Vitamin and supplement talk

As of Jan. 10th 2014 I am officially 9 months out (YAY!!!)

Now that I'm far enough out that I can swallow bigger pills without chocking I got rid of the chewables. 

I know most of us with bariatric surgery have our nutritionist on speed dial so that when ever we have a question or concern we have them to fall back on. I however like to research things myself as well. 

In reading many of the posts in the support groups I am a member of I noticed that many of us are told completely different dosages to take when it comes to Vitamins and supplements so I decided that was one area I really wanted to check out and know for sure what the majority rule was on doses and such. So I'm going to share wit you what I found.

MULTI-VITAMIN

Multi-vitamin/mineral supplements ensure that you are getting enough of all of the micronutrients you need.

 I take 1 twice a day

Start taking one chewable multivitamin/mineral supplement twice a day (bypass) or once a day (band) while on liquids (Phase 1 liquid diet).

When you progress to Phase 2 (soft foods), take your supplement with meals.

 one of the following is recommended:

Bariatric Advantage® Chewable Multi Formula (available in the office or online at www.bariatricadvantage.com)

Celebrate Vitamins® chewable (available at www.celebratevitamins.com)

OpurityTM chewable (available at www.opurity.com)

Centrum® Chewable

( My surgeon had me take flintstones chewables multi vitamin with Iron twice a day)

About 3 months after surgery (or when you are able to swallow pills and  tolerate solid foods, in Phase 3), you can switch to a non-chewable if desired. However, it's recommended to use a bariatric-specific chewable multivitamin long-term over any other product. If you choose to take an over-the-counter vitamin,  any of the following is recommended, to be taken twice a day with food (generic, store-brand equivalents are fine):

Celebrate Vitamins® multivitamin capsule (available at www.celebratevitamins.com)

One-A-Day® Men’s/Women’s Formula

Centrum Performance®  (what I use)

Centrum Silver® based on your age

Take one multivitamin, twice a day (for example one at breakfast, one at lunch), rather than both at the same time to maximize your absorption of each vitamin.

CALCIUM:

Calcium is important for bone health. After weight loss surgery, you may be at risk for the brittle bone disease osteoporosis and related fractures. This is a direct result of the nature of the surgeries.

 I take 1 twice a day

Since there is typically only a small amount of calcium in multivitamins. , it's recommended that you take an additional 1000mg-1500mg of calcium everyday when you progress to soft foods.

At the soft foods stage you will need to take a chewable form because most non-chewable supplements are too big and difficult to swallow. There are different forms of calcium such as calcium carbonate and calcium citrate. Calcium citrate is the most efficiently absorbed form of calcium following gastric bypass. However, citrate can be difficult to find in a chewable form, so it's recommended to use a bariatric-specific calcium which provides citrate in a chewable form.

Bariatric Advantage® Calcium Citrate Chewy Bites (2 chews 2 times per day)

Bariatric Advantage® Calcium Citrate Lozenges (one lozenge 2 times per day)

Celebrate Vitamins® Chewable Calcium Citrate (one chewable 2 times per day)

OpurityTM Calcium Citrate (2 chewables 2 times per day)

Taking a liquid vs. chewable form of calcium citrate is acceptable.

Wellesse Calcium and Vitamin D3 liquid can be found at

Kroger

Rite Aid

Walgreens

Walmart

Order directly at 800.232.4005 

Switch to a pill form of calcium citrate when able to tolerate them, if desired. Take one dose (500mg-600mg) twice a day with meals for a total of 1000-1200mg of additional calcium per day. Be sure to check the dose on each individual brand to be certain you are getting the correct amount.

Citracal-any version

Again, take your calcium supplements twice a day in two smaller doses rather than taking one large dose all at once because you will absorb the smaller doses better. Also, calcium is best absorbed with taken with food.  

***It is important to not take the calcium and iron supplements at the same time, as they interfere with the absorption of each other. Take your calcium and iron supplements at least two hours apart from one another. ***

IRON:

Vital to the formation of red blood cells that provide oxygen to the human body. Prevents anemia. Anemia is common in the months and years following weight loss surgery. Iron deficiency is the most common cause of anemia after bariatric surgery. This risk is heightened after gastric bypass and other malabsorptive surgeries in women who are still menstruating, and in the super-obese (body mass index of 50 or above).

