Going into surgery some people have some very unrealistic expectations. Sometimes I want to just shake my head at the misconceptions people have going into surgery or having had surgery. I don't know if it is because they depended on their surgical centre to tell them everything they needed or because they just didn't take the time to read. It baffles me that people don't go into surgery learning all they can learn about their new life.
To have the expectation that you are going to dump and then expect that to carry you through life post op is very unrealistic. While I *prayed* for dumping, I knew that many people don't dump. I dumped maybe a handful of times, hardly ever.
Here's a post I read in another group:
I have a question. I am out 14 months now since RNY Gastric Bypass Surgery. I am not doing well with weightloss. Since regaining about 41 pounds, I discovered that I do not ever experience "Dumping Syndrome" with any food at all - including SUGAR???? How can this be possible?? That is why I requested RNY with malapsorbtion, so I would not be able to eat surgar and other bad foods. Anyone out there with a logical explanation? I sure would appreciate it.
Let's dispell this myth: Do not count on dumping (getting sick from too much fat or sugar) to "save" you from food. Realistically, the surgery will only do so much for you and it will be the choices that you make that result in success or failure. Many people expect dumping but realistically, only around 60% of people dump. Out of those that do, many only dump early out. Eventually for most, the body adapts well to sugar and reactions diminish over time (unless you beome one of those who develop reactive hypoglycemia like myself).
The best advice: eat as though you will dump. Follow those guidelines for sugar/fat limits like they are the be all and end all. Keep triggers out of your life as long as you can. And most of all, do not depend on dumping. It's all about choices still and that's why we say surgery is a tool =)
And if you are having thoughts like the person above, you *need* therapy because obviously the psychological issue is winning and not you. To gain 41 lbs back at 14 months out is pretty scary. Remember folks, surgery only changes your body, not your brain.
I truly hope this lady gets the help she desperately needs.
Dawn
Sunday, January 29, 2012
Saturday, January 21, 2012
Great Iron Info
This is a great article (published) from my friend Leona who works in an anemia clinic. Lots of interesting information.
Anemia and the Surgical Bariatric Patient
By: Leona A. Dove RN, BScN
Anemia is a prevalent diagnosis among the surgical weight loss community. The primary cause of this anemia is related to the absorption of components necessary to build healthy red blood cells. Anemia is clinically defined as a HGB < 120 g/L in men and non-menstruating women and a HGB < 115 g/L in menstruating women. As a Blood Conservation Specialist, I tend to treat all patients whose HGB is < 120. Making allowances for the fact that women bleed once a month does not necessarily make that person feel any less symptomatic in terms of fatigue etc.
Hemoglobin (HGB) is an iron derived blood protein that carries oxygen and nutrients to the tissue. It is what makes our red blood cells, and thus our blood red. Low hemoglobin means less than optimal oxygen and nutrients are getting to our tissues. Some of the symptoms of this lack of oxygen and nutrients getting to our tissues are directly related to the tissues not getting enough oxygen and nutrients (e.g. slow healing and infection at the site of surgery, moodiness because the brain is not getting enough oxygen etc). Other symptoms are related to our body’s reaction to not having enough oxygen and nutrients (e.g. Our respiratory rate increases to get more oxygen into our lungs, our heart beats faster to get more blood carrying less oxygen to our vital centres, our blood pressure drops to hold what blood we have in our vital core instead of sending it to our extremities etc).
As I mentioned HGB is an iron derived blood protein. There are three components necessary for the body to convert Iron to hemoglobin.
Iron-The building blocks of hemoglobin
Vitamin B12- The brick mason
Erythropoietin-The General Contractor
Anemia is a result of a lack of, or functional failure of, one of these three components. The type of anemia can be determined from a common blood test (a complete blood count) specifically two values of that count. Once the CBC is evaluated additional blood work may need to be ordered.
Iron Deficient Anemia
Anemia related to low iron is the most commonly diagnosed anemia. If your body does not have enough iron to convert to hemoglobin, you will not have an adequate hemoglobin level. In the bariatric patient, the iron deficiency is often related to the decreased iron absorption surface. Eighty percent of the iron from our food is absorbed at the level of our stomach. Weight loss surgery significantly reduces the size of the stomach thus significantly reducing the absorption surface for iron as a result most Surgical Bariatric Patients need to increase the intake of iron rich foods and rely on iron supplements to ensure they have the “building blocks” necessary for HGB production.
