- HEALTH TRACKER
Cool--congratulations. Good luck.
I forget the bougie size used, but I want to say 34fr? Maybe? My common channel is 100cm and I lost most of my weight in 18 months.
Wow! You win the award for highest dose I've ever seen.
I kinda theorize that once someone is taking 200,000 IU or more, maybe something else is going on besides JUST malabsorption. Totally just a theory, but maybe there's an issue with it being utilized too quickly, or an issue with another vitamin/mineral that makes it difficult to absorb or use the vitamin D, like a co-dependent relationship not working out well...or something like that.
I like the idea of possibly looking for other possible sources of improvement in bone health before adding more, more, more vitamin D.
OK, so the vitamin D 1,25 is the "active" form of vitamin D. It's the form of the vitamin that actually acts to increase calcium absorption in the intestine. We usually measure the vitamin D 25 OH (inactive form) because that's the one that has been studied to tell us that's what is most indicative of our overall vitamin D status.
The pathway is something like:
Body recognizes that calcium level is low > body tells PTH to increase > PTH tells areas of the body (usually kidney) to activate vitamin D > vitamin D 25 turns to vitamin D 1, 25 > vitamin D 1,25 acts to increase calcium absorption
And yes, theoretically it could be dangerous if the vitamin D 1,25 never goes down because it just keeps telling the body to absorb absorb absorb calcium and that could raise the serum calcium level. Which, in your case, isn't true.
My question would be -- why is the PTH still so high? The correct response would be that once the body get its calcium back, the PTH goes down so that signal isn't constantly being sent. It's certainly not something to worry about TODAY, but what about next year? PTH also tells the body to take calcium from bone in order to maintain that balance so I really wouldn't want to see it high forever.
So, my next thought would be that maybe it's possible something else besides vitamin D is going on? Is there enough calcium coming in? Are other minerals doing OK? These are just the things that'd be rolling around in my head instead of just writing it off completely. I can't really give recommendations beyond that, I try to avoid that--I'm not really qualified to do so. Sorry!
Hope that helped at least somewhat, maybe.
Some providers automatically would like a patient to check for colon problems and bleeding before administering an iron infusion because micro bleeding would cause the iron to deplete really quickly. This could be the reason for the referral.
Otherwise, I haven't personally heard of a gastroenterologist giving an iron infusion, unless they refer you to a local hospital, because most gastro offices do not have an infusion center in them.
Beano is just an enzyme that helps digest very specific sugars more easily. These are raffinose sugars. If the food doesn't contain raffinose starch, it's not going to help.
So it can help with beans, cruciferous veggies like broccoli or cauliflower, or some whole grains. But not necessarily something like a cookie or a candy bar.
There is sooo much swelling, you just look like frankenstein the first month, it's normal. But get a compression garment STAT! It helps so much with swelling. Don't overthink the results right now. PS isn't perfect so never go into it expecting that. And you can ask about the scars you don't like at your post op visit. He may have done it for a reason so that you had a better result.
Keep bugging about pain meds. I took percoset and muscle relaxers like candy for the first two weeks and I was still in a lot of pain. I can't imagine anything less.
This is the convention for posting lab results:
Hemoglobin -your result- (lab range)
Hgb: 11.5 (12-16)
And you put them whether the result is high, low, or normal.
Even better would be if you begin an excel or google spreadsheet, upload it to the internet, and share the link with the forum. Keep all lab results in one file so you can see changes. That is the best way to do it.
If you have an infection, it can mess with certain levels. Makes some of them seem lower than they are and some higher than they really are. Makes labs really difficult to interpret. If you're really, truly sick with a cold...I'd wait. If it's just allergies or something though, it should be fine.
If you're eating a varied diet, I would not be concerned. If your whole diet consists of refried beans only, we may have a problem. I'd also be more concerned if you eat no complete protein/animal sources whatsoever. Personally, I don't keep track of the trace amount of protein available in carbohydrate heavy foods (bread, tortillas, rice, noodles). If you eat the incomplete proteins, you might need to eat more total grams than you would if you're throwing back whey protein isolate all day.
In general: If it's not a problem, don't make it into one.
I'd just worry on nutrient timing and let your body tell you how much you need.
If you run out of energy during the workout, add a small ~10-15 g "slow" carb before hand. Still out of energy, add 10 more grams. Best time to eat "fast" carbs (sugar) will be after a muscle work out. Muscle glycogen will be gone and what you eat will go toward replenishing that. Combo with protein to repair. And I do mean right after the workout. Within an hour. Doesn't have to be a big meal, but something.
I'm guessing you'll be eating at least 150g/day. Depends on your size/height/individual needs.
I definitely eat it occasionally. I love it.
It's a whole grain, can be a good vehicle for fat, and you can eat a whole mini bag for about ~20g of carb. One mini bag fills a big bowl of mine twice, so it definitely feels like a big portion.
Scary. Definitely hit the protein hard. As long as you are capable of oral intake, you should be able to get yourself back on track without intervention. I would even consider a digestive enzyme supplement for a short period of time with meals to help with absorption.
Definitely lots of protein shakes, as Gina mentioned.
Albumin has a half life of 20 days, so there really is no good in retesting sooner than 3 weeks from now. You can, on the other hand, test prealbumin within the next week to see if your improvements are enough. If you are still low on prealbumin, you need to be more aggressive.
Out of curiousity, when was your albumin tested? Like, day one in the ER? Couple days later? Did you have an infection of any sort -- high WBCs? Were you on IV fluids? Certain things can make your albumin appear lower than it actually is.
