Question:
How do I get all of my vitamins/food/water in when there's only 24 hours in a day?

Hello all- this is going to be a long post, so please bear with me. I am 5 days post-op Lap RNY and I am feeling VERY overwhelmed and frustrated. Here's the deal: I know the pouch rules about not eating and drinking at the same time and that I would be on a few medications, however, my surgeon (and the accompanying guidebook) did not mention anything about the huge number of medications/supplements that I would be taking. I also did not know that when you take a med or supplement, you can't eat or drink for an hour before or after. I am on eight different meds (ranitidine, citracal, ursodiol, B-12, daily vitamin, triamterene, liquid acetaminiphen, percaset and iron), some of which I have to take twice a day but more like 4x a day because some of the pills are so huge that i have to break them into tiny bits. I am on a pureed diet for the first 4 weeks, which is going OK, I guess-- I'm not throwing up and I'm just a little nauseaus-- but I cannot get all of these pills down unless I stay awake all day. Add to that that I am so light-headed, and so exhausted, that all I want to do is sleep. It's the weekend, so my doctor's office is closed. I am hoping someone out there can give me some advice or tell me that these feelings are normal. Do all new post-ops go through this?    — lizinPA (posted on February 15, 2003)


February 15, 2003
I am curious as to why you are taking so much, so often. I take a mltivitamin everyday. I just had my lab work for the first 3 months and I was a little low on iron so I started a Iron supplement. That is all I take, and it is only once a day. Check with your doctor and see if all of that is necessary, you might get some releif.
   — dkinson

February 15, 2003
At 5 days out, I wasn't taking any calcium or vitamins, etc. I don't think I'd worry about that too much right now. Your prime concern is getting as much fluid into you as you can manage. Trust me. I had numerous ER visits due to dehydration and it is not something you want to have happen to you. <p> However, one of the things I do to get some of these things down now is to take them with yogurt. I'm taking 2 1/2 Citrical tablets a day since my PCP didn't want me to take more than that. Now that I'm several months out, I can take them whole, but I can't swallow them with water, so I take a spoonful of yogurt, then pop the pill in and swallow them together. I use the sub-lingual B12, so that doesn't have to be swallowed either. I'm also taking a pre-natal vitamin, at my surgeon's direction. I also take that with yogurt. Then I am still taking a couple of prescription drugs that I will probably have to take my entire life. Again, yogurt helps me get them down, although you could use the same technique with sugar free jello or pudding, or a bit of applesauce. I did use jello and applesauce early on, until I was finally able to come home. Then I switched to yogurt because I was thoroughly sick of sf jello. I do take all my pills throughout the day although I can take some of the smaller things at the same time. It will get easier as you go along, I promise.
   — garw

February 15, 2003
I know it seems very overwhelming at first, but you will get used to it! It becomes second nature. Where did you hear about not drinking before and after taking medication? Not saying it's wrong or anything, I just never heard that before. I mean if I followed that, I'd totally understand your frustration! I take alot of meds and vitamins, too. Just be careful, our little tummies can only handle so much, I ended up developing an ulcer/hole in my stomach most likely due to all the meds I took b/c of a chronic illness. I was on 8 meds, PLUS all the vitamins, like 25 pills a day, and that's alot for a regular stomach, let alone a 1oz stomach! Besides that, however, i really just follow a couple simple rules. Don't drink 30 minutes after meals (they say not to drink 30 before, but I don't follow that as much, and I know many others don't either, I know I should...) Also, don't take calcium with iron. And don't take all the calcium all at once since only so much can be absorbed. And I get in atleast 80oz of water a day, it's really important! <p> You're going to be exhausted and weak for a little bit, you just went through major surgery. I promise, it will get better. I am now 8 months post-op and exercise regularly and have so much energy. And I still find I eat more at night due to not getting in enough protein during the day. but I never reached my "goal" amount of protein until a few months ago. At your stage, you need to focus on getting those 64oz of water in, and staying hydrated. Get in protein as much as you can, but if it's only 20grams right now, it's fine! You're still so early post-op and your tummy needs time to heal- that's why we're told to eat pureed and liquid foods at first. Don't stres yourself out about it, I know it seems hard, but it gets easier, and you will feel better and gain more energy eventually. Right now, just drink your water and focus on recooperating! Goodluck to you, if you want to talk, e-mail me anytime! ([email protected])
   — Lezlie Y.

