August 22nd!

[preemiemommy2009 5]

Hw 230

Sw 225

Cw 204

Loss 26

Almost to onederland...can't wait

I had about a 5 day stall, realized it was that time of the month. Then after that weight started to come off again.

[katie206 12]

HW 290.6

SW: 274.9

CW: 256.8

Lost 33.8!

Great job everybody!

[mrs.katie 27]

Y'all are doing awesome!

[mrs.katie 27]

Y'all are doing awesome!

[MamboMan 6]

Mine as well. I stick to chewables. I take a chewable Multivitamin (Walmart brand)' date=' Caltrate Plus chewable, CVS brand chewable C and B12, a liquid D3, and a Vitamelt that has Biotin and C for my hair and nails. I take everything twice a day, 12 hours apart.[/quote']

You said you were taking Caltrate Plus. That is made from Calcium CARBONATE, which we do not absorb well after surgery. Your MD and RD/nutritionist should have educated you about this and told you that we need calcium citrate. Also, if you are not taking Iron, that is recommended as well, but you cannot take the iron with the calcium. You can get some great Vitamin and supplement information from the ASMBS. Not sure which multivitamin you are taking from Walmart, but make sure it has magnesium (I don't think the children's variety does). And for anyone else that is supplementing with D3, it is recommended it be taken in a dry form, liquid, or sublingual NOT in the Fluid filled pills; those are fat soluble and we don't absorb them well after surgery.

[mrs.katie 27]

You said you were taking Caltrate Plus. That is made from Calcium CARBONATE' date=' which we do not absorb well after surgery. Your MD and RD/nutritionist should have educated you about this and told you that we need calcium citrate. Also, if you are not taking Iron, that is recommended as well, but you cannot take the iron with the calcium. You can get some great Vitamin and supplement information from the ASMBS. Not sure which Multivitamin you are taking from Walmart, but make sure it has magnesium (I don't think the children's variety does). And for anyone else that is supplementing with D3, it is recommended it be taken in a dry form, liquid, or sublingual NOT in the Fluid filled pills; those are fat soluble and we don't absorb them well after surgery.[/quote']

While I appreciate your info, I completely disagree. There have been no peer reviewed studies on this and I know many patients who take exactly what I do and have no problems. In fact, I just had blood work done Wednesday and my levels of everything are normal, my iron has actually continued to rise since surgery.

My D3 is sublingual since pills after surgery isn't advised. As far as the ASMBS, I don't listen to them about much. Their articles and findings are simply propaganda. They still state the Lap Band is as effective as the RNY, which we all know is completely false. I do my research and listen to real patients experience, I trust my body and will continue to monitor my blood levels for the next several years. I suggest you do the same. Test your blood; see what works for you and customize your routine based on that, not what someone tells you.

[MamboMan 6]

While I appreciate your info' date=' I completely disagree. There have been no peer reviewed studies on this and I know many patients who take exactly what I do and have no problems. In fact, I just had blood work done Wednesday and my levels of everything are normal, my Iron has actually continued to rise since surgery.

My D3 is sublingual since pills after surgery isn't advised. As far as the ASMBS, I don't listen to them about much. Their articles and findings are simply propaganda. They still state the Lap Band is as effective as the RNY, which we all know is completely false. I do my research and listen to real patients experience, I trust my body and will continue to monitor my blood levels for the next several years. I suggest you do the same. Test your blood; see what works for you and customize your routine based on that, not what someone tells you.[/quote']

I was merely trying to be helpful. We can agree to disagree. After all, it is your body. I do agree with you that you need to test your blood, customize, and do what works for you.

It seems there are a lot of people that do not educate themselves before or after surgery. Also, it appears there are a lot of surgeons that do not fully educate their patients for one reason or another and provide inaccurate info (ie. your pouch will stretch if you drink carbonation, or that you can't take pills after surgery) as a means to scare you. I've no idea what kind of work you do or how you know of the many patients who have no problems. I do know that bone density loss cannot be measured by your blood. You need a bone density scan for that and you can still have bone loss even though your blood work is okay, since blood work measures the amount of Calcium (or whatever you're measuring) available in your blood. I'm glad you are doing so well and your blood work looks good. Didn't you just recently have surgery? I believe it takes some time to show Vitamin and mineral deficiencies.

