Question:
If drs. are professionals, should we listen to them?
Ok, another question for everyone and this one is long, once again I apologize in advance. I'm researching the RNY still and have read countless posts that say to listen or talk to your surgeon when a problem arises, I agree with this. If my surgeon didn't know what he was doing, I would not trust my life to him to cut me open. That said...I have also read dozens of posts about the type of calcium gastric bypass patients should take, the forever on-going debate is the calcium carbonate vs calcium citrate. I spoke with a pharmacist and he said that the carbonate CAN cause kidney stones IF, and he emphasized IF, you have a family history of them, mine does not, so he said my chances were nil. If dieticians and surgeons go through so much training to become "professionals" then why do so many on here say different? I spoke with a doctor, in a hyperthetical situation and this doctor knows a great deal about wls and he said that if I did have the RNY it would be fine to take tums for calcium, that I don't have to spend the extra money to buy what others choose to be their type of calcium supplement. I AM NOT TRYING TO STEP ON ANY TOES, I'm trying to get as much information as possible before I make a decision that will alter the rest of my life. It just seems that this is a topic that causes a lot of disagreement...if our surgeons are so wise and we trust them with a knife to change and cut our insides around, then do we trust them about a topic like calcium? If not, where can I find the Proper information ( a medical web-site) on which type of calcium I would take post-op? Thank you, Vicki. — Vicki L. (posted on January 11, 2003)
January 11, 2003
You said it! Surgeons are professionals and well trained fro their jobs but
the truth is nurses even have more knowledge about nutrition than doctors.
These things we are learning about gastric bypass are slowly emerging and
sometimes the surgeons are slow to jump on board since most of them are
unwilling to listen to anyone's opinion that differs with theirs. There is
tons of research on this site about this and other questions. In case you
havent found it yet, there is even a place on here to educate docs about
wls.
— Delores S.
January 11, 2003
Vicki - Sorry I can't answer your question, however, in all my research pre
and post op....the one thing that I STILL DON'T GET is how different every
surgeon is in the after care of WLS patients. Some surgeons say liquid
diets for 2 weeks post, some say 6 weeks, some even 3 months, Some allow
anything that you can tolerate at 6 weeks while some have patients on a
very limit reintroduction to food. I had to wait 6 months to have red meat
and pork and my friend who used another surgeon was allowed red meat at 8
weeks.......What can we do but trust our surgeons....My surgeons has many,
many years of experience not only in the surgical procedure but in the
field of research regarding weight loss and how the WLS patients system is
different from normal people. I trusted him with my life....I am going to
do exactly what he says even if I know others are doing just as well with
completly different after care. Good Luck and Best Wishes - Sharon - 115
pounds (OPEN RNY 05/13/02)
— Sharon H.
January 11, 2003
You toss the dice. That's all. You can't lose with calc citrate. You can
with carbonate. Why take the chance? It was never expalined that clearly
to me. I took the carbonate. I tossed the dice. Cost me my bones. And those
of my husband. There is no going back to correct my error. My doc NOW
recommends calc citrate, ONLY. They don't have the wisdom of the universe
at all times. They go on learning. You toss the dice. BTW, I'm not mad at
my doc or anything. He just didn't know "yet". Kidney stones were
not in my family or my dh. But we got them. It is very common after WLS.
That time, when I tossed the dice to go on with carbonate, I was better
informed. But *I* knew better. I got the stones, while losing my bones. I
am OH SO SMART, huh? That's why I'm so verbal. At least make an informed
toss.
— vitalady
January 11, 2003
In my opinion, surgeons are trained to do surgery, but that doesn't mean
they are experts in nutrition....That said, my nutritionist said that
Calcium Carbonate is fine, as long as it has vitamin D in it. I take
calcium citrate, because I figure so many people can't be wrong, and if I
have the choice of either one...I'll take the one that most people feel is
correct. I hope someday they find out that calcium carbonate is just as
good...so I can take a couple calcium chews instead of 10 half-pills, but
until then, I'll stick with what I feel to be right.
— thekatinthehat
January 11, 2003
Well my 2 cents. The surgeon is just that a surgeon. He is trained in
cutting, they usually have nutritionist for the diet. At least thats what
my has. He will guide you, but for the biggy questions he sends me to her.
Just my 2 cents.
The other thing I have found is that this web site and the long terms have
wonderful information and they can guide you as well.
— Jeana S.
January 11, 2003
I think that the reason there are differing opinions on this is because
there is probably no long-term scientific research on which is better.
Michelle Curran, who posted already, had taken her calcium carbonate
faithfully for years before she discovered she had osteoporosis and that
gave me pause. The dietician who taught my nutrition classes said to use
citrate only. That's what I'm taking, but as I said, I don't think there
have been any studies of long-term post-ops to prove or disprove that. I
do know that I sent a question to the osteoporosis foundation and they
replied that they did not know anything about which is better for gastric
bypass patients.
— garw
January 12, 2003
Doctors are required to take 1 nutrition class in Med School...'nuff said
about that. To keep it simple, carbonate requires stomach acid to be
useful. RNY'ers & DS'ers have none, therefore, citrate (no acid
required) is the answer. VBG'ers & Bandsters can get the calcium
benefit from carbonate but, as previously mentioned, run the risk of kidney
stones. A very simplified explanation.
— Leslie F.
January 12, 2003
Vicki, there just aren't the studies out there yet on RNY'ers and the
effects of citrate vs. carbonate. In fact, some wise surgeon who does WLS
ought to track his patients for years post-op thru dexascans and see the
difference between citrate and carbonate's effect on the bones. While it
is not true that we do not have stomach acid, (we have about 10 percent of
what we used to have), you do need stomach acid to help the carbonate,
perhaps more than the 10 percent. You also need to take elemental calcium
as that absorbs into our system. Some of the liquid calciums say they have
750 mg or more per tablespoon yet when you call them to ask how much is
elemental, its really only 250....I am in a support group with several long
term post-ops, around the 2-5 year post-op mark. Several of them said they
showed the beginning signs of osteoporosis while taking carbonate approx 6
months to a year after their RNY and switched to citrate. Now is it
because they were taking carbonate or perhaps the dosage was too low? I
don't know. But I'm not going to take the time to find out. I take my
citrate daily and will get a dexascan yearly, along with the blood tests to
see how the bones are doing and if I need to up the dosage. I also think
that those with more bypassed, like the 150 cm and more, have more to worry
about and may have to have even more citrate on a daily basis.
— Cindy R.
January 13, 2003
You wouldn't let your electrician decorate your house, would you? MOST
surgeons (not all, of course) are the mechanics of the medical world. I
look at it this way: I know that from the research I have done calcium
carbonate requires strong acid to be absorbed. I also know that the acidic
portions of my stomach and duodenum have been bypassed. THEREFORE it is
worth a couple of dollars more to me to buy calcium citrate. If I am right
and the carbonate is not absorbed, then I have avoided a lifetime of
problems. If I am wrong and the carbonate would have been just fine, then I
have only spent a few extra dollars. It's worth it to me. Everybody has to
make their own decision. For what it's worth, my own dr tells people to
take Viactiv. But I wouldn't let him decorate my house! ;)
— ctyst
January 22, 2003
My surgeon has come around on the calcium issue and does NOT reccomend tums
for calcium and advices us to take calcium citrate sublingual. Also , he
gives us B12 sublingual right off the bat. Some surgeons are good
surgeons, but don't want to budge on what they've preached for so long.
Maybe it's a pride thing.
Michelle
— Michelle A.
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