I recently addressed the topic of post-op gastric bypass diet on my Squidoo lens, but wanted to go into more detail here on the gastric bypass support aspect of post-op life.

Gastric Bypass Support

If you frequent online support forums, you will notice a majority of the active participants are pre-op through new post-ops. It seems that one year post-op is usually a common time-frame when post-ops’ visits to support forums start to dwindle down to eventually very infrequent to not at all.

Having gone through this phenomenon myself, I know that for me, it was due to getting my ‘life’ back and feeling good enough to get out of the house and go and do things! On one hand, this is a very good thing; but on the other hand, the lack of accountability from those who know and understand this post-op life and body can lead to our downfall into old habits.

I’ve seen it happen over and over again: a post-op, 18 -24 months (or more) out from surgery comes back onto an online support forum devastated because they have gained back 10, 20 or even 50 or more pounds! How could this be? Well, it didn’t happen overnight: it happened one pound at a time just like how we became obese before we had our surgeries. It’s the little, small choices we make that add up and before you know it, they catch up with you and you find yourself dealing with a weight gain issue, or malnourishment issue with labs all out of whack,  you feeling like you’ve been hit by a truck, losing hair again, or worse, such as neurological damage or osteoporosis, all because you haven’t been taking your supplements.

How Support Groups Help

They help in two primary ways:

1. Accountability. If you have others who are going to hold you accountable in your post-op journey, you are more likely to stick with the gastric bypass diet, nutrition supplementation and exercise to keep you healthy.
2. Education. Even though you know a lot about being a post-op, bariatric surgery is still an evolving medical field. What surgeon’s recommended for post-op care and nutritional supplementation 5 years ago, is not the same as today. These changes effect you, even if your surgeon did not tell you these same things at that time. Surgeons are learning too!

Offline or Online Support

I personally feel that both is best. There will be times you can’t make an offline/in-person support group due to weather, other committments or whatever. So having an online support group that’s always there is ideal.

But, offline support, where you are looking folks in the eyeball, can not be matched with online support. If folks are going to actually see you, it’s hard to hide the truth in how you’re really doing and how well you’re staying on track.

That said, I love online support groups too. There are many fine forums where you can connect with long-term post-ops who have given their time to helping those new to this life. They are paying it forward and helping, just as someone else helped them. You may very well find a wider variety of help online than offline, depending on where you live and what offline support is available to you.

Whether you can obtain the ideal gastric bypass support situation with both offline and online support; it is essential that you do seek out and participate in a gastric bypass support group.  It will help your long-term success, and health, as a gastric bypass post-op.

Online Support Resources

A few of my favorites.

Renewed Reflections

ObesityHelp.com Graduates Forum

Living After WLS Neighborhood

Thinner Times forum

Gastric Bypass Info Central (yahoo group)

Graduate OSSG (Obesity Surgery Support Group – yahoo group)

Christian WLS Friends (yahoo group)

Gastric Bypass Nutrition Resources
Veriuni Advanced Liquid Nutrition – 98% absorbability liquid multi-vitamins

Supreme Whey Protein – uses hydrolyzed whey peptides for highest bioavailability

Floradix Iron & Herbs – natural liquid iron

Call to Action: get connected with a gastric bypass support group today.

Are you currently part of a gastric bypass support group? Is it online or offline – or do you belong to both?  I’d love to hear your weight loss story and why you are, or are not, part of a support group. Post your comments below.

With a little planning, you can still enjoy a nice holiday meal that is post-op friendly. There are many WLS specific cookbooks on the market and a web search will turn up as many free recipes floating around web forums and email lists. Here’s one recipe for you Kabuki’s Sugarless Pumpkin Pie

Try these simple tips to help you through the holidays:

• Remember the first rule of WLS eating: protein first
• Stick with sugar-free/low-sugar, lower-carb, low-fat choices: make them and bring them to ensure that you have those choices!!
• Avoid drinking your calories.
• Drink your water!
• Don’t forget to exercise, even though you’re busy – you need to do it!
• Don’t forget to take your supplements
• Drink a protein shake before you leave home to keep you satiated so you won’t feel the need to overeat.
• Keep a protein bar with you at all times, in case there isn’t any post-op friendly food available and you were not able to bring a post-op friendly dish yourself.
• In case you are tempted by a sweet treats or something you shouldn’t: remember, your tool is there, and you may not have dumped in a long time, but you may very well this time and believe me, it’s not worth it. Put that sweet monster down and run the other way!
• Remember that the holidays isn’t really about focusing on food; it’s about time spent with our family and the people we love. Shift your focus on them and you’ll feel better in the morning when you haven’t overloaded on carbs and when you won’t see the scale creeping up.