Iron Rich Diet
It is nearly impossible to poison yourself eating foods naturally containing iron; as such this strategy is perhaps one of the easiest if not safest ways to increase the body’s iron reserve. There are two types of Iron we can get from our food:
Heme Iron: Found in animal protein sources, red meat, poultry (specifically the dark meat of the legs and thighs vs. the breast) and fish. Heme Iron is readily absorbed and used by the body, is not affected by what you eat and drink in conjunction with them and helps the body to absorb and use non-heme irons.
Non-Heme Iron: Found in plant protein sources, beans, lentils, whole grains, dried fruits, nuts, green leafy vegetables and some fruits. Non-Heme Iron is not as readily absorbed and used by the body and are affected by what you eat and drink with them. Heme Iron containing foods, and foods rich in Vitamin C (bell peppers, broccoli, strawberries, citrus fruit, Cantaloupes) increase the absorption and use of non-heme iron. Foods containing Oxalates (coffee, tea, cola, and chocolate) and foods rich in calcium (milk, cheese etc) block the absorption and use of non-heme irons.
To Maximize The Absorption of Iron From your Food:
ü Remember iron is in colourful foods red meat, green leafy vegetables and the rich golden browns of whole wheat. If your food is grey because of age or over cooking what iron was in it is likely minimized.
ü Maximize the body’s absorption and use of Non-Heme Iron by consuming them withfoods containing Heme Iron and/or foods rich in Vitamin C.
ü Avoid the consumption of oxalate and calcium containing foods for one hour before and after your Iron Rich Meal
Iron Supplements
The arbitrary use of an iron supplement without the recommendation of a health care professional can be dangerous. Iron is a “fat stored” mineral, which can reach toxic levels, resulting in liver damage. If an iron supplement is recommended there is some valuable information you need to have.
There are two generations of iron supplements; the difference is related to where the iron is absorbed.
I. Iron Salts (ferrous sulfate, ferrous Gluconate, ferrous Fumarate) are absorbed in the stomach. They must be taken on an empty stomach (1 hour before a meal or 2 hours after a meal) to maximize its absorption. They cannot be taken with calcium containing medications or foods, aluminum salts based antacids (Maalox, gaviscon, Tums) or oxalate containing foods as these things block the absorption of the iron salt. The use of Vitamin C in conjunction with the Iron Salt will increase the absorption of the iron salt. Recent studies have also proven that the use of Proton Pump Inhibitors and H2 inhibitors (medications that reduce the acidity of the stomach “juices”) inhibit the digestion and absorption of iron salts.
Things to know about Iron Salts
ü Can cause black “tarry” or “sticky” constipated stools. Fastidious skin care is necessary after bowel movements to avoid painful skin irritation in this area.
ü Should not be taken with coffee, tea, milk, cola, or chocolate as these will block its absorption
ü Consider taking your iron salt supplement with a juice rich in Vitamin C to maximize its absorption. My personal favorite is a swallow of prune juice for two reasons:
i. Prune juice is a natural laxative ii. Prune juice is rich in iron
ü Can cause gastric irritation and GERD like symptoms, this can be minimized by remaining in an upright position for 30 minutes after taking the iron salt
ü Antacids (Maalox, Gaviscon), or calcium supplements should not be taken within 30-60 minutes of the iron salt because its absorption will be blocked.
ü Absorption of Iron Salts is most effective when taken on an empty stomach (one hour before you eat or two hours after you eat). Personally and professionally I recommend two hours after you eat to decrease the gastric irritation and GERD like symptoms common to iron salts
II. Non-Salt Iron Supplements
A. Proferrin is a bovine sourced HEME iron. It is absorbed in the small intestine
B. Polysaccharide Irons (FeraMAX, Triferritin) are manufactured irons also absorbed lower in the digestive tract. Severely Iron Deficient patients may be prescribed an intravenous form of polysaccharide iron, while beneficial in some cases this alternative will not be discussed today. Things to know about Heme and Polysaccharide Irons ü DO NOT need to be taken on an empty stomach
ü Are Not effected by the use of antacids, calcium supplements Proton Pump Inhibitors, or H2 Inhibitors
ü Are Not effected by Vitamin C consumption
ü DO NOT cause Gastric Irritation or GERD like symptoms
ü DO NOT usually cause black tarry, sticky or constipated stools.
