Wanna bet?

This is quite long, might get a touch political, technical, and snarky.  But I feel it has a number of things that needs to be said so please be patient with me.

Bariatric Eating has never been one to join the Obesity Help events.  There’s a long bit of history that new members won’t know, but maybe should?  I’m putting it up to provide a bit of back story as to WHY BE traditionally does not attend the OH events:

From February of 2006, quoted from here:

On January 20-21 my company, BariatricEating.com, participated in an ‘American Society for Bariatric Surgery’ conference in Las Vegas as a member of the ASBS corporate council. I say it every chance I get as I’m proud to operate at such a high level of excellence. I don’t compromise my principles and walk the walk while I talk the talk.

I have grown this company with a wonderful team of people, but I was the sole bariatric patient until now. We are now blessed with the addition of two stellar examples of how this surgery is supposed to turn out in a perfect world, Glen Blind & Teresa White. Their stories inspire and both have earned the right to be called superstars in this arena with a combined weight loss of almost 600 pounds. They stood by my side in the MGM Grand Convention Center and shoulder to shoulder with surgeons, anesthesiologists, bariatricians, and nutrionists from Tufts, Duke, and Harvard Universities, ASBS Centers of Excellence from across the country, the top hospitals in the world including Johns Hopkins, and Mayo Clinic. We talked with these professionals about patient compliance or more accurately, patient non-compliance.

The surgeons realize that there are patients who are failing. Did the surgery fail the patient or did the patient fail the surgery? There are those who never got close to goal, those who gained back substantial weight, many stopped being accountable, they learned to cheat the surgery in their own support group meetings, and are now eating in the closet again. Too embarrassed by failure to come out and ask for help from the surgeons who saved them from morbid obesity, we need to reach out to these people. The surgery didn’t fail them; they have just failed to use the surgery as a means to implement lifelong behavioral changes.

We all know post-ops who ate Chicken McNuggets & chocolate covered graham crackers in their first weeks after surgery, post-ops so nutritionally void that they need IV iron infusions to qualify for plastic surgery, and long-term post-ops that have no idea why they are tired and practically bald. I have business dinners with patients who now work in the bariatric field and I’m stunned by their eating habits; drinking sodas with dinner, devouring the bread basket, ordering pasta, and scoffing down desserts. Sure they eat smaller quantities, but no wonder they hover at 200 pounds. Sure it is better than 400 pounds, but is that really what we were shooting for? At least ‘make believe’ you follow a program when you have dinner with the chick from BariatricEating.com!

The ‘Vultures’ are starting to gather with hyped up diet programs, diet pills, food programs to buy, and slick sales pitches; it wouldn’t surprise me in the least if Weight Watchers and Jenny Craig were to introduce ‘Failed Bariatric Diet’ programs. We were all vulnerable before, and now many of us are vulnerable again. Once again we’re searching for the Magic Pill when we have already had the Golden Ring (or Golden Pouch) surgically implanted. If we feel we are surgical failures all we need to do is to ask for help. We don’t need snake oil diet programs; we need to use our heads to work our surgically created pouches as a tool to regain control.

After Las Vegas, I am even more determined than ever to help ‘lost’ post-ops but I dont want to hear that vitamins taste ‘yucky’ or you can’t ‘tolerate’ protein. If you need help, take my hand and let’s get to work. I have just launched my ‘Before & After’ Message Board to compliment my website, highlight my carefully selected protein products & best-selling bariatric book. You don’t need diet pills and a program, you need accountability, and here is the link for help.

Susan Maria’s ‘Before & After’ Message Board.

Ciao,
Susan Maria

y_february2006

Copyright © 2006 by Susan Maria Leach, BariatricEating.com, Before & After Nutrition, HarperCollins Pub.Co. Inc. all rights reserved.

From March of 2006, quoted from here:

The “March Rant” was the one where she proclaimed all of the members
Of OH to be————————-
Pissy whiners who were
Ben & Jerry’s Chubby Hubby pint testers,
Uneducated candy bar nibbling biscuit addicts,
Who were concerned only with Star Jones and having nasty
Attitudes about spelling, but have no idea
Of what it takes to be successful, because
The members of OH were completely
Un-educated about bariatric procedures.
—————————————
She contrasted that with compliment of how
The real people who were positive And successful at WLS
Were all members of “Her Message Board!”

While this is in the past, it paints a picture of someone who does not “canoodle” with us “Dorito-Eaters” (a direct quote, by the way, leveled at MeltingMama) — so why now?

Why to launch a new vitamin, that’s why!  I believe I called it.  Where’s my money?

