Question:
Will future qtys of medications be affected by malabsorbtion (DS)?
Will I be able to see my local doctor about other heath issues in the future? Will I need to have doses of prescriptions for medications such as antibiotics etc. adjusted to allow for the malabsorbtion? I want to be able to consult general practitioners (what a doctor is called in Australia) in future years when/if I have illnesses not related to WLS. How dependent will I be on my surgeon and for how long? Sorry, a lot of questions in one!! Thanks in advance for any help!! Anne B — AnneB (posted on October 5, 2004)
October 5, 2004
Hi Anne,
For the most-part - no. Keep in mind that we (DS post-ops) really
malabsorb fats - I have a 65 cm common channel, so my rate of fat
malabsorption is pretty high. So, fat soluable vitamins (vitamins A, D, E,
and K) are not as effective, so I take ADEKs - water soluable formulations
of these vitamins. It'll be best to NOT take extended release medications,
most patients just switch over to a regular dosage after surgery - if there
is a continued need for that particular medication. Most of us end up not
needing most, if not all of our pre-op RXs.
Hey - hope this helps some. Let me know if I can answer any questions,
okay?
Blessings,
dina
— Dina McBride
October 5, 2004
Okay - sorry, didn't get a chance to finish answering your questions - kids
are just home from school, so it's a little wild! :)
Okay - so yes, totally okay to see your regular doc in the future. I live
in Oregon and had my surgery in Spain. My primary care physician (PCP) is
who does my follow-up; I fax or email copies of any lab results, etc to my
surgeon when appropriate.
I actually am needing lesser dosages of some medications as a 2 year plus
DS post-op - not sure why, but some things just work better for me now than
they did before.
I think it's really important to have a good relationship with your
surgeon, and it was extremely important to me to have a surgeon who was
committed to being involved in my life for the rest of my life; but
honestly, mine surgeon lives half a world away, and so while I want him to
know how things are going, it's not practicable to assume that he has to be
point man on my health care. You know?
Anyway, hope that helps.
Blessings,
dina
— Dina McBride
October 5, 2004
As long as your have a regular doctor who is willing to work with you and
educate themselves on what the particular issues are associated with the
surgery you have, it should not be a problem. My internist made it clear
from the start he would support me all the way. He has actually taken a
much more involved approach than my WL surgeon. The surgeon runs all kinds
of bloodwork but has somewhat downplayed some of the readings I had at 1 yr
and 18 months. My internist dove into them more and made some changes so
as to keep me as close to normal as possible and not let the numbers get
too low. My WL surgeon might say it was an overreaction, I don't know.
All I know is my internist has been there for me through a lot of crap over
the last 9 years and I'd rather error on the side of overcautious than not
taking things seriously.
<p>As far as the malabsorption I cannot speak to the DS but my
experience with a 150cm bypass RNY has been that we had to adjust my
depression meds over time. It took a good 9 months for the problems to
surface. It only took a small increase to bring me back to where I was. I
also have found that the meds I take for my daytime sleep disorder have had
to be bumped up a small amount. I've not noticed any problems with
antibiotics not working though. However, the DS may be a different story
and like you always hear every body is different.
— zoedogcbr
October 5, 2004
Thanks Chris,
That is very reassuring, especially with your long term history of 9 years.
I hope you contine to do so well:)
It's scary because local doctors don't really support doing anything
radical to your body that is elective. But don't really see WLS as being
elective for me, it is a "live a quality life" or 'die young'
choice!
Thanks also, Dina, your insight and experience is so helpful to me!
— AnneB
October 5, 2004
I had a DS 3.5 yrs ago and am just now experiencing where a med needs to be
adjusted. My vitamins and all are fine as I take 3x a day and I've been on
antibiotics that didn't seem to be an issue. I have a new med know that's
supposed to be 1x per day. I actually need to take 2x per day as my body
must be breaking it down faster. My Dr. and I totally forgot about the
potential of the malabsorbtion. I use my regular Dr. and I follow up with
my surgeon 1x per year. I have both Dr.'s get copies of my blood work so we
all work together.