The Great Supplemental Iron Debate
ü ODB most supplemental health plan will cover prescribed Iron Salts.
Some supplemental health plans will cover Proferrin if bought with a prescription.
Polysaccharide Iron Supplements are considered a dietary supplement (they have no DIN) and are not covered by either ODB or Supplemental health plan
ü Decreased absorption surfaces resultant from surgically decreasing the stomach size directly results in the decreased absorption of iron salts
ü Use of Proton Pump Inhibitors, and H2 inhibitors decrease the digestion and absorption of iron salts
ü Although exact location in the intestine where polysaccharide and heme irons are absorbed has not been mapped, it is believed that polysaccharide irons are absorbed still lower than Heme irons and as such are the supplement of choice for Duodenal Switch patients
ü Heme irons are derived from animal sources vegetarians, and certain religious groups may object to using such derivatives
ü Physicians and dieticians are more familiar, and thus more comfortable with the use of Iron Salts as opposed to Heme and Polysaccharide Irons
B12 Deficient Anemias
As mentioned earlier B12 is the brick mason of HGB production. B12 stimulates the conversion of Iron into Hemoglobin. Without sufficient B12 adequate Iron reserves cannot be converted into oxygen and nutrients carrying Hemoglobin. The absorption of B12 requires Intrinsic Factor which is secreted by the stomach. The area where Intrinsic Factor is excreted is severely reduced and/or completely lost during the surgical reduction of the stomach. Without sufficient Intrinsic Factor, B12 from food or oral supplements cannot be absorbed. It is recommended that Surgical Bariatric Patients take a sublingual (under the tongue) B12 supplement or regular B12 injections.
Erythropoietin and Anemias
Erythropoietin is a hormone manufactured and excreted by the kidneys; it is the substance that triggers the bone marrow to use hemoglobin to produce Red Blood Cells. It is very possible to have adequate stores of Iron and B12 and still be anemic related to an insufficiency of erythropoietin. This malady is common in patients with impaired kidney function. The reason why I mention it however is that it is possible to use synthetic erythropoietin (Eprex) in conjunction with oral and sometimes intravenous iron supplements to rapidly boost the hemoglobin of patients with severe iron deficient anemias.
Conclusion
Anemia is a broad spectrum diagnosis, individually honed through the assessment of the patient and their lab work. Just as every patient is unique so is the treatment of their anemia. I urge you all to advocate for yourself, be health care consumers, educate yourselves and in turn educate the health care professional that is caring for you
Anemia and the Surgical Bariatric Patient
By: Leona A. Dove RN, BScN
Anemia is a prevalent diagnosis among the surgical weight loss community. The primary cause of this anemia is related to the absorption of components necessary to build healthy red blood cells. Anemia is clinically defined as a HGB < 120 g/L in men and non-menstruating women and a HGB < 115 g/L in menstruating women. As a Blood Conservation Specialist, I tend to treat all patients whose HGB is < 120. Making allowances for the fact that women bleed once a month does not necessarily make that person feel any less symptomatic in terms of fatigue etc.
Hemoglobin (HGB) is an iron derived blood protein that carries oxygen and nutrients to the tissue. It is what makes our red blood cells, and thus our blood red. Low hemoglobin means less than optimal oxygen and nutrients are getting to our tissues. Some of the symptoms of this lack of oxygen and nutrients getting to our tissues are directly related to the tissues not getting enough oxygen and nutrients (e.g. slow healing and infection at the site of surgery, moodiness because the brain is not getting enough oxygen etc). Other symptoms are related to our body’s reaction to not having enough oxygen and nutrients (e.g. Our respiratory rate increases to get more oxygen into our lungs, our heart beats faster to get more blood carrying less oxygen to our vital centres, our blood pressure drops to hold what blood we have in our vital core instead of sending it to our extremities etc).
As I mentioned HGB is an iron derived blood protein. There are three components necessary for the body to convert Iron to hemoglobin.
Iron-The building blocks of hemoglobin
Vitamin B12- The brick mason
Erythropoietin-The General Contractor
Anemia is a result of a lack of, or functional failure of, one of these three components. The type of anemia can be determined from a common blood test (a complete blood count) specifically two values of that count. Once the CBC is evaluated additional blood work may need to be ordered.
