RNY to ERNY 1/27/18

Revision to DS wasn't an option, as insurance wouldn't cover a revision (lost too much before regain, they said). I was able to do a self-pay to distal RNY with a resized pouch and stoma. One week out, and I'm feeling good.

Since a distal is similar to DS in terms of nutritional needs, I'm looking for opinions on vitamins. I've seen too much info out there, and for some reason the surgeon's paperwork doesn't specifically discuss ERNY. I'm thinking of going with a Celebrate multi high ADEK. Chewable or capsule? Will I need additional D (I run really low...an 8). What do you do for iron and calcium?

Thanks!

Go to vitalady.com and look at her DS list. This is what you need to start on ASAP. You can adjust later per your labs. She is actually an ERNY too! You are right the needs are comparable. Forget Celebrate and all in 1 ADEKS. The dosage is too small. Buy wherever you want but this what you need to take.

Meanwhile... D at 8 is critical. You are heading right down the broken hip/osteoporosis/dentures road. You need to work on fixing this. What is your PTH? Probably sky high because your body is leaching calcium from your bones. This is not a good place to be. In addition to calcium citrate you need to add Boneup(calcium apatite) and extra dry D. I would start at 50K on top of what Vitalady says because you are in trouble and need to catch up.

Whatever you buy, read the labels and know how many pills you need to take per day to meet the correct dosage. Do not buy anything in an oil based gelcap because they are packaging what you need to absorb in fat...and that's what you malabsorb! And yes, you will be taking a lot of pills. I suggest you take them at least twice a day, 1/2 and 1/2, morning and evening.

Next, schedule some labs for about 6 months from now to see how you are progressing. At least Ca, D, PTH, and Fe(including ferritin). There is no perfect advice for everyone all the time. Your needs change. You have to learn how to adjust what you take according to your lab results over time. If your iron runs consistently low you may need infusions periodically.

I've been on a D supplement for 6 months now, no worries :)

I think you are essentially the same nutritionally and vitamin wise. At least that is the way I
understand it.

You will definitely need additional D. The majority of us find the high ADEK's like celebrate to be too low on D and A. You should monitor your labs and be prepared to add as necessary. I think the multi's like that give false sense of security but I have seen a few people that add enough so that they seem to get by. D is probably the biggest sticking point and the others are pretty variable depending on the person.

It's also cheaper to buy separate and while that may not be much of a concern to start when I sat down and thought about the years I was looking forward to getting adequate vitamins at a low price became a little more important. :)

Pete