VSG Maintenance Group
Met with Dr. C yesterday
He was holding a clinic out my way yesterday, so I went in to talk to him about the possibility of any surgical fix for my ongoing GERD problem (answer: get another upper GI and then we'll talk but he's not terribly hopeful that he can fix it).
He was very pleased at my lack of regain, though I complained about the weight I put on so suddenly last March (which on his scale was only 5 lbs!). He took one look at my labs that I had brought and immediately zeroed in on the thyroid and said he absolutely thought that was the most likely cause. So that made me feel better and gave me hope that it will come back off once I get the meds properly tweaked.
Since I'm way beyond the 3 years of support that was part of my self pay plan, I hadn't sent him the labs, but I will from now on. He jumped on the fact that my B1 is a teensy bit low -- just one point below normal. Neither my PCP nor the endocrinologist said a word about it, but Dr. C made a fairly big deal about it and said that low B1 can lead to permanent nerve damage. He wants me to have it retested in 6 weeks. Apparently, low B1 is VERY common with VSG patients, not because of that whole intrinic factor thing but because it's hard to get enough of it from food with our small stomachs. I was already taking a B complex but now have to add additional B1. So my take away on that was twofold: 1) I do still have to have all the labs done annually ****ep thinking that since I can eat more now we don't malabsorb that I can skip it) and 2) I'll ask him to look at anything outside of normal since he's clearly more on top of our physiologies...
I also met a bunch of very recent post ops in the waiting room since "Dr. Cirangle was running a little behind schedule :-) It was fun being treated as a font of wisdom and experience! I encouraged them to get on OH...
Lizanne
He was very pleased at my lack of regain, though I complained about the weight I put on so suddenly last March (which on his scale was only 5 lbs!). He took one look at my labs that I had brought and immediately zeroed in on the thyroid and said he absolutely thought that was the most likely cause. So that made me feel better and gave me hope that it will come back off once I get the meds properly tweaked.
Since I'm way beyond the 3 years of support that was part of my self pay plan, I hadn't sent him the labs, but I will from now on. He jumped on the fact that my B1 is a teensy bit low -- just one point below normal. Neither my PCP nor the endocrinologist said a word about it, but Dr. C made a fairly big deal about it and said that low B1 can lead to permanent nerve damage. He wants me to have it retested in 6 weeks. Apparently, low B1 is VERY common with VSG patients, not because of that whole intrinic factor thing but because it's hard to get enough of it from food with our small stomachs. I was already taking a B complex but now have to add additional B1. So my take away on that was twofold: 1) I do still have to have all the labs done annually ****ep thinking that since I can eat more now we don't malabsorb that I can skip it) and 2) I'll ask him to look at anything outside of normal since he's clearly more on top of our physiologies...
I also met a bunch of very recent post ops in the waiting room since "Dr. Cirangle was running a little behind schedule :-) It was fun being treated as a font of wisdom and experience! I encouraged them to get on OH...
Lizanne
Sure hope you can get that GERD issue resolved! My surgeon requires B 12 weekly and B Complex daily for life. The B Complex sure do smell nasty, but I manage to choke them down. LOL
Even though I also self paid, I continue to see my surgeon every 6 months and have labs drawn. I'm almost 2 years out. She told me that I can come annually, but I choose to go every 6 months. Helps keep me accountable. I also see the NUT and exercise physiologist when I go, so it's really worth it.
I'm always interested in seeing my labs. Need to make that appointment as I will have my 2 year check up in early March.
Even though I also self paid, I continue to see my surgeon every 6 months and have labs drawn. I'm almost 2 years out. She told me that I can come annually, but I choose to go every 6 months. Helps keep me accountable. I also see the NUT and exercise physiologist when I go, so it's really worth it.
I'm always interested in seeing my labs. Need to make that appointment as I will have my 2 year check up in early March.
Wanda
Some people might not support my WLS decision.
Those people remind me of slinkys. Not good for much but it would would bring a smile to my face if someone pushed them down the stairs.
Ticker includes Pre-op weight loss 24 lb.
Some people might not support my WLS decision.
Those people remind me of slinkys. Not good for much but it would would bring a smile to my face if someone pushed them down the stairs.
Ticker includes Pre-op weight loss 24 lb.
Thanks for sharing, I tend to forget my vitamins sometimes. I
know better, but it's good to be reminded how dire the consequences can be.
Hope you can get the gerd issues resolved. I have had far less problems with the gerd since surgery than before, after your upper gi, let us know what the story is.
keep us up to date on how you do with that.
Thanks again for sharing.
know better, but it's good to be reminded how dire the consequences can be.
Hope you can get the gerd issues resolved. I have had far less problems with the gerd since surgery than before, after your upper gi, let us know what the story is.
keep us up to date on how you do with that.
Thanks again for sharing.
Wishing you all the best, Carol
count your blessings!!!! At goal weight. I am 5 ft 3. 
