Thursday, July 12, 2012

Some Tricks We've Learned

We are 40 months out from Tom and T's bariatric weight loss surgeries.  The weight loss that occurred in those first wild months has become our new "normal," and we go on our way, most days, without a lot of "direct" thought about the dietary regimen that we follow in the aftermath.  Just recently, though, Tom had a total knee replacement, and coping with the after effects of that major surgery and recovery, reminded me that there are a whole bunch of things that we just do without really thinking about it much.  There are things that we have learned that might be helpful to someone else, and we've grown so accustomed to doing these things, and using these products, that we've not shared the information with readers.  Maybe some of this will help someone else...

Protein -- Protein intake is such an important and critical need following bariatric surgery, especially Rouen Y, that it can become an all consuming project trying to figure out how to meet the requirements.  We were told that it was important to get 75-80 grams of protein in the diet every single day.  Most often, Tom and T both focus on eating the protein portion of any meal first.  It is complicated, though, by the fact that both of them, but especially Tom, have trouble with some kinds of meat (especially beef and chicken).  So we use a protein supplement, recommended by the dietitian who works with our surgeon, called Unjury.   This is a medical grade protein, of a much higher quality than the typical protein powder that can be purchased at most retail places.  In general, we use the Chocolate Splendor flavor (sweetened with Splenda).  Tom likes it mixed into coffee -- we are careful to cool it to between 120 and 130 degrees first.  I generally drink it mixed into unsweetened almond milk.  Three scoops of Unjury in His morning coffee gets Him most of the protein He needs for the day.  I can relax then, figuring that whatever else I can include in meals through the day is gravy.

MultiVitamins -- Absorption is a huge issue for patients after weight loss surgery.  We choose to buy a chewable vitamin product called Opurity, manufactured by Unjury, and optimized for bariatric surgery patients.

Calcium -- Calcium is an important mineral to supplement after the surgery.  If the levels of calcium drop too low, it may not even show up in a blood test.  The body will simply rob calcium from bones and teeth, weakening those structures.  By the time a blood test shows a deficiency, there could be huge and irreversible damage.  As with other minerals, mal-absorption is a real problem.  It is important to supplement with high quality, easily absorbed products.  Too, many calcium pills are too large to be safely swallowed by the gastric bypass patient.  We use a liquid calcium and magnesium citrate supplement by Vitacost.  It is orange flavored, and we order it online.

We have just recently discovered that another important mineral to supplement and monitor is iron.  No one told us about that one following the surgery.  It was only when the pre-operative tests for Tom's knee replacement turned up dangerous iron deficiencies that we began to try and figure out what we ought to be doing about iron supplements.  Right now, we are using a very inexpensive iron tablet from NatureMade.  We've learned to avoid enteric-coated and slow release iron preparations.  We have found that iron should be taken with a meal, and that eating citrus fruits with iron helps to improve the absorption.  

Finally, some of the biggest challenges that we've encountered  have to do with intestinal/bowel function following gastric bypass.  We've dealt with three issues:  flatulence, constipation, and lactose intolerance.  Our best "weapons" in combating these problems have come from a company called Digestive Advantage.  They manufacture a group of probiotic based products that work gently and steadily to help maintain digestive tract balance.  We use their gas defense, daily constipation formula, and lactose defense formula.  In general we use the gas defense and lactose defense capsules daily.  The constipation formula is something that we use "as needed."  It tends to create an intestinal bacteria overgrowth when used on a daily basis...  It needs to be managed carefully.