I'm not supplementing omega 3s right now. I have in the past, but right now it's one of the "nice to haves" but not a must have. I rank eating lots of fresh and yummy food higher than the omega 3s right now. I've taken coromega and I've taken the barlean's swirl product. Both are definitely yummy.
Those products use egg as an emulsifier. Similarly, bile is an emulsifer. That basically means that it breaks the big blob of fat into tinier little blobs of fat that are more easily digested by enzymes (lipases). If there are tiny blobs it's easier for a lipase to attack the fat as opposed to one big blob. Once the tiny blobs are broken down small enough, they can be absorbed.
And so, reminder with the DS, we separate bile and pancreatic enzymes from food until the common channel. There's a tiny bit of lipase in the alimentary limb, but not much. So typically we'd be waiting to emulsify + digest with lipase until the common channel, but in an emulsified product, there's going to be a greater chance of absorption earlier on. Do we absorb the whole thing? I think probably not, but I don't know for sure.
I doubt you have an essential fatty acid deficiency though. Just try to remind yourself that omega 3s help with inflammation and just by losing weight you have decreased the amount of inflammation in your body...so it's not all bad :) Trade-offs and such, you know...
I've heard it's a pressed tablet, but these sorts of things are still oils. So, I mean, you can add powdery stuff as much as you want to make it feel dry to the touch, but the fat is still there. I mean, think of a buttery cracker. Tons of butter in there, but there's so much flour added that the cracker feels "dry." Does it make the butter easier to absorb?
And yes, there is an essential fatty acid panel. I've had it done and I didn't get much out of it, other than some random fatty acid was low that I'd never heard of before and could never figure out a source to raise it... so, I didn't get that much out of it...haha. You can also test triene:tetraene ratio which is supposed to give an idea of whether you are deficient or not.
The thing with MCT is that it's a type of fat that does not require pancreatic enzymes to be absorbed, it is just directly absorbed. So yes, in those with malabsorption, it's probably better absorbed.
As far as it being good for weight loss, I have some reservations about that, considering this is going to add mroe absorbably calories to your daily total.
What kind of MCT oil is this -- coconut oil? I know a lot of people purport the health benefits. I'm not sure there's research to back this up.
20 lbs is a molehill compared to what you have already done.
I would not drink alcohol every day if you are trying to lose weight. It's not just the sugar (which is 4 calories per gram), but the alcohol, which has 7 calories per gram. I would limit to something manageable. Say, one glass 2 days per week. Think of wine as dessert. It's essentially the same thing. Calories with no nutrition. So, think of how often you might have a piece of cake while you're trying to lose weight.
Egg rolls shouldn't have rice, usually just cabbage, carrots, and probably some sort of meat.
Some people can't eat them since the wonton wrapper is usually made of wheat, which is a common intolerance in DSers.
I will eat the ones with the thin, crispy wrappers. But don't like the ones with the thick poofy wrappers.
Glad to hear someone is having success. I'm very pleased that your doctor allows them to get them frequently as dictated by your labs. I REALLY dislike when a doctor tell someone they get one per year without testing. Do these raise your 25(OH)D above 50 ng/ml?
Does the DS turn you into a pill popper?
I know a few DSers that are healthy and only take vitamins 2x per day but they are a rarity. Most take them about 4 times, from what I can tell. Don't go into surgery with the mindset that you'll be one of the ones that takes them two times. If it works out, great. If it doesn't. you need to be willing to change. Lots of things are going to change and I think it's best to go in with the mindset that you will do anything necessary to become healthier after surgery because that's the point of doing it in the first place. There is no rationale for having a surgery to decrease obesity but just trade those obesity-related issues for vitamin deficiency related issues.
Go into surgery with the can-do, will-do attitude.
"I will do anything necessary for my health."
You'll adapt. :)
I can find something to eat at any restaurant. It'd be easier for you to post your favorite places and I'd tell you what I'd get based on their menu.
I basically look for any protein-based meals (fish, chicken, or beef without any sort of breading), and I like veggies or potato for a side. Favorite is fresh green beans for a side if they have it.
Seafood place: I'll get something like shrimp scampi or crab legs.
Italian: they usually have some sort of non-pasta protein dish with chicken or seafood in a wine/cream sauce. I like to get a side salad with vinaigrette dressing.
Steak places I like to get steak, obviously! haha
Sandwich places I'll get any sandwich with lots of vegetables and eat open faced with lots of sauces/condiments, cheese, etc.
I'll eat burger without the bun, again with lots of mayo/mustard/ketchup/vegetables. Skip pasta salad and bread, but will eat a few french fries if they come with it. I try to share the starchy side with at least one other person, and will skip altogether if I can't share.
Asian places - any sort of stir fried non-breaded meat with vegetables in a spicy red sauce like red chili sauce. I'll eat a few bites of fried rice.
BBQ - pulled pork, sausage, brisket, etc. Any meat without bread. I will eat cole slaw and potato salad if I have room.
Another favorite type place to go is to get hot wings, which, as long as they are unbreaded, I can eat plenty of.
Mexican - I always end up getting fajitas and don't eat the tortillas. I like mexican food, but I find that many places have not a whole lot of things I can eat. That's the most frustrating place for me to eat at. The food is so good but gives me gas if I eat too many chips, tortillas, etc, so that cuts out any taco, burrito, enchilada, etc.
That's all I can think of now. But if I am eating out I mainly try to avoid side effects from flour products. So I look for unbreaded meats and vegetables. I also like to try new things so if they have some sort of funky cheese dish or cool appetizer that can be eaten without bread, tortillas, breading, etc. I avoid wheat flour.