Vitamin Recommendation From GB Hosp Site????????
Okay...so I read a question from a woman who had surgery 5 days ago...She wanted to know "When can I have soft foods?" I couldn't imagine this being a serious question...So I wanted to scold her initially because, my gosh, this is her LIFE!!!! It's like bringing home a baby from the hospital and asking if you can feed them Lucky Charms yet! So I went to her doctor link and looked up where she had surgery and was going to have her read what HER specific doctor recommends for Vitamins, Nutrition and Long Term....Afterall, I'm no expert or doctor....but.....
I could not get past vitamins info without feeling quite ill...What do you all think? I was going to have this woman follow her doctors rules...and now I cannot answer her question whatsoever because her doctors guidelines just for vitamins made me feel so sorry for this woman that I am at a complete loss of words...You can't tell her to go against her doc..I mean who the heck am I to tell her "you doc doesn't know that RNYers can't absorb calcium carbonate or time released pills ....What the heck???
Am I crazy??? Is this for REAL???? I took this right from her doctors/hospital website. (Somewhere in PA)
Check out the Red highlighted vits...Forget the diet...One month of liquids only...(and states they can have about 20-25 grams of sugar in those drinks before they get dumping syndrome!!!!!!!!!!!) Quoted from website " It is very important to avoid any liquids with a high amount of sugar at this time (more than 20-25 g. in an 8 oz. serving)."
I'm just beside myself...This website was updated in 2008...YES this is for RNY surgery....
No wonder this poor woman has no idea what she is supposed to do...She has probably heard all kinds of conflicting information and is not sure what to eat or drink or what vits to take.
Sorry for the rant...I needed to post this because it DISTURBED me intensely!
I could not get past vitamins info without feeling quite ill...What do you all think? I was going to have this woman follow her doctors rules...and now I cannot answer her question whatsoever because her doctors guidelines just for vitamins made me feel so sorry for this woman that I am at a complete loss of words...You can't tell her to go against her doc..I mean who the heck am I to tell her "you doc doesn't know that RNYers can't absorb calcium carbonate or time released pills ....What the heck???
Am I crazy??? Is this for REAL???? I took this right from her doctors/hospital website. (Somewhere in PA)
Check out the Red highlighted vits...Forget the diet...One month of liquids only...(and states they can have about 20-25 grams of sugar in those drinks before they get dumping syndrome!!!!!!!!!!!) Quoted from website " It is very important to avoid any liquids with a high amount of sugar at this time (more than 20-25 g. in an 8 oz. serving)."
I'm just beside myself...This website was updated in 2008...YES this is for RNY surgery....
No wonder this poor woman has no idea what she is supposed to do...She has probably heard all kinds of conflicting information and is not sure what to eat or drink or what vits to take.
Sorry for the rant...I needed to post this because it DISTURBED me intensely!
Vitamin List
It is important that you take vitamin supplements every day for the rest of your life after having a gastric bypass. The key vitamins that are necessary include vitamin B12, iron, and calcium. We recommend that you take a multivitamin, plus extra calcium, iron, and B12 supplements. This is because most multivitamins do not have sufficient calcium, iron, or B12, and because you will have decreased absorption of these substances after a gastric bypass. Start all vitamins within the first few weeks after surgery.- Multivitamin/mineral supplement, twice daily with food. Chewable supplements are necessary for the first two to three months after surgery because you cannot swallow large pills (bigger than an aspirin) and they are easier to digest and absorb. Choose one of the following:
- Flintstone’s Complete <-----made for children...Must take two (doubling the price)
- Centrum Chewables
A few months after surgery, or when you feel you are able to swallow large pills (bigger than an aspirin), you may switch to non-chewable supplements if you would like to. Choose one of the following: (WHY???? He even stated that chewables are easier to digest and absorb, and yet he says to switch to a larger pill form "if you want to????" WHY WOULD you WANT to when malabsorption is an issue?
