Re: Digest Number 2256

[Guest guest]

In a message dated 5/2/02 9:33:24 AM Pacific Daylight Time, writes:

My biopsy says I have fibrosis. Can you or anyone shed any light on this?

Lyn in Arkansas, fibrosis just means "the initial stage of the formation of scar tissue in the liver." It's not as advanced or serious as cirrhosis, which is scarring. It IS hard to keep track of things while you're in the doctor's office, isn't it, with all this new information and unfamiliar terms. Take someone with you, if you can, and write things down. I'm glad to hear from you again.

Jo, I'm sorrier than I can say that you have to deal with this problem. Life is such a strange process, such an odd and interesting journey. You are clearly a good warrior. Keep fighting. Please keep us informed.

Purplegrace, you wrote: I have Primary Sclerosing CHOLANGITIS DIAGNOSED in 1994 I continued to work til 1997 but had one infection after another and finaly took my doctor's advice and retired I got SS dissability I'm now awaiting a liver transplant If a doner liver can't be found My son is willing to share his.   I recently had a bad bleed from my esophageal varices (needed 5 units of blood) I also had some amonia in my blood (227) and went a little Crazy. But my husband and my 7 kids took turns staying by me until I was myself again. The worst part of that is realizing that I couldn"t read I decided to join a support group because I was very frightened.    I had to lose weight but have no engery to excerise, any ideas???    I'll close for now, purplegrace@...

Purplegrace, there are a few other people in the group with PSC, including some women (I believe it's more commonly found in men.) When you had encephalopathy with raised ammonia levels, did you treat it with diet and lactulose? I'm sorry that reading remains a problem for you; I wonder if the treatment would help reading. (I, too, had difficulty reading at one point.) I'm glad you've found the group.

Eadam, you write:

My mom found out today that she has ALD and is pretty upset about it. I'm really not sure what to say to her. She read the information on the web about it and found out it was fatal and is pretty upset about it. My mom is 49 years old. She shouldnt be having these problems just yet. I welcome any kind of information you guys can give me.

Eadam, ALD (Alcoholic Liver Disease) can be fatal, as your mother says, but it doesn't have to be. It depends on what complications have taken place and whether one continues drinking. According to Palmer's "Guide to Hepatitis and Liver Disease", "If alcohol use is discontinued prior to the developmjent of cirrhosis, any inflammation or injury that has occurred to the liver is potentially reversible. . . .(however) Those who do not abstain from drinking have a very poor prognosis."

Jan, regarding your sister's not being taken seriously when she complains of mental confusion: I was greatly relieved to learn, through this group, that mental confusion was not uncommon with liver disease. In my addled state, I'd come to fear that my mental disorderliness was a sign of laziness or irresponsibility or self-centeredness or some other dreadful character trait coming to the forefront -- that I just wasn't trying. Your sister may need some similar reassurance.

Nutty.., you wrote:

Neighbors must think that several old fat women live here...one with very short gray hair sprouts sticking up on her head, one red head (wig #1), one blonde (wig #2)...and two more on the way [my Mother has ordered) It is fun to keep the neighbors guessing..lol.

This reminds me of a time, long ago during graduate school. My husband and I lived in an apartment building owned by a very religious, elderly landlady who believed all the tenants were bed-hoppers. One of the tenants, a young married woman with straight, dark hair, went home to visit her parents. Her mother treated her to a "day of beauty", and she returned to the apartment building as a platinum blonde with a mop of curls. The landlady saw her going into the apartment and attacked her, screaming "Slut, slut, slut!" and shoving her out the door. She thought the newly-blonde tenant was a stranger, using the apartment and the husband for a lunch-time quickie! (This landlady also routinely went through my dresser drawers looking for pornography, communist writings, and liquor; she refolded my panties, socks, and bras in the way she thought best, and she rearranged the refrigerator shelves to be "orderly." Well, the rent was low, apartments were scarce, and I was poor.)

Harper

[Guest guest]

Harper, that's awful what your neighbor did!!! Talk about a crazy

woman.