That’s fine.  Shove down the contempt you feel for our organization, our community of people to sell us things.  Hell, the bodybuilding community does it all the time — they just hide it better.  And many have good products, so we overlook some flaws in personality.

Let’s delve into the science, shall we?

If you’ve read my blog for any length of time, you’ll know I am a firm believer in the ASMBS Allied Health Nutrition Guidelines for the Surgical Weight Loss Patient until your labs dictate otherwise (ie if your PT/PTT are slow, then you need to up your K, if your iron is tanking, etc.)

For those who don’t have them memorized, let’s go over them:

Multivitamin
- Adjustable Gastric Band/VSG: 100% of daily value
- RNY: 200% of daily value
- BPD/DS: 200% of daily value

  • Choose a multivitamin that is a high-potency vitamin containing 100% of daily value for at least 100% of daily value of 2/3 of nutrients
  • Begin with chewable or liquid
  • Progress to whole tablet/capsule as tolerated
  • Avoid time-released supplements
  • Avoid enteric coating
  • Choose a complete formula containing at least 18 mg iron, 400mcg folic acid, as well as selenium, and zinc in each serving
  • Avoid children’s formulas that are incomplete
  • May improve gastrointestinal tolerance when taken close to food intake
  • May separate dosage
  • Do not mix multivitamin containing iron with calcium supplement, take at least 2 hours apart
  • Individual brands should be reviewed for absorption rate and bioavailability
  • Specialized bariatric formulations are available

Additional cobalamin (B12)
- AGB/VSG: Not Applicable
- RNY: 350-500mcg if taken orally, 1000mcg / mo intramuscular injection
- BPD/DS: NA

Additional elemental calcium
- AGB/VSG: 1500mg /day
- RNY: 1500-2000mg
- BPD/DS: 1800-2400mg

  • Choose a brand that contains calcium citrate and vitamin D3
  • Begin with chewable or liquid
  • Progress to whole tablet / capsule as tolerated
  • Split into 500-600 mg doses; be mindful of serving size on supplement label
  • Space doses evenly throughout day
  • Suggest a brand that contains magnesium, especially for BPD/DS
  • Do not combine calcium with iron containing supplements
  • Wait 2 or more hours after taking multivite or iron supplement to take
  • Wait 2 or more hours between doses
  • Promote intake of dairy beverages and/or foods that are significant sources of dietary calcium in addition to recommended supplements
  • Combined dietary and supplemental calcium intake greater than 1700 mg/day might be required to prevent bone loss during rapid weight loss

Additional elemental iron
- AGB / VSG: NA
- RNY: Minimum 18-27mg / day elemental
- BPD/DS: Minimum 18-27mg / day elemental

  • Recommended for menstruating women and those at risk of anemia
  • Begin with chewable or liquid
  • Progress to tablet as tolerated
  • Dosage may need to be adjusted based on biochemical markers
  • No enteric coating
  • Do not mix iron and calcium supplements, take at least 2 hours apart
  • Avoid excessive intake of tea due to tannin interaction
  • Encourage foods rich in heme iron
  • Vitamin C may enhance absorption of non-heme iron sources

Fat-soluble vitamins
- AGB / VSG: NA
- RNY: NA
- BPD/DS: 10,000 IU of vitamin A, 2000 IU of vitamin D, 300 mcg of vitamin K

  • With all procedures, higher maintenance doses may be required for those with a history of deficieincy
  • Water-soluble preparations of fat-soluble vitamins are available
  • Retinol sources of vitamin A should be used to calculate dosage
  • Most supplements contain a high percentage of beta carotene which does not contribute to vitamin A toxicity
  • Intake of 2000 IU vitamin D3 may be achieved with careful selection of multivitamin and calcium supplements
  • No toxic effect known for Vitamin K1, phytonadione (phyloquinone)
  • Vitamin K requirement varies with dietary sources and colonic production
  • Caution with vitamin K supplementation should be used for patients receiving coagulation therapy
  • Vitamin E deficiency is not prevalent in published studies

Optional B complex
- AGB / VSG: 1 per day
- RNY: 1 per day
- BPD/DS: 1 per day

  • B-50 dosage
  • Liquid form is available
  • Avoid time released tablets
  • No known risk of toxicity
  • May provide additional prophylaxis against B-vitamin deficiencies, including thiamin, especially for BPD/DS procedures as water-soluble vitamins are absorbed in the proximal jejunum

Multivitamin
- Adjustable Gastric Band/VSG: 100% of daily value
- RNY: 200% of daily value
- BPD/DS: 200% of daily value

