Everything (I think) I've Learned About the DS

[more2adore]

So I've been accumulating info I think is important from here, DSFacts, OH, etc., and I thought I'd share my list today since I meet with my surgeon for the first time ON FRIDAY! Is there anything major I'm missing or messed up or got wrong? Thanks, and sorry for how long it is.


Pre-Surgery:

· Pick up some VitaLady DS packages.

· Get a few bariatric gowns that will fit if hospital won’t have a supply.

· Get some protein powder (Unjury won’t ship to Aus. and doesn’t seem to be available through any resellers like Amazon for shipment to Aus. Vitaminshoppe.com carries tons of ISOPURE and Syntrax flavours, though no Unjury, and will ship to Australia! Vitalady also carries Syntrax and her own brand and ships to Aus) and try some well in advance so you can have flavours you like (AND an unflavored one) post-surgery. More protein powder ideas if you need them.

· Take pillow to hold against stomach on way home.

· Get a FitBit?

Immediately Post-Surgery:

· Move, move, move at the hospital.

· Do not weigh yourself for at least a month post-surgery.

· Don’t worry too much about vitamins or protein (or carb?) totals in the first few weeks. Aim to eat something protein-rich when you do eat, but primarily focus on getting in as many liquids as you can and staying hydrated. SIP, SIP, SIP! Aim for 64 oz. of any liquid (water, sugar-free juice, soup [minus the food pieces in it when still on liquids), broth, etc.)

· If you’re having trouble with nausea/vomiting, get an anti-nausea med and a PPI if you don’t have one already. If it isn’t working, try another kind of PPI.

· Bowel issues early out and how to handle them.

· When you get to solid food, slow cook meat to make it easier to eat.

· Post-Op high-protein food ideas:

o http://www.dsfacts.com/post-op-eating.php​

o Eggface Protein shakes.​

· Start tracking food/water/activity. Best app for tracking low-carb, high-protein, liquids and activity is ____?

Later:

· Focus on high-protein, low-carb (under 50g/day?) eating. To get total carbs to be absorbed subtract dietary fiber and sugar alcohols, neither of which are absorbable for us. Avoid sugar alcohols though (ending in –itol) as they cause “bathroom side effects.”

· Constipation = need more fat? Diarrhea and/or smelly stools could mean you need less fat or less sugar, or that there’s some lactose intolerance going on. “Constant diarrhea is not normal and requires medical attention. Constipation is also not normal and requires more fat, more fluids, more fiber, probiotics and possibly laxatives. Uncontrollable foul gas is not normal and may require a medication like Flagyl, followed up by probiotics. It might also require changes in your diet. If you insist on eating carbs, don't be surprised if you fart a lot.” –E.N.

· By 4-6 weeks(?) out you should be on full vitamin schedule.

o Vitamins:​

§ DRY A (see How to Take A), DRY D (D3, see How to Take D), DRY E, DRY K.

§ Calcium Citrate (no more than 500mg/tablet – that’s all the body can absorb at once)

§ Zinc

§ Multivite (Kirkland Daily from Costco... yes, we have Costco here in AU!)

§ Do take your iron with vitamin C

§ Do take your calcium with vitamin D

§ Don't take iron at the same time as calcium or zinc

§ Don't take zinc at the same time as iron or calcium

§ Don't take calcium at the same time as iron or zinc​

· Labs every three months in Year 1: http://www.dsfacts.com/blood-work-and-lab-orders.php

o Lab tips from SouthernLady:​

§ PTH is CRITICAL to get. If PTH is HIGH it indicates probs with Calcium & Vit D and indicates calcium is being leeched from your bones.

§ Try to stay at the high end of normal for most things...not mid range or just in range.

§ Vit D - keep high

§ Vit B12 - at least 900, better if over 1000.

§ B6 - like PTH, is better on the LOW end of the scale.

§ Ferritin – keep high

§ Absorption rate on iron (ferritin) needs to be NO lower than 30% and is better if at 50%.​

· Protein: Aim for 30 g/day by 30 days out, 60 g/day by 60 days out, 90g/day by 90 days out.

· Walk, walk, walk to avoid blood clots.