Ruth

> Neighbors must think that several old fat women live here...one

with very

> short gray hair sprouts sticking up on her head, one red head (wig

#1), one

> blonde (wig #2)...and two more on the way [my Mother has ordered)

It is fun

> to keep the neighbors guessing..lol.

>

> This reminds me of a time, long ago during graduate school. My

husband and I

> lived in an apartment building owned by a very religious, elderly

landlady

> who believed all the tenants were bed-hoppers. One of the tenants,

a young

> married woman with straight, dark hair, went home to visit her

parents. Her

> mother treated her to a " day of beauty " , and she returned to the

apartment

> building as a platinum blonde with a mop of curls. The landlady

saw her

> going into the apartment and attacked her, screaming " Slut, slut,

slut! " and

> shoving her out the door. She thought the newly-blonde tenant was

a

> stranger, using the apartment and the husband for a lunch-time

quickie!

> (This landlady also routinely went through my dresser drawers

looking for

> pornography, communist writings, and liquor; she refolded my

panties, socks,

> and bras in the way she thought best, and she rearranged the

refrigerator

> shelves to be " orderly. " Well, the rent was low, apartments were

scarce, and

> I was poor.)

>

> Harper

[Guest guest]

Harper, how totally hysterical! Well, at least she took the time to fold! Heck, she can come to my house and do my drawers any day!

debby

Re: [ ] Digest Number 2256

In a message dated 5/2/02 9:33:24 AM Pacific Daylight Time, writes:

My biopsy says I have fibrosis. Can you or anyone shed any light on this? Lyn in Arkansas, fibrosis just means "the initial stage of the formation of scar tissue in the liver." It's not as advanced or serious as cirrhosis, which is scarring. It IS hard to keep track of things while you're in the doctor's office, isn't it, with all this new information and unfamiliar terms. Take someone with you, if you can, and write things down. I'm glad to hear from you again. Jo, I'm sorrier than I can say that you have to deal with this problem. Life is such a strange process, such an odd and interesting journey. You are clearly a good warrior. Keep fighting. Please keep us informed. Purplegrace, you wrote: I have Primary Sclerosing CHOLANGITIS DIAGNOSED in 1994 I continued to work til 1997 but had one infection after another and finaly took my doctor's advice and retired I got SS dissability I'm now awaiting a liver transplant If a doner liver can't be found My son is willing to share his. I recently had a bad bleed from my esophageal varices (needed 5 units of blood) I also had some amonia in my blood (227) and went a little Crazy. But my husband and my 7 kids took turns staying by me until I was myself again. The worst part of that is realizing that I couldn"t read I decided to join a support group because I was very frightened. I had to lose weight but have no engery to excerise, any ideas??? I'll close for now, purplegrace@... Purplegrace, there are a few other people in the group with PSC, including some women (I believe it's more commonly found in men.) When you had encephalopathy with raised ammonia levels, did you treat it with diet and lactulose? I'm sorry that reading remains a problem for you; I wonder if the treatment would help reading. (I, too, had difficulty reading at one point.) I'm glad you've found the group. Eadam, you write: My mom found out today that she has ALD and is pretty upset about it. I'm really not sure what to say to her. She read the information on the web about it and found out it was fatal and is pretty upset about it. My mom is 49 years old. She shouldnt be having these problems just yet. I welcome any kind of information you guys can give me. Eadam, ALD (Alcoholic Liver Disease) can be fatal, as your mother says, but it doesn't have to be. It depends on what complications have taken place and whether one continues drinking. According to Palmer's "Guide to Hepatitis and Liver Disease", "If alcohol use is discontinued prior to the developmjent of cirrhosis, any inflammation or injury that has occurred to the liver is potentially reversible. . . .(however) Those who do not abstain from drinking have a very poor prognosis." Jan, regarding your sister's not being taken seriously when she complains of mental confusion: I was greatly relieved to learn, through this group, that mental confusion was not uncommon with liver disease. In my addled state, I'd come to fear that my mental disorderliness was a sign of laziness or irresponsibility or self-centeredness or some other dreadful character trait coming to the forefront -- that I just wasn't trying. Your sister may need some similar reassurance. Nutty.., you wrote: Neighbors must think that several old fat women live here...one with very short gray hair sprouts sticking up on her head, one red head (wig #1), one blonde (wig #2)...and two more on the way [my Mother has ordered) It is fun to keep the neighbors guessing..lol. This reminds me of a time, long ago during graduate school. My husband and I lived in an apartment building owned by a very religious, elderly landlady who believed all the tenants were bed-hoppers. One of the tenants, a young married woman with straight, dark hair, went home to visit her parents. Her mother treated her to a "day of beauty", and she returned to the apartment building as a platinum blonde with a mop of curls. The landlady saw her going into the apartment and attacked her, screaming "Slut, slut, slut!" and shoving her out the door. She thought the newly-blonde tenant was a stranger, using the apartment and the husband for a lunch-time quickie! (This landlady also routinely went through my dresser drawers looking for pornography, communist writings, and liquor; she refolded my panties, socks, and bras in the way she thought best, and she rearranged the refrigerator shelves to be "orderly." Well, the rent was low, apartments were scarce, and I was poor.) Harper