One-A-Day Maximum
- One-A-Day Today
- Centrum Performance
- Centrum with lycopene
- Centrum Carb Assist
- Calcium with vitamin D, twice daily with food for at least 1000mg per day. Again, chewable supplements must be taken for the first two to three months after surgery because you cannot swallow large pills (bigger than an aspirin) and they are easier to digest and absorb. Because calcium is such a large mineral, many patients prefer to stay on chewable calcium supplements because the non-chewables are just too big. Choose one of the following:
- Citracal Creamy Bites <----These are not being made anymore!!!!!
- Viactiv <----Calcium carbonate!!!!!
- Caltrate 600 Plus Chewables <-----Calcium Carbonate!!!!!
Please remember not to take your calcium with your iron supplement as the two interfere with one another. Calcium and iron should be taken at least two hours apart.
- Iron, once daily with food. If you become constipated after surgery and believe your iron supplement is the cause, please call the office for suggestions on how to alleviate this problem. Again, please remember not to take your calcium with your iron supplement as the two interfere with one another. Calcium and iron should be taken at least two hours apart. Choose one of the following:
- GNC Iron 18 <------TIME RELEASED!!!!!
- Ferro-Sequels <-----Time released (At least it is fumarate!!!)
- Fergon
- Slow-Fe <-----Time Released....Is this FOR REAL?????
- B12, choose one of the following:
- Monthly B12 shots, at your PCP’s office or self-administered
- 500mcg sublingual (under-the-tongue) B12 daily, which can be purchased at any drug store, GNC store, or Vitamin World.
It is important to take your B12 either sublingually (under-the-tongue) or by injection because you cannot digest or absorb B12 after having gastric bypass surgery.
This is what my surgeon recommends .
They also did a check on some vitamins. Here are a couple of brands. I have heard of Optisource and Bariatric Adv but not the other ,Vital Active but that one seems to be the better of the three from the ingredients
Sandy
Remember....... Click to Give .....Hunger, Breast Cancer, literacy, rain f orest, animal rescue and CHILD HEALTH
Yes...exactly! This is a good list...The other is a list for a woman who JUST HAD surgery five days ago.
Your doc specifically says to take calcium Citrate NOT calcium carbonate and he underlines CITRATE!
Yours also says not to take Iron as Ferrous Sulfate and to take it with Vit C...This woman is being told to take time released iron and never mentions Vit C!
It just blew my mind....Some doctors seem to do some pretty sloppy work researching the patient as well as just the surgical portion of his responsibility...and it just seems so wrong...
Your doc specifically says to take calcium Citrate NOT calcium carbonate and he underlines CITRATE!
Yours also says not to take Iron as Ferrous Sulfate and to take it with Vit C...This woman is being told to take time released iron and never mentions Vit C!
It just blew my mind....Some doctors seem to do some pretty sloppy work researching the patient as well as just the surgical portion of his responsibility...and it just seems so wrong...
I really thought maybe I'm just missing something...I wanted to lead this woman to her own doctors plan for her question of "What am I supposed to eat 5 days post op"? And I realised that she needs to do her own research after reading his plan...but ...how do you tell someone "Don't listen to your doc"? LOL It just shocked me....I had never seen such bad advice from a doc in BARIATRICS!
I'm gonna write to her, but the whole thing just completely knocked me off my chair...And nothing much shocks me these days! LOL
Welcome to my world! 
Just think, I've been dealing with this since 1995! And ppl have always said, "If that was true, my doc would know it."
So, now you know why I have a pre-built fixit plan.
I always say that your doc doesn't know it YET. That's all. YET.
Just think, I've been dealing with this since 1995! And ppl have always said, "If that was true, my doc would know it."
So, now you know why I have a pre-built fixit plan.
I always say that your doc doesn't know it YET. That's all. YET.
Michelle
RNY, distal, 10/5/94
P.S. My year + long absence has NOTHING to do with my WLS, or my type of WLS. See my profile.
Michelle,
That's a great idea! "YET" That's so much nicer than what I WANTED to say about her surgeon!
