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Old 02-08-2014, 08:50 PM   #1
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New and have questions

Hi everyone! I had RNY surgery back in 2005 at the age of 19.
I've pretty much fluctuated around my desired weight of 130 (125-145) for the past 9 years. I've tried to eat well, but have lacked in the exercise dept. I also should mention that I had a huge fall out with my dr. And haven't seen him since my post op in early 2006. I lack a support group or a doctor who understands and is willing to help, since they were not my surgeon. Also in quite ashamed of myself, as I haven't really tried to do more to better my situation. I really dislike going to the dr's because on one will listen. I'm starting to get a bit desperate.

My questions are:
* I haven't taken vitamins regularly since early 2006, with the exception of small events in my life. I'm very confused on what to take and how to motivate myself. Anything I should worry about or look into? I already know I have low levels of iron and vit d.

* has anyone had issues losing weight when returning to Low carb lifestyle? I've been doing Atkins since 12/27 and have only lost 5 lbs. I did induction for 3 weeks, which is when I lost the 5 lbs, but haven't seen movement since. I have integrated in almonds, pistachios and blueberries (after the 3 weeks). I'm only looking to drop 10 more lbs, but it seems like the scale won't budge.

*excess skin, I'm so ashamed of my body. How do you all deal with it? I try to just accept myself as I am, but it's so hard! I live in south Florida where a lot of women dress in shorts, have nice bodies and so on. I feel like I will never be enough.

* blood sugar, I seem to feel like my body crashes during certain Times of the day, but I've Already eaten. On low carb, I feel better but still have moments. What do you all do during those moments? Any ways to help ease the nausea, shakiness and dizziness?

Thanks for letting me vent! Hopefully I can gain some knowledge and inspiration from you all!
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Old 02-09-2014, 09:57 AM   #2
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Oh wow. I have so many comments on this post.

First of all. GO find a physician. STAT. You need labs. You don't need a surgeon, you aren't having surgery. A pcp is fine. IF they have knowledge of WLS great, but it isn't necessary. Our normal lab ranges don't change because we're post WLS. Low is low is low.

You need 200% rdv as a post op RNY for your vitamins. That means 2 multivitamins that are comprehensive - contain 100% of most in each. AT LEAST 36mg iron, probably more if you're deficient. Carbonyl or heme. They're best absorbed. B12 sublingual. B complex sublingual. 1500mg calcium citrate a day, taking no more than 600mg at once and never within 2 hrs of iron. Dry vitamin d3, no oil. I have 15000mcg a day. This is bare minimum. Lab results dictate what else you need to supplement. Vitamin supplementation is non negotiable. It can cause irreversible damage yet is so easily preventable if you only take a few minutes a day!

Weight. LC is fine. But EXERCISE. Being active burns calories. You can lose those 10lbs no problem.

I have no problem with excess skin. I HAVE it, but it is what it is. It isn't a big bag of fat anymore so there's that. There's no amount of anything we can say to help with that. That's your mental block. YOU are choosing to compare yourself to others rather than to your previous self. That is a huge part of the journey.

Blood sugar. This is something that is also easily preventable. It's all diet choices. You probably have reactive hypoglycemia. You put food in that's higher in carbs than protein and because of our anatomy and the fact that carbs break down faster than protein and fat it raises glucose significantly and your body reacts by pushing a ton of insulin at it. And within an hour you're crashing. Preventable by eating meals that contain a ratio of at least 40:40:20 protein:carb:fat. Protein and fat slow the breakdown process so glucose doesn't raise significantly. You said it's better with LC. That's why.

How many times a day are you eating? 6 small is preferred with RH.

How much protein are you getting in a day?

And again - get in to a physician STAT and get labs. 8 years of not taking supplements regularly can cause a lot of deficiencies. You say they won't listen to you. Having someone you feel listens is important, but having someine PERIOD is preferable to going without.

Please take everything I've said in the helpful manner that it is intended! I don't want to come across as scolding, but I can be blunt sometimes when I'm answering. There's a whole thread on post op vitamins. They don't have to be special bariatric brands or even expensive name brands. Just read labels and look at how much of what it contains. Start taking them today. I have two 7 day containers and I fill them every Sunday. I take today's pills and put them in a pill box. It stays in front of me all day so I take them. It need not be hard or confusing. Just pack and swallow, it's almost mindless.