  • Choose a multivitamin that is a high-potency vitamin containing 100% of daily value for at least 100% of daily value of 2/3 of nutrients
  • Begin with chewable or liquid
  • Progress to whole tablet/capsule as tolerated
  • Avoid time-released supplements
  • Avoid enteric coating
  • Choose a complete formula containing at least 18 mg iron, 400mcg folic acid, as well as selenium, and zinc in each serving
  • Avoid children’s formulas that are incomplete
  • May improve gastrointestinal tolerance when taken close to food intake
  • May separate dosage
  • Do not mix multivitamin containing iron with calcium supplement, take at least 2 hours apart
  • Individual brands should be reviewed for absorption rate and bioavailability
  • Specialized bariatric formulations are available

Additional cobalamin (B12)
- AGB/VSG: Not Applicable
- RNY: 350-500mcg if taken orally, 1000mcg / mo intramuscular injection
- BPD/DS: NA

Additional elemental calcium
- AGB/VSG: 1500mg /day
- RNY: 1500-2000mg
- BPD/DS: 1800-2400mg

  • Choose a brand that contains calcium citrate and vitamin D3
  • Begin with chewable or liquid
  • Progress to whole tablet / capsule as tolerated
  • Split into 500-600 mg doses; be mindful of serving size on supplement label
  • Space doses evenly throughout day
  • Suggest a brand that contains magnesium, especially for BPD/DS
  • Do not combine calcium with iron containing supplements
  • Wait 2 or more hours after taking multivite or iron supplement to take
  • Wait 2 or more hours between doses
  • Promote intake of dairy beverages and/or foods that are significant sources of dietary calcium in addition to recommended supplements
  • Combined dietary and supplemental calcium intake greater than 1700 mg/day might be required to prevent bone loss during rapid weight loss

Additional elemental iron
- AGB / VSG: NA
- RNY: Minimum 18-27mg / day elemental
- BPD/DS: Minimum 18-27mg / day elemental

  • Recommended for menstruating women and those at risk of anemia
  • Begin with chewable or liquid
  • Progress to tablet as tolerated
  • Dosage may need to be adjusted based on biochemical markers
  • No enteric coating
  • Do not mix iron and calcium supplements, take at least 2 hours apart
  • Avoid excessive intake of tea due to tannin interaction
  • Encourage foods rich in heme iron
  • Vitamin C may enhance absorption of non-heme iron sources

Fat-soluble vitamins
- AGB / VSG: NA
- RNY: NA
- BPD/DS: 10,000 IU of vitamin A, 2000 IU of vitamin D, 300 mcg of vitamin K

  • With all procedures, higher maintenance doses may be required for those with a history of deficieincy
  • Water-soluble preparations of fat-soluble vitamins are available
  • Retinol sources of vitamin A should be used to calculate dosage
  • Most supplements contain a high percentage of beta carotene which does not contribute to vitamin A toxicity
  • Intake of 2000 IU vitamin D3 may be achieved with careful selection of multivitamin and calcium supplements
  • No toxic effect known for Vitamin K1, phytonadione (phyloquinone)
  • Vitamin K requirement varies with dietary sources and colonic production
  • Caution with vitamin K supplementation should be used for patients receiving coagulation therapy
  • Vitamin E deficiency is not prevalent in published studies

Optional B complex
- AGB / VSG: 1 per day
- RNY: 1 per day
- BPD/DS: 1 per day

  • B-50 dosage
  • Liquid form is available
  • Avoid time released tablets
  • No known risk of toxicity
  • May provide additional prophylaxis against B-vitamin deficiencies, including thiamin, especially for BPD/DS procedures as water-soluble vitamins are absorbed in the proximal jejunum
  • Note >1000mg of supplemental folic acid provided in combination with multivitamins could mask B12 deficiency

Now, let’s look at the Journey Multivitamin:

Now, the first thing of concern to me is simply the makeup of this vitamin.

It is using proprietary formulations by a company called Albion.  The calcium is a strange concoction called DimaCal (dicalcium malate).  When doing literature searches for studies, I couldn’t find a single one, much less one in an achlorhydriac environment (such as RNY, DS, VSG, older adults, or in those who take H2 blockers or PPIs).  Mixed with the DimaCal is “Ferrochel” – a proprietary ferrous bisglyscinate chelate.  Looking for research, I can find few studies about the compound.  They are a mixed bag – some showing positive results in formula-fortification for infants (which have a HIGH degree of stomach acid), and some showing not so favorable results.  However, there are no studies that I can find that show benefit in an achlorhydriac environment.  Additionally, the magical number for ionic iron absorption when paired with calcium is 300mgs.  If one were to take all 4 tablets of this vitamin at one time, the iron receptors would be blocked and thus useless.  The magnesium, zinc, selenium, manganese, chromium, and molybdenum are ALL Albion proprietary chelates – which means there is little real research on the quality of how they react in normal guts, much less our specialty surgically-altered ones.  Who wants to be the first guinea pig?