[Guest guest]

From: " " < > Sent: Saturday, 25 July, 2009 0:54:49Subject: Digest Number 2256

Bariatric Nutrition Dietitians

Messages In This Digest (12 Messages)

1.1.

Re: B-complex From: Fehrenbacher

1.2.

Re: B-complex From: Fehrenbacher

2a.

Re: post op RNY after Whipple procedure - any suggestions? From: Corey Filbert

2b.

Re: post op RNY after Whipple procedure - any suggestions? From: Corey Filbert

3a.

Re: Indirect Calorimetry From: Mackie

3b.

Re: Indirect Calorimetry From: julie.parrott

3c.

Re: Indirect Calorimetry From: Walenta,

3d.

Re: Indirect Calorimetry From: Sue Manchester

4.

Fw: [aspenet] Pt s/p gastric bypass sugery on TPN in ICU with ARF an From: melissa miceli

5a.

Re: Vita-4-Life From: , MS, RD

5b.

Re: Vita-4-Life From: Bizzarro, Missy

6.

Support group near Culpepper or Warrenton, VA From: , MS, RD

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Messages

1.1.

Re: B-complex

Posted by: " Fehrenbacher" jafehre@... jafehre

Thu Jul 23, 2009 6:32 pm (PDT)

Thanks!From: Sue Manchester <suem4@...>Subject: RE: [bariatricNutrition Dietitians] post op RNY after Whipple procedure - any suggestions?BariatricNutritionD ietitiansDate: Wednesday, July 22, 2009, 10:23 PM

Is she taking pancreatic enzymes? From: BariatricNutritionD ietitians [mailto:BariatricNu tritionDietitian sgroups (DOT) com] On Behalf Of filbertnut22Sent: Wednesday, July 22, 2009 12:21 PMBariatricNutritionD ietitiansSubject: [bariatricNutrition Dietitians] post op RNY after Whipple procedure - any suggestions? Below is an email from a local outpatient dietitian. I told her I would post this on the listserv for any more suggestions. The head of the pancreas was removed in the Whipple procedure - she did not know of removal of any other parts of digestive tract (portion of intestine etc). Pt states she tried digestive enzymes in the past, but they did not seem to work and is not taking them currently. Any suggestions would be appreciated. Thank you in advance,Corey Filbert RDSt. 's Weight Management CenterI saw a woman

today that is S/P Roux-en-Y times 9 years and had a Whipple done in January 09 d/t bile duct cancer. Since January she has lost 25# and continues to lose and doesn't want to. She has chronic diarrhea and really that is her biggest complaint. She doesn't think the food is staying in her long enough to do any good, plus not keep weight on. She mostly eats lean meat, eggs, cheese and dry shredded wheat squares. She used to eat more F & V, but now can only tolerate berries and cantaloupe. She is afraid to eat starches because of the bypass. And she thinks she has become lactose-intolerant (but apparently cheese is not a problem).When I looked up the Whipple rec'd on the web it said to limit fats, so limiting fats and starches and eating low volume - - gaining weight is a problem. Any ideas? What about having some more starches other than the wheat squares with the bypass? What is she supposed to limit herself to?AmyNo virus found in

this incoming message.Checked by AVG - www.avg.comVersion: 8.5.392 / Virus Database: 270.13.22/2253 - Release Date: 07/22/09 05:59:00

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3a.

