malabsorbtion and long term affect?

I didn't take your post as sarcastic at all, I wonder about my decision myself. I'm proximal, standard 50cm for all with my surgeon, I guess that when we were told that as you progress the body starts to adapt and grow more villi in the part of the small intestine that's not bypassed to better absorb the nutrients we need, I figured that health status would stabilize d/t better absorption and the proper diet with supplemental vits/minerals would be enough to maintain it all. I've had more problems than just the iron/anemia issue: ulcers, reactive hypoglycemia, 2nd surgery for really bad adhesions, series of hernias needing repair, continued weight loss without stabilization, and now have rheumatoid arthritis for which I can't take anti-inflammatories and must inject myself weekly with medication to treat it, so I have a different perspective on it all, seems that it's one thing after another since my RNY. I'm not trying to dissuade anyone from having WLS, just to go into it with eyes wide open and well-informed.

Well, now I understand your perspective much better and all the things you listed are known side effects, but very few people get all of them like you did. Unfortunately, it's only hindsight that's 20/20!! I'm sorry you've had such a rough journey!!!! If you could get some of these issues under control, it will be so much better!

Rachel, It isn't really a question of *IF* you'll absorb it...you will, to some degree. The real question is *How Much* you will absorb. As I mentioned in my post about my wife, those are the supplements she takes to *make up (compensate) for* what she DOESN'T absorb. This is why they're called "Supplements". As you are finding out, the "Rules" are not the same for everyone. As an example, while 2000mg of calcium may work fine for my wife, it may only be half of what YOU need...really depends on how much of the intestine is bypassed. I would ask your doctor how you can SUPPLEMENT your iron so that future infusions may not be necessary. May be possible, maybe not, but it's sure worth asking. Have a great week! -Paul

I think he's treating the acute right now, with the infusions, and we'll come up with a game plan for the chronic/long-term. I'm concerned about tolerating the iron, I have major GI issues with ulcers, take Nexium daily, and still have burning and stomach pain. Thanks for your input. You have a great rest of the week Rachel

I have a Vit D def. High PTH. Calcium is one of my problems also. I just turned 60 the end of Dec. Yes, I still have problems with the malabsoprtion. Darlene

I am 42...had my WLS a few days after my 38th birthday (and a few days before 9/11). My absorption issues are limited to iron, B-12 and pottassium. The iron thing is still a problem, I am not one of the lucky ones who can absorb iron through pill or food...currently working on a solution through hematology. I get a monthly B-12 shot, and take a B-6/B-12/Folate Sublingual 5 days/wk...this value is now in the normal range. I take Liquid Potassium (5.06 mEq) daily...still low but getting better as I have added 1/2 banana to my daily intake (bananas are still tough for me to eat...1/2 pizza no problem!). Low potassium is not good for cardiac function, but I have aligned myself with the Cleveland Clinic's preventative cardiology department and my Cardiologist (who is the wizard behind the research curtain) is closely monitoring me. I don't have heart problems...just a wicked family history. My organs are all normal functioning. I am guessing that had I not had WLS and/or maintained a successful lifestyle to date, my organs, body functions, systems, etc. would all be at greater risk than results of malabsorption. Who knows...you may have absorption problems in your 70's...and you will be health conscious, and a strong advocate for yourself and your health enough to be empowered to find answers and get results. You will have no choice... Best of luck, Karen

One of the longest-term post-ops I know would be Michelle Curran, who is about 12 years out, I think. She answers a lot of questions on the Q&A board, and also runs vitalady.com, where you can buy lots of good, WLS friendly supplements and protein stuff. She will also answer emails from the vitalady.com website. She is very knowledgable about all of our post-op needs. Malabsorption issues can happen to any of us, or to none of us. I think this is a very individual thing for us as post-ops, just as some of us can eat certain things and not others, and some of us lose more weight than others. Anyway, here is some info from Michelle as to amounts and type of supplements that she recommends for new post-ops. AM: 1 Vit C, 1 Polysaccharide Iron (or 6 chewable Tender Iron) Mid-day: 1 Vit A&D, 1 Vit B12, 1 B-complex, 1 Vit E, 2 Calcium Citrate, 1 Multi vit Evening: 1 B-complex, 1 Vit E, 2 Calcium Citrate, 1 Multi, 1 Zinc Bed time: 1 Vit C, 2 Calcium Citrate Some may be skeptical that because Michelle sells vitamins, she would have an interest in seeing us all take more! But I really don't believe this - her advice has always been right on, and I believe her concern for all of us is genuine, and not profit-centered. What she's recommending is a lot of stuff to take, and I'm not there yet myself, but just points out what a long-termer who knows her vits thinks we should be taking.

As others have said I think it's an individual thing as to how well we absorb. I was discussing this with my PCP recently who has a lot of wls patients. I personally know 12 patients of his who had wls from my support group. He said he'd never had a patient with any long term malabsorbtion problems. Strangely enough my bone density test came back better at 2 years than it was pre-op. All of my other blood work came back equal or better than pre-op. My PCP told me the good news was that I was absorbing my vitamin/calcium/food well, but the bad news was I also would absorb calories better than others who didn't absorb as well. Guess there's a good and bad side to everything. I think we all go into this assuming we won't be one of the unlucky ones, but it is a well documented fact that every patient doesn't sail through their wls journey as easily as others. I did a lot of research prior to surgery and was prepared for the fact that I may have to deal with physical problems as a post-op. I was dealing with a lot of physical problems as a pre-op that have disappeared with the weight loss. I've been very fortunate so far, but others do have some problems. Best of luck to you.

The only real answer I can give you from a personal perspective is that without WLS I wouldn't have lived long enough to see retirement . . . so if there are any long term issues I don't know about . . . so be it.

Hi - I realize I'm posting 2 weeks behind everyone elses answer, but here goes... I'm four years out tomorrow, have lost 105 pounds, had a RnY/distal, with complications that required my surgeons to hand sew my new "stomach" and wrap it in teflon, which inhibits it from EVER growing and stretching. I fight every day to get my liquids and proteins in. I too am now discovering that even with my "normal" labs for the last four years, I am now experiencing severe iron deficiency anemia. I had my first IV iron transfusion last week, my second this week. My experience is there are a lot of surgeons jumping on the gastric bypass bandwagon, not so much doctors who are educated enough for the life long followup. Every body IS different most certainly. I know that as we age, malabsorption becomes more common in normal, "healthy" seniors, so starting out with that as a handicap means extra diligence and proactive interaction with our drs. I have to be a bit aggressive, and go in armed with articles I've looked up, to prove I know my body and what I'm talking about. I also may be calcium deficient, labs are still out. I've doubled my sublingual B12 to help aid with the iron, and hope and pray these transfusions "take" and I start creating my own iron again in my bone marrow. The symptoms I have are no fun, especially working full time: Weakness (like having difficulty sitting in a chair!) "fainting" episodes while driving, extreme cold (wearing sweaters in a room that registers 77 degrees and still shivering) diaphoresis (cold sweats and then chills back and forth constantly) Oh it's just fun, fun, fun. Education is KEY. I like that the majority of posters are so happy and positive, but be aware that there are a lot more people who had experiences like mine and they just don't post. I was in the hospital 30 days after my surgery with complications and I met another patient who had her own series of problems... Good Luck to you!