Of course, I do have some scrupples! (As my Dad calls the word "tact") I don't even know what the woman is taking for vits...but you can bet I'll be checking up on her! That poor woman...she's not gonna know what hit her after the info I send her!!! LOL
When it comes to vits and supps and what-to-do's....You are Goddess! LOL I get can't wait to get my labs so I can call on you to fix me! (hopefully I won't need fixing, maybe just a little tweaking here and there) LOL I don't trust the docs in my healthcare system at all!!!!!! I just picked a new doc and I'm scared to death she's gonna be worse than the my pcp of 12 years.... she was CLUELESS about WLS, as much as I love her...she is just so forgetful and so busy...I just can't handle it anymore...With a new doc, I can stay stern and not care if I step on her big ole doctor toes...I didn't have the heart to tell my other doc that she gave me the WRONG kind of iron script...So I start fresh now with someone I won't allow myself to get attached to! LOL I'm so unruly....
Hugs
That's a great idea! "YET" That's so much nicer than what I WANTED to say about her surgeon!
Of course, I do have some scrupples! (As my Dad calls the word "tact") I don't even know what the woman is taking for vits...but you can bet I'll be checking up on her! That poor woman...she's not gonna know what hit her after the info I send her!!! LOL
When it comes to vits and supps and what-to-do's....You are Goddess! LOL I get can't wait to get my labs so I can call on you to fix me! (hopefully I won't need fixing, maybe just a little tweaking here and there) LOL I don't trust the docs in my healthcare system at all!!!!!! I just picked a new doc and I'm scared to death she's gonna be worse than the my pcp of 12 years.... she was CLUELESS about WLS, as much as I love her...she is just so forgetful and so busy...I just can't handle it anymore...With a new doc, I can stay stern and not care if I step on her big ole doctor toes...I didn't have the heart to tell my other doc that she gave me the WRONG kind of iron script...So I start fresh now with someone I won't allow myself to get attached to! LOL I'm so unruly....
Hugs
Well, let's think of it this way. I hope no one thinks I am slamming their surgeon or even mine!
They know everything they learned in school. They learned BETTER the stuff that fascinated them. Just like us. I have had a computer 20 yrs and am still clueless. They had 2-8 hrs of nutrition. So, that's FOOD nutrition. Low in iron? eat spinach and liver cooked in cast iron. That's what they learned. Not WHY are you anemic, or why didn't that solution work before or why didn't the fe sulfate work. That was all written off as non-compliance. That's what they are taught!
They learned 0 about malabsorption So, as time goes on, and they are faced with it, they h ave to learn it BRAND NEW INFO. And many pu**** off to the RN or PA or NP or RD they have in their system. And they don't have tha authority to change much of anything, AND they also didn't learn it in school. So each person starts over with, spinach and liver in cast iron. And fe sulfate. And the pt is written off as non-compliant. And so it goes.
Until someone gets curious about malabsorptoin, then the trial and error begins. And most are afraid to be the first to "try" stuff they didn't learn in school. There is a TON of liability in trying new stuff. The risk of malpractice is so high!
They are taught the very high potential of hypervitaminosis (too high vites) and even then, the message doesn't get thru that you can't "catch" a genetic disorder like hemachromatosis from iron pills. And that it takes years for a person in HYPOvitaminosis (too little) to even reach normal, long, long before they reach HYPER, but routine monitoring covers everybody's butt, medical professional, the practice AND the patient.
I once thought they didn't CARE, but the more I sit 'n chat, the more I see what they don't know, the fear of being "first" to try something "new" (to them) and the main fear being malpractice... what if that last paragraph under vitamins is TRUE?
It's hard to get them past their training, which doesn't include alabsorption, or how to dose vitamins to cover severe shortages. It just doesn't.
YET.
But each person will gradually and gently bring their docs around to seeing better products (hey, look, my iron went up into normal range on this cheap iron in my hand <----) and then you remind them again in 6 months that levels are holding steady in this cheap iron i my hand <----).