· Use birth control. Don’t get pregnant. Not yet. 18 months. You can wait.

· If weight loss stalls – more liquid, more protein, fewer carbs. 3 week stall is normal (but you shouldn’t be on the scale yet anyway). 3 month stall is normal.

 

[hilary1617]

Nicely done!

Some additional tips:

Keep an eye on whether medicines prescribed prior to surgery remain appropriate post-surgery. Doses may need to be adjusted for weight loss or absorption reasons or more.

Post-surgery, it is probably best to start out with a multivitamin once possible and then introduce additional vitamins to the schedule over time, with dry A and dry D near the top of the list. Calcium can have a welcome binding effect. Save the iron for last as it can cause stomach upset. Vitamins needs will be dictated by results of your personal periodic lab testing of blood samples. You may need to add copper and selenium.

Check medicines to make sure that you are aware of any interactions with vitamins. (e.g. Coumadin(warfarin)/Vitamin K, Welchol(coleselvam HCI)/absorption).

A long bathrobe is nice to have to cover up what the hospital gowns don't cover when you walk, walk, walk in the hallways after surgery. Also handy to bring wet wipes or a hand held wash bottle for early bathroom experiences.

Compression stockings will need to be replaced within a month or two after surgery for fit.

MyFitnessPal is a good tool to track protein consumption.

Keep in mind the surgery can alter ones tastes drastically, particularly protein powders. Don't stock up on too much of anything in advance.

 

[DianaCox]

Corrections:

Calcium citrate usually requires TWO pills to make up 500-630 mg. (I take two Citrical big tabs which add up to 630 mg)

Labs at 3 mo, 6 mo and a year - 9 mo labs probably not necessary unless there was an issue at ) 6mo.

Use TWO forms of birth control.

 

[Brandy]

Since I'm on the 26th day past surgery I thought I would add my notes of what it is like for me. I am playing a bit of devil's advocate here. I was a professional software tester and do occasional editing work, so when I say "a bit" what I really mean is full on satanic rituals. I was also thinking of people who are looking at the cost of the surgery plus the time off and need to keep an eye on the budget, even if to just postpone some the costs for a while. A lot of this things are nice to have, but not 100% necessary.


Pre-Surgery:

RE VitaLady: If you are flush with money, hit VitaLady. I did this and even a month out her vitamin program is beyond me. I had to go to Costco and get simpler vitamins. Also, my surgeon has his own vitamin program and after much thought and research I am going more towards his program. I know I wanted this to be a simple checklist thing with zero controversy, but it isn't. This is now our lifeline and we can't just throw the details over the wall how ever much I, at least, want to.

RE Gowns: You are about to start losing tons of weight. The hospital will be the last time you even wear some of those clothes. Just wear your favorite and most comfortable clothes. Loose on the tummy is a must, but otherwise the last thing I wanted was to spend more time than I had to in the hospital gowns. Open surgery probably requires the gowns much longer, but as soon as the IV came off the third day, I was out of those hated gowns.

RE Protein Powders: Stocking up is probably good to do if you are flush with money, but for me it has been a waste so far. The stuff I liked before surgery I can hardly tolerate now. I must have 6 tubs of isopure, unjury and their like just gathering dust in my pantry. I try them again every week or so, but for some reason they just are too much right now. I don't want to force it too much because I need to spend my life with them, and I don't want to get to the place where I HATE them with a FIREY PASSION like some people on these forums do. Luckily for me, somebody said an aside of "after surgery I could only deal with "OhYeah!" on some post somewhere on this forum. I have found the same is true for me. Perhaps the key might be to lie in one or two samples of everything and then see how it goes.

RE Pillow: Never needed it. This is an open surgery .vs. laparoscopic thing, probably. It took us over 12 hours to get from the hospital to our house. It was long and mildly uncomfortable, but it wasn't painful. I did order a wheelchair, but ended up getting up and walking most of the last leg just because it felt wonderful to stretch my legs.

RE Fitbit: I have one and I've been wearing it. I suppose that it has started to be useful lately, as I am ready to actually set goals rather than do what my body tells me it is ready to do. And I guess it has kept me honest, but really, it hasn't told me anything I didn't already know. So again, I would put this in the "if you are flush with money..." category.

