2 Week Post-Op - Dietitian Frustration

[Spiky Bugger]

Dr Sudan recommends ADEKs made by Scandipharm
I don't think those are still available.
Further evidence an authoritative text on DS nutrition is needed.

I used to use them, but...it's like...in the olden days, I used to take "Sudafed," for sinus congestion/allergies. It contained THREE drugs, one of which was acetaminophen. Why? I didn't ALWAYS have a headache and acetaminophen was not my first choice for pain relief...so WHY? I now buy the non-tylenol ingredients separately.

 

[Larra]

See, @Spiky is the one who knows me best. I'm almost useless at the important stuff, like swearing at stupid people.

A couple thoughts... I would have expected better of Dr. Sudan as well, as he is known for doing the DS. However, there are a few things in his advice I would agree with - first, we do need to make sure we get in enough protein, no question about that. Yes, carbs do cause gas, and many people with both DS and gastric bypass do become lactose intolerant. And excessive amounts of fat will lead to more poop, or very loose poop and/or oil slicks.

BUT the rest is not good, and as @Spiky pointed out, any advice that is identical for both operations has to be wrong for at least one of them. So just focus on protein, don't worry about the fat that comes along with the protein, and limit carbs, esp simple carbs. One of the great things about the DS is that you don't have to eat just lean protein, you can use whatever form of protein you like. You also don't have to cook fat free, or use artificial low fat foods. It's a much more normal way of eating.

And the only other advice I can offer about those classes is, when you meet other DS patients there, direct them here. Pay it forward.

 

[Spiky Bugger]

THIS RIGHT HERE ^^^^^

Which is why we need to learn our own systems.

I fired a PCP who asked why I was using Cytomel T3, cause my labs were fine. My labs were fine cause I was taking it!!!!

Darn...typos and a missing word or two...chaos abounds here...roof, solar panels, concrete, etc.

 

[Stefanie S.]

Oh...and your vitamins...that's also bad advice, in that DS is a YMMV thing. Because of that, your labs tell you what vitamins you need.

And, depending on how YOUR body adapts, TWO multi-vitamins may end up providing you with not enough of what you DO need and TOO MUCH of something you don't need more of. Ergo, many of us avoid "cocktail" vitamins...like "ADEKs," a brand that provides a combo of vitamins A, D, E and K. I would rather take those individually, as I need them. In fact, yesterday, I got injections of A and D, so I can stop those individual vitamins, but continue my Vit K as a separate pill. ( I know I need that because my "clotting time" is just a tad too slow and has delayed unrelated surgical procedures.)

To me, a vet of 11+ years, what random doctors (even my PCP and other specialists) THINK I need means nothing if their opinions do not comport with what my lab results SHOW I need.

Thankfully I have been reading all of the posts on this site. I just started my Vit D at 50,000 IU's and Vit A at 25,000 IU's, plus I'm taking Vitamin K2, iron, and zinc. I guess I don't get labs until 6 months, and I don't want to risk tanking my levels during that time. I was low on Vit D before surgery and already took 5000 IU's. I'm considering finding a PCP that is versed in the DS and proper nutrition/supplementation needs. If anyone knows someone in the Raleigh, NC area, I'd love suggestions!

 

[Stefanie S.]

See, @Spiky is the one who knows me best. I'm almost useless at the important stuff, like swearing at stupid people.

A couple thoughts... I would have expected better of Dr. Sudan as well, as he is known for doing the DS. However, there are a few things in his advice I would agree with - first, we do need to make sure we get in enough protein, no question about that. Yes, carbs do cause gas, and many people with both DS and gastric bypass do become lactose intolerant. And excessive amounts of fat will lead to more poop, or very loose poop and/or oil slicks.

BUT the rest is not good, and as @Spiky pointed out, any advice that is identical for both operations has to be wrong for at least one of them. So just focus on protein, don't worry about the fat that comes along with the protein, and limit carbs, esp simple carbs. One of the great things about the DS is that you don't have to eat just lean protein, you can use whatever form of protein you like. You also don't have to cook fat free, or use artificial low fat foods. It's a much more normal way of eating.