Glad to hear that you received some good news and encouragement. GERD is a problem for me and I have started cutting down on my morning coffee. DARN!!! The acid really creates a gnawing and mimics hunger. I have to take generic protonix on a daily basis and I am even thinking of increasing it to twice/day.
I thought that your thyroid needed to be looked at, when you posted your values awhile back. Glad that you received from validation from your surgeon about the need to increase your meds.
As far as B1, I take a separate B1 (thiamine) everyday and it is very important to stay within normal to prevent nerve damage. Thiamine is found in a lot of grain based foods, and since we generally don't eat very much of this type of food, we are at risk for developing a deficiency.
Intrinsic factor is involved in the absorption of B12, which is why we need to supplement with a separate B12 sublingual tablet. Instrinsic factor is found in the stomach, so since we have had the majority of our stomachs removed, we no longer have the surface area to produce enough B12 and have to supplement .
gail
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Yes, the endocrinologist put me on meds for the thyroid right after those labs came back, and we've been slowly upping them to get the labs better. It was nice to hear that Dr. C thought that WOULD account for the small weight gain.
I was told to take two protonix daily, and I did that for quite a while after my endoscopy showed gastritis and esophagitis (sp?) , but my endocrinologist said the long term use of protonix was really contributing to my osteopenia/osteoporosis as it interferes with calcium absorption. So I've gotten back down to 1 and just live with the discomfort. Which is NOT a good solution either because I don't want it to turn in to Barrett's. Unfortunately, I'm in a tough place. The surgery that I had to fix the hiatal hernia didn't work and there's not much else that can be done, probably. Have you had an upper GI to check for a hernia?
Lizanne
I was told to take two protonix daily, and I did that for quite a while after my endoscopy showed gastritis and esophagitis (sp?) , but my endocrinologist said the long term use of protonix was really contributing to my osteopenia/osteoporosis as it interferes with calcium absorption. So I've gotten back down to 1 and just live with the discomfort. Which is NOT a good solution either because I don't want it to turn in to Barrett's. Unfortunately, I'm in a tough place. The surgery that I had to fix the hiatal hernia didn't work and there's not much else that can be done, probably. Have you had an upper GI to check for a hernia?
Lizanne
No, I haven't had an upper GI. I don't think that I have a hernia, but I will ask my PCP about it.
I thought that I would start with decreasing my caffeine intake and see if this would make a difference. So far, decreasing my caffeine in the AM for the past 3 days seems to have helped. I still have my latte, which I seem to be able to tolerate. Sometimes, tomato sauce seems to cause more acid.
Everytime that I have tried to stop the protonix, the gnawing in my stomach gets worse. I take my calcium far away from the AM protonix, but I know that it can some problems. My PCP would like me off of it. I think I might ask my PCP about trying something different and see, if a new medication might help with the acid, but not cause the problems with calcium absorption. Thanks for the information.
gail
I thought that I would start with decreasing my caffeine intake and see if this would make a difference. So far, decreasing my caffeine in the AM for the past 3 days seems to have helped. I still have my latte, which I seem to be able to tolerate. Sometimes, tomato sauce seems to cause more acid.
Everytime that I have tried to stop the protonix, the gnawing in my stomach gets worse. I take my calcium far away from the AM protonix, but I know that it can some problems. My PCP would like me off of it. I think I might ask my PCP about trying something different and see, if a new medication might help with the acid, but not cause the problems with calcium absorption. Thanks for the information.
gail
"
That was smart of you to sneak in a visit.
I am just doing B12 and it is always super high (at 6 months I cut my dose in half and at 12 months it was still sky high) but I am unsure about the B1. I will look into as I'm having labs drawn in a few months in anticipation of my 18 month checkup coming in Apr.
Nice to be a VET on here AND in real LIFE.
I am just doing B12 and it is always super high (at 6 months I cut my dose in half and at 12 months it was still sky high) but I am unsure about the B1. I will look into as I'm having labs drawn in a few months in anticipation of my 18 month checkup coming in Apr.
Nice to be a VET on here AND in real LIFE.
-8lbs lost during the 6 month insurance hoop jumping,
the rest is since surgery.
the rest is since surgery.
Yes! Congratulations on VetHood!!
My B12 was high in the beginning, too, so I only do a sublingual 3x a week and it's fine. And I've been taking a separate b-complex for the last 3 years and the B-1 has always been on the low side even with that. So I guess B1 is going to be my nemesis, lol!
Lizanne
My B12 was high in the beginning, too, so I only do a sublingual 3x a week and it's fine. And I've been taking a separate b-complex for the last 3 years and the B-1 has always been on the low side even with that. So I guess B1 is going to be my nemesis, lol!
Lizanne
The recommendation for Vitamin B1 (Thiamin) is 100 mg/day, plus what is contained in your multivitamin. It is one of the common vitamins that WLS folks can become deficient and does need to be monitored.
My labs have been within normal limits and I supplement with Vitamin B1 100 mg on a daily basis. This was recommended by my program.
gail
My labs have been within normal limits and I supplement with Vitamin B1 100 mg on a daily basis. This was recommended by my program.
gail
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