I would add:

Bathroom Smells Strategies: I felt better once I had laid in some products in this category. I haven't yet really needed them, but being prepared keeps the paranoia down.

Liquid Food in the freezer. Sugar Free popsicles, broth and Jell-O and plenty of them. In the beginning the last thing I wanted to do was cook or shop. But even now I am now growing my diet to soft foods and as I make mistakes growing my diet, it helps to be able to return to the simple 'liquids only' phase for a few meals. I'm happy that I have a bunch stashed away so that it is simple to do.

​

Immediately Post-Surgery:

RE Weigh Yourself: Do it! It's fun! I've lost over 25 pounds! While I agree that obsessing over the scale or trying to lose weight is stupid right now, but we all have to grow up sometime. In the bad pre-surgery days I had a certain relationship with my scale. Everything has changed now. The impossible is happening and I need to get with the program. The scale needs to stop being my mental nemesis and just be only a tool that gives me a small glimpse into one attribute of my health. Watching it now when I'm focused on my liquids and my protein is a good way to reset my relationship. It's fun, I know, because I'm losing weight. But if I wasn't, I think I would like to know this so that I could be double checking that I have al my ducks in a row. Knowing in advance of the three week stall was helpful.

RE Food Intake: This month my surgeon wants me to work towards: 50 to 64 oz of liquid. 80 g protein. My Vitamins. Advancing my diet from clear liquids, to liquids, to soft, to ... I know pre-surgery this sounded so incredibly easy, but even 26 days out I have not had one perfect day. It is amazing how the pre-made cups that jell-o comes in go from "pathetically small" pre-surgery to being 3 full meals post surgery. I went out for breakfast with my husband on day 18 and he had chicken-fried steak and eggs, hash browns, toast, OJ and coffee. I had an egg. We finished eating at about the same time. I think I was fuller. So, the bottom line is liquids, protein and vitamins. If a few extra carbs helps you get those in, then do it. The first month isn't about losing weight. Besides, until the last few days, I haven't been able to get my calories over 500. I just run out of time to shovel things in my mouth at a rate my tummy can handle.

RE Bowel issues: I have not had one episode of what I was afraid it would be like. Not one. Although, it seems like this first month has been one long question "Does THIS food agree with me now?" Followed by "That would be no." Followed by mild nausea, gas, bloating, and or the runs. I've been constipated only once. It a journey of discovery and it changes every day as I get better. I had all kinds of lemonade type drinks lined up because that has always been my favorite, but now it is way too acidic. My husband has been all "Oh, don't try that, you might get the runs!" or "We can't go downtown for dinner, you might get the runs!" and I'm so over worrying about it. Once it really happens I will probably change my mind, but so far I've always had plenty of warning. If it happens, it isn't the worst thing in the world. Nobody loses a ton of weight without suffering and in the scheme of things, this isn't so bad.

RE Tracking: http://www.myfitnesspal.com is my favorite tracker. It just has most of the foods listed and that makes it so easy. They will often have foods listed twice; once with all carbs and once with net carbs. I haven't started tracking my food yet, although I suppose I should. When the day's intake was water, 6 maybe 7 sips of broth, 3 bites of chili, 3 frozen popsicles, it just didn't seem worth it. It's hard to track when you don't ever finish what you make yourself. ​

Later:

RE Total Carbs: Do you mean "Net Carbs?” The thing to remember with carbs is that we do not have a free pass here. We do have a free pass (basically) on fat. Atkins, the king of low carbs, has some very specific ideas on exactly what carbs you need a day. I think it is 18 g of elemental veggies (or something). Their phase zero is 20 carbs. Some research just came out that says the problem with very low carb diets is that you regain FOUR times faster once you go back on carbs, but I don't know how that applies to us DS'ers. I don't have any answers here and doubt this can ever be boiled down into some kind of universal truth bumper sticker.

RE sugar alcohols: I don't have a problem with them. I figure I might in quantity, but so far they have been the easiest on my body of all the sweeteners.

