Milk

[Guest guest]

I think in my mind I translate milk into lactose directly. Keeps me a FURTHER

distance away. I know MOST surgeons who do obesity surgeries start their folks

on milk right after surgery! I sometimes think our doc is the only one who does

NOT. We use high quality protein, take a certain set of vites & that's it. Our

food counts for so little that we only avoid milk 'n sugar as being sure to

cause weight problems. But then, we're distals. We can eat cottage cheese,

cheese, yogurts (watching the sugar), but NO ice cream, NO milk. I hate pain.

Thanks!

vitalady@...

www.vitalady.com

[Guest guest]

Hillary,

Any surgeon who does not have a balanced program including nutritional advise

should not be doing this surgery. It is vital that all areas of nutrition as

well as surgical recovery are covered. Our surgeon (Dr. Wm. Marcus in Silver

Spring, MD, has a nutritionist who is experienced working with WLS patients

and he also attends our 3/month support group meetings. His staff is trained

in dealing with the post op eating problems that often develop. Granted Dr.

Marcus performs a very distal RNY called a biliopancreatic diversion where

85% to 90% of the stomach is removed and about 8 feet of the small intestine

is bypassed. We all start a very intense vitamin regimen that is specially

prescribed by the nutritionist and ordered from a local pharmacy that

compounds the vitamins so we can absorb them easier. We also supplement the

vitamins with protein drinks. I use the Designer Protein or the Atkins Shake

Mix mixed with a diet chocolate soda in a blender to remove the bubbles. I

also add some flavoring or even a teaspoon or two of fat-free/sugar-free

pudding mix. I try to get at least 75 extra grams of protein each day.

Even proximal patients need nutritional and emotional support and advise.

This surgery requires a total physical and emotional approach for patients

that should start in the preop phase and continue as long as the postop

patient needs support.

Bob Altman

Biliopancreatic Diversion (A Very Distal RNY) on 10/8/98

214 Pounds Gone Forever, But Not Forgotten!

[Guest guest]

Trish, ,

Dr. Marcus firmly believes that the ongoing weight loss and maintenance is

from the malabsorbtion he creates from the very distal bypass he uses. His

patients who do gain weight really have to work at it to do so. Just

following the basic low carb-high protein rules is enough to maintain the

initial weight loss. I'm only 14 months post op and maybe I'll have more of a

problem in a year or two, but I doubt it. I haven't heard that the body

adjusts so that other parts of the intestine begin to perform some of the

digestive functions. Its worth examining. We should bring it up with

Charlotte and Dr. Marcus.

Bob Altman

Biliopancreatic Diversion (A Very Distal RNY) on 10/8/98

214 Pounds Gone Forever, But Not Forgotten!

[Guest guest]

,

I was given to understand that after a while post op, our bodies work

to overcome some of the deprivation/malabsorption that the surgery

achieves... that the body adjusts & finds other routes to get what it

wants... the remaining intestine getting the food elongates, thickens,

& changes occur so that the " body gets what it wants " ... I have

heard about the hair loss from early post ops (mainly from protein

deprivation), that usually seems to stop. So, I suspect that the body

learns to improve its ability to get protein from some foods after a

while post op. Have you heard of this? What do you think of this?

Trish

> >>>

>.

>Also, bearing in mind that it is physiologically impossible to digest and

>absorb much protein from food if you are RNY, any size. That all occurs in

>the stomach and first part of the intestine that is bypassed in all of us.

>>>>>

>

[Guest guest]

In a message dated 12/18/1999 6:18:10 PM Eastern Standard Time,

vitalady@... writes:

> Except for my lapse into idiocy when I hit protein deficiency (I

> didn't take enough after my TT and crashed), I have steadily taken mine and

> my weight holds steady.

Do you mean at this is the fact that you loose memory and stuff.

I was wondering because its a fact that I am lazy to! I am awful about my

vitamins and such. I ive been really feeling crapy lately and I haven't been

able to concentrate. It seems that ive been looking around but IM not seeing

its like IM going through the moves but yet not seeing it? Ive had several

close calls lately with the car so IM getting my eyes checked first thing

Monday.

If you got any idea let me know?

angi

[Guest guest]

Trish, you asked:

>>..after a while post op, our bodies work

to overcome some of the deprivation/malabsorption that the surgery

achieves... that the body adjusts & finds other routes to get what it

wants... the remaining intestine getting the food elongates, thickens,

& changes occur so that the " body gets what it wants " ... I have

heard about the hair loss from early post ops (mainly from protein

deprivation), that usually seems to stop. So, I suspect that the body

learns to improve its ability to get protein from some foods after a

while post op. ..<<

Absolutely! BUT if you provide enough of the correct nourishment, you

needn't go through the starvation mode thing. We've been told we WILL

regain at least to the top end of our wt range by our doc. There is no way,

he says, that you can maintain bottom end of range for long as your body

WILL try to normalize. I'm waiting. I do NOT work at maintaining this wt.

