Born in Missouri

@Tealael Most likely she's a PharmD, which is a Doctor of Pharmacy. My daughter is a PharmD. A pharmacologist is basically a researcher. They study the chemistry of drugs and how they work in our bodies. Drug companies hire pharmacologists. A PharmD can be a clinical pharmacist (works in hospitals or nursing homes) or a retail pharmacist (fills prescriptions at drugs stores like CVS or a mail-order facility). No, I have no qualms about her thoroughness. That's what PharmDs do. But that doesn't change the fact that little is understood about the interactions and malabsorption unknowns with the majority of drugs as they pertain specifically to the bariatric community. You're lucky that someone is hands-on with your meds, but she is basically working off what little is known and applying that knowledge as best as she can to the patients she serves.

I just realized that this is an old, archived post and the original poster hasn't even visited this forum for at least a couple of years. I hope other people will read about and learn from this thread anyway.

@Tealael Also, congrats on all the weight you've lost. I'm still having a hard time imagining myself a year or so from now and enjoying your level of success. Wow.

@Tealael Doctors, including bariatric surgeons, know very little about the effects of most meds out there when it comes to helping those of us in the bariatric community feel confident about the meds we take, prescription and OTC. I'd be interested in seeing the list they've compiled and their reasons.

I was interested in this topic recently, too. https://www.bariatricpal.com/topic/416632-altered-taste-buds/?tab=comments#comment-4657450

@sillykitty. I talked to my youngest doctor son and he pretty much, but nicely, let me know that I didn't actually have a good grasp on the TOTAL PROTEIN test. His explanation was way over my head. All I remember him saying was something about children in poor countries who are protein-starved... I think, I'm still not sure. That said, I stand corrected. I'm the first to admit when I've mispresented a medical fact. Another confession!!!

I found two interesting slideshows on the site Matt recommended to calculate one's BMR. https://www.active.com/fitness/articles/10-surprising-reasons-you-re-not-losing-weight https://www.active.com/food-and-nutrition/articles/8-ways-to-eat-more-protein Obviously, some of us haven't graduated to some of the foods suggested... yet. I'm not terribly disappointed in not being able to eat turkey jerky anyway.

I know nothing about tattoos, but that's not why I'm writing. Don't apologize for asking questions, Cheyenne. Don't put yourself down because you have doubts about your questions or because you assume people will judge you or think you are "ignorant." Have confidence in yourself. Don't devalue your thoughts, questions, or opinions. You obviously spent time and effort composing a clear, concise, and well-organized set of questions about a topic that is of interest to those in the bariatric community who share your passion for tattoos. So, next time you post a response or start a new topic, don't apologize. Okay? https://www.bustle.com/p/22-little-ways-women-are-expected-to-apologize-for-their-existence-every-day-30296 https://www.huffingtonpost.com/bustle/23-things-women-apologize-for-all-the-time_b_5915414.html

Yes, @CyclicalLoser. Keep us posted. I very much want to know how things progress for you, too.

@Briswife15 Hopefully, the psychologist you visit will have some background in evaluating potential bariatric patients. We're actually a scary population for most health professionals because it exposes their lack of knowledge about what bariatric surgery involves. My psych evaluation was a 20-minute appointment that assessed my readiness to commit to the lifestyle changes ahead. When we were finished talking, she took a blank page of letterhead and wrote, by hand, a short letter "psychologically" clearing me for surgery. Psychologists know zilcho about meds, by the way, because they aren't medical doctors; they're either licensed social workers or PhDs... and neither can prescribe medication. Not that you wouldn't know this. Sometimes I can't stop my fingers from talking my hand off!

My insurance plan had no penalty for gaining weight during the pre-op period. I merely had to make weight-loss attempts for six months, successful or not. Do you know what your bariatric benefits say?

Every doctor's office seems to have their scales calibrated differently. My digital scale at home is different, too. I recently had two back-to-back doctor appointments. I weighed as much as 25 more in one office than in the other on the same day. I was also told (emphatically; how rude!) that I was 5'5" when I've been 5'6" forever. Really? So, that must mean that I grew an inch or shrank an inch, I can't remember, from one office to the next? Politely challenge. Figure out how to convert from kg to lbs yourself -- with an app or an old-school calculator. Be prepared. Pretend that you're a boy scout. (That's the Boy Scout motto, btw. Be Prepared. https://blog.scoutingmagazine.org/2017/05/08/be-prepared-scout-motto-origin/) Find another scale in another office, if possible, and compare. If the numbers are too far off, then one or both scales are worthless.

