Went to the local support group tonight...
Sorry, Brian, but you've got quite a lot of bad information.
Meloxicam: The fact that one doctor does something doesn't mean that it's correct, nor that other doctors should. NSAIDs are No Bueno post-op, and though this one may be better than Advil it's still not recommended.
...Because of these effects, use of NSAIDs in these patients should be avoided if possible, and alternative oral pain medications, such as acetaminophen, should be substituted. (...) When NSAIDs cannot be avoided, it may be beneficial to select an NSAID that is more selective for COX-2 (such as celecoxib [Celebrex] and meloxicam [Mobic, others]), because these will have fewer effects on the secretion of gastric mucous. (Source)
Hemp hearts: I pulled up the nutrition info (here), and one serving of these are 160 cal, 10g protein, 3g carb. Yes, there's some protein in there, but there are FAR better choices that get you closer to the ideal 1g protein/10 cal ratio. Despite a lot of "all natural" woo promotion, there does look to be quite a bit of good stuff in there, including important fatty acids, but you can certainly get it from elsewhere in your diet. (Science info here)
Shrinking pouch: This person was probably talking about the "five day pouch test," which basically suggests you do full liquids for several days to allegedly "reset" one's digestive system. This is complete bunk-- stomach size cannot be changed this way, and following this plan is essentially a crash died like so many that failed us before surgery. If you REALLY want a mental reset. try doing All Meat All Week to get back to basics with protein. I've semi-jokingly written that up as the Five Day Meat Test.
Carbs plus protein: Nope. A research study looked at insulin levels in diabetics after food. One group had carbs, the other had carbs and protein together. The combination did NOT improve blood glucose response. (Source) Even if this was true, we'd need evidence that it works specifically in bariatric patients because our digestion works a bit differently.
Carbonation stretches sleeves/pouches: Nope. Looking for the appropriate "official" citation, but in the interim: "Carbonation does not stretch out your stomach, but it can cause gas that may be painful." (Source)
Bone density: The ASMBS only recommends bone density scans for patients who have existing risk factors (female estrogen deficiency, men over 70, men 50 - 69 with other existing bone-loss risk factors), so it's entirely possible that your situation at the time did not merit a baseline scan. (Source)
Peanuts: Independent of fat, peanuts are not a great food in the protein-to-calorie ratio. (Nutrition info) One serving is 164 cal and only 6g protein; to be a good snack for us, it should have at least ~16g protein.
Sparklekitty / Julie / Nerdy Little Secret (#42)
Roller derby - cycling - triathlon
VSG 2013, RNY conversion 2019 due to GERD. Trendweight here!
AAAAHHHH...I spend over an hour responding to your post. Opened another page (to find the word of the sleeve (banana...It starts with a B) and OH dropped my whole post. I will respond to your post in every detail. Have to do business now...Just really frustrating!! Please wait before you flame me anymore. I woke up at 11:45am PT and need to get work done. Look for my response later tonight. Brian
Oh that's the worst! I wish browsers had auto-recover like Word does :-p
I don't intend to "flame" nor antagonize anybody, just trying to correct bad information by referring to experts. Not sure why it would take an hour to rebut unless you have some citations of your own, but I look forward to seeing what you've got, whenever that may be.
Sparklekitty / Julie / Nerdy Little Secret (#42)
Roller derby - cycling - triathlon
VSG 2013, RNY conversion 2019 due to GERD. Trendweight here!
I'm back!! Had to work and exercise. How can I say these things without sounding "puffed up"? Years ago I was asked by OH to be a "Friends of OH"...I chose not to. If you look at the "Friends of OH" their posts are pretty common sense and rational. Also I do watch what I eat...Not great, but average post op. Just saw my labs at the doctor's on Tuesday. Total cholesterol 123, triglycerides 68, LDL 65...Just saying I'm not a nut!! Last night I was on Xanax...Late at night. I was just sharing everything I heard. I should have put some "caveats" (that is why my posts take so long...Spelling), saying I didn't agree with much of what was said at the meeting. Sorry I won't read your sources till after I write. I would have to copy and paste or lose my writing.
