Day 20 and feeling like crap
Are you on any blood pressure meds? If so, call your doc. You may not need them anymore.
I think 500 calories is pretty typical that early out. However, maybe you could try adding an extra protein shake for more calories. And are you eating several times a day? Not going for a long time between meals or snacks? Eating a little bit every couple hours might help.
I think 500 calories is pretty typical that early out. However, maybe you could try adding an extra protein shake for more calories. And are you eating several times a day? Not going for a long time between meals or snacks? Eating a little bit every couple hours might help.
Kelly
Please note: I AM NOT A DOCTOR. If you want medical advice, talk to your doctor. Whatever I post, there is probably some surgeon or other health care provider somewhere that disagrees with me. If you want to know what your surgeon thinks, then ask him or her. Check out my blog.
No blood pressure meds for me pre-surgery. I had the surgery in part as a way to prevent that, as my bp had been creeping up gradually the last couple years.
My doc wanted me to try to wean off the protein shakes as soon as possible so that is why I am only having one a day. I've been trying to eat every 3 hours or so but sometimes I forget because I don't get hungry. I'll have to work on this.
Should I be worried that I am burning more calories than eating? Yesterday I only took in 400 calories (wasn't feeling well) but burned 420 when I took an hour long walk with the dogs.
My doc wanted me to try to wean off the protein shakes as soon as possible so that is why I am only having one a day. I've been trying to eat every 3 hours or so but sometimes I forget because I don't get hungry. I'll have to work on this.
Should I be worried that I am burning more calories than eating? Yesterday I only took in 400 calories (wasn't feeling well) but burned 420 when I took an hour long walk with the dogs.
You have to burn more calories than you eat in order to lose weight. 400 calories a day is pretty low, though.
I was just thinking an extra protein shake would be an easy way to add calories, along with protein. If you can increase your calories with food instead, that's fine.
I was just thinking an extra protein shake would be an easy way to add calories, along with protein. If you can increase your calories with food instead, that's fine.
Kelly
Please note: I AM NOT A DOCTOR. If you want medical advice, talk to your doctor. Whatever I post, there is probably some surgeon or other health care provider somewhere that disagrees with me. If you want to know what your surgeon thinks, then ask him or her. Check out my blog.
You are only 3 weeks out and have reason to be concerned. You shouldn't feel this way and part is the way you are eating and the fact that you are missing many supplements.
It is great that you are getting your fluids and protein but you are getting half your calories and protein in one drink. I am not sure what you program calls for as far as foods/pureeds or liquids at your stage but you say you are eating cottage cheese, eggs and yogurt already. It seems pretty early for eggs - most of us can't tolerate eggs for months. I was on liquids for 3 weeks, then pureeds and solids at 1 month.
Either way, you need to get more food it, whether soft, pureeds or otherwise. You should be eating tiny amounts every couple of hours - that is the only way to get in the necessary nutrition, calories, protein and also increases your metabolism, matains your blood sugar and decreases hunger. This is the best way to lose weight - eat 5-6 small meals - every 2-3 hours. My program at the beginning had us eat every 2 hours - up to 8 times per day, since we were only eat 1 to 2 ounces at a time. Once we were able to increase our portion size to 3 to 4 ounces, then we could decrease to 5 to 6 times per day.
You can also have more than one protein drink per day at the beginning if you are having trouble getting in the food, but you still have to get in some food. When not eating, you have to be drinking.
As far as the pain in your legs, it is probably due to a vitamin B deficiency - either B12 or B1. You should be taking both of these from day 1. You should be taking a minimum of 1000mcg of vitamin B12 daily and it has to be sublingual. If you are already deficient, you might need to take more than this. When you get them, you might want to take 2 day for the first week and then go back to one per day. Hopefully your symptoms will go away.
Vitamin B1 - you need to take 100mg per day. If you are deficient you need more than that but it is unlikely that you would be deficient this early out but you need to take this to prevent it - it can happen within a few months and can lead to nerve damage.
