So I saw my surgical team this morning. Apparently I skip right over purees and go straight into real food now. How excited am I? I just ate 3 meatballs without any problems (shout out to Gwen for the idea). I feel satisfied and unable to eat more, but not full. I?m also down 20 lbs since my surgery. I?m happy with that and so was my surgeon.
I can also start swallowing pills. A little nervous about the calcium. I may half it at first. Anyone have problems with larger pills?
I take 11 large pills a day and half a dozen smaller ones. (6 calcium, 3 vitamin, 2 antibiotic and various thyroid, BP, and supplements). I used to take them with liquid, but discovered that was a problem due to not being able to eat anything right after. Pills can make me nauseous if I don't eat something after I take them.
Previously I tried crushing them and mixing them with yogurt or soup or ricotta. That was just plain out disgusting. It was truly gag-worthy.
So the dilemma was: How do I take the pills uncrushed with food if I can't drink anything.
Here was the solution that worked for me. I chew up a bite of food very well and then pop a big pill in my mouth, hide it in the chewed up food and swallow. Unless it is super dry chicken it goes down quite nicely. Rinse and repeat. No nausea and I manage to get the pills down with little to no effort. They don't get stuck and my sleeve doesn't even know I slipped them in.
VSG with Dr. Wanchick - Sept 29 2017
Age 52 Height 5'2" HW 585 (2012) Initial Consult Weight 522 SW 460 (9/29/2017) CW 350 (4/5/2018) Next Goal 325 Starting BMI 95.5 Current BMI 64.0
Pre-Op: 62 M1: 36 M2: 20 M3: 15 M4: 19 M5: 10 M6: 10 M7: ?
Thanks for the idea. I just took two Tylenol and they went down fine. I?m hopeful for the Calcium.
Ladyblu's suggestion sounds like a winner!
I have a question (not to hijack this post!) Everyone seems to be taking multiple supplements and vitamins (including calcium and other things.)
My surgical team told me that because of my age I only need to take one multivitamin twice a day for the two weeks before and after surgery and one a day thereafter for the rest of my life. I bought the Centrum Chewables. I like the tangy flavor and someone told me that chewables would be easy right after surgery. However, I see multiple people on here in their mid to late twenties that take multiple supplements.
Should I be concerned that I was told I don't need anything else at all? I'm also taking one biotin a day (1000 mcg) on my own. A friend told me that she took it two weeks before surgery and a few months after and she didn't experience ANY hair loss.
Yeah each surgeon is very different it seems. Like today I asked mine if I should take two multivitamins in a day (since I see that many patients take two) and they said with VSG one was sufficient. My program requires 1 multivitamin, 1 iron, 1 calcium with D twice/day, and 1 b-12.
Yes. You should be concerned. The only supplementation I've ever seen that is based on age is iron and only where women are concerned due to menstruation.
The ASMBS recommends the following in their current set of recommendations. I've put the relevant parts in bold. SG = sleeve gastrectomy:
Vitamin B1 (Thiamin)
Thiamin supplementation above the RDA is suggested to prevent thiamin deficiency.
All post-WLS patients should take at least 12 mg thiamin daily and preferably a 50 mg dose of thiamin from a B-complex supplement
or multivitamin once or twice daily to maintain blood levels of thiamin and prevent TD.
Vitamin B12 (Cobalamin)
All post-WLS patients should take vitamin B12 supplementation.
Supplement dose for vitamin B12 in post-WLS patients varies based on route of administration:
Orally by disintegrating tablet, sublingual, or liquid: 350?500 mg daily
Nasal spray as directed by manufacturer
Parenteral (IM or SQ): 1000 mg monthly
Folate (Folic Acid)
Post-WLS patients should take 400?800 mg oral folate daily from their multivitamin.
Women of childbearing age should take 800?1000 mg oral folate daily.
Post-WLS patients at low risk (males and patients without history of anemia) for post-WLS iron deficiency should receive at least 18 mg of iron from their
Menstruating females and patients who have undergone RYGB, SG, or BPD/DS should take at least 45?60 mg of elemental iron daily (cumulatively,
including iron from all vitamin and mineral supplements).
