A couple of questions re pregnancy post wls & vitamins / folate??

I am almost 4 months post op, I have lost a bit over 56 pounds, which is a bit over 1/3 of the way to my goal.  I still have a long way to go to reach my goal of 150, though I am happy with my progress so far.  I have always planned to try and fall pregnant as soon as possible post op as I am almost 36 and am fully aware of the many statistics re fertility and age etc etc.  There is also a slight financial advantage to me going on maternity leave prior to 1st January 2011.  My husband and I have just this week stopped trying to prevent pregnancy and from early December will be actively trying to get pregnant.

My doctor is very happy with this plan and feels I will have a good chance of a healthy pregnancy with the weight loss I have already had and that I will continue to lose weight whilst pregnant.  In fact he says the extra demands pregnancy places on my body will possibly speed the rate of loss (whilst still factoring in additional weight from baby and fluid etc).

So I guess my first question is there anyone here who has fallen pregnant following the sleeve (or other weight loss surgeries)??  Especially those who fall pregnant before goal weight?  If you fell pregnant before goal weight did you ultimately lose more weight than you gained though out your pregnancy?  Did you feel ok during pregnancy - do you think your vsg impacted how you felt and coped positively or negatively?

Finally, this might be an extremely dumb question and probably one to confirm with my doc or pharmacist.  I am taking Bariatric Advantage chewable Complete Multi Formula.  I presume this will be ok as an ante natal vitamin??  BUT my big question is I bought a special prenatal / pregnancy folate supplement, then checked my multi and saw it has more folate than the pregnancy one.  I am guessing this means I only need to take the multi which has 800mcg of folate (per the two daily tablets) compared to takoing the pregnancy one which has 500mcg?? 

Any thoughts on this would be greatly appreciated.

That's a REALLY touchy subject here and MANY women get flamed when asking about purposely getting pregnant  before 12-18 months post-op...just a warning!  

I got pregnant 4 months post op - it was NOT planned.  Although I had a VERY healthy baby, I NEVER lost another pound from the moment of conception (except for some of the pregnancy weight).  I actually managed to gain 50 lbs in my pregnancy and have a 10.5 lb little moose.  NO IDEA how that happened but it did.  I had RNY and was only eating 900 calories AT MOST a day.  I lost 42 lbs after having my son but never got down to what I was at 4 months post-op.

My suggestion is to wait until you've lost as much as you can.  It's not the safest to lose weight while pregnant (losing purposely, that is) as ketosis can be dangerous for your fetus.  I understand your urgency but age-wise, a few more months shouldn't make a huge difference in your success - I'm sure.  You wanna be healthy and have a healthy baby - that's the ultimate goal.

Good luck in whatever you do...
Sandy

Thanks for your thoughts and advice Sandy:)  Woops, I have only discovered this pregnancy area today, so was not aware that falling pregnant within that timeframe might upset people - eeek. 

My doctor and surgeon are both on board with it, though I think the surgeon wouldl ike me to wait another one or two months, so I will probably do that at least.

The Bariatric Advantage are great but I think they have too much Vit. A in them to take after pregnancy. Too much Vit. A can cause birth defects!

I *think* your body will dispose of whatever Folate it doesn't need ..

Good Luck,
Cathie

I am pregnant and got pregnant at 6 months out. As I havent gained any weight... I have lost 6+lbs... However my surgeon and OB were not on board or happy because they feared Ketosis... I have never heard of a surgeon or OB that is okay with a person having weight loss surgery and ok to start trying at 4-6 months out. Most warn because of the mal-aborstion issues and vitamins issues and the fact that you can't always get the required calories in.

I'm one of the ones Sandy warned you about.




I feel it was malpractice for your surgeon to tell you it was alright for you to go ahead and plan on getting pregnant now.. even moreso for an OB to greenlight it.  It would never fly in my OB's office, and it's a teaching hospital where they don't know better.

Ketosis, especially in early pregnancy, is basically the same as drinking high amounts of alcohol, in terms of fetal brain development.  Ketones are a form of alcohol, and in high-concentrations, can inhibit fetal-brain development, including in ways we may not be cognizant of until later years (sorry, Sandy, but it's true).  This is why when we see a new preggie early out, we immediately advise them to go eat a sandwich to get some carbs in.