You also need to be taking iron - carbonyl from vitalady.com 60-120mg per day ( I was already iron deficient at my 5 week set of labs) and dry vitamin D3 - minimum of 5,000 - 10,000 units per day.
calcium citrate - 1500-1800 mg per day
multi vitamin 2 per day - centrum silver chewables recommended.
It is great that you are getting your fluids and protein but you are getting half your calories and protein in one drink. I am not sure what you program calls for as far as foods/pureeds or liquids at your stage but you say you are eating cottage cheese, eggs and yogurt already. It seems pretty early for eggs - most of us can't tolerate eggs for months. I was on liquids for 3 weeks, then pureeds and solids at 1 month.
Either way, you need to get more food it, whether soft, pureeds or otherwise. You should be eating tiny amounts every couple of hours - that is the only way to get in the necessary nutrition, calories, protein and also increases your metabolism, matains your blood sugar and decreases hunger. This is the best way to lose weight - eat 5-6 small meals - every 2-3 hours. My program at the beginning had us eat every 2 hours - up to 8 times per day, since we were only eat 1 to 2 ounces at a time. Once we were able to increase our portion size to 3 to 4 ounces, then we could decrease to 5 to 6 times per day.
You can also have more than one protein drink per day at the beginning if you are having trouble getting in the food, but you still have to get in some food. When not eating, you have to be drinking.
As far as the pain in your legs, it is probably due to a vitamin B deficiency - either B12 or B1. You should be taking both of these from day 1. You should be taking a minimum of 1000mcg of vitamin B12 daily and it has to be sublingual. If you are already deficient, you might need to take more than this. When you get them, you might want to take 2 day for the first week and then go back to one per day. Hopefully your symptoms will go away.
Vitamin B1 - you need to take 100mg per day. If you are deficient you need more than that but it is unlikely that you would be deficient this early out but you need to take this to prevent it - it can happen within a few months and can lead to nerve damage.
You also need to be taking iron - carbonyl from vitalady.com 60-120mg per day ( I was already iron deficient at my 5 week set of labs) and dry vitamin D3 - minimum of 5,000 - 10,000 units per day.
calcium citrate - 1500-1800 mg per day
multi vitamin 2 per day - centrum silver chewables recommended.
I asked my doc about the supplements. He told me that I absolutely should NOT start taking all these from the beginning, as my labs were normal for all of them and too much could be dangerous. He has me taking 2 multi-vitamins, vitamin D (I was deficient before surgery) and calcium citrate but wants me to wait on anything else. He also said my B-12 level was fine and that I could wait until my next appointment to get the B-12 shot.
I will try to up my protein drinks each day, though. Good suggestion.
As I said below, he said as long as my body could take it, I could start easing into normal foods. I didn't have any problems with eggs (mixed with a tsp. of lowfat mayo and water), chicken salad or even beef jerky yet.
I will try to up my protein drinks each day, though. Good suggestion.
As I said below, he said as long as my body could take it, I could start easing into normal foods. I didn't have any problems with eggs (mixed with a tsp. of lowfat mayo and water), chicken salad or even beef jerky yet.
I am not quite sure how it is dangerous to take vitamins that we need since we start malabsorbing from day one and since we are practically getting no food, we need to get our vitamins in through supplements. I am glad that you are atleast taking a multi, vitamin D and calcium but not taking any B12, B1 or Iron - you may regret. I had perfectly normal levels and started all my supplements preop except for my iron. Well, sure enough at my 5 week labs, I was already iron deficient. Things happen very quickly for us.
When is your next appointment? If it is only one month and you get an injection that should be okay but any longer than 1 month without an injection and no sublinguals, and you are looking for trouble - b12 deficiency leads to nerve damage. I have been giving myself injections for years. This past winter I had complications and was in the hospital for 2 months. Unfortunatley they were busy trying to keep me alive that some of my vitamins got overlooked including my b12 - well, when I went in, my levels was a great level of 1800, when I had it retested a few weeks after being discharged - about 10 weeks without injections and it plummeted down to 400. I was in danger of nerve damage. Thankfully, I caught it in time and got my levels back up. We malabsorb and things can change very quickly - just because you are normal preop, doesn't mean you will stay that way without any supplementation.
