Question:
What are the nutritional requirements after surgery?

After having WLS surgery, what are the nutritional requirements--how much calcium, protein, carbohydrates, calories are needed daily? I had surgery 5 months ago and have already lost 103 pounds. My doctor is always busy and rescheduling my appointments. As a result, I don't have any guidelines to follow. I don't know if I am eating enough or too much. I have no clue about how much I should be taking in. I do take 2 Flinstone vitamis everyday, along with 2 Viactive Calcium Chews and 2 Skin, Hair and Nail supplement to try and stop the hair loss. Someone please help!    — Norma R. (posted on May 26, 2004)

May 26, 2004
First, congratulations on a wonderful weight loss. Second, I'm sorry you have a surgeon who doesn't seem to care about his patients after he's performed the surgery and collected the cash. Unfortunately, that's becoming pretty common as more surgeons want to cash in on the bariatric business. In my program, I got a big binder of information from do's and dont's to nutritional requirements and recipes. As for your nutrition - I take 2 pre-natal vitamins and a b-12 sublingual daily as well as calcium citrate (Viactiv is calcium carbonate and is not well absorbed by RNY patients). The hair loss will stop on it's own, there isn't much you can do about that except get in at least 65 grams of protein daily. In addition to the prenatal and calcium, I take iron and a mega b-complex because my 6 month labs showed these as being low. On my own, I have chosen to try biotin and Dry forms of vitamins A,D & E to see if it helps my dry skin and hair. Check out either Susan Maria's bariatriceating website or the vitalady website. Both are post-ops and are good sources of info. Just add the www in front of the names (vitalady or bariatric eating) to get to their sites. You might want to find a WLS friendly PCP to follow you long-term and take care of your blood work. Good Luck
   — Carolyn M.

May 26, 2004
I'm really sorry that you have been left in the lurch (which is what I would call it). Do you have a primary care physician (PCP)? If so, go talk with him or her. Have you had any post-op labwork done? Please go to your PCP and have some done. There is a list of recommended labwork that should be done at intervals post-op. The list is available somewhere on this website. While it would be great if your surgeon took more responsibility with the aftercare of his patients, you will need to step up to the plate to care for yourself. Check out the library here on this website for post-op eating and nutrition info-- they can be different depending on the type of surgery you have had. About what you are taking now: the Flintstones sound OK but you could choose an adult multi-vitamin (they have them in chewable form), Viactive chews are calcium carbonate and for most WLS patients they are useless. You need calcium CITRATE, I take 1500mg per day. HSN won't do anything to stop the hairloss. You might want to consider taking iron and Vitamin B-12. Do you attend any support groups? They can be a great resource for nutrition info, clothing swaps and just general camaraderie with other WLS patients, as well as possible sources of info on PCP who are WLS-friendly and WLS-experienced.
   — lizinPA

May 26, 2004
So sorry you've been left without decent aftercare. My surgeon's office has a nurse practitioner who's an angel in disguise. My aftercare program had a phased in eating program, but basically after 8 weeks, I could eat almost anything I desired. Of course we need to stay away from sugar. Eating rules were protein first, then fruits and veggies and then carbs. No in-between meal eating. Get in a minimum of 60 grams of protein per day, 64 oz. of water per day. Stay in the 1000-1200 calorie range per day and have no more than 20 grams of fat per day. As far as vitamins, I take 2 multivitams with iron per day, 1 Vitamin A & D and 1 Vitamin B-12.
   — Cathy S.

May 26, 2004
Norma, I looked at your profile where in Texas are you? To figure your min. daily requirement on protein take your goal weight and divide by 2.2 that is the # of grams you need to work for. I sometimes take 3-4 flintstones complete make sure you get the complete so you get the iron. You need the B-12 most prefer the injections or the sublinguals but the part of our stomach that absorbs B-12 from our food is the part that is bypassed so you are not getting any B-12 and it takes about 3-4 months to become deficient in B-12 and this can lead to major problems with anemia and other health issues. You should be taking calcium citrate at least 1200 mgs per day I take 2 Citracal + D you need the D to help your body absorb the calcium. And never take the calcium and iron together they cancel each othee out and so with the same don't take the iron with milk products. E-mail me if you like I have some info that I would gladly copy for you about the vitamins and send to you. ....Nancy
   — nefish

May 26, 2004
Whoops...I forgot one really important thing . . . don't forget the calcium citrate.
   — Cathy S.