Good Morning. When do you stand up for yourself...

...and when do you shut up and listen? 

Over the years here on OH I've watched many people self-sabotage their health, safety or success by being so stubborn or prideful.  What do you think is the right balance and how would a stubborn person know when to stop themselves?  We preach all the time about standing up for yourself when confronted with less than stellar doctors when it comes to vitamins and lab test needs, so I can see how it happens. But how would you know if you aren't listening to the vets here or reading and learning from other people's mistakes? 

The WLS community is especially vulnerable to docs giving them stupid vitamin and nutritional advice. But the docs wear the white lab coats and have a bunch of letters after their name! That doesn't mean they know anything about preventative health vitamins. They know how to fix you when you're broke...sometimes, but vitamins are not one of their strong suits. {sigh} So what is the balance for the WLS community?  

1. Know your surgery. Be able to describe it to a medical professional. Have a picture with you at all times. Have your surgeon's office number on you at all times.

2. Understand that all ailments are not WLS related and you may need another specialist. Get a recommendation from your surgeon for a hematologist, endocrinologist or OB/GYN that understands your surgery especially if you have a malabsorptive one. If you can't get a referal, interview the specialist and ask that they confer with your surgeon to make sure some issue or treatment is or isn't affected by your WLS. Don't be afraid to shop around for a receptive specialist.

3. Understand what medications and forms of vitamins and minerals work for us. Slow release medications for example aren't a good idea, in most cases, for malabsorbers. Ferrous sulfate iron is an awful option for WLS patients to try to bring up iron numbers and many hematologists don't know this. Calcium citrate is not the same or as good as calcium carbonate. Read up on the contents of any meds your are prescribed. Google the stuff, you'll find it.  ****Edit: Calcium carbonate is not the same or as good as calcium citrate.***

Any more ideas? Liz and Randi, I know you have a lot of experience with this issue as pre-ops as well as post-ops.

"3. Understand what medications and forms of vitamins and minerals work for us. Slow release medications for example aren't a good idea, in most cases, for malabsorbers. Ferrous sulfate iron is an awful option for WLS patients to try to bring up iron numbers and many hematologists don't know this. Calcium citrate is not the same or as good as calcium carbonate. Read up on the contents of any meds your are prescribed. Google the stuff, you'll find it."

Not sure if calcium is different for DSers than it is for RNYers but Calcium citrate is better then carbonate for RNYers. The following link: http://www.ncbi.nlm.nih.gov/pubmed/19437082 explains that "Calcium citrate has superior bioavailability than calcium carbonate in RYGB patients."

Re calcium, I think Gina was just posting too early in the day - I knew what she meant so I didn't even pick up on that.  Glad you've clarified for noobs. 

Ooops! Thanks for catching that. Calcium citrate is better than calcium carbonate.

Liz and Randi, I know you have a lot of experience with this issue as pre-ops as well as post-ops.

Oh yeah, esp pre-op...we fought the system for many years with both of us...I've fired doctors for stupid!

Do NOT be afraid to fire one if you need to...use your gut instinct, if you feel something IS wrong, keep asking.

I was diagnosed with peripheral neuropathy, almost 2 decades ago now. When we got to Michigan, the closest major hospital was UM at Ann Arbor. While I loved my gastro there, I fired the neurology dept. They INFORMED me I did not have PN...yet five doctors in THREE different states at well recognized hospital systems had told me differently. So I found a neuro who was NOT affiliated with UM...extremely hard to do there. His comment was small fiber neuropathy seldom shows up on tests but is there. I just had not gotten around to damaging the larger fibers of neurons, THANK GOODNESS. But when it came to dh, we even had to fire him from dh's care....he let who dh was and his age interfere with diagnosis. We fired a neurosurgeon in Wilmington, NC that we were gonna use for dh's follow up care when he informed us that dh could NOT have the issue he did...he was UNDER 60 years old.

I also fired a PCP cause he did not want to cooperate with my request for test meter strips and the amount I needed. Now, thanks to not being on insulin AND being on Medicare, the system is far bigger than just my PCP...he prescribes as many as he can get away with for me.

All these experiences give me the ability to stand up for myself. But it is hard to deal with the ingrained attitude many doctors, nurses, and general health staff have. Esp when it comes to vitamin levels. My doctors understand the need for not giving me extended relief meds...FINALLY, but still weird out over my vitamin levels when in the higher range. And the persuasiveness of the "low fat" diet being so ingrained...makes it doubly hard for us to explain we HAVE to eat fat.

So I follow the vets ahead of me...normally what is online is not something you blindly follow but in this case, we have to be aware that it may be the ONLY place we can get accurate information for our continued good health.

And I agree, google is your friend...it's how I found my pain/sleep aid was actually keeping me awake.

Liz

I have worked in the medical field for many years and have seen some dumb stuff done by medical personnel.  I do not trust any doctor just because he/she is a doctor.  Anything he/she tells me, I research.

***Like***

My surgeon left right after surgery so I didn't get much follow up care so I'm thankful that I have my "family" of LWs to keep me up to what I should be doing.  Practically everything I learned about WLS was from this site.

I'm not very impressed with our PCP but DH loves him and since he needs more care than I do we continue to go to him.  I've had to speak up a few times about my DH's and Mom's care. 

The good thing is he is very accommodating to what I tell him I need to get done.  He never questions or gives his opinion  when I gave him Vitalady's lab list or when I when I asked him for a bone scan. 

You are very lucky that your PCP does as you ask without a surgeon to back you up. I see so many fighting and fighting for the basic labs.

--g

Major mom  is ferrous gluconate a better choice  for Wls patients? If not can I have the name  of the best choice of iron. Thanks