"New" ASMBS recommendations

They're not that new, since they're from 2013, but here's the link -- http://asmbs.org/resources/clinical-practice-guidelines-for- the-perioperative-nutritional-metabolic-and-nonsurgical-supp ort-of-the-bariatric-surgery-patient

The things that stand out to me, and that I wanted to bring to the attention of others, include the following:

VSGers are recommended NOT to use NSAIDs.  I know that a lot of people pick VSG because we're allowed to take NSAIDs, but the ASBMS has determined that this isn't the case for us any longer.  It's worth addressing with your surgeon.  

VSGers are also now recommended to take TWO multivitamins so that we're getting 200% of most vitamins and minerals every day.  

Here's the entire recommendation for supplementation (LSG is us)-- 
Minimal daily nutritional supplementation for patients with RYGB and LSG all in chewable form initially (i.e., 3 to 6 months), should include 2 adult multivitamin plus mineral (each containing iron, folic acid, and thiamine) supplements(Grade B, BEL 2), 1200 to 1500 mg of elemental calcium (in diet and as citrated supplement in divided doses) (Grade B, BEL 2), at least 3000 international units of vitamin D (titrated to therapeutic 25-hydroxyvitamin D levels >30 ng/ml) (Grade A, BEL 1), and vitamin B12 (parenterally as sublingual, subcutaneous, or intramuscular preparations, or orally, if determined to be adequately absorbed) as needed to maintain B12 levels in the normal range (Grade B; BEL 2). Total iron provided should be 45–60 mg via multivitamins and additional supplements.

In my opinion, it's worth reading the entire document, even though it's long.  Silly for us to go through this surgery and not know what the recommendations are!

I also noticed that we're recommended to have a 24-hour calcium excretion urine test at 6 months post-op and then every year after.  And a DEXA scan at the 2-year post-op mark.  I'm not sure if those were recommended in previous documents or not, but they were news to me!

It checks bone density. 

A DEXA scan checks your bone density. It's very important to track your bone density over time. The calcium that is listed on your lab reports gives you almost no useful information. If you are not getting enough calcium through diet and supplements, your body will leach calcium from your bones to keep the blood level up. So your bloodwork will show normal calcium, while every day you are losing bone mass. A DEXA scan will tell you if that's happening. Ideally, you would have a baseline DEXA scan before surgery, and every two years after.

Many doctors recommend DEXA scans for patients over age 50, as this is not just a WLS issue.

I was always told no NSAIDS. My surgeon told me that honestly nobody should use them on a regular basis because they can thin your stomach lining. Well since we have less stomach we want to be careful.

I was told no NSAIDs as well, since I had an ulcer pre-op.