RE Zinc & Calcium: I hadn't heard this. These are taken together in the VitaLady plan although there are several flame wars about it in the old OH files. Doing a quick study I can't find any reliable data one way or the other. Does anybody have a good reference study?

I would add:

Do not think more is better when it comes to vitamins. There was just a post on OH about some poor woman who tripled the already high VitaLady recommendations for Vitamin B and the folic acid turned her poop into a weapon's grade acid strong enough to burn her. She spent a year sitting on ice bags before she got so depressed she stopped taking her vitamins and got better. You must own this for yourself. Vitamins have side effects. If you are not prospering after your surgery, they should be on the list of things at which you take a critical look. There may be a different form that wouldn’t cause your individual body to have the same issues. I think this is where VitaLady and the personalized advice she is happy to bestow upon us can really make a difference.

​

So, I hope I didn't ruffle any feathers. I can only speak from my own experience and I wanted to get across to our future brothers and sisters of the knife that the experience is individualized and they should be committed to doing their own research and discovery.

 

[Munchkin]

Good job! On traveling for surgery, take your oldest, nastiest, rattiest clothes, and throw them away after you wear them. Less to carry home!

At first drink whatever is allowed that you can stand regardless of carbs. If you like sports drinks even better because they have electrolytes your body needs to function. When you are drinking well, it's time to never drink sugar again! And KNOW the difference between a protein supplement and a meal replacement shake!

On carbs. Well, I would limit that as much as possible. You are a superabsorber and you already know the deck is stacked against you. But your goal is realistic. The only person I know who started with similar stats and MADE it to a normal BMI did almost all shakes with no carbs while she was in the fast loss stage. She ate a bite of this or that but that's about it! Honestly I wish I had done this!

I will be thinking about you on Friday! Best of luck!

 

[more2adore]

Nicely done!

Some additional tips:

Keep an eye on whether medicines prescribed prior to surgery remain appropriate post-surgery. Doses may need to be adjusted for weight loss or absorption reasons or more.

Post-surgery, it is probably best to start out with a multivitamin once possible and then introduce additional vitamins to the schedule over time, with dry A and dry D near the top of the list. Calcium can have a welcome binding effect. Save the iron for last as it can cause stomach upset. Vitamins needs will be dictated by results of your personal periodic lab testing of blood samples. You may need to add copper and selenium.

Check medicines to make sure that you are aware of any interactions with vitamins. (e.g. Coumadin(warfarin)/Vitamin K, Welchol(coleselvam HCI)/absorption).

A long bathrobe is nice to have to cover up what the hospital gowns don't cover when you walk, walk, walk in the hallways after surgery. Also handy to bring wet wipes or a hand held wash bottle for early bathroom experiences.

Compression stockings will need to be replaced within a month or two after surgery for fit.

MyFitnessPal is a good tool to track protein consumption.

Keep in mind the surgery can alter ones tastes drastically, particularly protein powders. Don't stock up on too much of anything in advance.

Thank you so much, Hilary. Great list! The only one of these that won't be practical is the compression stockings - mine have to be custom made and the wait list for them here in Aus is one year. I'm not sure exactly what the solution is going to be while I'm losing, but my doctor is putting in a referral so I can see a lymphedema physical therapist here (like I did in the US) so I can talk to them about it.

 

[more2adore]

Corrections:

Calcium citrate usually requires TWO pills to make up 500-630 mg. (I take two Citrical big tabs which add up to 630 mg)

Labs at 3 mo, 6 mo and a year - 9 mo labs probably not necessary unless there was an issue at ) 6mo.

Use TWO forms of birth control.

Thanks! Yes, I should have been clearer - I understand that I will likely need TWO calcium citrate - it's just that (from what I've read here) the body can only absorb about 500 mg at a time so you have to take the two pills at separate times, not together.

Thanks for the info on not necessarily needing the 9 month labs (good to know), and we'll do our best to find two forms of bc we can use. I'd read somewhere that you aren't supposed to use BC pills post-DS for some reason(?) and I've had REALLY bad experiences with an IUD and a couple others. We'll get creative. There are bound to be other things we haven't tried. Er, in regards to the BC, I mean, not the, uh,... nevermind.

