Hey everyone!!  Boy is this weather here in the Philly area getting stifling hot!  YUCK.  

Anyway I was wondering why so many of you take soooo many vitamins?  My doctor only told me to do the high ADEK multi, calicum and iron.  But I have iron infusions so I don't need to take the pill form thank god cause that causes issues for me.  I found out recently that I have low potassium ( I am 8 weeks out), it was 3.2, which I looked up and isn't extremely low but enough I have now got to take a potassium pill, which are GIGANTIC, so I crush them as per instructions and swallow it down.  It upsets my tummy for a few minutes as it causes indigestion and bubbles which are always uncomfortable.  Hoping with them and eating higher potassium foods it will raise it back up, already feeling a difference just in eating higher volume foods as I have known for 2 weeks now.  I had issues with swelling and PCP wanted me on a water pill but needed to confirm bloodwork was ok as water pills cause potassium to drop, and that can cause heart issues and we don't want that.  After 3 calls to my surgeon's office they got back to me finally with what to do.  I am mortified that my surgeon's office took 2 weeks to get an answer from and it is ONLY cause my PCP office was so diligent about following up with them.  UGH, anyway all other blood looked great he said.  I go this week for my hematology bloodwork (standing order, once a month).  Frustrating all the bloodwork I need but that is how it goes.  Last month everything was great and there was no need for any additional vitamins or infusions.  So my main question is why take so many different vitamins?  The high ADEK multi isn't enough to cover what we malabsorb?  I feel like it is a marketing ploy or something as vitaladies DS package is so extensive.  I certainly can't afford to be peeing out the money I am spending on them.  lol  Thanks girls/guys for all your help.  I surely appreciate it.  

Oh of course I am also taking in as much protein as I can.  Finally found a shake that works for me but the cost is more then I like but I know I gotta get it in, so I use the atkins 15gram shake while I add another 15 grams or so of unflavored protein powder to boost the shakes total amount.  Plus I feel like all I eat is high protein foods, well along now with high potassium foods.  lol  The day isn't long enough to get anything else in...lol  

Hugs,
Donna

Donna,

I'm sure there will be vets here who can give you tons more details than I can, but the short answer about why so many vitamins is because of the malaborption.  A DS person doesn't absorbp 100% of anything after the surgery (with the exception of simple carbs) and in order to keep yourself healthy you have to take the vitamins.  There can be terrible problems ahead for you if you don't.  Your dr did explain this to you beforehand, right??  Vitamin deficiency isn't something to be played around with.

If you haven't already done so, I would suggest that you go to dsfacts.com and do some reading as well as visiting http://www.weightlosssurgery.proboards.com/.  You will be able to get a much better understanding after doing research.  I can assure you that it's not a marketing ploy by Vitalady or anyone else - it's all fact.  I'm glad your pcp is trying to be your advocate because it doesn't sound like your surgeon's practice really is.  Even with that said, not alot of pcp's or nutritionists are that familiar with the DS and all that it entails.  You really need to do alot of research and plan on doing those labs everything 3 months for at least the 1st year so you can make sure you can get your arms around any problems you may see before they become too serious.  Always keep a copy of every lab slip and always ask for a copy of your lab reports as well so you can spot trends.

 Yes Virgo I understand our malabsortion issues, but I don't understand the numbers I guess.  Even with all the reading I have done and compared to my surgeons office and what they advise.  They don't order bloodwork til 6 months out, as I was told right after surgery they don't see drops usually until that far out as we have enoughed stored, altho that was wrong apparantly with my potassium.  Maybe I wasn't clear enough in my question.  The multi vitamin I take is a HIGH ADEK and has over 100% of everything and for what I was told and read we malabsorb abt 50% of that?  It also includes all the B's and many other vitamins so why would we need to go above that and take stuff separately?  I guess it is just frustrating me to hear all the differences of opinions and I wanted to hear from some ppl who do it as to why they go so above and beyond?  was it due to bloodwork abnormalities or were they told straight out the gate they needed to do this?  

My biggest frustration right now is the fact that my highly recommended surgeon's office is being so difficult to track down with answers, for me and my PCP.  My PCP couldn't recommend them enough and I have always heard such good things about abington but ever since I had the surgery it has been nothing but issues and I don't know where to turn for answers.  I feel like they got my money and now are done with me kinda.  They always say when i am there to call if there is a problem but when you do you get a machine to leave a message 9 times out of 10 and you leave said message and they don't return your call.  I am just venting, sorry to come off harsh, but just like everyone my time is precious and I expected different results then I am getting.  And now I feel stuck.  My mother is my "support" person and she is overly frustrated with them, it doesn't help me.  I feel like I am doing what I have been told and I am finally feeling more normal again, just don't want to backwards again, it has been a tough 8 weeks and I surely want to keep improving.  Thanks though for your thoughts!

Hey Donna,

I'd be frustrated too and I think I'd feel the same way as you - they were there to take your money for the surgery and then the aftercare sucked.  I hear alot of other people say the same thing.  Let me ask you - are you the the DS facebook board?  If not let me know.