@Briswife15 That doesn't sound right. The overall health benefits of weight-loss surgery shouldn't be dismissed outright because of an unknown bioavailability issue that most likely can be managed with dose experimentation. There just isn't enough research out there for him to declare, "Don't get surgery!" This puts you in a very fragile and frustrating position. Bariatric medicine is something too few doctors understand, so is it any wonder that they prefer avoidance -- hey, it's easier, right? "Surgeons and psychiatrists often practice in very different professional circles. There is often no rounding service for inpatient psychiatric consultations available unless patients proclaim suicidal ideations. There is a mutual reticence of psychiatrists to care for perioperative patients who may be having GI symptoms, and surgeon reluctance to manage psychiatric issues when a consultant is not readily available. When patients with significant psychiatric conditions suffer a loss of stability on surgical floors, it can be very difficult, time-consuming, and disconcerting for surgical teams to manage. Patients are presenting for bariatric evaluation with significant psychiatric disorders with increasing frequency. Existing data do suggest that the benefits of bariatric surgery in terms of weight loss are real, and that surgical outcomes should be good. There is a glaring lack of any information regarding the effect on the person as a whole to guide us as surgeons. The best evidence continues to suggest that in carefully selected patients, bipolar disorder or other Axis 1 disorders are not a contraindication to bariatric surgery. This requires a means and willingness for surgeons and psychiatrists to work closely together to deliver coordinated care and to ensure that recommended follow-up is achieved. Currently, this is not an easy task in most institutions. Lastly, while patients with significant psychiatric conditions may not be contraindicated for bariatric surgery, neither is bariatric surgery a treatment for these conditions, and this fact does not always match up with preoperative patient expectations. This is an area that is ripe for research." See: Clinical Challenges of Bariatric Surgery for Patients with Psychiatric Disorders. Commentary on: “Lithium Toxicity Following Roux-en-Y Gastric Bypass”. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4063371/

Hey, what's wrong with benzodiazepines? I take two short-acting ones, clonazepam (at bedtime) and alprazolam (for panic attacks.) Don't worry, I understand how and when not to mix my meds, including my opioids and benzos. I also take sertraline (depression) and buspirone (anxiety). I used to be touchy about the idea of taking addictive medication. As a chronic pain patient, I tried several non-narcotic and holistic approaches to pain relief. My daughter finally explained to me the difference between addiction and dependence. She told me that there is no shame in taking morphine, for example. I am dependent on the drug for pain relief. Yes, I would have withdrawal symptoms if I stopped taking it, but I'm not addicted in the sense that I'm stealing money out of my 19-year-old son's piggy bank because it makes me feel all warm and wonderful. Really, I'm just addicted to not being in around-the-clock pain! And taking morphine for someone who is opioid-tolerant does give one a "high"; it merely takes the edge off the pain so I can function without tears of pain running down my face.

Thanks for posting this topic, Matt. It's been fun.

@TaylorMade4One I'm not sure I feel the same way about Burger King's onion rings --or any onion rings for that matter-- but your post was hilarious from start to finish. I almost felt like I was riding shotgun with you while you were in that parking lot eating away sauceless and guilt-free.

@KimTriesRNY When I say generic drug name, I don't mean generic in the sense of "lesser" or "off-brand". This is more like it's pharmaceutical name. It's real name. Think about the common acetaminophen. Many people refer to it as Tylenol, which is well-known but it's really just a brand name for acetaminophen. Many drug stores (CVS, Walgreen's, Wal-Mart) carry there own brands of acetaminophen with more obscure brand names like CVSHealth or Equate. What if someone went to the hospital and when asked what they take for pain relief they answered. "I take Equate." Giving the brand name, in this case, tells the hospital staff nothing. If you're able to remember acetaminophen, however, there is absolutely no mistake. The generic drug name is not always easy to "remember" or even spell or say, so it's a good idea to write down your meds with their generic drug names, if possible. I often have to admit to nurses and other health professionals that I don't speak brand names. For that reason, I get confused when asked, "Do you still take Xanax?" Yes, Xanax is a common brand name, but I only know it as alprazolam. Likewise, some bariatric patients are given Dilaudid (the brand name) but its generic drug name is hydromorphone. It's not wrong to use a brand name, but there can be confusion. I'm just following the advice of my daughter, and my two sons (who are medical doctors). This is not something I do to appear snooty-toot-toot. I do it because I now understand the difference between a drug's generic drug name and its brand name. If you're not sure what the generic drug name is, describe the pill (color, letters, numbers) and enter into a pill-identifier site this one: https://www.drugs.com/pill_identification.html Brand names for lisinopril include Prinivil and Zestril. Sites like this one identify over-the-counter medication as well as by-prescription medication. When I said I didn't want to bore anybody, I didn't intend to appear facetious; I was really just too lazy to continue with my way-after-midnight post and, truthfully, I wasn't sure if anyone gave a flying fig newton.

