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What Happens When You’re Gastrically Altered? The Scoop on Vitamins

Ahhhh, let’s wax nostalgic, shall we?

Remember, back in the day, when you could eat like a human being and then take a Flintstones Chewable to supplement  any nutrition deficit caused by a diet high in Twinkies and diet Coke?

Even if you didn’t eat as badly as I did, you’ve probably never realized a time when you had to take more than one multivitamin daily to ensure you were getting all the things in your diet that you needed.  As women, sometimes we add iron and often calcium, but for the most part, you’re probably thinking you’re pretty well covered with a gummy vitamin.

Well, my gastrically twisted brothers and sisters, lets think back to our Lays days.  Remember those Lays commercials?  Betcha can’t eat just one?  Yeah, well, now instead of potato chips, I’m talking about vitamins.  There are so many things that you aren’t absorbing properly, and there’s no way you can get what you need between your diet and one multivitamin a day.  Here are some recommendations on what should be in your pill box on a daily basis.

Multivitamins – Honestly, it doesn’t matter what kind you take.  You want chewables?  They have them in all shapes and flavors.  Are you brave enough for liquid vitamins?  Ewwww, you’re gross!  But you’ll find them at most nutrition shops.  Your average one a day vitamins are perfect for you, with one HUGE exception.  In order to get the value from the vitamins that you need, instead of taking one a day, you’ll probably need three.  As with any medication, check with your doctor, but to make up for the vitamins you aren’t properly absorbing, you’ll need three multivitamins daily.  Yum.

Vitamin B-12 – I’ve met some gastric bypass patients who do weekly B-12 injections.  I do fine with one sub-lingual a day – and it doesn’t taste half bad (which means it DOES taste half bad, but mixed with the half that doesn’t taste bad, I can get it down without incident).  If you just can’t seem to do the under the tongue thing, you may want to ask your doctor about a monthly injection.  Doesn’t that sound like fun?

Calcium – First tip – if you are taking iron, don’t take your Calcium with your iron.  When Calcium and Iron get together, they have a bit of a smack-down over which one is actually going to be absorbed.  Give your Calcium a fighting chance and space out the Calcium and Iron doses.  Second tip – I know it tastes WAY better when you take your Calcium in those little chewy bits of chocolatey goodness, but guess what?  That’s not the best kind of Calcium for you.  Our bodies absorb Calcium Citrate much better than Calcium Carbonate.  Yeah, see if you can find that in a chocolatey delicious flavor.  It doesn’t matter – you’re going to need at least 1000 mg daily.  And if you can find Calcium Citrate that contains Vitamin D, you’re golden!  Vitamin D helps you to absorb the Calcium.  Good for you!!  You’re looking at taking two to three doses a day.  Are you full yet?

Iron – Do you know there are bypass patients who need blood transfusions?  They become anemic and have all sorts of clotting issues.  Back in August, when I was busy dying, my blood was busy plotting a mutiny.  Iron tablets saved me from a transfusion, but it took three pills daily to do it.  Have your doctor take a look at your labs and see what he recommends for you.  And women, yeah, we tend to need this more than our bulge battling brothers.  Remember what I told you about Calcium before?  Iron and Calcium are like the Hatfields and the McCoys.  You don’t want them in the same tummy together.

Vitamin C – We all love Vitamin C – it’s everybody’s friend.  It is especially Iron’s friend.  You can – and should – take Vitamin C with iron to aid in absorption.  You can usually get away with a regular dose of this one – but you’ll want to accompany your iron dose with a Vitamin C dose, so that means you’ll be taking it more frequently.

Zinc – This is a touchy one, because generally, we all need to take extra zinc.  It promotes healing and can help boost your immune system.  Is your hair falling out?  Of course it is.  That may mean you need more Zinc.  But here’s where things get touchy.  Zinc likes to mess up your absorption.  I know, right?  That sucks.  Because you’re taking practically a vitamin buffet, and you’d hate for it all to be wasted because Zinc stepped in, kicked ass, and took names.  10 mg a day should be enough without causing too much interference, but if your doctor indicates you need more, remember to take this one all by itself.  Cue the Eric Carmen music.  Does anyone even remember Eric Carmen?  Geez, I AM old.