February 15, 2003
Beth, Can I relate!! I am 12 days out and also am struggling to get in my calcium. In my case the first week my doctor told me to not worry about the vitamins etc. I'm still not back on some of my pills (allergy, anti-inflammatory), but since I am doing okay I'm just focusing on the things I really need (daytime sleep disorder meds and depression medication - don't want to mess with that one right now). The 2nd week I started with the vitamins, B-12 and calcium. The vitamin is easy because it's chewable. I first bought the Centrum adult chewables but YUCK! Now I have Centrum Kids Rugrats and the grape and cherry are great but I still don't like the orange, but it's better than the adult. Sorry I digressed! <p>The B-12 is a piece of cake, once a week under the tongue. I'm also doing fine with getting my prescription meds (once a day) in but the calcium, that's another issue. I have to cut each pill into 2-4 pieces and there are 4 pills to take. I mentioned to the doctor that I was having trouble and he told me to work up to the 4 pills that 4 is the goal. As long as I'm getting the multi-vitamin down that is okay for now and start with at least 1 calcium a day and advance it as I can. <p>I've been fortunate that I've been off prescription pain meds since day 6. I occassionally take some extra-strength tylenol but usually at bedtime when my stomach is empty and then it goes in okay. <p>As far as the water part, I was not told I could not drink after I took pills, only after I eat so that I did not wash the nutrients through too fast and get no nutritional absorption plus don't want to over-stretch the pouch. Hopefully in the next few days you can lower or get off the pain meds which will lower the quantity somewhat. The percoset that I got is liquid form, which would help you. Make sure you have chewable vitamins. Have you discussed why you need the extra iron? If you must have it then maybe an adult vitamin with iron and cut it into pieces would be best as you could get both the multi-vitamin and extra iron taken care of at once. <p>I know that first week+ it was really hard because I was sleeping so much in between meals. Then I would wake up and want to take a drink but then that delayed eating and so on. I'd find out why you can't drink after taking your pills. A lot of medicines are absorbed in the bowel anyway so it's not a big deal that they get moved through the pouch quickly. I know I'm absorbing my meds, because if I wasn't I would not be able to stay awake during the day and I'd be feeling my depression flare-up. It sounds like if you could drink after taking meds that would definitely help in addressing the need for fluid. Good Luck! I am in your shoes and know what you are going through. Chris D.
   — zoedogcbr

February 15, 2003
I've never heard that we shouldn't drink for an hour before or after meds and supplements! If that was true, I should be in big trouble, because I wash my pills down with liquids and continue drinking... However, my labs have all come out just fine. It was quite difficult in the beginning to squeeze everything in, especially when I was still breaking up pills or trying to mix capsules into liquid or food. Eventually, it becomes more routine. I have a Sunday through Saturday pill case, only I fill it with my DAILY meds in the morning, and carry that with me to work. It helped me to establish a routine in taking my pills and it does eventually get easier.
   — sandsonik

February 15, 2003
I'd doublecheck that rule about "no eating an hour before or after a medication/supplement." If that's true of everything you're taking, and I don't think it is, no wonder you can't figure out how the heck to get it all in. And some meds actually are supposedly better absorbed if taken WITH food, but again, I'd check with your doc or pharmacist on that. And have the doc or nutritionist or pharmacist figure out which meds you can combine and take at once, and which ones have to be separarate from the others. Like the previous posters, I know you shouldn't take an iron supplement at the same time as a calcium supplement (iron won't let the calcium be absorbed if taken together). And fortunately, you won't be on percocet or acetaminiphen for much longer.
   — Suzy C.

February 15, 2003
Personally, I don't drink 30 min after a solid food meal. I drink protein supps throughout the day. Many people take their vites & meds with protein supplements. I take mine with food. Always remember that iron + C go together, alone, apart from anything else for an hour. As for what the meds can be taken with, the pharmacist will be your best guide. How often do you eat and drink, perhaps we can help you iron out a schedule?
   — vitalady

February 16, 2003
CRUSH YOUR PILLS!! Put them in a little applesauce after crushing and just swallow them that way. Get a Ziplock baggie, put your pills in there, get a hammer, and crush away. I am a nurse and I crushed all my meds for the first few weeks. You can also put them in whatever you are drinking. Good luck to ya!
   — Rachel W.

