questions about nutrition ???

HI I had an my RNY in 2000.  I have lost about 170 lbs.  Over the last few years, I have regained about 40 lbs.  I have forgotten how to eat, apparently.  I am having some issues also, with fatigue and low blood sugar.  I have been to my new doc, as I have recently moved to fla, and she has ordered all my labs, as that is something I have not kept up with.  (bad girl, got off track here)  She does not think that I am diabetic, but she believes I am vitamin deficient, and I tend to believe her.  I have never had  the B shots, and have not taken "good" vitamins, and I really do not KNOW WHAT I AM DOING ANYMORE... I guess, I am hoping that someone can help steer me back on track with eating, I went to old habits and was eating more carbs than protien (gee, wonder WHY I feel like crap??) But mostly, I am looking for GOOD vitamins that are geared for bypass patients.  I never knew they existed and I hear they do.  I am looking for the chewable multivitamin and the calcium citrate, and I also wonder who knows WHAT your labs are supposed to be number-wise?  I have not gotten my numbers back yet, but I am guessing they are bad, as I am losing hair again, and I feel like I always am coming down with the flu, and now that I am  serious about avoiding white carbs, I don't feel like I am about to pass out anymore,  sad HUH.  The good news is, is that my new doc seems passionate on helping me.  She is not a bariatric doc, but she seems to know what she is talking about with my nutrition.  So, I will start there.  I want to know also, about your opinion on vitamin shots...I suspect I will need shots.  I want to go back to a good protein shake, high protein low cal low carb...any advice? good protein bars for my busy mornings so I will not shovel food into my face at work and good vitamins chewabel wtih calcium. I live in Brevard county...would LOVE advice on where to go shopping for all of this any and ALL advice, tips, opinions will be greatly appreciated. I don't think my bypass is broken, I do think I stretched my self, but I think I can reverse that with eating denser foods, and not the "slider" foods.   I think I just need to remember now, that I had some surgery that makes me not absorb nutrients, and I have to get back on track and WORK this thing the way I used to when I was brand new with it.  Anyone who is living life this far out like me, and who is still working the program so it WORKS, I'd love to hear from.  THANKS for listening!

You might want to check out this post about vitamins. http://www.obesityhelp.com/forums/rny/a,messageboard/action, replies/board_id,5465/cat_id,5065/topic_id,3548146/

Hello Swimmergirl and welcome aboard!  I know it takes a lot of stength to come and ask for help, but it's a GREAT step!!! Firstly, congrats on being 4 years and your weight loss.   I am not a nutritionist or a dietician, but love studying and researching nutrition/food/vitamins.  I am almost 3 years out and can share with you my personal experience to try and give you some idea of direction: As far as vitamins, though I did take my vitamins, my surgeon found that I was not absorbing enough B12 and Vitamin D so I am on B12 shots once a month and very high dose of Vitamin D.  I feel so much better being on them in addition to my other vitamins.  I never want to take those for granted again.  (I was getting sick with colds and sinus infections a lot and feeling overall very tired and weak) Turns out it was my vitamin levels. As far as protein shakes, I love Slimfast Low Carb shakes (they are my favorite) but I also do Carnation Instant Breakfast with 2% milk.  Other shakes are the Atkins shakes that people have also talked about.  There is a great website that offers other bariatric products: www.bariactriceating.com.  They actually have a store in Florida but do all their products online also. (They sell bariactric vitamins as well there) I would go back to the fundamentals of when you first had surgery (I have to do it myself), Protein first, plenty of fluids, take your vitamins, eat veggies and fruits (if you can tolerate them).  I have talked to a lot of people and speak at seminars and I truly believe it's about finding balance.  Because we are all so different, even after surgery, what plan works for me may not for my friend sitting next to me.  But as a general guide, we know that Protein, Protein, Protein is super super important.  60-80 grams a day is what I am recommended, some people do more than that.  I try to stay within 1400 calories, but if I am working out that number will go to maybe 1700 calories or so.  I do incorporate complex carbohydrates (per my dietician) and for my body, it's important for me.   I will eat 3 small meals a day that incorporate protein and veggies and then a fruit.  I drink two protein drinks a day and have snacks inbetween (South Beach cereal bar or apple with peanut butter or yogurt, etc)   I hope this offers you some insight to reaching your goal.  Wishing you a lot of luck on your journey!!! ~Shannon

Hi Swimmergirl, I meant to add, keep a food journal.  Most nutritionist and dieticians, if not all will suggest this.  This is a great way to easily keep track of how much you are really taking in.   There are some fantastic free sites:  www.fitday.com, www.sparkpeople.com, www.thedailyplate.com, and some others out there.   This is something that would be very very helpful to narrow down what you have been eating and making sure you are getting the right balance of protein, veggies, fiber, minerals, and carbs.   ~Shannon

Hi...thanks so much for the advice.  So, I got some of my labs back and apparently, my doc says everything is within normal limits except for my iron and B12.  She says my iron should be over 20 and it is only 2.  anyone know more about that?  My B12 is low, but she did not give me exact numbers.  She suggested I take B12 sublinguallyy, however I asked her why others take this in shot form, and I did not get an anwer exactly, but she asked if I would rather take the B12 as a shot...I don't care how I take B12, I just want to make sure that  what I take will be properly absorbed.  anyone have comments on that? She tells me to take the iron 3 times a day and chewable centrum 3 times a day and a B12 shot once a month....I wish I asked her for my numbers on everything, but does this sound about right? Lately, I have been trying to stay away from  carbs, and the only carbs I do have is in the form of veggies and fruit.  I find that if I don't eat the fruit for right now, I am craving something sweet, and then I reach for stuff that makes my blood sugar crash an hour after I eat it.  I have never had a problem with sugars and dumping as severe as I am having it right now, and wonder if anyone could enlighten me as to WHY I am having such issues with refined sugars and refined carbs at this late stage (7 years out).  In a way, its a good thing, becaue it is detering me from eating the carbs and junk that has caused me to gain some weight back...I just hope that by changing my eating and getting my body back in line nutritionally, that I will start to lose what I have gained. Anyway, thanks...I already am starting to feel better now that I have cut the junk out, and amazing what a bit of vitamins can do to your  energy level... Lynne

Hi Lynne, vitamins are super duper important, and even as I took mine, I still ended up with some very low levels.  There are quite a few post ops that have low iron and are on supplements, and some try to eat more veggies containing iron, ie. spinach.  Iron helps your blood and muscles, so it's super important.   B12 is a biggie for all post ops.  I know I am currently on shots once every month currently.  I do suggest the sublingual as our bodies absorb that better after surgery.  B12 is very important for our nervous system and red blood cells.  Long term deficiencies in this vitamin can be severe, so this one is VERY important.   Great job on staying away from the junk, it can be very difficult sometimes, especially around the holidays and different seasons, but you can find your balance.  I personally have taught myself that a bit or two is more than plenty, and dumping is NOT fun by any means.  So I learned my limits. Keep up the good work!  You will feel even better after you up your two vitamin levels. :) ~Shannon