Post-op Vitamin and Diet Guidelines
I am gathering as much info as possible to toss at my doc in case of argument and I ran across this .pdf. University of Minnesota Duodenal Switch Post-op Guidelines
Their basic rules say to avoid fats as it causes diarrhea, increased gas and slows weight loss, no drinking with meals through the pureed stage and for vitamins they suggest two childrens chewables, three SourceCF chewables and 500-600 mg of calcium citrate three times a day.
Is this relatively accurate or way off the wall? Is there a great place to find what we will need right out of the gate? I know to follow doctor's orders, but I am afriad my docs here won't be as informed as others.
ETA: What about this guideline someone put on eHow?
Their basic rules say to avoid fats as it causes diarrhea, increased gas and slows weight loss, no drinking with meals through the pureed stage and for vitamins they suggest two childrens chewables, three SourceCF chewables and 500-600 mg of calcium citrate three times a day.
Is this relatively accurate or way off the wall? Is there a great place to find what we will need right out of the gate? I know to follow doctor's orders, but I am afriad my docs here won't be as informed as others.
ETA: What about this guideline someone put on eHow?
Pink!
(deactivated member)
on 4/29/11 3:34 am, edited 4/29/11 4:06 am
on 4/29/11 3:34 am, edited 4/29/11 4:06 am
Fat does cause diarrhea for some people, usually just early out. Most, or at least a lot, of us tend to run on the constipated side and need extra fat to keep things moving. Early out, drinking with meals can use up valuable tummy space. Their vitamin regimen will kill you slowly.
Really, the best vitamin guide I have seen is Vitalady's. She knows how hard it is to correct a deficiency in a DS post-op. I recommend that you start with her plan and then tweak up or down as your post-op labs indicate.
You are correct about your Doctors, most DS surgeons are great cutters but know next to nothing about nutritional needs, same with most nutritionists.
Michele
Really, the best vitamin guide I have seen is Vitalady's. She knows how hard it is to correct a deficiency in a DS post-op. I recommend that you start with her plan and then tweak up or down as your post-op labs indicate.
You are correct about your Doctors, most DS surgeons are great cutters but know next to nothing about nutritional needs, same with most nutritionists.
Michele
And when surgeons have such crappy vitamin advice they also tend to not request the labs we need. VitaLady also has a list of labs you should get at 3,6,9 and 12 months.
I had to write my own lab slip, which was a PITA, but I get ALL the labs I need done.
You will also need to get the results, as your surgeon is likely to say your labs are "fine." You need to track your labs (starting with complete pre-op labs) over time so that you can spot trends early.
You should also get a baseline dexa scan.
~Becky
I had to write my own lab slip, which was a PITA, but I get ALL the labs I need done.
You will also need to get the results, as your surgeon is likely to say your labs are "fine." You need to track your labs (starting with complete pre-op labs) over time so that you can spot trends early.
You should also get a baseline dexa scan.
~Becky
Your docs will not be informed on nutrition. There are about three surgeons on the planet who actually KNOW something REAL about DS nutritional needs. Actually, I think Dr. Baltasar is one of them, so if you use him, that might be different :-).
Fat is YMMV. You'll have to find your happy amount of fat that makes you poop nicely, neither trots nor rocks. One of the great delights of the DS, for me, is lovely flowing pudding poop. Ahhhhhhh the joy of taking a good dump!
Fat does not generally equal gas. CARBS usually equal gas. I dunno why they keep preaching this propaganda. Decreased weight loss is bull**** That, again, is CARBS.
If you get the ****s, you'll lose more nutrients, yes. Having the ****s is to be avoided. Duh. We all understand that.
Drinking with meals is a little funky because at first you won't have any SPACE. But I found, and have heard from many others, that it took a sip of fluid per nibble of food to get stuff down for a long, long time. So I just had to adapt what and how often I ate to get the protein in. But you will have a fully functioning pylorus and you will NOT wash food out of your stomach by drinking.
Both supplement lists are completely inadequate. The absolute bottom line minimum I would start with would be:
Adult multivitamin at double the recommended daily dose
Calcium CITRATE 1800 mg daily in at least three doses
Zinc 50 mg daily taken with one or two calcium doses
Iron at....oh crap, I don't have my Tender Iron handy. Two of those, whatever size they are
Copper, ditto I don't have the pill bottle at hand to see the size, but one of those with the iron
500 mg vitamin C with the iron and copper together
10K IU dry vitamin D3 (cholecalciferol) but only IF beginning D levels were well into the top half of normal scale preop. Otherwise I'd take 25K or 50K D.
10K dry A palmitate.
That would be my BARE MINIMUM starting regimen, then tweak as I go. And as I said with the D, this is all ONLY if I had good preop nutrient levels.
Fat is YMMV. You'll have to find your happy amount of fat that makes you poop nicely, neither trots nor rocks. One of the great delights of the DS, for me, is lovely flowing pudding poop. Ahhhhhhh the joy of taking a good dump!
Fat does not generally equal gas. CARBS usually equal gas. I dunno why they keep preaching this propaganda. Decreased weight loss is bull**** That, again, is CARBS.
If you get the ****s, you'll lose more nutrients, yes. Having the ****s is to be avoided. Duh. We all understand that.
Drinking with meals is a little funky because at first you won't have any SPACE. But I found, and have heard from many others, that it took a sip of fluid per nibble of food to get stuff down for a long, long time. So I just had to adapt what and how often I ate to get the protein in. But you will have a fully functioning pylorus and you will NOT wash food out of your stomach by drinking.
Both supplement lists are completely inadequate. The absolute bottom line minimum I would start with would be:
Adult multivitamin at double the recommended daily dose
Calcium CITRATE 1800 mg daily in at least three doses
Zinc 50 mg daily taken with one or two calcium doses
Iron at....oh crap, I don't have my Tender Iron handy. Two of those, whatever size they are
Copper, ditto I don't have the pill bottle at hand to see the size, but one of those with the iron
500 mg vitamin C with the iron and copper together
10K IU dry vitamin D3 (cholecalciferol) but only IF beginning D levels were well into the top half of normal scale preop. Otherwise I'd take 25K or 50K D.
10K dry A palmitate.
That would be my BARE MINIMUM starting regimen, then tweak as I go. And as I said with the D, this is all ONLY if I had good preop nutrient levels.
fat does help you stay more regular, but for a DSer and our configuration, carbs (usually simple) are the ones that cause bloating, gas and will slow/stop weight loss. any medical professional that recommends children's chewables, I would be leary of. the list you posted above for a DS would most likely have you vit/min deficient within 2 years (depending on the nutrient we have a supply stored). every site has different vitamins and amount. Suggest starting at ASMBS and AACE as they have guidelines for DSers and add on to those according to your blood work. It is not so much what you need right away, but because DSers have about 60% of the small bowel bypassed, in time the body would become deficient. that list you posted for a DSer is quite shockingly slim
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