Iron Deficient Anemia
Anemia related to low iron is the most commonly diagnosed anemia. If your body does not have enough iron to convert to hemoglobin, you will not have an adequate hemoglobin level. In the bariatric patient, the iron deficiency is often related to the decreased iron absorption surface. Eighty percent of the iron from our food is absorbed at the level of our stomach. Weight loss surgery significantly reduces the size of the stomach thus significantly reducing the absorption surface for iron as a result most Surgical Bariatric Patients need to increase the intake of iron rich foods and rely on iron supplements to ensure they have the “building blocks” necessary for HGB production.
Iron Rich Diet
It is nearly impossible to poison yourself eating foods naturally containing iron; as such this strategy is perhaps one of the easiest if not safest ways to increase the body’s iron reserve. There are two types of Iron we can get from our food:
Heme Iron: Found in animal protein sources, red meat, poultry (specifically the dark meat of the legs and thighs vs. the breast) and fish. Heme Iron is readily absorbed and used by the body, is not affected by what you eat and drink in conjunction with them and helps the body to absorb and use non-heme irons.
Non-Heme Iron: Found in plant protein sources, beans, lentils, whole grains, dried fruits, nuts, green leafy vegetables and some fruits. Non-Heme Iron is not as readily absorbed and used by the body and are affected by what you eat and drink with them. Heme Iron containing foods, and foods rich in Vitamin C (bell peppers, broccoli, strawberries, citrus fruit, Cantaloupes) increase the absorption and use of non-heme iron. Foods containing Oxalates (coffee, tea, cola, and chocolate) and foods rich in calcium (milk, cheese etc) block the absorption and use of non-heme irons.
To Maximize The Absorption of Iron From your Food:
ü Remember iron is in colourful foods red meat, green leafy vegetables and the rich golden browns of whole wheat. If your food is grey because of age or over cooking what iron was in it is likely minimized.
ü Maximize the body’s absorption and use of Non-Heme Iron by consuming them withfoods containing Heme Iron and/or foods rich in Vitamin C.
ü Avoid the consumption of oxalate and calcium containing foods for one hour before and after your Iron Rich Meal
Iron Supplements
The arbitrary use of an iron supplement without the recommendation of a health care professional can be dangerous. Iron is a “fat stored” mineral, which can reach toxic levels, resulting in liver damage. If an iron supplement is recommended there is some valuable information you need to have.
There are two generations of iron supplements; the difference is related to where the iron is absorbed.
I. Iron Salts (ferrous sulfate, ferrous Gluconate, ferrous Fumarate) are absorbed in the stomach. They must be taken on an empty stomach (1 hour before a meal or 2 hours after a meal) to maximize its absorption. They cannot be taken with calcium containing medications or foods, aluminum salts based antacids (Maalox, gaviscon, Tums) or oxalate containing foods as these things block the absorption of the iron salt. The use of Vitamin C in conjunction with the Iron Salt will increase the absorption of the iron salt. Recent studies have also proven that the use of Proton Pump Inhibitors and H2 inhibitors (medications that reduce the acidity of the stomach “juices”) inhibit the digestion and absorption of iron salts.
Things to know about Iron Salts
ü Can cause black “tarry” or “sticky” constipated stools. Fastidious skin care is necessary after bowel movements to avoid painful skin irritation in this area.
ü Should not be taken with coffee, tea, milk, cola, or chocolate as these will block its absorption
ü Consider taking your iron salt supplement with a juice rich in Vitamin C to maximize its absorption. My personal favorite is a swallow of prune juice for two reasons:
i. Prune juice is a natural laxative ii. Prune juice is rich in iron
ü Can cause gastric irritation and GERD like symptoms, this can be minimized by remaining in an upright position for 30 minutes after taking the iron salt
ü Antacids (Maalox, Gaviscon), or calcium supplements should not be taken within 30-60 minutes of the iron salt because its absorption will be blocked.