I could not find the info you were referring to regarding the ASMBS and the Lap Band. I'm also not sure how they are propaganda, but as with anything, take the info you want and leave the rest. As for the calcium carbonate versus citrate issue, I stand by my original statement. I would encourage anyone to do a search regarding the two and how they are absorbed by RNY patients, as well as the increased risk of kidney stones. Here are a couple of peer reviewed studies to get you started.

I wish you well and much success on your journey.

"Calcium citrate has superior bioavailability than calcium carbonate in RYGB patients. Research conducted at the University of Texas Southwestern Medical Center supports the use of calcium citrate over calcium carbonate after gastric bypass surgery. Calcium absorption is impaired after gastric bypass surgery as there is significantly less stomach acid as well as malabsorption from bypassing the duodenum. This study was a double-blind crossover study to compare the absorption of calcium citrate to calcium carbonate after gastric bypass. This is important as bone loss is a serious risk after surgery. Patients are asked to take large amounts of supplemental calcium after surgery, and these are the commonly supplemented forms. This study showed not only better absorption of calcium as calcium citrate, but also a greater decline in serum PTH levels in response to calcium citrate."

Tondapu P, Provost D, Adams-Huet B, Sims T, Chang C, Sakhaee K. Comparison of the Absorption of Calcium Carbonate and Calcium Citrate after Roux-en-Y Gastric Bypass. Obes Surg. 2009 Sep;19(9):1256-61. E

"Calcium carbonate depends on acid for its absorption; calcium citrate does not. One study comparing the bioavailability of both products in achlorhydric patients found the bioavailability of calcium carbonate and calcium citrate to be 4% and 45%, respectively. [18] While calcium citrate is more expensive than calcium carbonate, it is logical to specifically recommend calcium supplementation with the citrate salt in this patient population. Decreased calcium absorption can increase the risk of osteoporosis."

Medication and Nutrient Administration Considerations After Bariatric Surgery

April D. Miller, Kelly M. SmithDisclosures

Am J Health Syst Pharm. 2006;63(19):1852-1857.

[mrs.katie 27]

I was merely trying to be helpful. We can agree to disagree. After all' date=' it is your body. I do agree with you that you need to test your blood, customize, and do what works for you.

It seems there are a lot of people that do not educate themselves before or after surgery. Also, it appears there are a lot of surgeons that do not fully educate their patients for one reason or another and provide inaccurate info (ie. your pouch will stretch if you drink carbonation, or that you can't take pills after surgery) as a means to scare you. I've no idea what kind of work you do or how you know of the many patients who have no problems. I do know that bone density loss cannot be measured by your blood. You need a bone density scan for that and you can still have bone loss even though your blood work is okay, since blood work measures the amount of Calcium (or whatever you're measuring) available in your blood. I'm glad you are doing so well and your blood work looks good. Didn't you just recently have surgery? I believe it takes some time to show Vitamin and mineral deficiencies.

I could not find the info you were referring to regarding the ASMBS and the Lap Band. I'm also not sure how they are propaganda, but as with anything, take the info you want and leave the rest. As for the calcium carbonate versus citrate issue, I stand by my original statement. I would encourage anyone to do a search regarding the two and how they are absorbed by RNY patients, as well as the increased risk of kidney stones. Here are a couple of peer reviewed studies to get you started.

I wish you well and much success on your journey.

"Calcium citrate has superior bioavailability than calcium carbonate in RYGB patients. Research conducted at the University of Texas Southwestern Medical Center supports the use of calcium citrate over calcium carbonate after gastric bypass surgery. Calcium absorption is impaired after gastric bypass surgery as there is significantly less stomach acid as well as malabsorption from bypassing the duodenum. This study was a double-blind crossover study to compare the absorption of calcium citrate to calcium carbonate after gastric bypass. This is important as bone loss is a serious risk after surgery. Patients are asked to take large amounts of supplemental calcium after surgery, and these are the commonly supplemented forms. This study showed not only better absorption of calcium as calcium citrate, but also a greater decline in serum PTH levels in response to calcium citrate."

