very tired since surgery and eventhough I know it will help...I'm having trouble getting in all of my protien and fluids and I have liquid vitamins but I'm not sure in what order to take them. The vitamins I have are multi vite , D3, calcium, iron, and B12. I know I have to space out the calcium and Iron but other than that I'm at a loss. I'd appreciate any help you all could give me with this :) 

Keep up the great work! Focus on healing!

Keep after the fluids. Fluids are most important right now. You only need to keep the iron separate from other vitamins and minerals, about an hour on the front end and an hour after taking it. 

Congratulations!

--gina

I am two months out and here is what I have learned so far. 

You have a very limited amount of intake of nourishment that you can cram into your body.  That means you will need to prioritize.  Everything has a cost and between your body's limits and the costs, you will not be able to get everything in for a while.

Right now, liquid is #1.  Not getting enough liquid will put you in the hospital.  Not getting enough liquid can give you constipation that you don't have the room to treat right now.  I found water to be filling enough.  At least once, measure you 50 oz of water.  That is your **minimum**.   Most people try for double that amount.  Pinch the skin on the back of your hand.  If it stays pinched for even a second, you are dehydrated.  If your pee is dark or smells strongly, you are dehydrated.  Take care of this before these dangerous symptoms show up.   

Protein is number 2.  In the long run, protein will keep your overall health up and keep you from losing your hair.  My doctor wanted 80 g / day right out of the gate.  When I tried to get all my liquid through protein shakes I wouldn't make my goal because they are too much.   I'm at two months now and I am just now finding that really doable.  Some surgeons say that you should have a g of protein per day out of surgery.  So at one month, you should reliably be able to get in 30 g or protein.  Protein is amazingly filling.  If you can't do standard whey protein powder, try the "OhYeah!" or muscle milk kind of pre mixed.  There are better options in the long run, but they were the only things close to doable for me at first. 

Vitamins are number 3 because your body has some slack built in.  I understand it will three to six months before most things can begin to go critical.  Everybody has some quirks and that may not be 100% true for you.  Also, studies show that the average bariatric patient comes to surgery with some deficiencies already in progress.  If you are menstruating and not on the pill, iron is likely to be an issue.  Older women can find their calcium levels dropping as early as the three month mark.  Also, getting your vitamin intake balanced with laxatives, fiber and fat is quite an achievement.  It isn't something I've been able to do yet.   Prioritize what vitamin's you think are the most important to your situation.  Other than the iron or the calcium, IMHO go for the multi and the d if you are not sure.

The good news is that we will getting detailed lab results at 3 and 6 months.  By the time most things could be hitting dangerous levels, we should know exactly what amounts our bodies need.  Right now you are at your most ignorant and most injured and most stressed about this subject.  My advice is OWN IT!!  Do not just go to VitaLady.com and order blindly.  Use that energy to learn about vitamins and symptoms but recognize that it will never be this hard again. 

Iron - must be taken two or more hours apart from your calcium.  Iron likes a acidic environment, so take it with your C.  There is one special type of iron that you can take at the same time.  It is more expensive and most people don't bother, although it can simplify things if you need it.  It seems like it is fairly common to get iron from annual to semi-annual infusions and not mess with the iron pills at all. 

B12 is something bypass patients have a problem with but is rare for a DS.  Unless this is one of your body quirks I would put all B vitamins at the bottom of your list.  From what I can tell, most DS people get all the B vitamin's they need from their multi vitamins and food. 

Calcium must be in citrate form.  We do not have enough acid to digest the other forms.  Make sure you read exactly how many pills it takes to make up a dose.  Often the bottle will say something like 600 mg, so you will be thinking "Oh, then I will 3 of them for 1800!" but reading further you will find that it takes 2 pills to get to 600, so you will be taking 6 pills a day.  You can only digest calcium in 600 g or less doses, separated by two or more hours.  Calcium also causes constipation.  Big time.  Stool softeners and magnesium oxide are your best answers.  It helps to find a ratio that keep things moving at one or two calcium pills a day and then increase the ratio.  Trying to up my calcium and then up my laxatives to match darn near put me in the hospital. 

My favorite places to learn are https://vitalady.com/faq/ and http://asmbs.org/resources/integrated-health-nutritional-guidelines.  They contradict each other quite often.  Trying to understand why is a great way to teach yourself how to think about this subject. 

Good luck!!

I agree liquids, protein, and vitamins should be prioritized that way early out. I found I could start getting in vitamins at about 3 to 4 weeks although
I had some chewables earlier than that. As you heal and get further along you will be able 
to do all 3.

I would keep with the B12. It doesn't hurt you to have a high number with that B vitamin and a lot of people like the number pretty high.

Unless your blood work finds you with other B issues you may get enough from your multi. I take a b Complex weekly jsut for added benefit.

Keep an eye on your vitamin A and K levels. Between 6 and 9 months mine started to trend down along with zinc so I increased my A from 10k to 25k
and started vitamin K. 

You might add magnesium oxide with your calcium doses if you find they constipate you. The oxide type helps counter that by drawing water into your bowels.

Mostly, pick a starting point and then change your vitamins according to your labs. Don't forget that generally DS people don't do well with gummies or gel-caps
long term, there are some exceptions.

Hmmm. More so your not putting yourself under a lot of pressure protein wise. A rule of thumb is to be at 30 gms by the end of the first 30 days, 60 after 60 days, and 90 after 90 days. SOme people do better some go slower. I had a hard time up until week 5 or 6 and then I was able to do better. More to do with healing then anything else.

Oh and welcome to the club.  

Pete