If you would like to discuss your struggles through the holidays, to help you stick to your goals, there are many fine message forums at ObesityHelp.com, there’s also the LivingAfterWLS forum, WLS Butterfly Network forum, and several email lists at Yahoo Groups: Christian WLS Friends, GastricBypass-InfoCentral, and Graduate OSSG to name a few. Plug-in and get connected to some support to help you through not only the holidays, but for long-term post-op success.

With my recent health issues stemming from nutrient deficiencies (calcium, vitamin D and iron) ,  I’ve had several people ask me if I regret having had the weight loss surgery. My answer is a resounding: NO!  I do not regret having had weight loss surgery!!

First, I think we need to put into perspective that while I have had some health issues, and while they have had some  debilitating side effects for me, frustrating because it’s taken a while to discover that they were in fact related to nutrient deficiencies and not something else; there are people who have had much more severe complications from not only weight loss surgery but from living with obesity.  I do not regret having had this surgery.  All I need to do is to adjust my supplements – tweak the amounts I’m taking, and perhaps continue with iron infusions periodically, if I can’t maintain with supplements.  But honestly, that’s a very small price to pay to maintain my health.  YES, it’s worth it – it’s just vitamins and nutrients people:  very important yes, but not a deal breaker for me.

Note to the Pre-Op folks:  If there is one key thing I want to stress to any pre-op folks who may be reading this blog entry:  is that you need to know you will have to take vitamins and nutritional supplements for the rest of your life after you have weight loss surgery.   If you don’t – you can die. Yes, that’s a very serious statement to make; but it’s true.  If you can not afford to buy vitamins and protein powders after your surgery, then you need to seriously re-think whether or not you can afford to have this surgery; because without vitamins and protein supplements after – you will not be healthy and you can do very serious damage to yourself that could be life-threatening.   The total cost each month varies, depending on where you buy your supplements and exactly what all you take, based on the core minimum that all post-ops really should be taking and your specific lab results.    I personally spend about $200 per month on supplements, including protein powders, prescriptions and everything I need to keep me healthy (not including food).

Which vitamins and how many of each you need to take will depend on your lab work; and of course, that means you’ll need to have your labs drawn regularly.  Every 6 months is ideal for labs, then you can catch something if your levels start to drop, before they get too far down.  Once a year just isn’t often enough and some recommend every 3 months.   So maintaining your health as a WLS post-op is work; but it’s worth it to stay healthy.   If you’re taking your supplements, then it really isn’t that big of a deal if you keep it up.  It’s just part of what you do.  If you stop doing it – then believe me, it will become a huge deal very quickly.

I am normally very much an encourager,  but I believe the in telling the honest truth too.  I believe this surgery works;  but I hear of a lot of post-ops gaining and struggling years down the road with this surgery.   In almost* every instance, it was a preventable problem.   I want everyone to go into this surgery eyes wide open.  It’s a great thing – it will work, but you will have to work too.  You will have to know why you became obese.  You will have to overcome your food addictions.  You will have to exercise.  You will have to take your supplements.  If you can’t do that: then don’t have this surgery.  Otherwise, you may find yourself, a few years down the road,  obese once again, and suffering from nutrient deficiencies to boot,  and it will not be the fault of the WLS, it will be your fault for not being compliant with the guidelines of the surgery.

Your tool didn’t fail you – you failed the tool.   Only you know your own true circumstances and if you are making excuses for your situation.   Let’s get real here.  We didn’t rearrange our guts to continue to lie about what we’re eating and make excuses as to why we’ve failed at this.  Be honest with yourself.  Deal with it and work at making it right.

[*There are some cases of known surgery failures.  Where the stoma is larger than it should be, or the food is going down and the intestine is actually enlarged and creating a pseudo stomach and holding food, and all sorts of things like this.  If you believe you are truly able to eat more than you believe you should be, then make an appointment with your bariatric surgeon for a endoscope to make sure your pouch and everything else is working and intact as it should be.   ]

These online free resources are a great alternative to MasterCook and Cooking Light software often used to calculate nutritional information for recipes.