 I take once a day

It's recommended that you take an iron supplement daily when you progress to soft foods. 

Nausea and constipation are common side effects of iron supplements.  For this reason, it's recommended to take one of the most absorb able forms of iron: ferrous fumarate, ferrous sulfate or ferrous gluconate. All three forms of iron can both be found in over-the-counter.

 Listed below are some specific products recommended. Take your iron supplement once a day with food.

Bariatric Advantage® Chewable Iron

Celebrate Vitamins® Chewable Iron

GNC Iron 18

Ferro-Sequels® (contains a stool softener as well)

Fergon

 if you have trouble with nausea and/or constipation, try taking your iron every other day instead of daily.

***Do not take iron supplements with tea, cola, coffee, calcium citrate or the thyroid medicine levothyroxine because they can interfere with absorption. Taking vitamin C with your iron supplements aids iron absorption. Either a Vitamin C pill or glass of orange juice can do the trick.***

B-12:

Helps with proper blood cell formation and nerve function. Deficiency may cause certain types of anemia.

I melt 1 under my tongue every other day

Vitamin B12 is digested and absorbed differently than most vitamins. After gastric bypass surgery, you will no longer be able to digest and absorb sufficient amounts of B12 to maintain health. You must take your B12 in a form that directly enters the bloodstream, not through the digestive tract. There are three ways to do this:

A monthly vitamin B12 injection can be obtained at your primary care physician’s office after gastric bypass surgery. Your doctor or physician assistant can write a prescription so you can give yourself the monthly B12 injection.

A weekly nasal spray (Nascobal®) is an option for your B12 needs. also your doctor or physician assistant can write a prescription for you.

Another option is to take sublingual B12 lozenges or drops that dissolve under your tongue. A 500 mcg supplement may be taken daily. A 1000-2000 mcg supplement may be taken every other day. If you purchase the 5000 mcg strength, 1 per week should be sufficient. Specific products to ask about include:

Sublingual B12 Microlozenges (all three doses are available at Vitamin World® stores or www.vitaminworld.com)

B12 drops 1000 mcg (at Vitamin World)

B12 5000 Zipmelts® (at GNC)

Bariatric Advantage Sublingual B12 with Folate®

VITAMIN D:

Vitamin D aids the absorption of calcium, which is needed to build strong bones after weight loss surgery. It is known as the sunshine vitamin because the human body produces it only when exposed to sunlight. Vitamin D also is added to multivitamins and milk.

I take 1 a day

In addition to the amount of vitamin D found in your multivitamin and calcium supplement, begin taking 1000 IU of a supplemental vitamin D (cholecalciferol D3) a day. The pill is usually small enough to swallow without difficulty, but size varies among different brands. You may begin the vitamin D when able to tolerate the size pill you purchase. 

 the following are recommended:

Bariatric Advantage® Dry Vitamin D3 (take one dose per week)

Bariatric Advantage® Liquid Vitamin D3 (take one dose every two weeks)

GNC Vitamin D3 1000 IU (take daily)

**Vitamin D deficiency is linked to a host of chronic diseases, including certain cancers, heart disease, osteoporosis, stroke, diabetes, immune system problems and inflammatory diseases. What's more, obesity increases risk of Vitamin D deficiency.**

NOTE!!!

The amounts of Vitamins and supplements in this post are for bariatric patients only. None surgical patients taking these dosages can lead to overdose!!!

Example Medication schedules:

Breakfast

1  multivitamin/mineral supplement

1  calcium

Sublingual B12 lozenge or drops

Vitamin D

Note: If you are taking the Bariatric Advantage Vitamin D supplement, take it ONLY 1 TIME/ WEEK!

Lunch

Iron supplement (18-30 mg elemental iron if a man or post-menopausal woman; 50-65 mg elemental iron if a pre-menopausal woman)

Dinner

1  multivitamin/mineral supplement

1  calcium

*Remember to separate Iron and calcium by 2 hours to optimize effectiveness

2nd example (Bypass)

(Note: This is an example based on using an over-the-counter multivitamin.)

Breakfast: 

1  multivitamin/mineral supplement

1 Sublingual B12 lozenge or drops

Vitamin D (Note: if Bariatric Advantage® Vitamin D, take one time per week, not daily!)

