What Revision is best when struggling with Iron and Vitamin Deficiencies

  I  am  seeking  a  revision ,I  had  the  RNY in  2009. I  am  a  candidate, My  Dr. suggested  the  DS  or  the  sleeve. With  the  amount of  weight I  have  to  lose  the DS would work  best  he  suggests,however from early after the  surgery I  have  struggled  with  vitamin and  iron deficiencies . I  take  an iron  infusions  regularly  and  prescription  Vitamin  D along  with  the  B-12  shot  for  the  past  3  years . I  would  like  the  DS  however  he  says  this  will  not  work  for  me  because of  these  reasons. He said  the  sleeve would  work  best with  my  problems.  Is  there anyone  who has  suffered  with  these  issues  that  have  had  a  revision and  if  so  what did you revise to?

 You may not lose or maintain what you need with the sleeve, as it's that malabsorbtion with the DS what makes it so successful, but the vitamins are not negotiable with DS (or RNY). Period. 

The sleeve may be inadequate for you, but that's better than malnutrition, and it sounds like what you are taking now is completely inadequate. The only vitamin D available by prescription is in oil form (little green caplets, right?) and you don't absorb it well. You need the dry form like Vitalady sells, which is in a large enough dose (50,000 iu, and many RNY and DS people take 2-5 of those per day!!!!). 

I pray you are taking way more in supplements than you have mentioned. Most of us start with Vitaladys list, whether we buy supplements from her or not, and tweak it from there, based on our labs. 

Thing is, you need to supplement some even with sleeve, and it sounds like you have issues taking what you need already, so I wouldn't even consider RNY or DS if you can't make the efforts to find out what you really need for supplements, and have regular labs and stay on top of that. It's actually life or death.

With a high BMI, you might still be fat with a sleeve, but you'll live.

I agree with Amy. Can you tell us exactly what vitamins and supplements you're taking right now? Are you willing to increase  and change your vitamins and supplements? Can you be diligent about taking them a minimum of 4 times a day? And would you be willing to consult with a different surgeon? (I just don't know Dr. Enochs' history with the DS---he *may* be great, but I've never heards of him.)

 In  response  to  both  of you ,I  take  what  my  Dr.  who  is  a  hematologist along  with  my  new  bariatric  DR. prescribed  me .I  take  an calcium the  prescribed  vitamin  d 50000mg once  a  week  b-12 injections monthly and  my  iron infusions every other  month. Dr. Enoch is  not my  current  Dr.He was  my  original surgeon.

Are you taking a multi-vitamin? You should be taking one twice a day.

Prescription D is D2, and oil-based. You need to be taking a 'dry' form of D3, which is not available by prescription, but is available OTC. If you're taking a 50,000 tablet is *may* be the 'dry' form, but if your D is low, you should be taking it DAILY, not once a week. How much clacium are you taking daily, and is it calcium citrate? (You should be taking 2 or 3 does every day, spaced at least two hours apart.) Do you take any B vites other than the B12 injections?

Who is your current surgeon?

Honestly, the more info you give us, the better advice we'll be able to give you.

That's odd. My surgeon, Dr. Buchwald, gave me a prescription for the small green capsules 50,000 iu, to be taken just 2x a week.  My D is really low.  They discovered it in my preop and they want to raise the levels before surgery (in 11 days).

Of course, I haven't yet had the distal revision which would make this type of D so difficult to absorb.  Duh!

 

If you're pre-op, you can still absorb the oil-based version. But after surgery, you want to be certain you're taking the 'dry' form of D3, which is not available by prescription.

If what you mentioned is all you take, you are lacking guidance and not taking NEARLY enough to survive with RNY or DS.

Many of us had great surgeons and doctors that didn't have the best nutritional advice, and why I think some posters here and elsewhere, as well as vitalady have actually saved lives by guiding us to information, and teaching us that we need to read our own labs. 

Again, if you can't get a hold of good supplementation information and follow it, then settle for the sleeve. It will be less deadly.

I know an RNY to DS revisioner (her revision was Decemer 2011) who had anemia, and several other vitamin deficiencies, and her DS has actually started to REVERSE them!!!  I know one was iron.  But there was 2 or more deficiences that she suffered from, and her levels, are finally coming up, for the first time in over like 5 years for her.

But, vitamins with ANY mal-absorptive surgery are a trade-off to having surgery are FOR LIFE, no EXCEPTIONS~~~~  

Vitalady Basic Vitamin & Mineral Schedule for DRNY, ERNY, BPD & DS Patients

*** DAILY SCHEDULE ***

 

Morning

1 Vitamin C 1,000mg

5 Tender Iron 60mg or 2 Polysaccharide = 300mg (elemental) (see note 1)

1 Copper 2mg

 

Mid-Day

1 Vitamin A 25,000IU

1 Vitamin B-12 5,000mcg

2 Calcium 300mg = 600mg (elemental)

1 B Complex (see note 2) (see note 3)

1 Vitamin E 400IU

1 Multi Vitamin/Mineral (see note 4)

1 Zinc 50mg or 2 each 23mg

 

Evening

2 Vitamin A 25,000IU = 50,000IU

1 Vitamin E 400IU

2 Calcium 300mg = 600mg (elemental)

1 Multi Vitamin/Mineral (see note 4)

1 Vitamin D3 50,000IU

1 Zinc 50mg or 2 each 23mg

1 Vitamin B-9 Folic Acid 1,200mcg

 

Bed Time

2 Calcium 300mg = 600mg (elemental)

1 Vitamin A 25,000IU

2 Magnesium Citrate 140mg=280mg (elemental)

1 Vitamin C 1,000mg

1 Vitamin K-1 1,000mcg (see note 5)

 

With this plan you will be supplementing with the following daily vitamin and mineral dosages: Vitamin A 100,000IU; Vitamin B-

12 5,000mcg; Vitamin C 2,000mg; Vitamin D3 50,000IU; Vitamin E 800IU; Vitamin K-1 1,000mcg; 1 B-50 Complex; 2 Complete

Multi-Vitamin/Mineral; Calcium Citrate 1800mg (elemental); Copper 2mg; Iron 300mg (elemental); Magnesium Citrate 280mg

(elemental); Zinc 100mg; Vitamin B-9 Folic Acid 1,200mcg.