At very minimum, you need to keep at least 100g carbs in to stay out of ketosis.  If you can't, then you have to drink a great deal of liquids to help keep the ketones diluted through your bloodstream.. which will make your overactive bladder even more active.. but very important.

Unfortunately, for some, getting pregnant early out will end your weight loss.  So this makes yet another arguement for getting the majority of your weightloss out of the way before losing weight.

And if you need yet another reason, the fetus will be leeching most of the micronutrients you need.  Be sure, if you decide to not heed our advice, to get blood draws every 8 weeks to verify you don't get low on anything too quickly.  It's amazing how quickly we can, and will, get low on something.


As for the vitamin A, I'd switch to the prenates simply due to the vitamin A issue.  Since you don't have any malabsorption issue, you don't need to double it, and you need to be cautious of overdoing the acetate and palmitate.  Beta carotene, however, is safe in ANY dosage.

Hi there! A little off topic, but I love the way Aussies speak. You guys say fall pregnant and we would say get pregnant. Love the subtle differences.

I found out I was pregnant a little shy of 4 months post-op. Not planned at all. I have to say I completely agree with Andrea. I don't think you should ru**** While I am happy where I am now, dont care if I stay at this weight and no longer lose and everything so far is going well with me and baby (and I pray it stays this way), I know all it takes is one day for things to make a drastic change. I have to get my blood drawn every 8 to 12 weeks compared to the every 6 months someone else would have to do. I feel like I am eating around the clock just to be able to get enough nutrients in to feed me and baby...and thats not even including what I should be getting in to try and stop the weight loss. I end days around 900 calories, my OB, surgeon, and nut all think I need at least 1200 a day. And carbs...man I never thought I would see the day that I would say that I DO NOT want to see one more bread product or potato, much less put it in my mouth (you never realize how much 100 grams of carbs are until you are forced to eat it day in and day out).

My weight loss so far. Better than anyone has expected. The last time I went to the OB I was 176 lbs. A mere 11 lbs from goal. She thinks I will be at goal before my 20 week app. because I average a loss of 8lbs a month still. Will I keep it off? I dont know, I still have 5.5 months of pregnancy and those numbers can swing in either direction. I can end up like some here (like Ashlie) who has had awesome weight loss success to date or like Sandy with gained more weight then expected and did not get back to pre-pregnancy weight (I hope you don't mind me using you as an example).
 
My point, why not wait a little longer just to get the odds at a better place. You won't have to worry as much about vitamins (which I really do as my iron started out low and can plummet quite quickly), you will be at a better place weight wise (which might help you get pregnant quicker), and your giving your baby more of a chance to develop properly. I know I wish my little miracle baby could have waited a few months more just for the benefits and because I am in a constant state of not knowing what could happen.

Simone

Well, since you had the sleeve, your case is a bit different, so don't let a lot of these responders make you feel too bad- You have different medical needs than RNYers and DSers. If your surgeon and doctor feel it would be fine, I imagine it would be. You may have to be more vigilent about eating and exercising, which can suck when morning sickness kicks in (I know I struggle with that). My surgeon told us to wait 12 months. He gave me the OK because I was at a plateau for over three months too, and 13 months post op when I got pregnant. Everyone is entitled to their opinion, but I trust my surgeon. If you trust yours, than following his advice would be in your best interests. When planning for my RNY, my surgeon mentioned that he had patients get pregnant soon after surgery and do fine, but he did not recommend that. Plus, because you are older, it may take you 6-8 months of trying anyway, so whatever you feel is best! Your intuition is important. Good luck! Making baby decisions are always tough!

Carrie

Here's a great link about VSG and pregnancy - and it's even an Aussie board :)

http://www.gastricsleevesupport.com/general-chat-f9/pregnancy-with-the-sleeve-t479.htm

Go to the last page and read from the bottom up, the 1st post on the 1st page is the most recent, the opposite from OH - if that makes sense.

T :)