Re: Pregnant at the time of surgery

[Guest guest]

Is her OB concerned about too much vit A? I added up what you listed and it comes out to 9,000 IU per day from palmitate. There are no reports of vit A toxicity in doses of 10,000 IU or less. - I read that in the Micronutrition and bariatric surgery book by Jaqueline Jaques. Is she tolerating Glucerna after gastric bypass? Sent via BlackBerry from T-MobileFrom: "dpetitpain" <petitpa@...>Date: Tue, 01 Jul 2008 19:36:36 -0000< >Subject: Pregnant at the time of surgery Does anyone have any case studies on pregnancy at the time of surgery? We have a pt who is 10 wks s/p GBP and 10 wks pregnant. She had a BMI of 65 at the time of surgery and she is down 40 lbs already. She has had a terrible time with hyperemesis (we r/o stenosis and obstruction) and therefore dietary intake. We plan to recheck her vitamins tomorrow b/c her OB is concerned with her getting >5000 IU of vitamin A/day and I think she was taking 2 Flintstones/day (3000 IU each, 33% as beta carotene) + 2 Glucerna/day (1250 IU each). I am watching her intake closely but the vomiting has made this difficult. I don't know how to guage her weight loss. She will be getting ultrasounds to monitor baby's growth. Thanks, Debbie Petitpain, MS, RD, LD MUSC Bariatric Surgery Team Dietitian www.muschealth.com/weightlosssurgery ph. (843) 876-4867 fax. (843) 876-4199

[Guest guest]

Is her OB concerned about too much vit A? I added up what you listed and it comes out to 9,000 IU per day from palmitate. There are no reports of vit A toxicity in doses of 10,000 IU or less. - I read that in the Micronutrition and bariatric surgery book by Jaqueline Jaques. Is she tolerating Glucerna after gastric bypass? Sent via BlackBerry from T-MobileFrom: "dpetitpain" <petitpa@...>Date: Tue, 01 Jul 2008 19:36:36 -0000< >Subject: Pregnant at the time of surgery Does anyone have any case studies on pregnancy at the time of surgery? We have a pt who is 10 wks s/p GBP and 10 wks pregnant. She had a BMI of 65 at the time of surgery and she is down 40 lbs already. She has had a terrible time with hyperemesis (we r/o stenosis and obstruction) and therefore dietary intake. We plan to recheck her vitamins tomorrow b/c her OB is concerned with her getting >5000 IU of vitamin A/day and I think she was taking 2 Flintstones/day (3000 IU each, 33% as beta carotene) + 2 Glucerna/day (1250 IU each). I am watching her intake closely but the vomiting has made this difficult. I don't know how to guage her weight loss. She will be getting ultrasounds to monitor baby's growth. Thanks, Debbie Petitpain, MS, RD, LD MUSC Bariatric Surgery Team Dietitian www.muschealth.com/weightlosssurgery ph. (843) 876-4867 fax. (843) 876-4199

[Guest guest]

Yes, OB is worried about too much vit A. She was tolerating the Glucerna.

Debbie Petitpain, MS, RD, LD

MUSC Bariatric Surgery Team Dietitian

www.muschealth.com/weightlosssurgery

ph. (843) 876-4867

fax. (843) 876-4199

From: [mailto: ] On Behalf Of danaeswilley@...Sent: Tuesday, July 01, 2008 3:53 PM Subject: Re: Pregnant at the time of surgery

Is her OB concerned about too much vit A? I added up what you listed and it comes out to 9,000 IU per day from palmitate. There are no reports of vit A toxicity in doses of 10,000 IU or less. - I read that in the Micronutrition and bariatric surgery book by Jaqueline Jaques. Is she tolerating Glucerna after gastric bypass? Sent via BlackBerry from T-Mobile

From: "dpetitpain" <petitpamusc (DOT) edu>Date: Tue, 01 Jul 2008 19:36:36 -0000< >Subject: Pregnant at the time of surgery

Does anyone have any case studies on pregnancy at the time of surgery?We have a pt who is 10 wks s/p GBP and 10 wks pregnant. Sh! e had a BMI of 65 at the time of surgery and she is down 40 lbs already. She has had a terrible time with hyperemesis (we r/o stenosis and obstruction) and therefore dietary intake. We plan to recheck her vitamins tomorrow b/c her OB is concerned with her getting >5000 IU of vitamin A/day and I think she was taking 2 Flintstones/day (3000 IU each, 33% as beta carotene) + 2 Glucerna/day (1250 IU each). I am watching her intake closely but the vomiting has made this difficult. I don't know how to guage her weight loss. She will be getting ultrasounds to monitor baby's growth.Thanks,Debbie Petitpain, MS, RD, LDMUSC Bariatric Surgery Team Dietitian www.muschealth.com/weightlosssurgeryph. (843) 876-4867fax. (843) 876-4199

[Guest guest]

Yes, OB is worried about too much vit A. She was tolerating the Glucerna.