So beyond the fact that this vitamin is using a single company to supply the majority of the formulation, in strange forms at that?  It’s not enough.  Let’s assume, for the sake of argument (and I’m not saying this is the case, but simply for this exercise) that these chelates are magickal (yes, I meant that ‘k’ in there) and have fairy dust that makes them absorb 100% in our altered guts.

The above dosing is 4 tablets.  The bottle holds 60 tablets.

  • We don’t absorb beta-carotene in achlorhydriac guts, nor without a duodenum.  So 4 tablets is only equivalent to 50% of daily dose, so to get 200% according to ASMBS, we need now 16 tablets.  That means the bottle will last for 3.75 days.  How much are these suckers?
  • There is only 375mg of calcium per 4 tablets.  That means 93.75mg of calcium per tablet.  To get to the ASMBS suggestion of 1500-2000mg for RNY patients, one would need 16-22 tablets.  If you are a DSer, you are supposed to get 1800-2400mg, so that’s 20-26 tablets per day.
  • ASSUMING the iron is okay, and you don’t take more than 2 tablets at a time, every 2 hours (wow, to get those 20-26 tablets, you’re gonna be busy!), to get the 18-27mg ADDITIONAL to the multivitamin, you’d need 16-20 tablets per day.  This is because there are 9mg of iron in 4 tablets, making it 2.25mg per tablet.
  • Magnesium?  Well each tablet contains 12.5mg and to get to 200% RDA?  You need 62 tablets. NO I’m not kidding.
  • Plus?  Where’s copper?  Copper is VITAL to iron function.  Cupric deficiency actually leads to a form of anemia that can look exactly like iron deficient anemia but will not rectify with iron treatment.  Additionally, cupric deficient anemia can have neurological implications.  Copper, zinc, and iron need to be taken in a specific formulation as they are kept in a balance by the body.  If you go completely without one, it’s asking for trouble.  And before anyone asks, yes, I know several people who currently battle cupric deficiencies post RNY.
  • Hello, vitamin K?  I understand why vitamin K is missing in senior formulations when the possibility of coagulation therapy is a possibility.  However, the further out we are from RNY the more our guts tend to act like DSers (and I’m not the only one who thinks that way) and the more we need ADEK vitamins.  There is no toxicity (and from me who says that one can get toxic on B12? Listen up) from K1 or K2.  Period.  There is no reason NOT to include it unless you are worried about interfering with coagulation therapy.  Last time I checked, most of us were bruising uncontrollably rather than needing heparin or coumadin.  And yes, I know manymanymany RNYers (including myself.. hi!) that need massive doses of vitamin K.  It’s not just an isolated thing.
  • B-vites are comparatively low to others within the field.  These are horribly difficult to maintain in many of us after surgery.  I will give a bit of praise for at least including some methylcobalamin for B12.  It’s a small step in the right direction, but unfortunately, not enough.  Why so low in riboflavin and B6?

I’m not even going to TOUCH the taste.  I think Beth handled that aspect much better than I could. Suffice to say?  I would not take another single tablet willingly.

To be fair, I do not know which vitamin I took.  I could not discern a flavor.  For all I know, I was taking their probiotic.  All I know is that at some time during the day I was told to “try this” and it lasted all of 20 seconds before I spit it out and later, we invited some others to try it who had not had the pleasure.  I could not tell you if this was “Mountain Berry” or “Lemon” or what.  Someone that I know and like said she liked the calcium.. so I can only hope and pray that I did not get the calcium.  Another person got violently ill after tasting one of the vitamins and vomited for the first time after surgery.  So as always, I suppose your mileage may vary.

Rather than discuss the science, the attack dogs immediately went after Beth’s review.  The two major malcontents are Beth’s stalker and the person whom I discussed here.  The following is all public record, by the way:

Laura J Beauregard Tvaroha

Why can’t people with the same goal work together? I am still amazed at the immaturity and childeshness in business. Millions of WLS patients exist. If people worked together to help us all live, learn, and eat think of how good our lives could be?

Grow up and get over it .

43 minutes ago

Clarissa ‘Khadijah’ Mouley

she cant until the world admits that she is the be all and end all to wls!

37 minutes ago

Laura J Beauregard Tvaroha

LOL. Oddly I was contacted by a couple of people who REALLY surprised me. I assumed they were fans/friends of her. I received 8 copies of her link. People are disgusted, finally. Felt this was crossing the line. She should have left it alone. They could taste like manna from heaven and she could not be unbiased. No shame i n that. Just admit it and leave it alone. Put on the big girl pants.