By 5 months out, not only was on the normal multi, calcium, vitamin D, iron and B12 injections but I also developed vitamin A, selenium and B1 deficiency. Everyone should take B1 from the start as this can also lead to nerve damage and can happen quickly.
When I forget my B12 or B1 for a few doses, I get terrible cramping in my feet and toes to the point where my toes actually lock up. These are nothing to fool with.
Iron is another vitamin not to fool with. We become anemic very quickly and once our iron and ferritin levels become really low, it is tough to get back up. By starting on iron right away, we can build our iron stores and protect ourselves from becoming anemic.
I can't tell you what to do, I am just giving you my 3 years personal experience and experience from these boards as well as experience with several of the supplements from preop as well.
When is your next appointment? If it is only one month and you get an injection that should be okay but any longer than 1 month without an injection and no sublinguals, and you are looking for trouble - b12 deficiency leads to nerve damage. I have been giving myself injections for years. This past winter I had complications and was in the hospital for 2 months. Unfortunatley they were busy trying to keep me alive that some of my vitamins got overlooked including my b12 - well, when I went in, my levels was a great level of 1800, when I had it retested a few weeks after being discharged - about 10 weeks without injections and it plummeted down to 400. I was in danger of nerve damage. Thankfully, I caught it in time and got my levels back up. We malabsorb and things can change very quickly - just because you are normal preop, doesn't mean you will stay that way without any supplementation.
By 5 months out, not only was on the normal multi, calcium, vitamin D, iron and B12 injections but I also developed vitamin A, selenium and B1 deficiency. Everyone should take B1 from the start as this can also lead to nerve damage and can happen quickly.
When I forget my B12 or B1 for a few doses, I get terrible cramping in my feet and toes to the point where my toes actually lock up. These are nothing to fool with.
Iron is another vitamin not to fool with. We become anemic very quickly and once our iron and ferritin levels become really low, it is tough to get back up. By starting on iron right away, we can build our iron stores and protect ourselves from becoming anemic.
I can't tell you what to do, I am just giving you my 3 years personal experience and experience from these boards as well as experience with several of the supplements from preop as well.
I hope you were kidding when you said you didn't understand why it was dangerous to take too many vitamins! Taking vitamins when you aren't deficient can cause major health issues such as ulcers, liver problems, anxiety, fatigue, depression, vomiting, headaches, rashes, kidney stones, increased risk of bone facture and about a million other moderate to severe side effects. In addition, it often goes undiagnosed! I'm going to stick with my surgeon's advice and only take the vitamins he recommends for now.
I truly appreciate your insight and knowledge! I am sure he DID take my B and B-12 as the clinic posts all our medical records online for us to access. I compared all the labs with what the ASMBS recommends and I am still on the high range for all except D. It makes me wonder if the malabsorbtion is different for everyone?
I'm headed in to my general practitioner next week. They recommended testing me for fibromyalgia (what a nightmare!) and a few other things but I'm hoping it just goes away :(
I truly appreciate your insight and knowledge! I am sure he DID take my B and B-12 as the clinic posts all our medical records online for us to access. I compared all the labs with what the ASMBS recommends and I am still on the high range for all except D. It makes me wonder if the malabsorbtion is different for everyone?
I'm headed in to my general practitioner next week. They recommended testing me for fibromyalgia (what a nightmare!) and a few other things but I'm hoping it just goes away :(
I never said I don't understand why it is dangerous to take many vitamins? I said "I don't understand why it is dangerous to take the vitamins that we need" If you look at the ASMBS - they state that all RNY patients should be taking the vitamins that I stated.
The vitamins you are questioning - B1 and B12 - there is absolutely no danger in taking these vitamins - they are water soluable and anything excess you just pee out but being deficient causes nerve damage and I actually just got my prescription today of B12 and I read the insert - it said that if B12 deficiency is left untreated for 3 months - it becomes permanent and causes nodules on your spinal cord. This is nothing to treat lightly. Yes, your levels are probably normal right now - low normal but we want them high. Normal is 200-900 and we want our levels to be between 1200-1800. Anything below 500 can cause nerve damage. So, if you are being told you are normal, that isnt telling you anything unless you get copies and know your levels. That is why we are all here for each other to help each other out. We have the experience that unfortunately many surgeons don't - they are trained to cut - they are trained other than 1 term in med school many years ago about supplements.