Debbie Petitpain, MS, RD, LD

MUSC Bariatric Surgery Team Dietitian

www.muschealth.com/weightlosssurgery

ph. (843) 876-4867

fax. (843) 876-4199

From: [mailto: ] On Behalf Of danaeswilley@...Sent: Tuesday, July 01, 2008 3:53 PM Subject: Re: Pregnant at the time of surgery

Is her OB concerned about too much vit A? I added up what you listed and it comes out to 9,000 IU per day from palmitate. There are no reports of vit A toxicity in doses of 10,000 IU or less. - I read that in the Micronutrition and bariatric surgery book by Jaqueline Jaques. Is she tolerating Glucerna after gastric bypass? Sent via BlackBerry from T-Mobile

From: "dpetitpain" <petitpamusc (DOT) edu>Date: Tue, 01 Jul 2008 19:36:36 -0000< >Subject: Pregnant at the time of surgery

Does anyone have any case studies on pregnancy at the time of surgery?We have a pt who is 10 wks s/p GBP and 10 wks pregnant. Sh! e had a BMI of 65 at the time of surgery and she is down 40 lbs already. She has had a terrible time with hyperemesis (we r/o stenosis and obstruction) and therefore dietary intake. We plan to recheck her vitamins tomorrow b/c her OB is concerned with her getting >5000 IU of vitamin A/day and I think she was taking 2 Flintstones/day (3000 IU each, 33% as beta carotene) + 2 Glucerna/day (1250 IU each). I am watching her intake closely but the vomiting has made this difficult. I don't know how to guage her weight loss. She will be getting ultrasounds to monitor baby's growth.Thanks,Debbie Petitpain, MS, RD, LDMUSC Bariatric Surgery Team Dietitian www.muschealth.com/weightlosssurgeryph. (843) 876-4867fax. (843) 876-4199

[Guest guest]

I'm just curious, knowing how intrauterine growth retardation is a risk for development of diabetes and other problems, I'm surprised that pregnant women are even being allowed to have these surgeries. Reading as much as I do about essential fats and their function in keeping the baby in utero with lower risk of premature birth and pre-eclampsia, making it more likely the mother will be a healthy breast feeder, and lower possibility of postpartum depression and disturbed baby sleep architecture...I am wondering why such a surgery would be prioritized over these considerations? Of course, I have an obvious bias which is why I'd love to hear others' opinions in case I should be adjusting my viewpoint past that personal bias. Monika M. Woolsey, MS, RD http://www.afterthediet.com http://www.incyst.blogspot.com http://www.thisisyourbrainonpsychdrugs.blogspot.com

[Guest guest]

We do not do surgery on pregnant pts and advise all of our pts to avoid pregnancy for 18 months after surgery. This pt had a last hurrah 48 hrs prior to surgery, using a condom, which resulted in a negative preg test on the day of surgery.

Debbie

From: [mailto: ] On Behalf Of monika@...Sent: Tuesday, July 01, 2008 4:13 PM Subject: Re: Pregnant at the time of surgery

I'm just curious, knowing how intrauterine growth retardation is a risk for development of diabetes and other problems, I'm surprised that pregnant women are even being allowed to have these surgeries.

Reading as much as I do about essential fats and their function in keeping the baby in utero with lower risk of premature birth and pre-eclampsia, making it more likely the mother will be a healthy breast feeder, and lower possibility of postpartum depression and disturbed baby sleep architecture...I am wondering why such a surgery would be prioritized over these considerations?

Of course, I have an obvious bias which is why I'd love to hear others' opinions in case I should be adjusting my viewpoint past that personal bias.

Monika M. Woolsey, MS, RD

http://www.afterthediet.com

http://www.incyst.blogspot.com

http://www.thisisyourbrainonpsychdrugs.blogspot.com

[Guest guest]

We do not do surgery on pregnant pts and advise all of our pts to avoid pregnancy for 18 months after surgery. This pt had a last hurrah 48 hrs prior to surgery, using a condom, which resulted in a negative preg test on the day of surgery.

Debbie

From: [mailto: ] On Behalf Of monika@...Sent: Tuesday, July 01, 2008 4:13 PM Subject: Re: Pregnant at the time of surgery

I'm just curious, knowing how intrauterine growth retardation is a risk for development of diabetes and other problems, I'm surprised that pregnant women are even being allowed to have these surgeries.

Reading as much as I do about essential fats and their function in keeping the baby in utero with lower risk of premature birth and pre-eclampsia, making it more likely the mother will be a healthy breast feeder, and lower possibility of postpartum depression and disturbed baby sleep architecture...I am wondering why such a surgery would be prioritized over these considerations?

Of course, I have an obvious bias which is why I'd love to hear others' opinions in case I should be adjusting my viewpoint past that personal bias.

Monika M. Woolsey, MS, RD

http://www.afterthediet.com

http://www.incyst.blogspot.com

http://www.thisisyourbrainonpsychdrugs.blogspot.com