31 minutes ago

Clarissa ‘Khadijah’ Mouley

im surprised but not really… ya know?! its good to see that ppl are starting to see her for what she is. you can only be so negative and cynical for so long before even you best friends get tired of hearing it.  think ill call sm tomorrow and beg a sample. ;)

25 minutes ago

Patti Rairden

I think you should do an informative and funny blog. You are a woman of more depth than MM . Call it the princess and the blog

15 minutes ago

Laura J Beauregard Tvaroha

OMG patti that is too awesome. I will become famous and you can be my agent

13 minutes ago

Laura J Beauregard Tvaroha

SM actually responded to me. I, of course, will not publish it but i LOVE her. She is so very classy and has a great outlook. I laughed out loud.

I would LOVE to have one of the above individuals try to speak to me about the QUALITY of the vitamin without using language of a gutter snipe.  Any takers?  No?  Didn’t think so.

I’d also KILL for some non-company-provided research about the efficacy of any of the above proprietary compounds in any environment, but specifically in an achlorhydriac environment as that is what we have.  I can be reached via the CONTACT info above.  I’m waiting.

This vitamin, unfortunately, represents a greater problem in our community.

The sheer fact that a prominent post-op who says she “has a horse in the race” can put a vitamin out on the market, slap a “bariatric” label on it, and people defend it because it is “bariatric”?  Is quite troubling to me.  It speaks to a complete and utter lack of knowledge about nutrition post surgery, what we are putting in our bodies, and how our bodies work after our guts have been rearranged.

Add to it the horrible amount of misinformation presented by the “experts” at the OH event?

This cannot be allowed to stand.

We as patients MUST be willing to stand up and say “HEY!  I know better and I won’t allow you to ruin my health for your own personal gain!” whether that is to your surgeon, nutritionist, or the person selling the vitamins.  And the answer for that is knowledge.

People bristle when they are told how WLS is the “easy way out” — but too many of us ARE taking the easy way out.  We aren’t taking charge of our health post-op.  We aren’t learning how our bodies work.  We aren’t learning how to read our labs.  We aren’t learning how to read the back of a vitamin bottle.  We aren’t learning why this vitamin is important or that one.

And the people we are trusting to do this for us do not have our best interests at heart.  They are trying to make money off our backs and we are letting them.

It’s up to you, but I personally think it’s time to stand up and say “Enough is Enough” and I’m willing to do what I can to help you with the knowledge part.  You’ve got to supply your own balls.. I’m using mine.

How will YOU raise your hand when they call your name?


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28 Responses to “Journey Vitamins… and what they represent to the WLS community”

  1. debra mcdonald says:

    Thank you… as a newbie I am always trying to find out information, and this is best information I have found on what kinds of vitamines I need… also I agree that when someone is trying to market something to bariatric patients that does not meet our needs then some one who knows what they are talking about should say something. The only thing that is realitive is taste… everything else I have read concerning this particular brand is about the facts… printed from their own lable, so why the fuss? I have no problem with someone wanting to make money… we all would like to make money, but be happy when someone examines your product, as a bariatric patient, and someone who proclaims that people need to take resposibility for their choices, I would have thought they would have been proud to find that so many are doing just that.

  2. Sharyn says:

    Awesome, Andrea!!!

  3. Diva Taunia says:

    I fully admit that I am poorly unedumacated when it comes to vitamins, and my head spins in circles when I try to decipher it all. Therefore, thank Gawd for you, that’s all I gotta say. Thank you, thank you, thank you.

  4. Halina says:

    Thanks for all your work..

  5. Melinda A says:

    Ditto to what Taunia said ….

  6. Ruth says:

    Thank you for providing all this good information and all your research. Keep on doing what you do, I appreciate it!

  7. Nicole says:

    Thank you for this information. My program actually encourages BE. I have been on a boycott of their products and site for approximately 6 months. Unfortunatey, my program also encourages the Flintstones chewable vitamin. I stopped that quickly. If I can’t rely on my program for good information, it is MY responsibility to research and take care of of myself. Thanks for this blog!

  8. Liz Grigat says:

    Kudos to you for taking a stand…not only for you…but for all of us that are still learning the ins and outs of the WLS journey. Have I made mistakes, yep! Will I make more, no doubt….but because of people like you who have experienced things and shared….there are fewer of us that will have to travel the road you did. Thanks again for being you and for keeping it real!!!