Lunch: 

Iron (18-30 mg elemental iron if a pre-menopausal woman, not necessary as a man or post-menopausal woman)

Mid-Afternoon:

1 calcium

Dinner:

1  multivitamin/mineral supplement

Bedtime:

1 calcium

You can read more about the information I found at

Barker Bariatric Center

Bariatric Choice

Your Bariatric Surgery Guide

West Penn Allegheny Health System

Med.Navy /Patients/Documents/Bariatric

TRANSFORMATION TUESDAY!!! 11/26/13

I just have to start with saying "I feel amazing"

Today was a great scale reading I'm now 147 lbs when I started this journey in January of 2013 I was 275 at my doctors visit but my scale at home was a bit closer to 300. I hated living in my skin because even though no one said anything to me about it I knew I was huge. I felt huge and found myself just feeling crappy. I hated doing anything. I hated the way my clothes fit. I never wanted to go to my kids school functions because I just know I was being judged and stared out because of my weight. 

It's crazy how something like weight can have such an impact on a person. Since loosing my weight I have wanted to do things I have never done before. I'm not ashamed to go places. I finally feel great in my skin (even if it's a bit loose) and I really love the variety of clothing I look amazing in.

My stats

Heaviest weight- 275

BMI- 50.3

Pant size- 26

Shirt size- XXL

Post-op weight- 259

BMI- 47.4

Pant size- 24

shirt size- XXL

Current weight- 147

BMI- 26.0

Pant size- 12

Shirt size- M-L

It's a sc"HAIRY" situation

Talking about hair loss!

Before surgery

Being someone that has always been crazy about my hair it was a known fact that the thought of loosing my hair after surgery scared the bu-gee-sus out of me. Before surgery I had super thick hair that really made any cosmetologist earn their money whenever I had it cut. I had been told that some hair loss may occur but was never told to what extent because just like with the rate of weight you loose is different so is the hair loss. The thought of possibly loosing my hair was almost a reason for my to back out. But I went ahead with it :)

Reasons for hair loss:

The body is a well-tuned machine. However, as we get older and our lifestyle patterns change, that delicate balance can be thrown off. This can result in overeating, under exercising and other behaviors that are not optimal for good health in adulthood. Bariatric surgery aims to rebalance the body, at least with regard to caloric intake and weight. It does so by restricting the number of calories that can be consumed or absorbed into the body.

In the case of an obese bariatric patient, the body will be used to consuming far more than it needs. This means that after bariatric surgery patients will be “depriving” their bodies of half or more of their usual caloric intake. The result is a shock to the body as it struggles to regain its caloric equilibrium with the new healthier lifestyle. This shock may, in turn, cause temporary hair loss and nutrients and vitamins are routed to other parts of the body.

The trauma of surgical procedure itself can also contribute to hair loss. Surgery in and of itself causes a temporary disturbance to the body which may also cause hair loss. Every person’s body reacts to traumatic effects in different ways, making causes difficult to pinpoint and prevention virtually impossible.

It is also important to remember that there are other reasons for hair loss that should be considered along with typical post-surgical issues.

Stress can cause hair loss as it affects many of the body’s normal functions. This can be heightened by obesity. One of the lifestyle changes on which a patient needs to focus includes stress reduction. Lowering stress levels may prevent some hair loss or thinning.

Genetic baldness, known as pattern baldness, can also be a contributing factor at virtually any age in adulthood. Patients should learn more by speaking to their physician.

No matter what the cause of hair loss, it can be very stressful to see hair falling out. Patients should be mindful that up to 50% of those who undergo weight loss surgery may lose some hair. It is often a temporary issue.

Patients concerned about hair loss should speak to their physician or surgeon to learn about the possible causes.

Hair loss after gastric bypass

First of all, everyone loses hair every day as part of the natural cycle of hair growth.

But after weight loss surgery, our bodies are forced to live on drastically lower amounts of calories. To compensate for the reduction, all the remaining nutrients are channeled to the organs that need them most. And our hair isn't one of them.

So suddenly, our hair must do without the nutrients it needs to grow. And it also has to compensate for that loss. It sends more strands into “resting” phases and temporarily suspends production of new strands.

Not to mention the fact that hormones go haywire after surgery and while all that fat is being metabolized. That just doesn't help matters.