— Linda M.
October 6, 2004
Dear Linda and Chris,
I would be interested to know how you are going with the weight loss
maintenance since you both had the DS a long time ago. Have you managed to
maintain the WL. How close to goal have you come?
I hope you see this message.
And thanks for the info - I will keep in mind that meds can be affected - I
guess, in time it might be easy to forget!! Of course I will have to have
the op before I can possibly forget! LOL
Anne
— AnneB
October 6, 2004
Just to clarify, I am 20 months PO and had an RNY with a 150cm bypass and
1/2 ounce pouch. What I was trying to say is that I have been working with
my internist for 9 years and he has helped me through a lot and therefore I
don't feel he was overreacting when he ordered some of the tests and
procedures that the WL surgeon did not seem to feel was needed.
<p>At 20 months I struggle with my old eating habits. I am able to
keep the yo-yo within about a 5-7 lb limit. I hit 200 for a few days last
week, which I was really bummed about since that is my upper limit I want
to stay under. But today I was at 194, so toning things down a bit and
focusing more on protein has worked again for me. I am starting to worry
that it won't continue to be as easy to take 5 lbs off. I will always
struggle with my old eating habits. I just try and keep things in
reasonable check and don't beat myself up too bad over it. But when I see
numbers on the scale I do not like, I buckle down.
— zoedogcbr
October 6, 2004
OOh, I understand now. Sorry Chris!! It sounds like you are really worried
about the long term control of your weight. I don't know if this is
helpful, but at least you are working within a few pounds, i.e. the time
and effort needed to lose a 'few' pounds probably won't be as massive as
before your op when you were struggling with so much more.
I lost 37 kgs (81 pounds according to my calculator - LOL) last year, I
gained it again within a very short few months. You have managed your
weight for 20 months - this is AMAZING. You sound like you are on top of
it, coz when I started to gain my weight back, I didn't even bother to look
at the scales anymore - that is when you know you are in trouble. The fact
that you are monitoring your weight and able to drop it back when it gets
high must be a good sign. Isn't this what 'never been overweight' people
do? You always hear them talking about the 3 extra kgs they are carrying
and what they are going to do about it! Very annoying!!!! LOL
Keep up the great work!!:)
Anne
— AnneB
October 8, 2004
HI Anne,
In the past 18 mos. I've gained 10 lbs. However,I have made choices that
weren't always the best.(by choice). Being a DS I don't absorb fat but I
absorb sugar and when I had my store,would be bored,I'd go next door to the
deli and grab a candy bar or a ring ding. However,I made those choices. I
also haven't been exercising. With that said-not too bad. I try to make
conscious choices and take full responsibilty for what goes into my mouth.
It's been very easy. There are times when I have a day when I'm tired of
eating the "right way" and I don't but usually only for a day. I
know my body dsn't feel good if I eat carbs/starch like pasta. Sometimes I
want fruit and veggies and I'll get protein but not the 80-100 that I
should. I had my labs done and all's fine. Saw my surgeon yesterday and
he's pleased. He recommends exercising and doing what I'm doing. He has no
problems. I even saw the nutritionist and she's pleased. I know what I need
to do,I just need to do it. I made a choice to have this surgery and it's a
tool. I've had to learn why I eat the way I do and all. Sometimes I
slip,when I do I don't beat myself up I just get back on ASAP and move
on-this is life. I don't weigh myself and play the numbers game. If I never
move down on the scale I'm okay with that. I would like to loose 5-8 lbs
but I'm not going to make myself nuts over it. That's old,done it.I'm done.
I love my surgery and I have no complaints. I've gotten to know my body and
what it responds to and dsn't. So, when I figured this med. thing out I was
thrilled. My Dr.s are willing to work together if needed. I take my
vitamins 3x a day and I'm good to go! Any questions don't hesitate to ask.
— Linda M.
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