 No I am not, don't want to "invite" myself to a board that was I believe intended for vets?  Altho I am sure there is good information there. 

It's not like that....  The vets there are more than willing to help.  I'm pre-op too and and reading the posts there has really helped educate me more.  I ask questions and there's always someone willing to provide answers.  I'm going to send you a pm in a minute so we can swap information.  Not sure that I can add anyone because I'm not a moderator, but I know others who are.

Donna, it is NO marketing ploy by Vitalady but what she and other LONG term vets have found out we need thru MANY years of walking the walk and talking the talk. While she is a RNY patient, her intestinal configuration is the same as a DS...she has what is called a distal RNY. She has the pouch but she also has the same bottom configuration we do.

You need to get a full set of labs post op (about the 3 month mark) and make sure ALL the values are in the HIGH NORMAL end of the range...

Example a D level of less than 80 is NOT high enough. And the range is 35-100. You need to be in the upper end of that range.

Plus taking them separately allows tweaking that a high aedk multi does NOT allow. I may need more D but need to cut down on my K...if I am taking them separately, that's easy enough to do but if they are all in one pill, what part of the pill do I delete??? I can't. And cutting down on the number of multi's would cut out some of the D....understand?

Liz

I was trying to follow my surgeon's guidelines at first too but we both agreed it wasn't enough as we watched my labs trend down every 6 weeks to 3 months of testing. My surgeon ok'd Vitalady's plan and my labs were optimal, not merely in range, at 1 year post-op and have been optimal since. He and his dietitian have since adopted her plan for the DSrs in their practice at the first sign of downward trending labs. Now, I take more than her basic plan in some areas and less in others--go by your labs as they start coming in. Good luck.

--gina

 

So many surgeons are clueless on what a DSer really needs for ongoing nutrition.  Mine wasn't much better with her recommendations.  Fortunately, there was a lot of sharing of information here before the moderators went rogue and chased off the majority of the veterans. 

Vitalady's packages are good in that they cover absolutely everything your body may need.  Some need more than others, but this is a great overall hit if you don't want to do your own analysis of labs and such.    The alternative would be to piece together from different recources.  I get the majority of my vitamins locally taking advantage of BOGO sales and stocking up.  I do get my dry vitamins from Vitalady, though.  I take the A D E and K separately, for the ADEK multi doesn't have near enough for me. 

At a minimum, I recommend:
Double-dose of a good multi like Centrum (generic equivalent is fine)
1500 mg Calicum Citrate (citrate is important - not the other types of calcium)
100 mg zinc
50 mcg B12
50,000 iu DRY D
10,000 iu DRY A
Copper (helps zinc to be absorbed)
(I added dry E and K later on when my body needed it)

If you choose to do it this way - you can save a lot of money, however you'll want to learn how to read your labwork (do NOT settle for a nurse telling you your levels are okay), see downward trends and adjust before they get low.  It's not hard.

 Hello Donna, I had the same surgeon two years ago.  Dr. G is a very good surgeon, and Abington is  a great hospital.  The DSrs who follow the Abington Practice recommendations for vites and eating, (Ann, the NUT, who does not have a clue)  do not do nearly as well as those of us who follow the tried and true life styles of vets.  That means we DO NOT take the recommendations of Abingtons vitamin regime.  Those who do are in sorry, sorry shape.  And yes, having hung around the practice for almost three years, I have met many of these sorry sacks.   I was very fortuante to get connected to the DSrs who all meet at Chilis down the street after the monthly Tuesday night meetings.  Those are the ones who have done the research and lived years successfully with the DS.  I have followed in ther footsteps and two years later, I am doing beautifully.  Dr. G calls me a model DSr.  That is because I DO NOT  follow their guidelines.  They are good surgeons, but they do not provide good vitamin or nutritional advice.  And, they all know how well I am doing, and they all know I follow Vitalady's vitamin schedule and not theirs.  PM me and I will get you connected to our PADS group here in greater Philly!

Please, Donna, listen to what Blank Out said.

Vitamins are not an option. Dr. G is a great surgeon. Abington is a great hospital. After care stinks. The NPs are all clueless, but are starting to catch on that the ones who follow VitaLady's regimine are the ones who have stellar labs and who are healthy and happy.

I'm very grateful that I found the PADS group early, before surgery, so I wasn't counting on Abington to fill in the holes and be my support system. That practice is NOT there for that. Sad, but true. The true support comes from the people who have lived it. Please get connected with us/them so that you're not putting yourself in any more danger or continuing to frustrate yourself.