The upshot: hair starts falling out.

Be Aware!!

Shedding hair 3 to 5 months after weight-loss surgery is a relatively common occurrence that happens from losing weight rapidly, not getting enough protein, and the general stress your body goes through from surgery. Other less common reasons for post-surgery hair loss might be a lack of important dietary nutrients such as zinc, biotin, potassium, vitamin B6, or phosphorus. 

A deficiency of these nutrients can damage the hair root, thus making follicles unsalvageable. Lack of protein in your diet, will cause the hair to break off as it grows through the scalp. 

Ensuring your post-surgery diet is rich in protein and the appropriate vitamins and minerals can help lessen the severity of hair loss, or even prevent it. Here are some tips to make sure you’re consuming the right nutrients to protect your hair.

http://penn-bariatric-weight-loss-surgery.blogspot.com/2013/03/hair-loss-after-weight-loss-surgery.html

My experience with Hair loss:

While in the hospital I didn't notice any hair loss but the nurses kept reassuring me that since my hair was so thick it wouldn't be noticeable. After I got home and as I got more mobile I chose to keep my hair in a ponytail so that it would be out of my way. It didn't take long before I noticed that my hair was coming out by the handfuls when I brushed it.

It was even worse after getting out of the shower

I honestly got to where I didn't even want to brush my hair. One day my husband noticed a bald spot on my head

This is not the actual picture of my head but it's somewhat what it looked like. I thought I was going to have a panic attack when he took a picture of it and showed it to me. I know I cried. I started looking up hair loss after weight loss surgery and started following others personal experiences and read that wearing a pony tail can put tension on you hair and can actually pull it out. So from that day on needless to say I never put another hair tie in my hair. I bought hair berets.

These things were a life saver. Not only did they cover up the bald spot but it also kept my hair out of my face and it didn't pull tension.

My thinned out hair

How to minimize hair loss

Nothing will keep you from losing any hair at all. Even without weight loss surgery, you lose a certain number of hairs every day. Afterwards, you’re going to lose more. It cannot be prevented.

But there are things you can do that seem to help. First off, be sure you’re getting all of your protein. My doctor recommended 60 grams or more a day. I’ve found 80 to be a better number, both for weight loss and for my hair. (Many other doctors recommend 80 as a minimum.)

Hair is built with protein. That’s what it’s made of. So making sure you’re taking in enough protein will help keep your hair healthy. At least, healthier.

http://gastricbypasstruth.com/life-after-gastric-bypass/hair-loss-after-gastric-bypass-tips-for-losing-less-and-regrowing-more-faster/

1). Make sure you get in the necessary dietary protein every day. That is 60 grams daily for women and 80 grams for men.

2). Take at least 3 mg (3000 mcg) of Biotin each day and start it long before your operation. In fact I recommend you start it as soon as you start thinking you want to have bariatric surgery. This was recommended to our patients by a dermatologist that is a friend of mine. Biotin is an over the counter vitamin that strengthens your nails and hair. You may know people that take biotin just to make their hair thicker.

3). Finally, if your hair loss is bothersome to you consider a naloxone scalp treatment at your hair dressers or a local spa. This is supposed to rejuvenate the scalp.

http://bariatricsurgeryblog.blogspot.com/2010/02/dr-myers-how-can-i-minimize-my-hair.html

The two most effective supplements for hair regrowth (at least according to the buzz on WLS forums and message boards) are Silica by Puritans Pride and Biotin.

The two most effective supplements for hair regrowth (at least according to the buzz on WLS forums and message boards) are Silica by Puritans Pride and Biotin.

The bottom line is that you’re going to lose some hair after gastric bypass surgery. But you really can minimize that loss, and help regrowth happen faster by taking good care of your hair.

http://pesurgicalweightloss.blogspot.com/2012/07/hair-loss-after-gastric-bypass-tips-for.html

Personally I started taking Biotin about 2 months before my surgery and still continue to take it today. I have read in some blogs that some women have experienced unwanted hair growth (facial hair) from taking biotin but in my experience I have not. I also started using OrganiX Biotin and Collagen shampoo and conditioner ( I buy mine at Walgreens). I did have my hair cut but refuse to have it cut short. At the beginning when my hair loss was worse than it is now I only washed my hair once a week. My hair loss has finally started to slow so I wash it more. The shampoo and biotin supplement DOES NOT STOP HAIR LOSS it helps with regrowth. 