Tondapu P, Provost D, Adams-Huet B, Sims T, Chang C, Sakhaee K. Comparison of the Absorption of Calcium Carbonate and Calcium Citrate after Roux-en-Y Gastric Bypass. Obes Surg. 2009 Sep;19(9):1256-61. E

"Calcium carbonate depends on acid for its absorption; calcium citrate does not. One study comparing the bioavailability of both products in achlorhydric patients found the bioavailability of calcium carbonate and calcium citrate to be 4% and 45%, respectively. [18'] While calcium citrate is more expensive than calcium carbonate, it is logical to specifically recommend calcium supplementation with the citrate salt in this patient population. Decreased calcium absorption can increase the risk of osteoporosis."

Medication and Nutrient Administration Considerations After Bariatric Surgery

April D. Miller, Kelly M. SmithDisclosures

Am J Health Syst Pharm. 2006;63(19):1852-1857.

Trying to be helpful, or a know-it-all? From your other posts I would say the latter.

[MamboMan 6]

Trying to be helpful' date=' or a know-it-all? From your other posts I would say the latter.[/quote']

Ouch! Seriously? I don't think I am a "know-it-all" because I can search, read, understand, and cite published data. I was merely responding to your inaccurate claim that there was NO peer reviewed information about Calcium carbonate versus citrate. I cannot help that the vast majority of people have either not received accurate or thorough information, have not (or don't know how to) searched for information regarding their own health, or those who choose to live a life of ignorance.

If I see wrong information being spread around on here, or anywhere for that matter, you can bet your ass I'm going to provide correct information so others may have an alternate view point and hopefully provide some much needed education. I am not a sheep and do not subscribe to the herd mentality. I am also not a hand-holder who is going to agree with someone when I know they are wrong. If you don't like it, too bad. You are posting in a public forum and you don't get to choose the responses you receive.

[mrs.katie 27]

Ouch! Seriously? I don't think I am a "know-it-all" because I can search' date=' read, understand, and cite published data. I was merely responding to your inaccurate claim that there was NO peer reviewed information about Calcium carbonate versus citrate. I cannot help that the vast majority of people have either not received accurate or thorough information, have not (or don't know how to) searched for information regarding their own health, or those who choose to live a life of ignorance.

If I see wrong information being spread around on here, or anywhere for that matter, you can bet your ass I'm going to provide correct information so others may have an alternate view point and hopefully provide some much needed education. I am not a sheep and do not subscribe to the herd mentality. I am also not a hand-holder who is going to agree with someone when I know they are wrong. If you don't like it, too bad. You are posting in a public forum and you don't get to choose the responses you receive.[/quote']

I say know-it-all because the only posts you make are as a "medical professional" and not as a patient. I don't spread misinformation, and I don't bet my bottom (or cuss) on anything. Nobody wants you to hold their hand, but I would like you to stop telling people they are ignorant. It is rude. You are also on a public forum, but that doesn't mean your superiority must be flaunted.

[Obeasta 92]

I have read your discussion and i have to say, Mrs Katie, it does seem that you are a bit overreacting. What Ricky is saying is really true and I for one appreciate it if one gives true and unbiased info and just also actually trying to help.

You do not have to take any of that advice of course, you alone make decisions for yourself. But you honestly come across as condescending and that is in fact a bit rude especially in a public forum like this where all of us are fighting their own kind of battle and come here for support and also to give support.

Please dont see this post as an attack from my part - that is not at all my intention, i am just speaking up because i do think your treatment of ricky is a bit unfair, and not nice. And all of us try and be nice and encouraging with each other here, because of course we all have suffered greatly in our lives because of all kinds of prejudice and also suffer a lot post op (especially on a psychological level).

Be kind.

[mrs.katie 27]

I have read your discussion and i have to say' date=' Mrs Katie, it does seem that you are a bit overreacting. What Ricky is saying is really true and I for one appreciate it if one gives true and unbiased info and just also actually trying to help.

You do not have to take any of that advice of course, you alone make decisions for yourself. But you honestly come across as condescending and that is in fact a bit rude especially in a public forum like this where all of us are fighting their own kind of battle and come here for support and also to give support.

Please dont see this post as an attack from my part - that is not at all my intention, i am just speaking up because i do think your treatment of ricky is a bit unfair, and not nice. And all of us try and be nice and encouraging with each other here, because of course we all have suffered greatly in our lives because of all kinds of prejudice and also suffer a lot post op (especially on a psychological level).

