Please help my surgeon convince the pharmacist/dietitian!

Parousia

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Joined
Jan 4, 2014
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Location
Adelaide, Australia
Is there a link to info, an illustration, something that I can show my surgical team, that they can show the pharmacist and dietitian in the hospital I'm in that/why we need the massive doses of supplements that we need? My surgeon (Prof Nottle) is convinced, but the pharmacist and dietitian cannot understand why we would need the doses we do. Prof Nottle has given the surgical team the task of trying to come up with a convincing argument, I gather, but they are struggling, I think. They have asked me for input! This is really important, because it could help many who come after me. They may even get the right nutritional advice from the dietitian (I've been put on a low fat, low calorie post-op diet!)
 
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You should probably show them vitalady's DS vitamin regimen.

And any basic digram of DS anatomy should do the trick. When a person only has 75(or however many)cm of normally functioning small bowel, it's a no brainer that they are going to need a lot of supplementation.
 
duodenal-switch-525x700.jpg


This gives a better idea of the proportions in each limb:
images


And then explain where the lines are for the DS - and that protein, complex carbs, and in particular fat and fat-soluble vitamins, require pancreatic enzymes and bile (for the fat) to be properly digested and absorbed.

RNY-Nutrient-Absorption.jpg


rny-ds-mal.jpg


Interesting blog (not updated in a long time) that I found - she doesn't seem to be a native English speaker, but it's not bad:
http://wlsworld.blogspot.com/2008/05/ds-is-modification-of-bpd.html
 
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:love30:Many kudos to Ms. Cox for posting all these in one place. I had some of them although not very organized. Now I have created a folder strictly for DS related items so I can find them quickly. These pictures will be as easy to find as my saved articles.

I also second using Vitalady's schedule as an example of how to supplement for the DS. :cheerleaders: to Munchkin.
 
@DianaCox

I believe that Sarah, from the blogspot info, is Lonesome Dove or Lovely Dove or some similar name...remember her? She was a fencing enthusiast and a pre-med student.
 
I just think that each surgery is a little different and our labs tell the story. If I take 150,000 IUs of Vitamin D, and a bunch of Vitamin A and 3,000 mg of calcium and my PTH is STILL slightly elevated and my serum calcium is BARELY within range...it shouldn't take a degree in rocket science to see that MY supplementation needs are beyond normal.

And when a crowd of us claim the same issues, we should...at the very least...be listened to.
 
And I linked to her cite and credited her (even without seeing the copyright notice). She hasn't posted on OH or on her blog since 2008.
 
I wish Pretty Dove would start posting again. If this is who I am thinking of she had many problems with diet and food. I Think she often talked about a revision to her DS. I followed her way back on OH. Again I may be wrong my B1 could be sinking. Great Pictures.
 
Hehe - I do that all the time myself - my usual eagle-eye for other people's typos missed yours - I wasn't correcting you. :)
 
I wish Pretty Dove would start posting again. If this is who I am thinking of she had many problems with diet and food. I Think she often talked about a revision to her DS. I followed her way back on OH. Again I may be wrong my B1 could be sinking. Great Pictures.

I think there was another user with "Dove" in her name who had issues, but I don't recall PD wanting a revision....Drawing on ancient history here though :).
 
Okay, I copied these to my personal info folder so I can print them and give them to my PCP. This will actually help more than me...but dh, @brooklyngirl, AND our PCP's nurse who is a RNY'er.
 

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