Hello  Donna;

I'm sure other vets will chime in, but basically, you need to keep in mind that your surgeon is the expert at the surgery . . . not necessarilyy the nutritional needs post-op.  That is a learning experience for everyone - surgeons, NUTS, PCP's and patients - and because we deal with the affects everyday, we kind of have one-up, if you will, on the surgeons in that regard (with the exception of those few *****ally put in the time and effort to really investigate, track and learn it).  There is a basic regimen and then you have to tweak it based upon your needs, how your body reacts and what your labs show.  The majority of my pills center around calcium.  I hate the horse pills, so I use Citrical Petites, which means I have to take two pills for a dose instead of one, then I add the appropriate magnesium based on what I've learned here.  My surgeon doesn't recommend it and doesn't quite understand why I take it, but I've learned from experience that it makes a difference.  Then, because my D is low, I take a D with two of my calcium doses (last at bedtime and first upon waking).  The other pills that I have are dictated by my own body.  I have lifelong potassium issues even prior to surgery and (because of the HCT my PCP put me on) ended up in the emergency room with severe Hypokalemia last year (you do NOT want to deal with that).  So now, I take the script potassium.  I take the two multi's recommended by my doctor, but have learned that my body better absorbs the A & E separately, so I don't do the ADEK's pills.

One other thing to be advised of is that if "normies" ever had a full bloodwork up done, they'd be taking way more supplements than they do.  Studies have already shown that the majority of people are sorely lacking in vitamin D, but it's not something tested unless they start to have serious problems due to the deficiency.  It's the same with other vitamins and minerals, they are overlooked until serious symptoms start.  We have to stay up on that because the serious systems can happen much more quickly for us than they can for normies and it's much more difficult for us to bring up deficiencies due to the malabsorption.

Yes, there are a lot of people who follow vitalady's regimen, but like everything else, it is a starting point . . . it's perhaps a more aggressive starting point than surgeon's may recommend, but it is a starting point and you tweak and customize based upon your own needs.

 Gosh THANK YOU ALL SO MUCH for all your wonderful insight from years of experience.  I am saddened by the fact that I was so mislead from the beginning with my surgeon's office.  I am thanking god now that I was referred to this website and have had the opportunity to ask questions and get straight honest answer from you all!!  I just had more bloobwork drawn this morning and feel as though it will be a necessary thing I will need to do more often then I orginally was told.  But honestly I am ok with that.  I just am dealing with so many different doctors now and it gets overwhleming all their opinions.  I do think I have started feeling better, not so sick to my stomach because I am listening to myself and what the "vets" are saying.  My D has always been low so I am still taking extra D, but I believe everyone's D is low, as I know so many normies that take next D also, icluding my own mother who has been a petite little thing all her life.  I never liked the "normal ranges" they quote on the bloodwork sheets as everyone is different and what is "normal" for one might not be normal for another.  I truely believe we are all different and need individual assesments, BUT trick is who is going to listen to us when we demand these answers and scripts, etc.  I guess my bottom line of nervousness is who to trust and when can I trust myself to feel good enough to go back to work and not feel like I have to run to the bathroom to get sick, to be able to eat when I need too, all those things that work can impede on.  I need to work so I can pay for all these vitamins I had NO idea would be costing me so much.  I need to find a way to make this all work and it isn't coming to me easily enough.  Even with all the praying lately.  If my job was not so important maybe it would be easier but I can't be sick, just no room for it.  HHHmmmm lots of figuring out and seeing where I will be by the end of the summer.  Thanks again everyone!

I don't think you should think of your surgeon's office as 'misleading' you---I think they truly have your best interests at heart, they're just woefully ignorant about nutrition, vitamin levels, etc.

I strongly urge you to set up a spread sheet and track your values over time. Did you get any pre-op baseline levels done? And yes, you do have a good little bit of most things stored---but the idea hre is to KEEP those stores by constantly taking in enough of everything you need.

The extra D you're taking---it needs to be a 'dry' formulation of D3, not D2. If you got it by prescription, it's the wrong kind. (Just a little FYI.)

Hey Donna,

Like you I was pretty put off by the initial cost of all these vitamins and supplements that you need to take after surgery.   My surgeon's office suggested that I take a mulitvit 3x daily, additional dry ADEK and Iron.  That was it.  But they didn't tell me how much of ADEK to take!  I went with VitaLady for my dry ADEK, the price was really good and I got a 3 month supply of my vites for about $80 (with shipping) and they were shipped really fast!  I got my mulitvit from Amazon and went with Celebrate, but I would like to go to a more "normal" brand to save some money.

Now being 3 months out from surgery they have added Calcium Citrate to my regiment.  And with my hair falling out in clumps, I've added 10,000mcg Biotin (my own research).  So far my levels at 3 months are FANTASTIC.  We will have to wait another 3 months to make sure that I am taking enough of these vitamins and supplements to keep my labs that way.  Personally, I struggle to get in the Calcium because they sit like a rock in my stomach, but I am working up to the 6 per day.

Keep your eyes open for the BOGO or 50% off sales at your local stores or pharmacies (Walgreens, Rite Aid, CVS, etc.).  I picked up 2 bottles of Biotin for $9.98 (over 6 months worth) and 2 bottles of the calcium (240 total count) for $9.49! 

Hang in there.