I like to call Biotin the bonus in the box.  It’s the pill I always had in my pill box because, quite frankly, my hair fell out in clumps.  Biotin helps grow strong hair and nails, and many of us find that after gastric bypass surgery, our hair and nails are the first things to show signs of vitamin deficiency.  My nails were so soft for a while, I was afraid to even go get a manicure.  And my hair even today tends to be on the crunchy side.  Biotin can help get you over the hump in those early days when you’re eating virtually nothing – at least where you’re hair and nails are concerned.

And girls, Folic Acid – add it.  I know, your plate is already full.  But it helps avoid anemia and is great for growing new cells.

You may find your doctor suggests more or less when it comes to vitamins, but the most important thing is regular blood work.  And it’s not enough to make sure your levels are “within normal limits”.  Make sure they check constantly what they were last time or the time before that.  You may be considered “normal”, but your body can be depleting what you’ve got stored up in there.  You need to see if you’re trending downward.

So, once you take all these vitamins, you realize you have no room for real food!  I know – pain in the flippin’ arse 🙁  But take them anyway.  They’re going to mean way more to your body than the little bits of food you’re able to get in – especially in the beginning.  So just take them.  You’ll heal better and feel better.


Some of the Ugly – What Happens When You Don’t Follow Orders

Everyone is different with regard to how things will go for them following gastric bypass surgery.  And today’s post op lesson is all about how you should do what you’re told with regard to your body and the nutrition you require.

I struggled with what to eat, and as an option to conquer the fear of new foods and what they might do to me, I decided to eat only chicken noodle soup.  Yep, that was it.  I got up each morning, had coffee, then for lunch and dinner, I ate a bowl of chicken noodle soup.

If you do the math, the calories amount to something like “Did you live in Ethiopia?” or “You know anorexia is dangerous, right?”  I don’t think I ever had a day where I went over about 400 calories – until I started putting crackers in my soup.

So here’s basically what happens when you don’t do what you’re told.

Your hair is going to fall out.  In big clumps.  It will feel like something is running down your back when you stand in the shower, and your plumber will become your new best friend, as he shows off the new Mercedes your clogged drain has allowed him to buy.

I didn't color my hair for fear I'd be bald afterwards.

Your nails will become brittle.  And by brittle, I mean Sally Hansen will call you and tell you to stop using her Hard As Nails because you are bad advertising for her product.  On the other hand, your nail salon owner will become your new best friend, as she shows off the new Mercedes your frequent trips to the salon have allowed her to buy.

Your skin will become dry and lack color.  People will call you Elvira (for those of you too young to remember her, it’s what vampires looked like before they were all sparkly), and they will tell you to get your pasty white arse to the tanning salon.

Why Yes, Those Are Painfully Small Wrists

You will lack energy.  Monday Night Football will become a distant memory, and the Late Night Movie for you will now be the one that starts at 4 PM.

Eventually, in my case, when my hair was so dry and crunchy you could use it to jump start the fire in your fireplace, my friends held an intervention and made me eat a banana.  At some point in this series, I will tell you where that led to, but at the time, just eating a bite of a banana was horrifying to me.  And the sugar in it made my face hot and flush.  And it was an awful feeling.  But I did it.

So, let’s recap.  Protein – remember that ugly little word?  Yeah, instead of making your plumber and nail salon owner your best friend, make it protein.  Vitamins – you need them.  Remember when I mentioned how little of what your body needs is going to come from your food?  Yeah, that means you need to take vitamins.  And I don’t mean a Flintstone chewable.  Quality food.  Eat good proteins first, veggies second, and skip the slider foods.  We’ll talk more about that next week.