 

[hilary1617]

@more2adore, one of the greatest benefits I received from the DS was a massive reduction in lipedema / lymphedema bulk in my legs. (Hooray! They aren't "normal" by any means, but they are much, much improved. ) The diameter of my calves was reduced by 3+ cm within a couple of months of surgery at which points not only were my stockings not providing compression, they would simply not stay on my legs. The tops of the stockings hit the floor as I walked. I could not wear them and *had* to have new ones made. I hope you enjoy a similar result, despite the expense of Elvarex.

 

[more2adore]

Since I'm on the 26th day past surgery I thought I would add my notes of what it is like for me. I am playing a bit of devil's advocate here. I was a professional software tester and do occasional editing work, so when I say "a bit" what I really mean is full on satanic rituals. I was also thinking of people who are looking at the cost of the surgery plus the time off and need to keep an eye on the budget, even if to just postpone some the costs for a while. A lot of this things are nice to have, but not 100% necessary.


Pre-Surgery:

RE VitaLady: If you are flush with money, hit VitaLady. I did this and even a month out her vitamin program is beyond me. I had to go to Costco and get simpler vitamins. Also, my surgeon has his own vitamin program and after much thought and research I am going more towards his program. I know I wanted this to be a simple checklist thing with zero controversy, but it isn't. This is now our lifeline and we can't just throw the details over the wall how ever much I, at least, want to.

RE Gowns: You are about to start losing tons of weight. The hospital will be the last time you even wear some of those clothes. Just wear your favorite and most comfortable clothes. Loose on the tummy is a must, but otherwise the last thing I wanted was to spend more time than I had to in the hospital gowns. Open surgery probably requires the gowns much longer, but as soon as the IV came off the third day, I was out of those hated gowns.

RE Protein Powders: Stocking up is probably good to do if you are flush with money, but for me it has been a waste so far. The stuff I liked before surgery I can hardly tolerate now. I must have 6 tubs of isopure, unjury and their like just gathering dust in my pantry. I try them again every week or so, but for some reason they just are too much right now. I don't want to force it too much because I need to spend my life with them, and I don't want to get to the place where I HATE them with a FIREY PASSION like some people on these forums do. Luckily for me, somebody said an aside of "after surgery I could only deal with "OhYeah!" on some post somewhere on this forum. I have found the same is true for me. Perhaps the key might be to lie in one or two samples of everything and then see how it goes.

RE Pillow: Never needed it. This is an open surgery .vs. laparoscopic thing, probably. It took us over 12 hours to get from the hospital to our house. It was long and mildly uncomfortable, but it wasn't painful. I did order a wheelchair, but ended up getting up and walking most of the last leg just because it felt wonderful to stretch my legs.

RE Fitbit: I have one and I've been wearing it. I suppose that it has started to be useful lately, as I am ready to actually set goals rather than do what my body tells me it is ready to do. And I guess it has kept me honest, but really, it hasn't told me anything I didn't already know. So again, I would put this in the "if you are flush with money..." category.

I would add:

Bathroom Smells Strategies: I felt better once I had laid in some products in this category. I haven't yet really needed them, but being prepared keeps the paranoia down.

Liquid Food in the freezer. Sugar Free popsicles, broth and Jell-O and plenty of them. In the beginning the last thing I wanted to do was cook or shop. But even now I am now growing my diet to soft foods and as I make mistakes growing my diet, it helps to be able to return to the simple 'liquids only' phase for a few meals. I'm happy that I have a bunch stashed away so that it is simple to do.

​

Immediately Post-Surgery:

RE Weigh Yourself: Do it! It's fun! I've lost over 25 pounds! While I agree that obsessing over the scale or trying to lose weight is stupid right now, but we all have to grow up sometime. In the bad pre-surgery days I had a certain relationship with my scale. Everything has changed now. The impossible is happening and I need to get with the program. The scale needs to stop being my mental nemesis and just be only a tool that gives me a small glimpse into one attribute of my health. Watching it now when I'm focused on my liquids and my protein is a good way to reset my relationship. It's fun, I know, because I'm losing weight. But if I wasn't, I think I would like to know this so that I could be double checking that I have al my ducks in a row. Knowing in advance of the three week stall was helpful.