It's growing back!!! :)

Now that my hair is growing back I can see little patches that are shorter than my hair ( right over my left ear). I don't mind it I'm just happy it is growing back.

Summer in ONEDERLAND
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A MONTH OF MY LIFE LOST

My first day out of ICU 4/21/13

My first procedure in Mumbai was done laparoscopically. My second required that I get cut from the top of my stomach to the bottom.

I had 2 drainage bulbs, a G tube and a 

feeding tube

I don't know what all had to be done but I do know that my husband told me that the surgeon told him that it took multiple surgeons to piece me back together and that my intestines were a mess and that the bottom of my stomach had closed up and that is why I couldn't hold anything down. 

APRIL 23rd 2013 {FB}

Yea!,,, got my very first Popsicle today, spoke with the kids for quite awhile, and had visitors... simple pleasures , can be so sweet. Happy girl

APRIL 26TH {FB}

Still on a feeding tube and walking around all hooked up like the bionic woman but still Improving. PAIN, PAIN, PAIN, YEAH I GOT IT!!!!!! Got put on the full clear liquid diet today. Did o.k. just going to take some practice. So happy hubby has started coming over to walk with me to help my healing come along. Earlier today I was told there was no ballpark as to when I may get to go home but later this evening when James and Nick were here the doc said as long as I keep progressing I maybe home by next Friday (no promises) but its at least goal to work toward. I still thank god everyday that I let James talk me into going to the ER. Chances are I wouldn't even be typing this had I not. OH YEAH AND A BIG THANK YOU TO THOSE WHO JUST BUSTED OUT OF THE WOODWORK AND TOOK THE TIME TO COME SEE ME. Ok I'ma stop so I don't get mushy but again you know who all you are and you mean a lot to me for just setting aside time for me.

April 27th 2013 {FB}

Another tube removed this morning. Still not the 2 I wish were gone but doc says they will more than likely be staying put till the day I leave. Breakfast of watered down grits wasn't to appealing but the cream of chicken soup this afternoon has so far been the winner of what I have been able to eat...well other than water, water, and more water. I'm getting to point that I think I really hate my veins. Its becoming a daily thing now where they are having to find a new one...curse you thin rolling uncooperative veins of trouble. Walking a bit more each day and getting my strength back.

27TH

Almost off the pain pump. Taking pain meds by mouth but still hooked up to the pump in case a little extra is needed. Feeding tube will be shut OFF tonight and disconnected. I cant believe how excited I am. So close to going home. Being a good girl and doing what I'm told. Thanks for all the prayers He is awesome!!!

27TH

It doesn't matter how I hold my belly or the pillow over it. Every time I sneeze I feel like its gonna blow wide open..lol

APRIL 29th 2013 {FB}

All these steps forward I've been taking and yesterday I have been pushed back the big green tube has been reconnected. Doc says its not a bad thing. Sometimes you gotta take a couple steps back to take more steps forward.

MAY 1st 2013 {FB}

As of last night I'm all most completely disconnected from everything. All that is left are my 2 tiny drainage bulbs.

1ST

Taking me back for another ct scan around noon. Looking for possible blockage, kink, or a part too narrow. Praying I won't have to be reopened. This is my only hurdle to overcome before getting to go home.

1ST

Results are a bit bittersweet. On the pro side everything looks good just swollen. On the con side, since the swelling is still so much they are reconnecting me to the feeding tube and so on and cutting out my oral intake for now.

MAY 7th 2013 {FB}

Even though I'm still going to  have a feeding tube and a g tube doc says I'm finally going to get to go home either tomorrow or Thursday!!!!!!!!!!!! Have to get a home health nurse set up to get me prepared to live a home with these tubes till I'm healed enough to have them disconnected. It's been a long painful month but I'm getting better and better as the days go by. Looking forward to the brighter days ahead. And again thanks again for the over flow of prayers for healing and a speedy recovery. Even though we have had to back track a tad I'm still getting better at a pretty speedy rate considering all that has been done.