ü Absorption of Iron Salts is most effective when taken on an empty stomach (one hour before you eat or two hours after you eat). Personally and professionally I recommend two hours after you eat to decrease the gastric irritation and GERD like symptoms common to iron salts
II. Non-Salt Iron Supplements
A. Proferrin is a bovine sourced HEME iron. It is absorbed in the small intestine
B. Polysaccharide Irons (FeraMAX, Triferritin) are manufactured irons also absorbed lower in the digestive tract. Severely Iron Deficient patients may be prescribed an intravenous form of polysaccharide iron, while beneficial in some cases this alternative will not be discussed today. Things to know about Heme and Polysaccharide Irons ü DO NOT need to be taken on an empty stomach
ü Are Not effected by the use of antacids, calcium supplements Proton Pump Inhibitors, or H2 Inhibitors
ü Are Not effected by Vitamin C consumption
ü DO NOT cause Gastric Irritation or GERD like symptoms
ü DO NOT usually cause black tarry, sticky or constipated stools.
The Great Supplemental Iron Debate
ü ODB most supplemental health plan will cover prescribed Iron Salts.
Some supplemental health plans will cover Proferrin if bought with a prescription.
Polysaccharide Iron Supplements are considered a dietary supplement (they have no DIN) and are not covered by either ODB or Supplemental health plan
ü Decreased absorption surfaces resultant from surgically decreasing the stomach size directly results in the decreased absorption of iron salts
ü Use of Proton Pump Inhibitors, and H2 inhibitors decrease the digestion and absorption of iron salts
ü Although exact location in the intestine where polysaccharide and heme irons are absorbed has not been mapped, it is believed that polysaccharide irons are absorbed still lower than Heme irons and as such are the supplement of choice for Duodenal Switch patients
ü Heme irons are derived from animal sources vegetarians, and certain religious groups may object to using such derivatives
ü Physicians and dieticians are more familiar, and thus more comfortable with the use of Iron Salts as opposed to Heme and Polysaccharide Irons
B12 Deficient Anemias
As mentioned earlier B12 is the brick mason of HGB production. B12 stimulates the conversion of Iron into Hemoglobin. Without sufficient B12 adequate Iron reserves cannot be converted into oxygen and nutrients carrying Hemoglobin. The absorption of B12 requires Intrinsic Factor which is secreted by the stomach. The area where Intrinsic Factor is excreted is severely reduced and/or completely lost during the surgical reduction of the stomach. Without sufficient Intrinsic Factor, B12 from food or oral supplements cannot be absorbed. It is recommended that Surgical Bariatric Patients take a sublingual (under the tongue) B12 supplement or regular B12 injections.
Erythropoietin and Anemias
Erythropoietin is a hormone manufactured and excreted by the kidneys; it is the substance that triggers the bone marrow to use hemoglobin to produce Red Blood Cells. It is very possible to have adequate stores of Iron and B12 and still be anemic related to an insufficiency of erythropoietin. This malady is common in patients with impaired kidney function. The reason why I mention it however is that it is possible to use synthetic erythropoietin (Eprex) in conjunction with oral and sometimes intravenous iron supplements to rapidly boost the hemoglobin of patients with severe iron deficient anemias.
Conclusion
Anemia is a broad spectrum diagnosis, individually honed through the assessment of the patient and their lab work. Just as every patient is unique so is the treatment of their anemia. I urge you all to advocate for yourself, be health care consumers, educate yourselves and in turn educate the health care professional that is caring for you
Saturday, December 24, 2011
Grateful
Well, 2011 is almost at an end. What a year it has been. I've not accomplished much this year to be honest.
I started to run...but fell off the wagon with my iron levels falling off.
I got rid of some regain, gained some back, got rid of some, gained some, got rid of some. Some progress over all but still want to lose another 15 lbs.
Work is work, is work is work....nothing new to report there.
But the big news of 2011 definitely has to be my husband's surgery and how he is doing now. I'm sooooo looking forward to an amazing 2012 with him, being more active, doing more things in partnership and being happier and healthier over all.
Hubby's surgery went "extremely well" to quote his surgeon. Textbook pretty much. Within three hours after surgery he was argueing with me to call his employer. LOL =) Within 9 hours, he was on facebook. The next day he was more than raring to go and walk the halls. He hasn't stopped since.
He's been in pretty good spirits considering that this is probably the hardest time to have the surgery when food is every where. He's positive, happy and already seeing results on the scale and in the clothes. He lost a significant amount of weight before surgery, quite a bit on Optifast and already he's into clothes he hasn't warn in a long time just over a week after surgery!
Bring on 2012!
Dawn
I started to run...but fell off the wagon with my iron levels falling off.