But so far, just on taste:  two thumbs up!  

How do you organize your supplements?  Do you keep them in the kitchen?  Living room?  Bedroom?   Maybe you don’t take as many as I do and it’s not an issue for you!  LOL   But with those huge jugs of protein powder, they all have to go somewhere and how convenient that the red and black on the Whey Stack containers blends in nicely with my kitchen decor. 

I’m just over 3 years post-op, and it’s my finding that I’m right at the time when many post-ops begin to notice some problems with their labs, if they haven’t already. Yet, I wonder how many post-ops are still going for their labs and taking their supplements. I frequent quite a few online message forums, where I mostly read and “lurk”, and I’m shocked to see how many are taking very little in the way of supplements and quite a few are still taking are children’s chewables and that’s pretty much it! :O

If you are a WLS post-op and had a surgery type where you malabsorb nutrients, then you need to supplement daily and more than just a couple multi-vitamins. You also need to get your labs checked every 6 months to make sure everything is staying on track and you need to do this for the rest of your life to stay healthy.

I found a sample supplement schedule on a couple WLS email groups that I’m on. It was a good place to start. I discussed it with my physician, did some research on the recommendation and we (my physician and I) both agreed in the logic found in this schedule, and need for these nutrients for me, based on the malabsorption of my surgery and my labs. So I’ve kept the core supplements, adding my own, as needed, and adjusting the dosage amounts for my needs. The end result is my own customized supplement schedule, including times and everything based on my daily life (and yes, I really do get up at 4:30 am!! LOL)

So, if you’re interested in what I’m taking, and care to use it as a starting point for yourself – here it is. This is the supplementing schedule of what I am currently taking. I just ordered the Coromega and will start taking that when it arrives, so that’s a brand new addition to the schedule for me. I will adjust what I take, based on my own personal lab results. So use this as a guide to know what a post-op should consider taking, not as medical advice. Consult with your physician, referencing your own lab work, to know what you need to be taking.

**Note: The quantity of each of the above may vary for you, based on your labs, so I have not listed the quantities I take.

• I give myself B12 injections monthly, thus are not noted in the above schedule.
• I have my labs checked every 6 months to ensure levels remain in safe and normal range.

So, as you can see, post-op supplementing a lot more involved than knocking back a couple children’s chewable vitamins a day! And by the way, you should not be taking children’s chewables, or any multi-vitamin that contains calcium and iron all in the same pill, as calcium and iron do not work well together, as far as absorption goes. And usually, the calcium found in children’s vitamins, and often in cheaper adult multi-vitamins, is the poorer quality calcium carbonate, and we need calcium citrate.

Whey protein shakes should be considered a nutritional supplement, not just something to drink with your supplements!! We don’t break down and digest protein from food the same as before our surgery; just the same as we malabsorb other nutrients – and we need to supplement vitamins, this is why we must also supplement with whey protein shakes. Read my article on this very important topic.

You can be healthy and maintain your weight loss as a post-op, but it requires diligence on your part, not just in your good eating habits and exercise, but in staying on track with the right supplements. Keep yourself educated – and stay healthy!

However, I’ve found that what one person loves, another hates. So I’ll share with you my favs, but your mileage-may-vary. I know the general recommendation for protein powders is to drink them in water. If you can do that – more power to you; I have a real hard time getting them down that way, so I prefer to mix mine in a little soy milk. The soy milk flavor seems to help cover or mask any odd taste that may be in the protein powder and actually makes a quite pleasing drink for me. Hey, if it makes it so I can drink the protein – then that’s what I’m gonna do.

Unjury – I love anything Unjury makes. Their vanilla is awesome.  I get my Unjury straight from the Unjury.com web site.

Champion Pure Whey Stack – I loved pretty much any of their flavors. I don’t care much for strawberry, so I avoid those, but loved all the ones I tried.  I buy my Whey Stack from VitaLady.

These are my favorite two, I’m always trying new samples – so may add more to this list later on. If you have any recommendations, please let me know.

I found a forum with a wonderfully informative lady named KimA. who explained it extremely well, so much so, there’s really not much room for argument. It’s not just her word on it, she gives the basic biology on protein digestion and how our new bodies function. So let there be no doubt, we need predigested protein supplementation as post-ops for the rest of our lives. The thread is available for public viewing here.