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Believe it or not, it doesn't seem to matter where you are in this journey, we seem struggle with developing a positive self image. I knew that I could be harsh with myself when I was large, but I was surprised that I seem to be harder on myself the smaller I got. I was more focused on the imperfections. As a matter of a fact, as we get smaller, it's not unusual for us to be MORE critical of our bodies, rather than more accepting. I think that for me, this is in part because I realize that I have 'done it to myself' when I see the extra skin. That said, I think it's important to not only appreciate the health aspects of our metamorphosis, but to also appreciate the positive changes in our physiques. So I'd like you to tell me at least one thing, and hopefully more, that you LIKE about your body now, no matter where you are in your journey. This is not about bragging. This is about really trying to see the positive in where you are. To be honest, it was harder for me than I thought it would be, but it's something I'm going to try to practice to see if it will help me become more comfortable with who I am now and what I look like. 

There are plenty of things that I like about how my body works, but these are the things about how my body looks. I like my

- slender frame

- the shape of my face... It's oval and I always thought is was round

- my feminine shape

- the length of my neck... I never realized I had a neck before!

- collar bones

- waist

Please tell me some things you like about your body now... 

 

Below is an overview of the supplementation guidelines that I recieved from Duke Metabolic and Weight Loss Surgery. They have distilled the information that appears in the document above into this easy to read form.

Daily Multivitamin

- chewable of liquid for the first 3 wks following surgery

- must contain 400mcg Folate, 18 mg Iron, and 15mg Zinc

- Gastric bypass and Biliopancreatic diversion patients need to take 2 multivitamins everyday

- LapBand only need 1 multivitamin daily

Calcium Citrate

- Chewable or Petite version until 3 months post op

- LapBand patients need 1500mg daily*

- RNY patients need 1500 to 2000mg daily*

- DS patients need 1800 - 2400mg daily*

* Limit calcium dosage to 400 to 600mgs every 4 hours to ensure effective absorptionand do not take within 2 hours of iron supplimentation, this will usually mean taking your multivitamin 2 hours before or after your calcium.

Additional Iron (for women who have had RNY or DS and are menstruating or have a history of anemia)

- Add 18 - 27mgs of elemental iron per day for a total dose of 50 to 100mgs, including iron in your multivitamin.*

- liquid forms of ferrous fumarate, ferrous sulfate and ferrous gluconate are the best absorbed forms of iron.

* You may want to add an over the counter stool softener such as Colace when starting an iron supplementation regimen to reduce problems with constipation when taking iron. 

Vitamin B12

- RNY patients should either take a sublingual 350mg B12 or obtain a monthly injection from their PCP. 

Vitamins A, D, E & K

- DS patients need 1 ADEK tablet daily

Here is a link to the supplementation guidelines from the American Society of Metabolic and Bariatric Surgeons (ASMBS) which are the governing body of bariatric surgeons. You will find a table that provides the information on page 7 as well as the details of what you need and why you need it. You may want to check these recommendations against your current regimen to be sure that it is complete and up to date. If you find that your regimen is incomplete, you may want to contact your surgeon to discuss modifying your supplementation regimen. This recommendation address all bariatric surgeries.

Hi Kat,

Sorry for the late response. I haven't been on for a couple of days. I take SSRIs as well as other meds for severe clinical depression. The medication that I take is a time released medication, as are many and it works fine for me. I know others that take SSRIs that have had RNY and have been able to handle it just fine. I have heard of others that have bipolar depression that have been able to continue meds successfully.

I would suggest that you consider cross posting this to the Mental Health, Main and the RNY forums to see if you get more responses by casting a wider net. I think that the mental health forum may be a good bet. 

Wishing you and your sister all the best,

You'll get a lot of good advice on getting back on the path. I just want to say don't beat yourself up and call yourself names..it doesn't help and will keep you stuck.

Has anyone run into taking meds for psychiatric issues (bipolar, depression, etc) only to find it it like they are off meds after the surgery. My sister is bipolar, and has regressed horribly since roux n y surgery...she has lost 220lb but also her stability.  I went with her to her psychiatrist, he admitted knowing NOTHING on this and was as perplexed as I on how to handle it. Is this not scary?  Hasn't anyone researched this, considering many bipolar and depressed people self medicate with food??