As far as the malabsorbtion - you are only a few weeks out and haven't had that much time to malabsorb that much yet but that is why we supplement from the start so we our numbers don't plummet due to the malabsorbtion - we supplement to keep us where we started from.
I have fibromyalgia and if you want to be tested, you need to see a Rheumatologist - a PCP can't test you properly for that.
Believe me, it is very rare that anyone that has gastric bypass takes too many vitamins. We get our labs done frequently or atleast you should. If they test for everything - which should be atleast 10-14 vials each time - I get them done every 3 months - most of the time, we find we are deficient and need to tweek a little here and little there.
I am just trying to help you and prevent you from future deficiencies. I only gave you basics that are recommended by both the ASMBS and most surgeons. These aren't randoms supplements that I made up
Nothing that I gave you would cause you to have any of the side effects that you listed either.
The vitamins you are questioning - B1 and B12 - there is absolutely no danger in taking these vitamins - they are water soluable and anything excess you just pee out but being deficient causes nerve damage and I actually just got my prescription today of B12 and I read the insert - it said that if B12 deficiency is left untreated for 3 months - it becomes permanent and causes nodules on your spinal cord. This is nothing to treat lightly. Yes, your levels are probably normal right now - low normal but we want them high. Normal is 200-900 and we want our levels to be between 1200-1800. Anything below 500 can cause nerve damage. So, if you are being told you are normal, that isnt telling you anything unless you get copies and know your levels. That is why we are all here for each other to help each other out. We have the experience that unfortunately many surgeons don't - they are trained to cut - they are trained other than 1 term in med school many years ago about supplements.
As far as the malabsorbtion - you are only a few weeks out and haven't had that much time to malabsorb that much yet but that is why we supplement from the start so we our numbers don't plummet due to the malabsorbtion - we supplement to keep us where we started from.
I have fibromyalgia and if you want to be tested, you need to see a Rheumatologist - a PCP can't test you properly for that.
Believe me, it is very rare that anyone that has gastric bypass takes too many vitamins. We get our labs done frequently or atleast you should. If they test for everything - which should be atleast 10-14 vials each time - I get them done every 3 months - most of the time, we find we are deficient and need to tweek a little here and little there.
I am just trying to help you and prevent you from future deficiencies. I only gave you basics that are recommended by both the ASMBS and most surgeons. These aren't randoms supplements that I made up
Nothing that I gave you would cause you to have any of the side effects that you listed either.
Thanks for the input everyone. I called the doctors office yesterday to get a letter for my vitamins to qualify for flex spending and also asked them if there was anything I should be worried about regarding how my legs were feeling. The nurse got very concerned and called me back shortly after talking to the surgeon. The surgeon sent me right back to the hospital for an ultrasound in my legs, as he was worried about blood clots. They also did a full metobolic panel.
The ultrasound showed no signs of clots and I just got the result back from the panel. All of my labs showed in the normal range so it's not my B12, B or anything else suggested. They had no other thoughts other than possibly fibromyalgia but suggested I make an appointment with my general practitioner.
UGH. That means I'm back to square one.
As for the food, my doc said that evidence suggests the sooner people return to regular food the less they have issues with certain foods long term. He cleared me to start entering new foods into my diet as long as I as handling them so far. I haven't had any problems with the food (with the exception of some minor dumping), even eggs.
The ultrasound showed no signs of clots and I just got the result back from the panel. All of my labs showed in the normal range so it's not my B12, B or anything else suggested. They had no other thoughts other than possibly fibromyalgia but suggested I make an appointment with my general practitioner.
UGH. That means I'm back to square one.
As for the food, my doc said that evidence suggests the sooner people return to regular food the less they have issues with certain foods long term. He cleared me to start entering new foods into my diet as long as I as handling them so far. I haven't had any problems with the food (with the exception of some minor dumping), even eggs.
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