  9. Patti says:

    As I have been attacked in this post , I believe it is imperative to answer you. I do not speak like a gutter snipe. I prefer to speak my heart and mind. I am of the understanding that Beth is the head of the stalkers not Laura B. Tvaroha. I have studied both nursing and pharmacology and, have a basic understanding of absorption, relating to the human body. I am not hiding,and am easily found. I stated my opinion that Laura should blog. Each individual is entitled to their own opinion. Had the individual directly contacted me I would have stated the reasons for my opinion. I am in agreement that just because a person has had wls does not insure they are educated in nutrition. We are all consumers of goods. We need to educate ourselves. When in doubt of any product we should thoroughly investigate its sources. Not all vitamins and minerals are obtained from healthy sources. Many companies are using minerals from China that are dangerous. I suggest that each person who has questions seek advice from a knowledgeable pharmacist,nutritionist, or medical doctor. Read the label. If in doubt toss it out. One reliable source is http://www.mercola.com. Make sure to check out the sites for the manufacturer. Call the 800 number request proof of their claims. Now I hope that I do not sound like a gutter snipe to you. Best wishes to all on your weight loss journey

  10. Andrea says:

    @Patti -

    I believe I stated that the two people I was referring to.. You were not one of the two. I do apologize for “lumping” you in there, and honestly should have put some different context in on your interaction. However, there are Cease and Desist arrangements against Laura in regards to stalking Beth, so believe as you will about the stalking issue. I have no quarrel with you, nor your thoughts on who should blog on what. However, taking your words out would have left thoughts without context. Yes, I could have handled YOU better, but my opinion of those who openly attacked information rather than discuss the science when asked to do so (and yes, I am still waiting, waiting, waiting…) has not changed.

    I agree that we MUST be strong advocates and ASK these questions. We agree on this wholeheartedly. I still am waiting for an open exchange of actual information, research, proof about the science that many RDs within the field simply cannot make sense of beyond “go to the company’s website” where we find few company-funded studies and zero studies on the chelates nor the DimaCal. Additionally, none of the studies that ARE on the site are in an achlorhydriac or malabsorbing environment, and with little research, there is little to even hypothesize on.

    (And you proved that you were not one of the above by being able to discuss science without resorting to threats, melodrama, etc. This proves you were most certainly not one of the aforementioned people.)

    Good luck on your journey as well. If you get any of the above information, I would appreciate seeing it. As you can see, I am willing to discuss things logically, and I hope, fairly.

    I agree about

  11. Beth says:

    Patti -

    You have it BACKWARDS. I have an order against the woman you speak of. I understand the confusion, no one would know, unless you dealt with what I have.

    I did not know you were educated in nursing in pharmacology, stick around, we could use you.

  12. Beth says:

    Ugh. Maybe you should remove the section about the woman you speak of, she’s at it again, like Beetlejuice.

    “Laura J Beauregard Tvaroha ummm when a woman and her spouse send letters to my home it is NOT a “cease and desist arrangement”, LOL. Believe me, my lawyer has explained both and the rules. I find it hysterical what people will just believe becuase someone says so. If you are TRULY interested contact the North Smithfield Police and Sparks Law …
    See More
    about an hour ago
    Laura J Beauregard Tvaroha yes, robin, I know. Believe me, I am waaaaay over it and could care less. That is why I did not bother to comment on the blog. Not worth my time and effort. I appreciate Patti defending me and she knows me VERY VERY well, so you can trust her judgement over someone who has never met me, spoke to me, etc. It is so very sad. I pity her.
    52 minutes ago”

  13. Andrea says:

    @Beth – or maybe it proves the point. Can’t refute the science, so let’s try bullying on a Facebook page?

    I’m still waiting, waiting, waiting…

  14. Beth says:

    Andrea – It won’t happen. They don’t have it.

    And, I apologize, this has triggered someone’s identities to pop up:

    “Laura J Beauregard Tvaroha to Patti Rairden

    Hello dear, I see you are SO very lucky! MM wants to be your friend? Asks you to stick around as you could be useful? Funny how small people think compliments, half truths, and sucking up can make people be your friend. Lure you to the “dark side”, LOL!”

  15. Beth says:

    Nicole – What program did you go through?

  16. Beth says:

    I cannot imagine ANY RD will allow this vitamin through.

  17. JaimeK says:

    There are so many in our community that really dig and educate themselves on what we, as WLS patients, need. You are one of them. I appreciate the information and the review.

    I will tell you that the BE site was very helpful to me at the beginning of my journey. I then came upon the Doritos conversation and I could not believe how, in my opinion at the time, this great site, with wonderful people could be so awful to someone else in their community. I will never understand tearing someone down or being so crappy that even the most strong stable of the most stable would have been reduced to crouching in a corner. I chose, at that time, to not support such dreck. I withdrew my support by not purchasing anything else from them. Was I lured to the dark side? I suppose you could say so. This journey is so frought with all kinds of different paths and possible difficulties that I would rather deal with it with humor and education (as Beth has) than to encourage crap behavior and viciousness.

