Need Help!

Hi I had the Duodenal switch back in 2007 and have always had problems with being Anaemic after the surgery and my hemoglobin levels are real low.

I was told by the people I get my vitamins from that I shouldn't be taking my iron pills with any other vitamins or medicine but when my doctor gave me information about taking my vitamins(back in 2007) it said in morning take my calcium citrate with my multivitamin with extra A,D,E & K. Afyer lunch take my vitamin dry D3 and dry A with my iron pills. I just read that I shouldn't mix my Calcium pills with my multi vitamins. I don't know what to do because MAYBE this might be causing some Vitamin deficiency???? My Bariatric doctor just retired. My question to anyone did your doctor give you information on how and when to take your vitamins and what vitamins not to mix with others??? I am going to another Bariatric Doctor on April 1st. I am also thinking about asking about trying to reverse my DS because Ever since surgery I have been having nothing but problems i have been dealing with for a long time and I feel My bariatric surgeon may have taken to much of my Intestines out because When they were preparing me for surgery he was still debating on how much of my Intestines to take out and I wasn't too happy with that And days before the surgery I was asking about the sleeve that just came out and he said he only did one surgery with the sleeve and said he wasn't doing another one until he found out what the results were from that one person. I wish now i would stuck to my guns and waited to have the Sleeve but my Doctor/Surgeon talked me into the full DS. I'm just looking to get my health back on track?

RNY here - but we were just told not to take iron within two hours of taking calcium. Not sure why you were told not to take calcium with a multivitamin - maybe because there's iron in the multi - but then, there's calcium in multis as well (I never could figure out why they put both in the same multi, because taking them together kind of cancels both of them out...). At any rate, other than the calcium/iron warning, we were never told to separate anything else.

If your multi has iron in it, then you should separate that from your calcium; if it doesn't then it should be fine in that regard. It is often suggested to take iron with vit C, though whether together is necessary if probably under some debate (as most things are.)

You may not need to totally undo your DS, but a common channel adjustment may be all that is needed. When my wife had her DS back in 05, their general finding at that time was that around 5% of their patients needed that adjusted, split fairly evenly between those with too much weight loss and those with too little. If your CC is seriously short (as in under 80cm, as a few docs did back then) that often caused some serious problems. That may be all that's needed rather than totally backing it out.

Who is the new doc that you are seeing next month? The main guy that I know of in the area who's been around for a while is Dr. Greenbaum, and then there's several in NYC. I would be disinclined to go to someone other than a long time DS surgeon as otherwise you may get a lot more done than is necessary (as in the total takedown) as opposed to a minor tweak that someone more experienced with the procedure may be able to do. In any event, when considering revisions, I like to think in terms of getting second or third opinions, as the causes of the problems, and possible solutions, are much more varied than with the original WLS. You have a better chance of meeting one surgeon over others *****ally seems to understand your problem and has a solution that really clicks and makes sense to you. Give that some thought.

Good luck,

My Doctor was DR.Greenbaum he is the one that did the surgery and like I said when they was getting me ready for surgery he was still think about how much of my Intestines to remove up until they put me to sleep. Every time I asked him a question or had a question from my family doctor he got real defensive. Like I told him I am not blaming anyone I just want it Corrected if there is a problem but I never really got a answer. But the last time I saw him right before he retired I asked him again because I lost to much weight and he just gave me a script for a medicine to help gain weight which it gave me the runs real bad and made me feel bad so I stopped taking it.

The doctor I am going to is Dr.Iqbal in Vineland NJ.

My Doctor was DR.Greenbaum he is the one that did the surgery and like I said when they was getting me ready for surgery he was still think about how much of my Intestines to remove up until they put me to sleep. Every time I asked him a question or had a question from my family doctor he got real defensive. Like I told him I am not blaming anyone I just want it Corrected if there is a problem but I never really got a answer. But the last time I saw him right before he retired I asked him again because I lost to much weight and he just gave me a script for a medicine to help gain weight which it gave me the runs real bad and made me feel bad so I stopped taking it.

The doctor I am going to is Dr.Iqbal in Vineland NJ.

Unfortunately it may be too late to get a copy of your original operative report (by right you should have had access to that). That would have told you (or your other doctors) everything they needed to know about the length of your intestines, etc.

As far as iron goes, it may be that you're just not absorbing it and need another option. I have never had any success absorbing oral iron. Didn't matter whether I separated everything or not. Whether I took massive amounts of oral iron or not. I was severely anemic (so I know how it feels).

My recommendation would be to seek out a hematologist who understands malabsorption. The only success I've had was iron infusions. Ultimately we settled on a drug called Injectafer. It has been the only one that worked for me (I've tried most of them over the years - I think my first infusion was around 2005 or 2006 - my DS was 2003). The last infusion has lasted almost 4 years.

Not sure how far back hospitals save records but you could attempt to get your operative report from the hospital where you had your surgery (since your WLS surgeon has retired).

I hope you can figure it out.

To help you properly ....I need more info....

What was your weight before surgery and what is it now, and when did you have surgery?

Your bariatric surgeon is for surgery, typically not great at follow ups

Anemia is not atypical, take iron if not absorbed have iron infusions, that is nothing to be concerned about and I would not revise for anemia, what other issues do you have?

Who was your surgeon, and what are your limb lengths? This is important you can get this on your operative report. The surgeon you picked will influence your results both positive or negative.

If this is a question of taking what vit/supplements with what what revision is extreme-of course some vitamins etc need to be taken apart from others...it is like anything else.

With the DS there are no "intestines out" you are intact only bypassed. DS revision, the small bowel part is not a difficult surgery, the question is, will they work (absorb again) after revision. The sleeve stomach has been surgically removed, that part is gone. Your dr most likely wanted a DS over a VSG due to your medical history, weight, age, etc. as the VSG has a high revision rate.

Sounds like this is more a question about education, not revision, take some time to read about DS, understanding what vitamins/supplements should not be mixed with others for absorption. you will most likely have issues with Fat-soluble vitamin (D, K, A, E, zinc), calcium, iron, protein. Have comprehensive lab work and see where you are, and address your deficiencies.

Hi I sent you a PM back