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Old 02-09-2014, 10:00 AM   #3
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What does/did a typical days diet for you consist of? Before you went back to lc recently. How far from your rules have you strayed? Do/did you eat sugar? What about drinking with or immediately after meals?
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Old 02-09-2014, 11:30 AM   #4
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Many wls programs run support groups that are free and open to anyone pre or post op. If you won't go back to your original clinic look into some other programs. You've done great keep your weight off especially with little to no support. But what about your long-term health? Listen to Heather, she's given you some great advice. Health is more than just a normal weight.
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Old 02-09-2014, 12:24 PM   #5
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I was mistaken. I take 150,000 vit d3 a day. I was VERY low so I upped it.
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Old 02-09-2014, 05:37 PM   #6
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Thanks for your response. I've had labs done throughout the years for different reasons (eating disorder, pregnancy, another surgery: to correct a problem with my RNY). Since the only thing that was ever low was iron, no dr has really cared much. I know problems can arise but I don't know what to look for. As for sugar, I did consume some but not in excess. I realized early on it wasn't worth it. I try combining protein with something for mostmeals. I do drink while eating, but not a lot. I drink mostly in between meals, like 64-90 oz of water. I don't drink diet soda regularly or any other beverage other than water and coffee.

A normal day before going lc:
B- coffee with almond milk and either a 1/2 c Greek yogurt and 1/4c oatmeal w/ flaxseed or hard boiled egg and toast with avocado and tomato.
S -slice of toast with peanut or almond butter
L - 3-4oz protein with 1/2 cup of cooked rice or something similar. A square or 2 of 70% dark chocolate.
S - toast w/ nut butter again or some type of high protein bar.
D - 4oz protein with 1/2 rice or pasta. 2 more squares of dark chocolate
S - popcorn w/ a cheese stick or nut butter on toast.

I lacked a lot in the veggies and fruit dept. Bring on Lc has helped me focus on eating lots of fresh produce. Pre lc if I did eat fruit, I would usually have it with Greek yogurt or nut butter.

As for vitamins, I think part of the reason I avoided taking them was that I was trying to punish myself. Although I don't feel that way now, I don't know what's holding me back. Uncertainty I guess or not knowing whether it will help.

Last edited by Ldominguez1022; 02-09-2014 at 05:48 PM.. Reason: Did mean to hit enter
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Old 02-09-2014, 06:07 PM   #7
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I haven't found any free support groups that aren't affiliated with a hospital or Dr. There was one that I went to 5 years ago, but they no longer meet up and it was an hour drive.

I may just need to do more digging or find an online group.
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Old 02-10-2014, 06:29 PM   #8
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Hey L - I'm in FL, too. If you're on the Gulf side maybe we're kinda close. I know my doc has a meeting the first Monday of each month...

I don't like to take vitamins because they tend to make me kinda queasy. Therefore, I almost always take them before bed. You might make it part of your night time routine, you know?

I agree with Heather. Please get yourself to a doctor and (nicely) insist that he/she does a variety of bloodwork.
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Old 02-10-2014, 10:13 PM   #9
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I'm glad to hear you've had some labwork. At first I was thinking you hadn't. I still think you need a set asap to get your baseline. Online support groups are good. We mind of are one here. My local hospital has a group, but it's open to anyone. Not just their patients. There's a website that helps you find support groups too. As soon as I remember it I'll come post it lol.
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Old 02-11-2014, 04:55 AM   #10
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I'm near Miami, so I'm a bit far from the gulf.

I'm thinking an online support group is going to be my best bet. Thank you all for your responses.

On a positive note, I took 2 of my leftover prenatals yesterday. Baby steps, but at least it is a start. I have like half a bottle left. They are from New Chapter I think, they seem to have high levels of everything.

I do have labs that were just taken about 3 weeks ago. I should be getting the results today or tomorrow, since I have an appt. with my hemotologist. I'm sure he will shed to light that my hemoglobin/iron is low, but that's all they ever really look at. Sadly none of my doctors are very familiar with WLS patients, so I end up kind of in a weird place.

I think my goal this year will be to find a solid Dr. who is able to help me and guide me in the proper direction.
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Old 02-11-2014, 06:41 AM   #11
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I'm near Miami, so I'm a bit far from the gulf.

I'm thinking an online support group is going to be my best bet. Thank you all for your responses.

On a positive note, I took 2 of my leftover prenatals yesterday. Baby steps, but at least it is a start. I have like half a bottle left. They are from New Chapter I think, they seem to have high levels of everything.

I do have labs that were just taken about 3 weeks ago. I should be getting the results today or tomorrow, since I have an appt. with my hemotologist. I'm sure he will shed to light that my hemoglobin/iron is low, but that's all they ever really look at. Sadly none of my doctors are very familiar with WLS patients, so I end up kind of in a weird place.