I got rid of some regain, gained some back, got rid of some, gained some, got rid of some. Some progress over all but still want to lose another 15 lbs.
Work is work, is work is work....nothing new to report there.
But the big news of 2011 definitely has to be my husband's surgery and how he is doing now. I'm sooooo looking forward to an amazing 2012 with him, being more active, doing more things in partnership and being happier and healthier over all.
Hubby's surgery went "extremely well" to quote his surgeon. Textbook pretty much. Within three hours after surgery he was argueing with me to call his employer. LOL =) Within 9 hours, he was on facebook. The next day he was more than raring to go and walk the halls. He hasn't stopped since.
He's been in pretty good spirits considering that this is probably the hardest time to have the surgery when food is every where. He's positive, happy and already seeing results on the scale and in the clothes. He lost a significant amount of weight before surgery, quite a bit on Optifast and already he's into clothes he hasn't warn in a long time just over a week after surgery!
Bring on 2012!
Dawn
Sunday, December 11, 2011
Hubby's Surgery
Hello friends!
Well it is a very exciting time for me in my life right now. Hope all is doing well today! I just have to share my news with everyone.
Here's a back story for people that don't know me (I don't post on here that much). I had my gastric bypass surgery (RNY) 5.5 years ago when health concerns started to arise. At that time, I had a very supportive hubby who was worried for me. He was also overweight but not nearly so much as me - but he had many comorbidities that would have warranted surgery.
Anyway, throughout my process, hubby was nothing less than supportive but he never really wanted to pursue surgery. I always kind of hoped it would be something we'd pursue together and lose weight together but it was never something he felt he needed to do and continued to try to lose weight on his own terms.
Two years later, I was doing great - more active and very busy doing lots of activities outside - walking, hiking, geocaching etc but hubby's mobility was becoming more limited due to his health. I could never convince him to have surgery despite him watching me go through the surgery.
Anyway, a year and a half plus ago, his endocrinologist (Who also happens to run the Windsor Clinic) told him that he NEEDED surgery. He finally started the process. Throughout the process, I've always found he's interested one minute and then not so sure about surgery. (I've always said that until I get him on that table, I'll never quite know if he'll go through with it!). But now he's resolved that this is the change he needs to restart his health. FINALLY!!!!
So now we are in the final stretch of hubby's surgery and he's had his PATS, is doing amazingly well with Optifast and is now committed to surgery! We have been walking together and are making plans to be active when he is post surgery. I get to be his coach. LOL :)
I'm so excited for his new life -- so excited to have a new walking partner in the new year. We've already discussed how we are going to start some 5Ks in the Spring - for him to walk and me to run hopefully! I'm SO EXCITED about having a new life together. It is truly the best Christmas present that I could get this year!
At the same time, a million thoughts are running through my head as he does have many comorbidities and Im worried about his surgery. I am not sleeping well although terribly tired from all this iron issue I'm going through, I can't seem to turn my worries off at all at night.
I could really use your positive thoughts and even a few prayers that everything goes amazingly smooth for him. It's weird being on the other side (not the patient but the supporter) and I'm honestly far more worried about his surgery than I was about my own...but at the same time, I have a TON of faith in Dr. Reed and the amazing staff at Guelph - who have been just phenomenal thus far!
Thanks so much!
Well it is a very exciting time for me in my life right now. Hope all is doing well today! I just have to share my news with everyone.
Here's a back story for people that don't know me (I don't post on here that much). I had my gastric bypass surgery (RNY) 5.5 years ago when health concerns started to arise. At that time, I had a very supportive hubby who was worried for me. He was also overweight but not nearly so much as me - but he had many comorbidities that would have warranted surgery.
Anyway, throughout my process, hubby was nothing less than supportive but he never really wanted to pursue surgery. I always kind of hoped it would be something we'd pursue together and lose weight together but it was never something he felt he needed to do and continued to try to lose weight on his own terms.
Two years later, I was doing great - more active and very busy doing lots of activities outside - walking, hiking, geocaching etc but hubby's mobility was becoming more limited due to his health. I could never convince him to have surgery despite him watching me go through the surgery.
Anyway, a year and a half plus ago, his endocrinologist (Who also happens to run the Windsor Clinic) told him that he NEEDED surgery. He finally started the process. Throughout the process, I've always found he's interested one minute and then not so sure about surgery. (I've always said that until I get him on that table, I'll never quite know if he'll go through with it!). But now he's resolved that this is the change he needs to restart his health. FINALLY!!!!