    I fail to comprehend how a person’s personal opinion about a vitamin product could turn into all this ick. As you said, look at the numbers. There are people out there who will follow what ever “they” sell because of how they present themselves – I should know, I was, at one time, one of them. It is good to see the numbers and compair them. It is not a good enough product for a bariatric patient to use and that is just based on looking at the freakin’ numbers. I don’t need to taste it. It could taste like Franken Berry cereal, but if I have to take half a bottle to get what I need who cares what it tastes like?

    It is an utter pipe dream to imagine all the crap will stop, but it should.

  18. Andrea says:

    Beth – there are RDs that recommend FLINTSTONES and GUMMY vites. Know why? Because they don’t look at the label. Sure, there will be RDs that will recommend this. And docs, too, because it has a “bariatric” label on it and because it comes from a “reputable” company. Look at oPurity and how “great” it is, simply because it comes from a reputable protein company (who DOES make a quality protein product, but not so much in vitamins).

    And I can think of several RDs that I know personally in the bariatric community that have no fricken clue how our bodies work. Such as, I dunnow, how beta-carotene is absorbed?

  19. Beth says:

    JaimeK.

    Thank you.

  20. MacMadame says:

    “The sheer fact that a prominent post-op who says she “has a horse in the race” can put a vitamin out on the market, slap a “bariatric” label on it, and people defend it because it is “bariatric”? Is quite troubling to me.”

    Me too. Just because something is labeled bariatric doesn’t automatically make it better than something that isn’t. None of my vitamins are “bariatric” but I read the labels and I get the multivitamin with the best combination of ingredients for what I need the most. Most of the bariatric vitamins I checked out didn’t meet my minimum standards, in fact. The rest were more expensive without providing more value.

    Keep in mind that “specially formulated for the bariatric patient” and other slogans are marketing hype. The label of ingredients and how much of X, Y and Z is in it is what matters, not the slogan.

  21. Kathy says:

    I went to an OH event in Pittsburg years back that was affiliated with what seemed to be a very reputable bariatric facility. I signed up for various discussions and was SHOCKED… no appalled… at their vitamin regiment for patients… Flintstones and Tums. That’s it. When questioned about their choices… they “poo poo”ed it. Their RD looked about 12 years old. The folks from Bariatric Advantage looked horrified.

    I felt very blessed to have gone through a program that stressed multivitamins, calcium citrate, b-complex and iron. As information on needs changed, they changed via their surgeons and in discussions in their support group.

    I know a few people who did not have a great program behind them and who ended up with drop foot, beri beri and had a stroke within the first year after surgery. YES. All for the sake of taking a B complex vitamin. This is something that could have been prevented. The one long term post op (from Hawaii, I believe) had strokes, heart attacks, etc due to a B deficiency. This is serious crap!

    Above our program, I made a point of keeping eyes and ears open on what people were taking or not taking. I did my research and yes even read medical journals if need be. If our labs were in normal range but not in the range appropriate for us or for health, I adjusted our vitamins. I did discuss with our physician sometimes before, sometimes after. She never had an issue with changes we made. My doctor does compare lab to lab to look for trending but I look at the much bigger picture.

    Lab ranges are not a good/bad. What value in the range is important. US Labs have the low end for B12 in the 200s. Well, values in the 200-300 range can allow neurological issues to occur. The range used is for cardiac issues not neurological issues. Even the World Health Organization which deals with nutritional deficiencies around the world, changed their low end to 460 (I believe that is the figure). How sad that some doctors look at that 250-350 and say “in range” = good. Doh! I’m grateful that my doctors says “> 2000″ – ah, okay, high is good… we like it high. She has never asked me to decrease B12. Obviously high isn’t good for some other vitamins but B12 yep

    Anyway, I am skeptical of all “end all, be all” products. I study labels. I do not take anyone’s word for it. I trust people like Vitalady and Andrea. If I ask questions, I get answered backed in research rather than “just cuz I said and I’m a long term post-op”.