Oh, gee willikers, Matt. My comment was meant to be purely tongue-in-cheek. I was attempting to be cute and clever, not jerky and judgmental. I feel sad and bad that you believed otherwise. I thought my devil emoji and my sarcastic, almost childlike-scolding tone (you are a very, very bad boy) would have been obvious tip-offs. Perhaps I should stick to sedate comments, ones that can't be misinterpreted.

@Matt Z This might be why, when you consume foods like this and then go to bed your body can't burn them off... try switching your cheat meal to the middle of the day to see if that helps any. Tsk, tsk, Matt. I thought this thread was about posting our cheating experiences, not giving lessons on how to be more effective cheaters!! You are a very, very bad boy.

That's not completely accurate, sillykitty. (Love saying sillykitty!) My most recent labwork tested my TOTAL PROTEIN. It was 7.0 Albumin and globulin are two types of protein in your body. The total protein test measures the total amount of albumin and globulin in your body. The normal range for total protein is between 6 and 8.3 grams per deciliter (g/dL). This range may vary slightly among laboratories. Gender and age also play a role in your test result.

@Orchids&Dragons. . . and then proceed to lose our ever-lovin'-minds. I just had to say this sentence out loud to myself several times because it was just so much fun to say!

My surgeon's calcium citrate recommendation is 1500mg to 2000mg, divided into three or four doses of about 500mg each, taken at least two hours apart. (And, of course, never take the calcium with iron.)

I've returned to drinking Diet Dr. Pepper. Every. Single. Day. No bloat. No pain. Nothing weird-feeling at all. It has to be supercold with ice, though. I never drink pop straight from the can. I always drink it with ice. (I didn't have ANY pop during my pre-op diet or for almost three weeks post-op.) This one concession makes me feel whole again. I can give up just about everything else, except for my daily pop habit.* * I've been craving salt. I mushed up a few Saltine crackers and some potato chips until they were pulp in my mouth. I bought a small cheeseburger at McDonald's. I chewed up each bite to a mushy consistency, then I spit it out. Except for the last bite. That one I swallowed. * *Phosphoric acid is a major component in most sodas. Phosphorus itself is an important bone mineral. But if you're getting a disproportionate amount of phosphorus compared to the amount of calcium you're getting, that could lead to bone loss. Another possible culprit is caffeine, which experts have long known can interfere with calcium absorption. In one study, both caffeinated and non-caffeinated colas were associated with lower bone density. But the caffeinated drinks appeared to do more damage. This study isn't the last word on the subject. Some experts point out that the amount of phosphoric acid in soda is minimal compared to that found in chicken or cheese. And no one's telling women to stop eating chicken. Smart Steps for Soda Lovers Whether the apparent soda and osteoporosis link is due to effects of the soda itself or simply because soda drinkers get less of other, healthier beverages, it's clear that you need to be extra-vigilant about your bone health if you're a soda fiend. "Soda drinkers need to pay extra attention to getting calcium from other sources." A few steps you can take to boost your bone health: Can't give soda up entirely? Cut out one or two cans a day (depending on how much you drink). Better still, for every soda you skip, reach for a glass of milk or fortified orange juice instead. Not only will you be cutting back on any harmful effect from the soda itself, you'll be adding calcium. (If you're a diet soda drinker worried about calories, here's a plus: fat-free milk has even more calcium than higher-calorie whole milk.) Have a breakfast cereal fortified with calcium -- and pour milk on top. Add milk instead of water when you prepare things like pancakes, waffles, and cocoa. Add nonfat powdered dry milk to all kinds of recipes -- puddings, cookies, breads, soups, gravy, and casseroles. One tablespoon adds 52 mg of calcium. You can add three tablespoons per cup of milk in puddings, cocoa and custard; four tablespoons per cup of hot cereal (before cooking); and 2 tablespoons per cup of flour in cakes, cookies and breads. Take a calcium (calcium citrate for bypass patients) and a vitamin D supplement if you aren't getting enough calcium in your diet. Get plenty of weight-bearing and resistance exercise.

Their combined weight or individually?

There are books for children that supposedly prepare them for a parent's surgery, but none seem to address bariatric surgery in particular. I found no YouTube videos that explain a parent's bariatric surgery to their children. I did find a few articles, though, including a past conversation about this topic on bariatricpal.com. I hope these links will help! (They're listed in no particular order. Meaning: the most helpful link might be first, in the middle, or last!) http://www.mydestinationweightloss.com/blogs/talking-with-your-kids-about-weight-loss-surgery https://www.bariatricpal.com/topic/209717-telling-your-child-youre-having-wls/ https://www.uhn.ca/PatientsFamilies/Health_Information/Health_Topics/Documents/Talking_to_Children_about_Bariatric_Surgery.pdf https://www.stirthewonder.com/when-a-parent-has-surgery/ http://health.alot.com/wellness/talking-to-your-family-about-bariatric-surgery--3074 http://blog.care4hire.com/surgery/270