So now we are in the final stretch of hubby's surgery and he's had his PATS, is doing amazingly well with Optifast and is now committed to surgery! We have been walking together and are making plans to be active when he is post surgery. I get to be his coach. LOL :)
I'm so excited for his new life -- so excited to have a new walking partner in the new year. We've already discussed how we are going to start some 5Ks in the Spring - for him to walk and me to run hopefully! I'm SO EXCITED about having a new life together. It is truly the best Christmas present that I could get this year!
At the same time, a million thoughts are running through my head as he does have many comorbidities and Im worried about his surgery. I am not sleeping well although terribly tired from all this iron issue I'm going through, I can't seem to turn my worries off at all at night.
I could really use your positive thoughts and even a few prayers that everything goes amazingly smooth for him. It's weird being on the other side (not the patient but the supporter) and I'm honestly far more worried about his surgery than I was about my own...but at the same time, I have a TON of faith in Dr. Reed and the amazing staff at Guelph - who have been just phenomenal thus far!
Thanks so much!
Fifth Year Bloodwork and Status
One thing I always did initially after surgery when I've gone for my bloodwork is that I've always asked for a copy of my results. Initially this was because I always needed to bring my bloodwork to my follow up appointments(just as a backup in case they don't get sent the files through a fax). Well over time, of course, I slacked off on that. So this time after the iron issue, and talking with friends and not knowing which actual reading was a 5, I asked for a copy of my bloodwork.
Using www.labtestsonline.com always was a help to make sense of the numbers.
Here's some of my levels post op and the reference ranges (what's considered normal)
Vitamin B -- 149 (RR=133+) Never deficient in this despite not being good with supplementation.
Albumin -- 34 (RR-35-48) A little low - one to watch.
Cholesterol -- 5.48 (RR 3.8-5.2). A little high which is surprising to me but not a worry - my LDL makes up for it - as I've always been high in LDL. (and is the reason why I never had a real cholesterol problem despite my 290 lbs).
Fasting Glucose -- 4.4 (RR 3.6-6)
Sodium -- 136 (RR=135-146)
Everything in the Hematology part is normal :)
Vitamin D -- 56 (RR=75-250). UGH low. Starting to get lower so I am starting to supplement this one. Hopefully January's bloodwork will reveal higher levels :)
Ferritin -- 5 (RR= 11-307. Huge reference range so I have to compare what MY "normal levels" are. They are usually 100-120 so obviously a 5 is really low and fits the category of "iron deficient".
So next bloodwork will be at the end of January and then I will see my doctor to follow up on that and decide if we need a referral to a Hemotologist for the iron issue to be resolved.
In the meantime, I'm trying to eat more red meat. Trying! LOL :)
As for weight, 5.5 years out. It's a struggle every day and I'm trying to lose right now which is hard with how much exercise is tiring me out. My lowest was around 139-140. My highest was back up to 167 in a very stressful time in my life. Right now I'm standing around 152 and am hoping to get back to under 200 by the new year or shortly thereafter.
Dawn
Using www.labtestsonline.com always was a help to make sense of the numbers.
Here's some of my levels post op and the reference ranges (what's considered normal)
Vitamin B -- 149 (RR=133+) Never deficient in this despite not being good with supplementation.
Albumin -- 34 (RR-35-48) A little low - one to watch.
Cholesterol -- 5.48 (RR 3.8-5.2). A little high which is surprising to me but not a worry - my LDL makes up for it - as I've always been high in LDL. (and is the reason why I never had a real cholesterol problem despite my 290 lbs).
Fasting Glucose -- 4.4 (RR 3.6-6)
Sodium -- 136 (RR=135-146)
Everything in the Hematology part is normal :)
Vitamin D -- 56 (RR=75-250). UGH low. Starting to get lower so I am starting to supplement this one. Hopefully January's bloodwork will reveal higher levels :)
Ferritin -- 5 (RR= 11-307. Huge reference range so I have to compare what MY "normal levels" are. They are usually 100-120 so obviously a 5 is really low and fits the category of "iron deficient".
So next bloodwork will be at the end of January and then I will see my doctor to follow up on that and decide if we need a referral to a Hemotologist for the iron issue to be resolved.
