Wonder Iron

Did we need a study to prove this?  I mean, really?  (Says the girl fighting back tooth and nail from a ferritin of 7!)

Now, being me, I read the summary first.  And then I read the actual study.  I’ll post the summary first, then the takeaways from the study that I got, and then I’ll post the actual study for those who want to read it.  Cause once I got some key details?  It’s an interesting comparison of information.  Some things that don’t get mentioned..

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Food Police

On April 11, 2010, in Uncategorized, by Andrea

Protein, protein, and more protein.

Okay.  The WLS world is all aflutter.

You’ve got the OMG HOW COULD THEY?’s, the OMG GIMME’s, and the Meh’s.  Well.  And you’ve got me — “OUCH!” but that’s just cause I’m broken.  If I weren’t, I think I’d fall in the Meh category.  Maybe I’d try it, maybe I wouldn’t.

So let’s put this out here — I. Don’t. Do. Vegetables.  AT ALL.  No, really.  My stoma doesn’t like 90% of them.  Fruits either.  It’s picky.  And this is on a good day.  What do I live on?  Protein.  And what you see above?  Is what I’d consider a normal meal.  Although I’d get it with bread.  It’s not special.  It’s not icky (although it looks like a sauce?  It would have to go in my world.  Andrea doesn’t do sauces.)

“But Andrea?  You had a surgery to change the way you live!  Don’t you want to eat well and have a healthy life?”

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I believe in stronger testing and vitamin supplementation than this article, but this is pretty comprehensive none-the-less.

A few takeaways -

  • generally recommended that women avoid pregnancy until 12-18 months, or until weight stabilizes
  • oral contraceptives poorly absorbed after RNY and transdermal patch has decreased efficacy in patients over 198.4lbs (90kg); recommended use of IUC’s or injections with regular use of condoms for full efficacy
  • iron, B12, folate, and calcium deficiencies most notable problems in post-RNY pregnancies; no data to exist demonstrate higher protein requirements during pregnancy unless weight loss or fetal growth is slow
  • folate deficiency great concern due to neural tube defects – however deficiency is rare
  • post-RNY patients should be supplemented with 40-65mg iron, 1200-1500mg calcium citrate, B12
  • post-RNY patients may not tolerate traditional 50-gram or 100-gram glucose tolerance test due to dumping; rather do 2-hour post paradinal test
  • follow hemoglobin, hematocrit, serum iron, ferritin, erythrocyte folate, methylmalonic acid, albumin, prealbumin, serum calcium, phosphate, and 25-hydroxy vitamin D levels; erythrocyte folate is better indicator of true deficiency and MMA is more sensitive in detecting vitamin B12 deficiency
  • RNY may lead to serious GI complications during pregnancy, most notably internal hernia resulting in small bowel obstruction
  • most common complications following gastric banding were band leakage and band migration – both requiring surgical intervention

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WLS in the news

On January 22, 2010, in Uncategorized, by Andrea

A surgeon on a local news channel discusses the four types of surgery:

From WZZM13.com:

Live in Cinci and hypoglycemic?

On January 19, 2010, in Uncategorized, by Andrea

Go be a labrat.

UC HEALTH LINE: Be Aware of Blood Sugar Post Gastric Bypass

CINCINNATI—People with type 2 diabetes who have gastric bypass surgery often leave the hospital without the need for previously prescribed diabetes medications.

Researchers and doctors believe this health benefit is related to changes in the body’s circulating hormones—particularly an increase of insulin secretion. Insulin is the hormone that controls the level of glucose (sugar) in the blood.

Marzieh Salehi, MD, a diabetologist with UC Health University of Cincinnati Physicians whose research is focused on the effect of weight-loss surgery on glucose metabolism, cautions that although there can be huge benefits for diabetic patients who undergo gastric bypass surgery, a group of patients experience severely low levels of blood sugar (hypoglycemia)—especially following a meal and typically several years after surgery. Symptoms of hypoglycemia often aren’t recognized until they become debilitating or life-threatening.

Salehi says that many patients with type 2 diabetes who qualify for gastric bypass surgery rely on anti-diabetic medications like insulin injections to regulate glucose in the body. These same patients often leave the hospital following surgery with normal glucose control without taking any medications.

“It’s possible,” says Salehi, “that gastric bypass increases gut hormone secretion or nervous system activity, which in turn increases insulin secretion and improves glucose metabolism in a majority of patients after surgery.

“However,” she adds, “there is a population of gastric bypass patients who, following surgery, develop high levels of endogenous insulin secretion, resulting in dangerously low glucose levels, or hypoglycemia. These glucose abnormalities due to too much insulin secretion represent an extreme effect of gastric bypass surgery.”

Salehi, who sees weight-loss surgery patients with glucose abnormalities at the UC Health Diabetes Center, says symptoms of hypoglycemia include shakiness, sweating, dizziness, light-headedness, weakness, confusion and difficulty speaking. More severe symptoms include seizure and cognitive abnormalities. Hypoglycemia can be life-threatening without proper monitoring or treatment.

“If hypoglycemia goes unnoticed, the body can become accustomed to low sugar and patients can then lose their awareness to low sugar. It is essential to seek help if any of these symptoms develop after gastric bypass surgery.”

Salehi is currently conducting a National Institutes of Health-sponsored study to determine how glucose metabolism is affected by gastric bypass surgery. For more information, call Leslie Baum, registered nurse and study coordinator, at (513) 558-0201.

To schedule an appointment with the UC Health Diabetes Center, call (513) 475-8200.

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