I've been showing my hema the Tender Iron for........ 7-8 yrs? I tell him it builds ferritin and he just smiles and thinks I'm cute, then he says, "How come your ferritin is always so high?" Um, it's this cheap iron here in my hand <----. He's starting to grasp it! He's not stupid, quite charming, but he did not know this. And it's a slow seep, for sure. LOL
So, we change their perspective, alleviate fear of the unknown by showing results with a smile, not a "told ya so". I'm already practicing arranging my face for my appt in August when II can point to the now fabulous CBC I've been fighting for 4 yrs and trying to smile and say: it's this cheap folic and copper in my hand <------, <-------. LOLOL He can't deny the result, and I don't put him in a position of WHO WAS RIGHT at all. Just WHAT is right.
Delivate. And I'm not overly known for that IRL. LOL
They know everything they learned in school. They learned BETTER the stuff that fascinated them. Just like us. I have had a computer 20 yrs and am still clueless. They had 2-8 hrs of nutrition. So, that's FOOD nutrition. Low in iron? eat spinach and liver cooked in cast iron. That's what they learned. Not WHY are you anemic, or why didn't that solution work before or why didn't the fe sulfate work. That was all written off as non-compliance. That's what they are taught!
They learned 0 about malabsorption So, as time goes on, and they are faced with it, they h ave to learn it BRAND NEW INFO. And many pu**** off to the RN or PA or NP or RD they have in their system. And they don't have tha authority to change much of anything, AND they also didn't learn it in school. So each person starts over with, spinach and liver in cast iron. And fe sulfate. And the pt is written off as non-compliant. And so it goes.
Until someone gets curious about malabsorptoin, then the trial and error begins. And most are afraid to be the first to "try" stuff they didn't learn in school. There is a TON of liability in trying new stuff. The risk of malpractice is so high!
They are taught the very high potential of hypervitaminosis (too high vites) and even then, the message doesn't get thru that you can't "catch" a genetic disorder like hemachromatosis from iron pills. And that it takes years for a person in HYPOvitaminosis (too little) to even reach normal, long, long before they reach HYPER, but routine monitoring covers everybody's butt, medical professional, the practice AND the patient.
I once thought they didn't CARE, but the more I sit 'n chat, the more I see what they don't know, the fear of being "first" to try something "new" (to them) and the main fear being malpractice... what if that last paragraph under vitamins is TRUE?
It's hard to get them past their training, which doesn't include alabsorption, or how to dose vitamins to cover severe shortages. It just doesn't.
YET.
But each person will gradually and gently bring their docs around to seeing better products (hey, look, my iron went up into normal range on this cheap iron in my hand <----) and then you remind them again in 6 months that levels are holding steady in this cheap iron i my hand <----).
I've been showing my hema the Tender Iron for........ 7-8 yrs? I tell him it builds ferritin and he just smiles and thinks I'm cute, then he says, "How come your ferritin is always so high?" Um, it's this cheap iron here in my hand <----. He's starting to grasp it! He's not stupid, quite charming, but he did not know this. And it's a slow seep, for sure. LOL
So, we change their perspective, alleviate fear of the unknown by showing results with a smile, not a "told ya so". I'm already practicing arranging my face for my appt in August when II can point to the now fabulous CBC I've been fighting for 4 yrs and trying to smile and say: it's this cheap folic and copper in my hand <------, <-------. LOLOL He can't deny the result, and I don't put him in a position of WHO WAS RIGHT at all. Just WHAT is right.
Delivate. And I'm not overly known for that IRL. LOL
Michelle
RNY, distal, 10/5/94
P.S. My year + long absence has NOTHING to do with my WLS, or my type of WLS. See my profile.
I have found that most surgeons are really good at the surgery itself, but their concept of life after surgery can be a little off. Alot don't seem to take the time to stay up to date on the lastest findings and that's why so many have to do their own research and start their own vit routine. I realize these are very busy people and they generally have a support staff that's sole job is to field these types of patient needs, but it does leave you feeling a little bit nervous and scared. As with any dr/patient relationship,they say we (the patient) need to be proactive and be our own advocates for health.
~*~Tracy B~*~
328/160 *** 5'9"
start/current
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