Meloxicam...I thought it was strange to hear. The PA did not refute what the bariatric surgeon was doing...She couldn't since she must send everything through the surgeon. PAs and NPs have to walk a very fine line to only practice medicine under their doctor. She was also there for support and to see what was going on...and gather information. She was not the guest speaker. So concerning NSAIDs I (we) have know for years what they can do to the remnant (that word "remnant" took 10 minutes to find...Google used the word "remaining"...But doctors use remnant) stomach. I was as shocked as everyone else at the meeting. But maybe this person was in such pain (RA or other pain) that putting them on a low dose and monitoring their progress made sense. Concerning "NEVER WITH NSAIDS" is just wrong. I take a 81 mg aspirin for my heart daily (doctor's orders). I have also gone against doctor's orders and taken an ibuprofen, 1 per day when I have a very bad pulled muscle...Again, that is just me. I am not recommending this for other people. When I do this, I can feel it effecting the lining of my remnant stomach. The (for me) the reward out weights the risk. Again I would take 1 per day for just a couple of days to reduce inflammation. Again we don't know why the surgeon prescribed Meloxicam, but it was done...And I'm sure for a good reason. Again over 10 years and this was the first time I had heard this...I thought it should be shared...Just me.
Hemp Hearts I was wrong on this one. I was just writing words on a paper, not really taking notes. The nutritionist recommend them for keeping a person regular. It is an OK source of protein and other properties. But she was stressing the benefit of movement of the bowels. My bad. It's was just something new I heard.
Shrinking the pouch This was the first time I had heard of this. We know there are procedures out there (ROSE and others) that make the pouch smaller. But again someone mentioned it, and my ears perked up. In my post I asked for any evidence, but none came forward, so I will disregard unless new studies show up.
I don't remember if it was the PA or the nutritionist who talked about the carbs + protein. But still for me, it makes sense when you think about it. If you take (examples) whey protein isolate by itself you blood sugar level would (will) drop not rise greatly (if at all). If you eat fruit (by itself), you sugar level will spike, but then quickly drop. But say you ate pinto or kidney beans. You have protein, fiber, and carbs. Your sugar level would remain fairly stable. I believe this is true. So in general protein + good carbs should keep a persons blood sugar level up for quite awhile. That is all that was said. Basic common sense I think.
Carbonation I believe the jury is still out on this one. Most WLS surgeon still (10 years out) have it in their "no no" list...Why? There must be a reason? What struck me was that it could effect the sleeve (banana/stomach) too it has been said. Again, many or most surgeon say don't do it...Are they stupid??
Baseline bone density scan Having a malabsorption surgery would seem to qualify for a need to at least have a baseline I would think. Even if you had one done every other year, it might be good to have. What someone else posted about the PTH Ionized Calcium Test (reading on the internet...Yeah scary), it seems you would have to lay off of calcium for several days to see how effective the test would be. I think most PCPs wouldn't even know how long to lay off of calcium. It would probably be a lab or orthopedic surgeon that would know that information. But it could evaluate possible bone loss if done correctly. I won't worry about it...I take my vitamins and my labs are good.
Peanuts I agree...Just a small amount. Other nuts (almonds/walnuts) are a much better choice for both good oils/fats and higher protein. I keep our pantry full of different plain nuts and put them in my pockets to snack on. I also put rye crackers (I get from IKEA), Cheerios, and raisins in my pockets to snack on also. I do graze...No, it's not good, but it works for me.
Two more things about the meeting (if anyone is still reading this). There was a woman there who could not control her blood sugar...Real problem (RNY). Every 2 hours she would have her phone go off to get some protein and carbs in. She mostly would go with peanut crackers...Just saying this is what she did. Almost daily she would become light headed...A major problem (I believe A1C not good at all). She is considering major surgery. She is looking to have the WLS surgeon convert her RNY into a sleeve. Yes, I know is a gamble. The remaining stomach must be useable. I don't know how often the surgery has been done...But for those who have major problems and still are looking for the weight loss (for health) this is a path she may go down.
The last one was there was a man who had the sleeve and had issues with H pylori. He had a hernia repaired and the flap from the hernia repair was infected with the scars from the H pylori...Hard to know what to do with that issue. He has lost a ton of weight...Some not by his choosing. Yes, he is on antibiotics...But they are not helping. Feel really sorry for this guy.
Well, this has been long...And again, I'm sorry I didn't just say "this is what I heard last night, take it with a grain (or ton) of salt. But it was late, so I just quickly posted what I heard. Later, Brian
I agree completely that local support groups are a great wake-up call and a chance for renewed commitment. But Brian did not get valuable information. He got some very bad info. I have seen a lot of it in my own local group as well.
I go because it keeps my head in the game. As for the bad information, I correct it when I can, and bite my tongue when I must.
6'3" tall, male.
Highest weight was 475. RNY on 08/21/12. Current weight: 198.
M1 -24; M2 -21; M3 -19; M4 -21; M5 -13; M6 -21; M7 -10; M8 -16; M9 -10; M10 -8; M11 -6; M12 -5.