Oral supplementation should be taken in divided doses separately from calcium supplements, acid-reducing medications, and foods high in phytates or
Vitamin D and Calcium
All post-WLS patients should take calcium supplementation.
The appropriate dose of daily calcium from all sources varies by surgical procedure:
BPD/DS: 1800?2400 mg/d
LAGB, SG, RYGB: 1200?1500 mg/d
The recommended preventative dose of vitamin D in post-WLS patients should be based on serum vitamin D levels: Recommended vitamin D3 dose is
3000 IU daily, until blood levels of 25(OH)D are greater than sufficient (30 ng/mL)
A 70?90% lower vitamin D3 bolus dose is needed (compared to vitamin D2) to achieve the same effects as those produced in healthy non-bariatric
To enhance calcium absorption in post-WLS patients:
Calcium should be given in divided doses.
Calcium carbonate should be taken with meals.
Calcium citrate may be taken with or without meals.
Vitamins A, E, and K
Post-WLS patients should take vitamins A, E, and K, with dosage based on type of procedure:
LAGB: Vitamin A 5000 IU/d and vitamin K 90?120 ug/d
RYGB and SG: Vitamin A 5000?10,000 IU/d and vitamin K 90?120 ug/d
LAGB, SG, RYGB, BPD/DS: Vitamin E 15 mg/d
DS: Vitamin A (10,000 IU/d) and vitamin K (300 mg/d)
Higher maintenance doses of fat-soluble vitamins may be required for post-WLS patients with a previous history of deficiency in vitamin A, E, or
Water-miscible forms of fat soluble vitamins are also available to improve absorption
Special attention should be paid to post-WLS supplementation of vitamin A and K in pregnant women.
All post-WLS patients should take greater than RDA zinc, with dosage based on type of procedure:
BPD/DS: Multivitamin with minerals containing 200% of the RDA (16?22 mg/d)
RYGB: Multivitamin with minerals containing 100?200% of the RDA (8?22 mg/d)
SG/LAGB: Multivitamin with minerals containing 100% of the RDA (8?11 mg/d)
To minimize the risk of copper deficiency in post-WLS patients, it is recommended that the supplementation protocol contain a ratio of 8?15 mg of
supplemental zinc per 1 mg of copper.
Formulation and composition of zinc supplements should be considered in post-WLS patients to calculate accurate levels of elemental zinc provided by the
All post-WLS patients should take greater than RDA copper as part of routine multivitamin and mineral supplementation, with dosage based on type of procedure:
BPD/DS or RYGB: 200% of the RDA (2 mg/d)
SG or LAGB: 100% of the RDA (1 mg/d)
In post-WLS patients, supplementation with 1 mg copper is recommended for every 8?15 mg of elemental zinc to prevent copper deficiency.
In post-WLS patients, copper gluconate or sulfate is the recommended source of copper for supplementation.
VSG with Dr. Salameh - 3/13/2014
Diagnosed with Binge Eating Disorder and started Vyvanse - 7/22/2016
Reconstructive Surgeries with Dr. Michaels - 6/5/2017 (LBL & brachioplasty), 8/14/2017 (UBL & mastopexy), 11/6/2017 (medial leg lift)
Age 41 Height 5'4" HW 319 (1/3/2014) SW 293 (3/13/2014) CW 149 (7/16/2017)
Next Goal 145 - normal BMI | Total Weight Lost 170
Hmm...it seems odd that my doctor is so accomplished and that at a "Bariatric Center of Excellence" that his team would tell me the wrong thing. Perhaps the surgical staff misunderstood my question about supplementation and thought that I was merely asking about PRE-surgery vitamins?
I have my hospital pre-admission checkin scheduled for next week and I'll be sure to ask for clarification! As for Iron, I didn't think about it, but I've been on Iron since I was a teenager. I'm anemic and I assume I'll continue my regular Iron pills after surgery.
Amanda 12/2016 HW: 393 11/2017 Consult: 378 12/2018 SW: 350
2/2018: 309 3/6/2018: Broke a barrier! 297 4/2018: 286 5/2018: 279
Pre-op: -28 M1: -25 M2: -16 M3: -12 M4: -11 M5: -7
Short-term Goal: 250 by August 15th!