February 16, 2003
Hi Beth! Sounds like you had your surgery the same day as me. I had Lap RNY Feb 10. First of all, I was wondering why you are taking so many supplements so soon after. I am taking only one dose of liquid Centrum (available in any pharmacy). My surgeon says not to worry so much about food intake at this point. I was worried too, the first couple of days, about getting in my 5 or 6 small meals every day. I even went so far as to put myself on a schedule! Then I realized that was a losing battle, given that I am sleeping twice during the day. My surgeon said your body can actually go 2 whole weeks (!) without any food, but only 2 days with no hydration. So I drink a LOT (trying to get in at least 32 oz a day)and experiment with like one mushy food a day (today I had mashed potatoes, yesterday sugar-free applesauce...woo hooo what fun!)I have been very very very blessed because I have had no pain medication since day 2.............didn't need it. But I know percoset makes you very drowsy, on top of being just physically drained because of the surgery. Last thing I want to say...could be the light-headed feeling is actually your body telling you to either eat or drink. I went 4 hours without food and didn't get hungry, but started feeling really woozy, almost buzzed (like right before you get drunk). I ate a quarter of a banana and was fine. Maybe in the morning you could call your surgeon's office and ask if you're supposed to be taking all those supplements already and how to work them into your diet. Just my 2 cents.
   — RedHeadBeauty

February 16, 2003
Original poster here-- Thank you for all of your answers. I have an update: Since my discharge from the hospital, I have been back to the ER twice due to high fevers and nausea. I had a CAT scan today and it turns out I have a touch of pancreatitis, so I am back on a clear liquid diet. I have started antibiotics. I was given an anti-nausea medication and Dilaudid (for some pain) via IV, so I'm feeling a little better. One thing I did make clear to my surgeon was that he needs to prescribe LIQUID vitamins/meds as much as possible to new post-ops. He did not realize how overwhelming it could be. For now, though, I am not taking anything except a chewable multi, and the meds for the pancreatitis for the next week.
   — lizinPA

February 17, 2003
This is what works for me: for pain I use excedrin quick tabs(cheaper than liquid tylenol) which dissolve in your mouth.I will soon be taking chewable calcium citrate(available at vitacost.com).I just bought chewable vitamin E(Bought at GNC) that taste like the maple glaze on a donut.I eat childrens flinstone chewable Vitamins(they have the same vitamins as the expensive $30 liquid at gnc except for the biotin content is higher in the expensive stuff)and chewable vitamin C. I remember to take the iron with vitamin c but not with Calcium. Anyway with all this vitamin chewing who's got time to be hungry :). Anything that does have to be crushed gets put into applesauce at breakfast and dinner.
   — Ishmael E.

February 17, 2003
Just a little word of caution - please be SO careful using Excedrin Quicktabs - this is an aspirin based product and is notorious for causing painful ulcers. You can substitute children's chewable tylenol instead of the Excedrin or tylenol liquid (yucko!). Just adjust the dosage of children's chewable tylenol to meet your needs. Best wishes!
   — ronascott

February 17, 2003
Hey, when I was post op I had this same fear...being so analytical I did the math..I think I ended up figuring I would need to stop sleeping! : ) but as I got farther out I can stand more at once..like more than a sip of water without feeling like I am going to explode..although I have mastered the art of taking a drink of water..realizing it is too much so making a dam in my mouth and allowing the first gulp to go down! suggestion on the calcium...you can add liquid calcium into your protein drinks..it comes flavored..but you can't really taste it. if you go to www.wlssuccess.com they sell it there and it is cheap and easy...plus depending on what sort of protein your drinking..you can count the water that you add as part of your daily water..at least thats what I was told ...so no one get mad! anyways I hope this info helps!!! also if you are having a hard time getting protein cause you think its icky...on that website you can order a protein sampler of all the most popular kinds..just an idea!!!
   — Jessica L.




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