  22. Patti says:

    Dear Andrea and Beth, Today I spoke to Beth on FB, She seemed upset when she realized I was and am That Patti. It is a sad day for me to realize that I am again being judged by being friendly with someone who Beth does not like at all. Beth Ism page has now blocked me and since you both know it is not legal to take my discussions on FB and reproduce them in any way shape or form. I would appreciate it if you cease and desist immediately. On FB I have a disclaimer, protecting my civil rights and liberties. The Court has decided that no one has the right to take another persons info or words from FB and use without their permission. To be honest I feel violated. To tell me how valuable I can be, then to block me well that just reiterates the doubt you have now placed in my mind. I wish you all the best in all you do. I ask you now to stop using me to attack another person. At best, it can be considered juvenile. At worst criminal. I have screen copied this page. and suggest that you continue on with your lives without using me to a nefarious end. thank you

  23. Andrea says:

    Actually, Patti, it’s in the Google cache. Once on the internet, it’s there. I can remove it from my page, but all someone has to do is search for it and they CAN find it. Here’s a screenshot: http://wlsvitagarten.com/wp-content/uploads/2010/11/patti_cache1.png simply to prove my point.

    Also, the “Court” (and, by the way, there are many “Courts” – please specify?) says that facebook is free speech. It does not say that I cannot use words that are open to all (and Laura’s wall was, in fact, open to the public at the time – which is how Google cached it in the first place. Those damned privacy controls will get you every time.) to prove a point, especially when used correctly in context, as they are here. The most recent decision, handed down by a “Court” was in regards to employees being fired by their employers when said employees complained about said employers on facebook. When said employers saw complaints and fired said employees, said employees complained, stating facebook was a form of free speech, protected under the First Ammendment. You have no such right with this argument.

    ASKING me to remove the comment with your name on it rather than DEMANDING it would have gone a whole lot better. Especially after I explained my position to you in a calm, collected, and rational manner.

    I cannot and will not speak for Beth. I have already explained MY position and have been done with it. Anything you have against Beth, you will need to take up with her, perhaps via email. We are not the same entity, regardless of how any may view us.

    As for using YOU for a nefarious end? I personally had not given you a second thought. Sorry to disappoint.

  24. Patti says:

    I am not asking you to remove anything Andrea, but informing you that my words are protected speech. I am simply stating that I feel violated by Beth asking me to hang around be a friend and then dumped. It is apparent you have misconstrued my words. It is a US Supreme Ct ruling. You would be advised to read the info pages of anyone you want to use their words,photos etc. I am not being argumentative, nor demanding. I do feel violated and rightly so. Again, Not Demanding anything. I wish you only the best. I do not wish to hurt anyone’s feelings nor create disharmony. The written word does not convey the feelings of the individual. While you may feel that I want it removed that is a feeling. I really do not care about removing it. The only thing I said is that I believe Laura Tvaroha would do a better blog than MM, that is my opinion and not necessarily correct in everyone’s eyes. I just believe that Laura may have a more easy less driven manner that may appeal to some . For that opinion I wish that it did not affect Beth. I wish no ill will toward anyone. Please get that straight I am not demanding anything, but to be left out of the pre nursery school antics which I have been dragged unwillingly into.
    To the rest of the wls community I apologize that any of you had to be a part in parcel of this discussion. May you all find the solace, comfort, joy and peace you all deserve .

  25. A patient ADVOCATE says:

    Beth and Andrea – please be aware of something (I’m sure you are – but perhaps you just overlook the use of the language). STUDYING something and being degreed in it is very different. I actually found the wording quite telling. Many people have, what I like to call. “Google degrees.”

    I studied serial killers in high school. Doesn’t make me one – nor does it make me any wiser to how they operate.

    However, I AM degreed in Nursing, Psycho-pharmacology, Nutrition, and minor in Neurobiology ;) I am also degreed in Psychology.

    Seeing as you don’t know me, I’m sure this won’t mean much, but you are both very correct. Also, I like how you discuss things in a very fashionable and easy to understand way. You provide back ups to your theories. Also – stumbling upon this and knowing no one involved (but finding interesting reading), you both handle yourselves quite well. I encourage you to just stop the dialog with other individuals involved. Clearly it goes no where, and because the dialog between them speaks loud and clear. I promise. And, whoa – a restraining order? People take this a little too seriously when they aren’t the popular kid, or when they can’t prove themselves accurate.

    As an attorney would advise, if you do not want your words used against you, then don’t put it on paper, or put them in writing in any way. You lose your privacy when you write it in a public forum. Sorry. If you want to maintain privacy, then you have a username and an email address set up for these purposes. I run several websites, but no one knows “who I am.” I intend to keep it that way.

    Keep educating. You never know how many lives you have touched by the ripple effect, or who you may have saved.

  26. Beth says:

    Thank you, Advocate.

    Patti, I ended our conversations because I want no further contact with Ms. Tvahora. Thank you.

  27. Leza says:

    Interesting. Very interesting. Are there any studies showing that this form of calcium will absorb any better (or as good as) calcium citrate? It’s been proven that the calcium from food sources does NOT absorb and should not be relied upon for calcium, at least for RNY patients. But I am still learning.

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