RE Food Intake: This month my surgeon wants me to work towards: 50 to 64 oz of liquid. 80 g protein. My Vitamins. Advancing my diet from clear liquids, to liquids, to soft, to ... I know pre-surgery this sounded so incredibly easy, but even 26 days out I have not had one perfect day. It is amazing how the pre-made cups that jell-o comes in go from "pathetically small" pre-surgery to being 3 full meals post surgery. I went out for breakfast with my husband on day 18 and he had chicken-fried steak and eggs, hash browns, toast, OJ and coffee. I had an egg. We finished eating at about the same time. I think I was fuller. So, the bottom line is liquids, protein and vitamins. If a few extra carbs helps you get those in, then do it. The first month isn't about losing weight. Besides, until the last few days, I haven't been able to get my calories over 500. I just run out of time to shovel things in my mouth at a rate my tummy can handle.

RE Bowel issues: I have not had one episode of what I was afraid it would be like. Not one. Although, it seems like this first month has been one long question "Does THIS food agree with me now?" Followed by "That would be no." Followed by mild nausea, gas, bloating, and or the runs. I've been constipated only once. It a journey of discovery and it changes every day as I get better. I had all kinds of lemonade type drinks lined up because that has always been my favorite, but now it is way too acidic. My husband has been all "Oh, don't try that, you might get the runs!" or "We can't go downtown for dinner, you might get the runs!" and I'm so over worrying about it. Once it really happens I will probably change my mind, but so far I've always had plenty of warning. If it happens, it isn't the worst thing in the world. Nobody loses a ton of weight without suffering and in the scheme of things, this isn't so bad.

RE Tracking: http://www.myfitnesspal.com is my favorite tracker. It just has most of the foods listed and that makes it so easy. They will often have foods listed twice; once with all carbs and once with net carbs. I haven't started tracking my food yet, although I suppose I should. When the day's intake was water, 6 maybe 7 sips of broth, 3 bites of chili, 3 frozen popsicles, it just didn't seem worth it. It's hard to track when you don't ever finish what you make yourself. ​

Later:

RE Total Carbs: Do you mean "Net Carbs?” The thing to remember with carbs is that we do not have a free pass here. We do have a free pass (basically) on fat. Atkins, the king of low carbs, has some very specific ideas on exactly what carbs you need a day. I think it is 18 g of elemental veggies (or something). Their phase zero is 20 carbs. Some research just came out that says the problem with very low carb diets is that you regain FOUR times faster once you go back on carbs, but I don't know how that applies to us DS'ers. I don't have any answers here and doubt this can ever be boiled down into some kind of universal truth bumper sticker.

RE sugar alcohols: I don't have a problem with them. I figure I might in quantity, but so far they have been the easiest on my body of all the sweeteners.

RE Zinc & Calcium: I hadn't heard this. These are taken together in the VitaLady plan although there are several flame wars about it in the old OH files. Doing a quick study I can't find any reliable data one way or the other. Does anybody have a good reference study?

I would add:

Do not think more is better when it comes to vitamins. There was just a post on OH about some poor woman who tripled the already high VitaLady recommendations for Vitamin B and the folic acid turned her poop into a weapon's grade acid strong enough to burn her. She spent a year sitting on ice bags before she got so depressed she stopped taking her vitamins and got better. You must own this for yourself. Vitamins have side effects. If you are not prospering after your surgery, they should be on the list of things at which you take a critical look. There may be a different form that wouldn’t cause your individual body to have the same issues. I think this is where VitaLady and the personalized advice she is happy to bestow upon us can really make a difference.

​

So, I hope I didn't ruffle any feathers. I can only speak from my own experience and I wanted to get across to our future brothers and sisters of the knife that the experience is individualized and they should be committed to doing their own research and discovery.

I REALLY want to thank you for the incredible amount of time you must have spent writing all this up for me, Brandy! This is so comprehensive and so incredibly useful. I'm still not 100% on what to do with the vitamins - I think I would rather start out with too many and work my way down than risk a deficiency. Since we do have Costcos here in Aus, I guess what I'll do is take VitaLady's list of what she includes and just price out what it would be to get similar vitamins there. We are definitely not flush with money for sure, but obviously getting the nutrients I need is a priority. If we can do that less expensively, then great.