Be kind.[/quote']

I'm out. I have enough drama in my life without this.

[MamboMan 6]

I say know-it-all because the only posts you make are as a "medical professional" and not as a patient. I don't spread misinformation' date=' and I don't bet my bottom (or cuss) on anything. Nobody wants you to hold their hand, but I would like you to stop telling people they are ignorant. It is rude. You are also on a public forum, but that doesn't mean your superiority must be flaunted.[/quote']

I am truly sorry you felt I was implying that you are ignorant, that was not my intention at all. Because I AM a medical professional AND a patient I feel people should receive the correct information, based upon science, rather than how one "feels," so they can make an informed choice, as in the case of the Calcium. You can choose to agree or disagree, it doesn't change how Calcium reacts to stomach acid, or in our case, a lack of acid. I think of it in the same vain of people who have untreated hypertension. They KNOW they should take medication to lower their blood pressure, but because they "feel" fine, they don't and end up having a heart attack or stroke that could be prevented. Just like bone loss, anemia, etc. can be prevented or lowered if you take the correct supplement.

While I put a large amount of blame on the medical community, people really need to be their own advocate. When I initially replied to your post, I was thinking "uh-oh, another doctor or NUT that didn't do their job and is putting their patient at risk for a whole lot of health problems in the future." My intention wasn't to "flaunt my superiority." You do not know me, you have only read my words and interpreted them in a negative way. My style of communicating in situations like this is to be straight forward because that is how I would want someone to be with me if they saw I had wrong information that may potentially be dangerous to my health. I don't think I have been rude at all. I will agree a lot of the few posts I have made on here are information based, but you are incorrect when you say "the only posts you make are ...". As a patient, I had to research and learn all of this, too. I'm not entirely sure how I'm supposed to post as a "patient"... I thought I was. I just happen to have a lot of medical knowledge and have read and researched everything I possibly could about this surgery and the life style afterwards.

By stating that there were NO peer reviewed studies about the calcium, you were, in fact, spreading misinformation. I didn't post the references to flaunt my superiority, but to support MY original response, so other people will be aware and can make an educated decision on what they want to use for their supplementation. I don't know why you just couldn't say "oh, I didn't know about that, thanks for the research." Instead, you decided that I was implying you were ignorant, inferior, or whatever. Maybe it is the influx of estrogen that is being released in your body right now, but maybe you can look back on this one day and see it through different eyes .... It was not an attack, I really WAS just trying to help.

[MamboMan 6]

I have read your discussion and i have to say' date=' Mrs Katie, it does seem that you are a bit overreacting. What Ricky is saying is really true and I for one appreciate it if one gives true and unbiased info and just also actually trying to help.

You do not have to take any of that advice of course, you alone make decisions for yourself. But you honestly come across as condescending and that is in fact a bit rude especially in a public forum like this where all of us are fighting their own kind of battle and come here for support and also to give support.

Please dont see this post as an attack from my part - that is not at all my intention, i am just speaking up because i do think your treatment of ricky is a bit unfair, and not nice. And all of us try and be nice and encouraging with each other here, because of course we all have suffered greatly in our lives because of all kinds of prejudice and also suffer a lot post op (especially on a psychological level).

Be kind.[/quote']

Thank you, Obeasta! YOU get me!!! Yay! I really am not a mean, bitchy, rude person. I just feel that people should have education so they can choose what is best for them. Some people just don't like to admit they are wrong and get defensive and have to call people names. It honestly doesn't bother me because I know my intention is good and well-meaning, and it is based in fact. Sometimes people need to be spoken to bluntly so the message can be heard, but that doesn't make it rude.

Thanks again for your support. Btw, I quite enjoy your blog.

[srofe5 56]

Please don't leave Mrs Katie because I for one would miss you. I just have one question regarding both posts that I am hoping to get clarification on.

ie. your pouch will stretch if you drink carbonation, or that you can't take pills after surgery)

Is none of this true? My biggest concern is in regard to the pills you can no longer take. I have taken aleve for headaches in the past and they work best for me. My dietician told me that I can no longer tke them. Is this true?

Any information with regard to this will be beneficial to me and thanks in advance.