I think my goal this year will be to find a solid Dr. who is able to help me and guide me in the proper direction.
Get a copy of your labs. I like my doctor, and I liked my surgeon, but I always get a copy for me. I not only look for anything outside of normal, but I watch my trends as well. If my protein was low normal, but was mid normal last time I know I need to intervene. The best patient advocate is the patient. So when the labs come in have them fax, mail or go pick up a copy for yourself. I keep a spreadsheet (super easy not time consuming at all) that allows me to see every result at a glance so I can see if it's trending up or down.
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Old 02-11-2014, 03:03 PM   #12
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Thanks, great idea. I'll start keep track.
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Old 02-11-2014, 03:42 PM   #13
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My WLS doctor has family in Miami and is really familiar with that area. I will see him soon, and when I do I will ask him if he can give me the name of a doctor who might be able to help you with a support group.
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Old 02-12-2014, 04:59 AM   #14
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Thank you so much Hot Tamale!! Yeah the doctors I've seen at Dr. Rosenthal at Cleveland Clinic and some Dr at Mt. Sinai. My original surgeon no longer practices in Florida, Dr. David Diaz.

There are a few offices I've called around to and the nurses/receptionist usually told me the Dr. only handles their patients. Dr. Rosenthal was one of the few to see me but then told me there wasnt much he could help me with. Kind of disheartening.

I've been to countless doctors over the past 9 years (and in different cities) and I still haven't found someone who will work with me.
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Old 02-12-2014, 06:04 AM   #15
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Thank you so much Hot Tamale!! Yeah the doctors I've seen at Dr. Rosenthal at Cleveland Clinic and some Dr at Mt. Sinai. My original surgeon no longer practices in Florida, Dr. David Diaz.

There are a few offices I've called around to and the nurses/receptionist usually told me the Dr. only handles their patients. Dr. Rosenthal was one of the few to see me but then told me there wasnt much he could help me with. Kind of disheartening.

I've been to countless doctors over the past 9 years (and in different cities) and I still haven't found someone who will work with me.
Most surgeons won't take on new patients to manage their aftercare, unless you need a second surgery. But again, unless you are needing surgery you don't need a surgeon. A general practitioner will work just fine after about 2-2 1/2 years out. I stopped seeing my surgeon quite some time ago (I'm about a month shy of 4 years) and just get regular labs drawn. I didn't listen to my surgeon anyway.

What was it Dr. Rosenthal couldn't help you with? And what is it you need your doctor to do?

If you haven't figured it out I'm a question-er.
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Old 02-12-2014, 06:41 AM   #16
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I do drink while eating, but not a lot.

A normal day before going lc:
B- coffee with almond milk and either a 1/2 c Greek yogurt and 1/4c oatmeal w/ flaxseed or hard boiled egg and toast with avocado and tomato.
S -slice of toast with peanut or almond butter
L - 3-4oz protein with 1/2 cup of cooked rice or something similar. A square or 2 of 70% dark chocolate.
S - toast w/ nut butter again or some type of high protein bar.
D - 4oz protein with 1/2 rice or pasta. 2 more squares of dark chocolate
S - popcorn w/ a cheese stick or nut butter on toast.

I lacked a lot in the veggies and fruit dept. Bring on Lc has helped me focus on eating lots of fresh produce. Pre lc if I did eat fruit, I would usually have it with Greek yogurt or nut butter.

As for vitamins, I think part of the reason I avoided taking them was that I was trying to punish myself. Although I don't feel that way now, I don't know what's holding me back. Uncertainty I guess or not knowing whether it will help.
First thing I would get a handle on is the drinking with meals. Even if it's not much, a few sips, it can push food out of the pouch and ultimately you end up eating more than you would otherwise. Might only be 100-200 calories a meal but even 100 calories extra a day equals 10 pounds over the course of a year. Even pennies add up.

Your pre-lc diet is heavy on the carbs and lower on the protein, which is poison for someone with reactive hypoglycemia. It's no surprise that you are doing better on lc with your glucose. All that toast, oatmeal, etc doesn't work well in someone with RH (I have RH so I understand it completely). Kudos to you for making that change, that's an awesome step. Glucose/insulin management is a big item in weight control. Your diet was also high in carbs, which is fine for someone who is working out, but you said you aren't, so I would work on that as well.

If you haven't popped in over on the other threads, come visit us.
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Old 02-12-2014, 06:42 AM   #17
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On a positive note, I took 2 of my leftover prenatals yesterday. Baby steps, but at least it is a start. I have like half a bottle left. They are from New Chapter I think, they seem to have high levels of everything.


It's a HUGE step in the right direction!
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Old 02-12-2014, 03:23 PM   #18
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general dr.'s that i have seen arent familiar with WLS patients, so they dont offer me much info or guidance.