Re: Indirect Calorimetry

Posted by: " Mackie" hmackie@... heather.mackie

Fri Jul 24, 2009 8:14 am (PDT)

We use the Korr Cardio Coach C02. we test at pre-op (baseline), andthen every 50 lbs down is our protocol or about 6 months post-op. weset that up when we started and it seems to be working pretty good. Butof course we may adapt as we continue to use indirect calorimetry K. Mackie, MS, RD, LDNSoutheast Bariatrics Nutritionist2300 Randolph Rd.Charlotte, NC 28207 704-347-4144 (P) 704-347-4148 (F)hmackie@southeastba riatrics. com www.southeastbariat rics.com ____________ _________ _________ __From: BariatricNutritionD ietitians[mailto:BariatricNutritionD ietitians] On Behalf OfmannfrdSent: Thursday, July 23, 2009 4:19 PMBariatricNutritionD ietitiansSubject: [bariatricNutrition Dietitians] Indirect CalorimetryFor those of you who are using it, can you tell me when you use it andthe intervals at which retest? Do you find it helpful? Which product doyou use? Feel free to email me directly. Thanks for any help you canoffer.

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3b.

Re: Indirect Calorimetry

Posted by: "julie.parrott" julie.parrott@... julie.parrott

Fri Jul 24, 2009 9:22 am (PDT)

Has anyone used both Korr & the MedGem? Which do you prefer for bariatric pts?Thanks in advance! Parrott, MS,RD,LDFrom: Bizzarro, Missy <Missy.Bizzarro@ khnetwork. org>Subject:

[bariatricNutrition Dietitians] Vita-4-LifeBariatricNutritionD ietitiansCc: "Banford, " <Beth.Banford@ khnetwork. org>, ",Marta" <Marta.@ khnetwork. org>Date: Thursday, July 23, 2009, 1:50 PMHello all, Anyone out there using Vita-4- Life? We have a surgeon thatjust started telling her RNY patients to take 12 of these capsules perday (on the directions 12 is dose for DS patients and distal RNYpatients). We do not do distal RNY's. The

instructions for proximaland medial RNY's are 4 capsules daily and 8 capsules daily respectively(which I am more comfortable with). My main concerns are 1) the very high level of Vitamin A60,000 IU (35,000 iu from palmitate and 25,000 iu for beta-carotene)Isn't this level high enough to cause liver toxicity with long term useand birth defects if a post op patient gets pregnant while on these). I think I am okay with the other levels in the product with 12capsules, however, a few other vitamins/minerals are bove the tolerableupper limit which worries me some. Can anyone comment on this and help PLEASE :-) Our surgeoninsists that vitamin/mineral deficiencies do not exist!! labworkdoesn't always detect toxicities, correct? I know it is mainlydeficiencies we are worried about with RNY, but, why subject a patientto 12 capsules a day when the directions state to take

less. I am notsure even showing her the SOARD paper or other articles on deficiencieswould help as she is so set on her views and this product. Thanks in advance for all your help!! Missy Bizzarro RD , LD Kettering/Sycamore Weight Loss Surgery Kettering, OH 45430 **KHN Confidentiality Notice**This message and the accompanying document or attachments maycontain information which is privileged and/or confidential. If you arenot the intended recipient, you may not review, discuss, disclose, copy,or distribute the contents of this message. If you have received this information in error, pleaseimmediately contact the Kettering Health Network representative whosenumber is listed on the message and destroy all evidence of thiscorrespondence.

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6.

Support group near Culpepper or Warrenton, VA

Posted by: " , MS, RD" alagsa_rd@... alagsa_rd

Fri Jul 24, 2009 12:57 pm (PDT)

If anyone knows of a group that meets near these cities, please let me know! Thank you,

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