In regards to protein powder, I'll look around and see if I can find samples of the types of powders we can get here in Aus, and I'll make getting some unflavored a priority since (I hope) that will be so frequently useful.

Re: waiting to weigh, I just know myself and my relationship with the scale very well. I just think it will be better for me mentally to stay off the scale (if I can) the first several weeks and then have a decently big number loss to be surprised with when I get on the scale finally. And I wouldn't have to worry about the discouragement that comes with the three-week stall.

Thank you so, so much. Your post was really helpful.

 

[more2adore]

Good job! On traveling for surgery, take your oldest, nastiest, rattiest clothes, and throw them away after you wear them. Less to carry home!

At first drink whatever is allowed that you can stand regardless of carbs. If you like sports drinks even better because they have electrolytes your body needs to function. When you are drinking well, it's time to never drink sugar again! And KNOW the difference between a protein supplement and a meal replacement shake!

On carbs. Well, I would limit that as much as possible. You are a superabsorber and you already know the deck is stacked against you. But your goal is realistic. The only person I know who started with similar stats and MADE it to a normal BMI did almost all shakes with no carbs while she was in the fast loss stage. She ate a bite of this or that but that's about it! Honestly I wish I had done this!

I will be thinking about you on Friday! Best of luck!

Not really a huge fan of sports drinks, but I'll drink them if I have to. I'll see if we can find any Gatorade Zero around here. We might be able to. I'll definitely limit carbs as soon as I'm drinking well. Thanks! We leave TOMORROW (it's Wednesday here already... gotta love the Aus - US time difference). I just hope I come outta there with a surgery date, or at least an idea of when it might be and a list of tests to get done first.

 

[Brandy]

Thank you for this post. It is great seeing it all listed out.

I did follow up on the zinc/calcium problem and posted to the vitamin forum. The short answer is that calcium depresses zinc absorption a little, but you can boost your zinc intake to compensate and not have to separate the pills. This is what VitaLady recommends.

 

[sophiehatter]

This thread is so helpful. Thank you all so much for the information! Thanks More2adore for starting it and for summarizing so much! And Brandy for the long list too, and everyone else. I am so grateful for all the good info on this board!

 

[Munchkin]

Best of luck! Will be thinking about you!

 

[Larra]

Re: calcium again. What Diana referred to is that even though those calcium citrate pills are large, each one contains only 250 mg of calcium citrate. It's a big molecule! So, each DOSE of calcium consists of 2 pills, AND you need probably 3-4 doses/day to maintain a good PTH level.
If you are like me and you really can't swallow those big pills, at least not consistently, get a pill cutter (about $5 at Walmart) or take the calcium citrate lozenges from Bariatric Advantage. You can order them either from BA or from Vitalady. They are a big chalky but the flavor isn't bad at all. You can either chew them up or just suck on them til they dissolve. These saved me early out, and I still use them. Bariatric Advantage also makes calcium cltrate chews in different flavors. But no matter what brand/form you use, you will need multiple doses each day.

 

[Spiky Bugger]

Re: calcium again. What Diana referred to is that even though those calcium citrate pills are large, each one contains only 250 mg of calcium citrate. It's a big molecule! So, each DOSE of calcium consists of 2 pills, AND you need probably 3-4 doses/day to maintain a good PTH level.
If you are like me and you really can't swallow those big pills, at least not consistently, get a pill cutter (about $5 at Walmart) or take the calcium citrate lozenges from Bariatric Advantage. You can order them either from BA or from Vitalady. They are a big chalky but the flavor isn't bad at all. You can either chew them up or just suck on them til they dissolve. These saved me early out, and I still use them. Bariatric Advantage also makes calcium cltrate chews in different flavors. But no matter what brand/form you use, you will need multiple doses each day.

What she said...but I think the chews contain sugar alcohols.

I take six "lozenges," 500 mg each, three chocolate, three cherry, every day and my PTH is still too high.