Dr. R - i originally went to see him because i was having issues with swallowing certain foods (meat, broccoli, etc). he did an endoscopy and found a small blockage but refused to operate on me. i ended up having to have corrective surgery in Colombia, by a doctor recommended by family. Since that surgery I have been able to eat properly, luckily.
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Old 02-12-2014, 03:43 PM   #19
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What info or guidance are you needing?
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Old 02-13-2014, 04:58 AM   #20
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Finding out if I am where I should be. Knowing what Labs to take and check for. Also someone I can reference if something comes up. I do not like going to the doctor's office in general, but if I am going to go, I'd like someone who is willing to help and offer guidance (not brush things off).

I gave birth to a healthy baby boy about a year and a half ago. But during my pregnancy I had to have blood transfusions for very low iron and even though I was taking prenatals, I felt very weak. I figured it was related to the WLS and at the end of my pregnancy, they finally decided to check my vit d and vit b12 levels. They were horrible. I got some injections and whatnot, but had I had a knowledgable doctor, it may have been found out sooner.

I know my lack of vitamin usage is catching up with me, but I want to know what I need to do (or take) to get to the appropriate levels of normalcy. I was young when I had the surgery and didn't think much about the health aspect because I was in denial, thought I was invinicible and also had some self-destructive behaviors. I am now starting to care and also getting sick of not being well enough.

I hope I can gain the momentum to kick start a healthy lifestyle that will stick with me.

As for being on LC, I really do find it is much better for me. Only thing is that I don't tolerate fats very well. In small amounts, sure. But in like eating the skin on chicken or a regular hamburger, it makes me feel nauseous. I need to find my happy medium.
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Old 02-13-2014, 10:06 AM   #21
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Finding out if I am where I should be. Knowing what Labs to take and check for. Also someone I can reference if something comes up. I do not like going to the doctor's office in general, but if I am going to go, I'd like someone who is willing to help and offer guidance (not brush things off).

I gave birth to a healthy baby boy about a year and a half ago. But during my pregnancy I had to have blood transfusions for very low iron and even though I was taking prenatals, I felt very weak. I figured it was related to the WLS and at the end of my pregnancy, they finally decided to check my vit d and vit b12 levels. They were horrible. I got some injections and whatnot, but had I had a knowledgable doctor, it may have been found out sooner.

I know my lack of vitamin usage is catching up with me, but I want to know what I need to do (or take) to get to the appropriate levels of normalcy. I was young when I had the surgery and didn't think much about the health aspect because I was in denial, thought I was invinicible and also had some self-destructive behaviors. I am now starting to care and also getting sick of not being well enough.

I hope I can gain the momentum to kick start a healthy lifestyle that will stick with me.

As for being on LC, I really do find it is much better for me. Only thing is that I don't tolerate fats very well. In small amounts, sure. But in like eating the skin on chicken or a regular hamburger, it makes me feel nauseous. I need to find my happy medium.
That perfectly answers my questions. I ask a lot of them. I'm willing to answer any as well. I'll send you a list of what I have checked. Hopefully HT can hook you up with a surgeon, but just remember that most surgeons will not take on new patients for management, but will if they need surgery. When I go to my PCP I give him a list of what I want checked and he's fine with ordering it. Whoever you end up with, PCP or otherwise, you want them to be like that. At the very least, start taking what I recommended earlier in the thread.

You had a RNY, right? Fat intolerance is a BIG side effect of RNY. I cannot tolerate fat at all. Period. None. I don't eat them. Makes me straight up nauseous. So that is an expectation of a post op RNY. We have two choices in general, decrease fat intake or learn to live with the nausea. I dislike nausea so I avoid fats. We're talking like a bit of mayo and I'm bleh. So no mayo, etc! No hamburgers either. Well, lean meat, homemade and sauced with tzatziki or something like that I can, but only about 2 oz of it. No restaurant burgers - nausea. LC doesn't have to be high fat, though. You can just adapt. I eat lean protein and a lot of fresh veggies and fruits.
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Old 02-14-2014, 04:59 AM   #22
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Thanks!! You've been a wealth of knowledge. I will try to be more active on this site and learn much more.

Happy Valentine's Day!!
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Old 02-21-2014, 02:01 PM   #23
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I haven't found any free support groups that aren't affiliated with a hospital or Dr. There was one that I went to 5 years ago, but they no longer meet up and it was an hour drive.

I may just need to do more digging or find an online group.
I attend my hospitals free monthly support group, it's run by the program administrator, a nutritionist, and a nurse. Why don't you want to go to a hospital-based program?
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Old 02-27-2014, 03:41 PM   #24
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The hospital nearby only offers the support group for their patients. :/

No worries though, I've been doing some research and connecting with people on the internet and finding it very helpful.
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