In the meantime, I'm trying to eat more red meat. Trying! LOL :)
As for weight, 5.5 years out. It's a struggle every day and I'm trying to lose right now which is hard with how much exercise is tiring me out. My lowest was around 139-140. My highest was back up to 167 in a very stressful time in my life. Right now I'm standing around 152 and am hoping to get back to under 200 by the new year or shortly thereafter.
Dawn
Saturday, November 26, 2011
Iron
So I've been feeling not so hot the last few months. I've been feeling extremely LAZY. In July, I felt fairly good, walked all over the damn city including some days with 10 miles and even lost 10 lbs. (Which I've re-found of course over time) It was pretty good...but then in August I just felt like crap. I assumed it was one of my "funks" of the summer. I tend to get in a funk during the summer time due to lack of doing things (like work) and then get a little depressed and lazy around the house, not knowing what what to do with myself. Then eventually I get myself busy and get passed it. I figured that instead of having this years funk in July, I just had it in August. Couldn't get my butt off the ground to do much exercise and just attributed it to pure laziness.
In September, got busy with work and it was a real whirlwind. So I figured that's why I was tired of course. In October, I did my Detroit half marathon and did it in a record time so I felt fairly good about that despite my current laziness and of course, was extremely SORE afterwards due to not prepping hard the last few months before the race but did it anyways. (NOTE TO SELF: book a massage every year after the marathon in the future!).
So in late October, I got my annual blood work done, not really thinking anything of it. Du-huh -- note to self #2 - when you are feeling this way, clue in and don't just think you are being lazy.
Got results back and finally had follow up with my doctor. Typically my iron is 100 or over in the result numbers. 100. My iron is 5. Quite the difference, n'est pas?
So oh boy - two months to try to eat and supplement to get iron levels back up to something decent enough or I'll go for iron infusions after next bloodwork in late January. Ugh! Blah! Sucky.
Talking with a lady I know who treats anemia patients - it sounds like I will be getting iron infusions regardless. She doesn't think I'll get it up significantly without IV. Ick.
Fun times.
Dawn
In September, got busy with work and it was a real whirlwind. So I figured that's why I was tired of course. In October, I did my Detroit half marathon and did it in a record time so I felt fairly good about that despite my current laziness and of course, was extremely SORE afterwards due to not prepping hard the last few months before the race but did it anyways. (NOTE TO SELF: book a massage every year after the marathon in the future!).
So in late October, I got my annual blood work done, not really thinking anything of it. Du-huh -- note to self #2 - when you are feeling this way, clue in and don't just think you are being lazy.
Got results back and finally had follow up with my doctor. Typically my iron is 100 or over in the result numbers. 100. My iron is 5. Quite the difference, n'est pas?
So oh boy - two months to try to eat and supplement to get iron levels back up to something decent enough or I'll go for iron infusions after next bloodwork in late January. Ugh! Blah! Sucky.
Talking with a lady I know who treats anemia patients - it sounds like I will be getting iron infusions regardless. She doesn't think I'll get it up significantly without IV. Ick.
Fun times.
Dawn
Sunday, September 25, 2011
Stomach Acid and Absorption
There is a bit of a myth that we don't have any stomach acid to break things down. This is not true. Let me remind you of our surgery.
You have two "stomachs". Your old stomach is called your "remnant stomach". Your remnant stomach is always functioning, creating stomach acids or juices and is spitting them out. Your new pouch produces very minimal stomach acid. That is why you must chew and chew your food, to help break up your food since your food will no longer meet up with the acids in the stomach for a long period of processing. Your food travels down and meets up the stomach acid where the two join up in the intestines.
So yes your food does mix in with stomach acids - but for a far briefer time than before and in a different place than before. So yes, it is possible that you still suffer from any reflux after surgery. For most, RNY helps decrease it and for many it is no longer an issue...but for some, yes reflux can be a problem still.
When it comes to absorption, we don't absorb until later in the intestines. We completely bypass the duodenum which is responsible for absorbing most minerals and vitamins a b d and k, iron and calcium. (Hence the tendency for us to be low in these). The old stomach also produced a substance called "intrinsic factor" that helped us absorbed b-12 and now we no longer have that as well...so hence constant supplementation of b12. Thats' a basic in absorption for you.
Here's a great picture for you!!!
Dawn
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