MAY 9th 2013 {FB}

I broke down and cried for the first time today. Today was supposed to be THE day. I was finally supposed to go home and be with my family. But since I woke up sick and dry heaving the doc had no choice but to refuse my leaving. I cant even find the words to best explain how much I miss my family or just the feeling of home. I'm going to stay strong but it's starting to affect me just a tad more each day.

MAY 10TH 2013 {FB}

Doing a little happy dance. The doctor said I can go home today!!!! They are working on my discharge papers now and I'm keeping my fingers crossed I don't get sick.

**PAST POST** 4/2/13 PACKED AND READY TO GO

The big day is finally here!!

Today I will be heading to the Charlotte airport to board my flight to India!! I cant believe the day is finally here. I've been on my pre-op diet now for 14 long days. I cant say that is has been easy but I just keep reminding myself that it will all be worth it in the long run. 

Originally my surgery was scheduled to be preformed on April 4th but I found out today that it was pushed back to the 8th. The pro to having my date changes is that I will be able to do all my sight seeing before the operation and I know I will be feeling up to it. Then again to me the con is having to wait 4 more days and being on this diet 4 more days.

I'm staying positive about this whole life change and am so excited about the opportunity to not only travel to 2 countries (we will have a layover in Munich Germany going to and coming from India) and being about to have this surgery that will help me finally get to where I want to be in life. I know it has not only been a learning and growing experience for me but with my children watching my determination to achieve my goal I hope that it has taught them that sacrifice, hard work, and determination does pay off.

I'm sure once all this is started and I have more going on I will have more to post. 

WEIGHT UPDATE:

Starting weight: 275

begin Pre-op weight: 259

Todays weight: 239

GOAL WEIGHT: 125

114lbs TO GO!!!!

**PAST POST** 3/24/13 I'M BACK: pre-op diet

I'm Finally back!!!

Since it is now Wednesday the 27th here I now have 7 days till my surgery. YAY!!!

I have been on my pre-op diet for the past 10 days and to be honest it hasn't been easy. It's been I know a week (give or take a day) since I've even cut my computer on. I really haven't felt up to communicating that much. Being a mom in a household of 6 and only being able to eat a tiny amount of food daily while still having to prepare 2 to 3 meals a day can not only be hard but upsetting. 

This is what I have been eating

The first couple days were awful I totally felt like I was starving to death. I have dieted before by means of eating healthy but I have never eaten so little in my life. I know I have to do this for multiple reasons. but that still doesn't make it easy. Thank goodness for the meal replacement shakes. They at least helped me feel fuller.

Before starting this diet I was never one to sit down and eat 3 meals a day. I mostly snacked here and there and we all sat down for a big dinner together. So my first plan of attack was to come up with a method of reminding myself to eat. Easy pesy since my cell phone goes with me every where I came up with the idea of setting 3 alarms to go off when it's time to eat.

Right now with all the changes and still having to keep up with my house and family I have to say the alarm clock on my phone has really helped out. Not only do I have it set to remind me when to eat, I also have notes to remind me not to forget my Vitamins and it also wakes me up for my workout. I am bound an determined to have my own success story with this surgery no matter what I have to do. I know it sounds crazy having all these alarms but I know I won't be needing them forever it's just helping train me for getting into a routine

Now lets talk about this lovely diet!!

I've posted above what my daily diet consists of but now I'm going to break it down to what I actually get to eat in one day.

BREAKFAST:

1 slimfast 321 plan shake (meal replacement)

1/2 c. plain greek yogert (as a sub for the skim milk since I cant drink milk)

1 slick of Natures own Double fiber whole wheat bread

LUNCH:

Either a slimfast or atkins shake

1/2 c. fruit with the juice drained or 1/2 a banana or a small apple or pear

DINNER:

1 of my shakes

1/2 c. 100% fat free low sodium chicken or beef broth

1/2 c. steamed or 1 c. raw veggies

1 slice of whole wheat bread (I find it easier to eat as toast)

SNACK:

Water

1/2 c raw veggies or I can have another cup of broth.

 to stop myself from being tempted to just grab something every night I get my little bowls and pre measure out all my food for the next day and put them on the bottom shelf of the fridge. It's simple easy and fast. I have 5 more days till I leave for India and 7 days till my surgery. I'm extremely excited and grow even more as every day passes. 

WISH ME LUCK!!!!!