And the only other advice I can offer about those classes is, when you meet other DS patients there, direct them here. Pay it forward.

I should have done that for the 2 other DSers there. But they were soaking up that no fat info... especially since they both had issues with diarrhea. Dr. Sudan hasn't given me any diet advice directly so I can't say that he has lead me astray. And the dietitian that lead yesterday's class has only been there about 5-6 months. Maybe that's some of it. I don't want to speak badly about any of them... but my frustration remains. Other than this site, I feel alone in trying to figure out the right things to do. That sounded harsh! I'm actually feeling pretty good. I feel like I've taken this time off from work and researched like crazy and come up with a pretty decent plan

 

[k9ophile]

Oh...and your vitamins...that's also bad advice, in that DS is a YMMV thing. Because of that, your labs tell you what vitamins you need.

And, depending on how YOUR body adapts, TWO multi-vitamins may end up providing you with not enough of what you DO need and TOO MUCH of something you don't need more of. Ergo, many of us avoid "cocktail" vitamins...like "ADEKs," a brand that provides a combo of vitamins A, D, E and K. I would rather take those individually, as I need them. In fact, yesterday, I got injections of A and D, so I can stop those individual vitamins, but continue my Vit K as a separate pill. ( I know I need that because my "clotting time" is just a tad too slow and has delayed unrelated surgical procedures.)

To me, a vet of 11+ years, what random doctors (even my PCP and other specialists) THINK I need means nothing if their opinions do not comport with what my lab results SHOW I need.

Clicking the "Like" button is not enough for this post. Taking the vitamins we need based on our labs should be tattooed on us somewhere lest we forget and actually listen to a nut.)

(However, I do not have the problem of needing help when I swear at stupid people. When riding with my husband, he drives and I swear at the idiot drivers.)

 

[Munchkin]

I seriously doubt you will find any NUT who understands the DS.

 

[Settledownnow]

That's a great idea. My insurance DOES pay for unlimited dietitian appointments. If I can find one in the Raleigh, NC area like what you have found, I'd definitely commit to that.

@Munchkin is right you are unlikely to find a RD that truly understands DS needs, but I can say that my RD does try. I also tell her what I want to work on by writing down my stumbling blocks (focus on eating low carb, high protein, and reducing stress eating and eating too much at night, etc.).

For anyone who wants to try a private practice dietitian (for whatever purpose) here is a link http://www.eatright.org/find-an-expert
Before scheduling, try to interview them on the phone first. The dietitian I see charges $25 for about 30-45 minutes which has been worth it to me to learn to new eating habits for long-term WL. My insurance would cover it if I resubmitted, but it is a hassle so I do not bother.

 

[Spiky Bugger]

I seriously doubt you will find any NUT who understands the DS.

What SHE said.

 

[Spiky Bugger]

@Munchkin is right you are unlikely to find a RD that truly understands DS needs, but I can say that my RD does try. I also tell her what I want to work on by writing down my stumbling blocks (focus on eating low carb, high protein, and reducing stress eating and eating too much at night, etc.).

For anyone who wants to try a private practice dietitian (for whatever purpose) here is a link http://www.eatright.org/find-an-expert
Before scheduling, try to interview them on the phone first. The dietitian I see charges $25 for about 30-45 minutes which has been worth it to me to learn to new eating habits for long-term WL. My insurance would cover it if I resubmitted, but it is a hassle so I do not bother.

At one time, I went to a registered dietician at tbe VA. When she started our session by holding up props...toy fruits and veggies and plastic slices of bread...I just announced that I was sure it was all too complicated for me...and left. That's probably still in my records.

 

[Stefanie S.]

At one time, I went to a registered dietician at tbe VA. When she started our session by holding up props...toy fruits and veggies and plastic slices of bread...I just announced that I was sure it was all too complicated for me...and left. That's probably still in my records.

This made me laugh!!! So true!!