Anyone who knows me knows that I am a fast food junkie, never exercise (but

never sit still except to compute) and pack away lots of protein

supplements. I'm not as good with water as I'd like to be, but I bet I

haven't ingested 1/2C of milk (all total) in over 5 yrs.

My OWN doctor used to say that our bodies will " reach " to get the protein

and the intestine will elongate & widen to accommodate it. But you know, I

just don't believe it. My need for protein has INCREASED but my weight has

not. Except for my lapse into idiocy when I hit protein deficiency (I

didn't take enough after my TT and crashed), I have steadily taken mine and

my weight holds steady. And my labs are OK, but not getting " better " .

So, my absorption is NOT increasing, nor is my husband's or any of us who

are holding steady.

Now, here's an interesting one. This guy had his surgery about half way

between my husband and me, so mid-95. He took some protein the first year,

less the 2nd, less the 3rd. He bottomed out in the 4th year and now is

suffering from severe osteoporosis and malnutrition. He's a brilliant and

likeable guy with a streak of stubborn. He's never avoided milk 'n sugar,

but without protein, the other pieces to the puzzle (vites & minerals) have

no glue. Hence, the osteoporosis.

Recently, he had to have his distal backed down some (to a proximal) since

he simply will NOT take his supps. He was as distal as I am with only 40 " of

common channel. Over time, he has developed " funnel syndrome " , which in

these parts means that he has no " stoma " in the sense that we think of it.

His opening as become larger, so he feels no sense of fullness. His pouch

has grown to 4 times it's original size. He eats CONSTANTLY, never stopping.

I did not get to observe his revision, though I really wanted to and he

invited me to do so. I suspect that perhaps he was higher risk, so that's

why there were no observers for that one. Drat. Anyway, his original 40 " had

turned into 66 " . In fact, at one point, he'd said his 40 " was actually 33 " ,

so if that was true, he'd have DOUBLED in 4 yrs!!

We refer to the amount bypassed and the common channel length, but we never

mention the Other side of the Y, the right side. We start with 60-70 " on

that side. His 60 " had elongated there to 73 " . IF we figure that we start

with about 25', which is really variable, I know, then in theory, his LEFT

side should've been 17 or 18 ft bypassed. He still had OVER 20 ft.

So, in answer to your question, IF someone deprives themselves of the

nutrients they need, obviously the body will work very hard to reach/stretch

and make more " fabric " available to try to absorb what it needs. He

basically had nearly doubled every new " small " measurement " his surgery had

given him. The result being that he was eating constantly since he was

quite literally starving, AND having about 18 trips " down the hall " a day,

and perpetual misery. Oddly, his weight was pretty stable, though.

HOWEVER, he lost his bones, some organ damage and he lost his career due to

the brain damage suffered. He seems his old self, but he remembers very

little about his career, in which he was " star " .

We also see among our people that those who take SOME protein, but not

enough, will get some wt loss, but not reach goal. My THEORY is that their

bodies start working overtime to reach out and grab whatever they can, be it

calories or whatever. Over time however, the body will begin to cannibalize

itself. Just like the flower planted under a tree, it will reach and

stretch and end up rather deformed in it's efforts to reach the sun and rain

it needs. So, with our bodies, they will compensate as best they can to

keep all systems running.

NOW, I am referring to distal RNY. Our situation is far more severe than

most of you guys. However, the theory is the same. If you don't get enough

useable nutrition on board, your body will " reach " to get it somewhere.

Usually it manifests itself in cravings for carbs. Protein deficiency is

often masked as a craving for sugar.

We ALL lose hair during months 4-6 due to the rapid wt loss, so annoying as

it is, at least it's a good sign. But the more protein you get during the

first month or two, the less severe the hair loss will be. I can't imagine

anyone taking less than 60g of protein supplement a day. If you can eat

cottage cheese and tuna and chicken, too, that's great, but if you do 30g of

pre-digested protein twice a day, you can be absolutely certain you aren't

running short at all. Unless you are severely bypassed, of course, in which

case you need more.

So, Trish, did I answer this to death or WHAT?

** No matter what my mail says in the " from " ,

please reply to me at: vitalady@... **

Thanks!

Please visit our web site at:

www.vitalady.com

Re: RE: milk

>

>

>,

>I was given to understand that after a while post op, our bodies work

>to overcome some of the deprivation/malabsorption that the surgery

>achieves... that the body adjusts & finds other routes to get what it

>wants... the remaining intestine getting the food elongates, thickens,

> & changes occur so that the " body gets what it wants " ... I have

>heard about the hair loss from early post ops (mainly from protein

>deprivation), that usually seems to stop. So, I suspect that the body

>learns to improve its ability to get protein from some foods after a

>while post op. Have you heard of this? What do you think of this?

>Trish

>

>

>

>> >>>

>>.

>>Also, bearing in mind that it is physiologically impossible to digest and

>>absorb much protein from food if you are RNY, any size. That all occurs

in

>>the stomach and first part of the intestine that is bypassed in all of us.

>>>>>>

>>

>

>