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Post-op Gastric Bypass Gastric bypass post-op concerns, milestones achieved, establishing new eating/exercise habits, dealing with emotions without food to turn to, etc.

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Old 03-18-2009, 01:25 AM   #1 (permalink)
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Default Bones may weaken after weight loss surgery

I'm posting this here, as well as in the Nutrition Forum, since it also relates to postop issues and I hope it's seen by anyone who chooses Roux-En-Y surgery.

From a recent physical, which led to a bone density scan because I'm 40, I learned I need medication because of a loss of bone density. I worried about this, and my fears have been realized. Ugh.

Anyway, since then I've done some research to find studies. Here is a recent study, with its findings, below (the website is linked at the bottom).

Hopefully everyone who has WLS will get annual bone density scans after surgery. They're NOT just for us older folks. But if you're older you're looking at other contributing issues.

The condition of our bones after WLS, and their density, looks like something EVERYONE should monitor, based on studies including just this one:

NEW YORK (Reuters Health) - Patients lose bone density after weight loss surgery, and the more weight they lose, the greater the drop, new research shows.


While the effect of bone density loss on future fracture risk is not yet clear, "for the present, a high degree of vigilance for nutritional deficiencies and bone loss in patients both before and after bariatric surgery is critical," the researchers write.


Dr. Shonni J. Silverberg and colleagues from Columbia University College of Physicians and Surgeons in New York City explain that after people have obesity surgery, they have a smaller gut area available to absorb nutrients from the food they eat. Evidence is mounting that weight-loss surgery may impair bone and mineral metabolism, the team notes in the Journal of Clinical Endocrinology and Metabolism.


To investigate, they followed 23 men and women who had undergone Roux-en-Y gastric bypass surgery, one of the most popular types of weight-loss surgery. This operation involves bypassing the duodenum, the portion of the small intestine that joins to the stomach, which is the chief site of calcium absorption by the body.


Before the surgery, the patients had less-than-optimal blood levels of vitamin D, even though their intake of the nutrient was relatively high.
After the surgery, they doubled their calcium intake and were consuming 2.6 times more vitamin D, but their blood levels of vitamin D remained low, and their blood levels of calcium actually fell.


Signs of poor calcium absorption appeared within three months of the surgery. Concentrations of parathyroid hormone, which fosters release of calcium from the bones, had been in the high normal range before the operation, and increased after the surgery.


Within a year of the surgery, patients had lost an average of 45 kilograms in weight. At that point, the density of their upper thigh bones had dropped by 9.2% and their hip bone density fell 8%, but most patients didn't show loss of bone density in the lower back or the forearm.


The degree of bone loss was closely linked to how much weight patients lost, Silverberg and colleagues found. This may have occurred, the researchers suggest, because bones no longer had to bear as much weight, and weight-bearing is a key component of maintaining and building bone strength. Increased secretion of parathyroid hormone could also have been a factor, they add.


"The small sample size of this study argues for larger, long-term studies to answer the critical question of how these losses relate to bone quality and fracture risk," the researchers state.


SOURCE: Journal of Clinical Endocrinology and Metabolism, published online July 22, 2008.

Here is the website link if you're curious.
And, again, the study argues for "larger, long-term studies." Big surprise...not enough research about WLS and its after effects!

Bones may weaken after weight loss surgery | Health | Reuters
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Open Roux-en-Y on October, 2002 - 7 year anniversary is right around the corner
Height: 5'8"
Highest weight: 300 lbs. with a BMI of 45.6
Current weight: 140-145 lbs. and a size 6/8 with a BMI of 21.7
Total weight lost after Roux-en-Y gastric bypass: 160 lbs. POUNDS!
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Old 03-18-2009, 02:03 PM   #2 (permalink)
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Thank you for the information! How old should you be before you get the scan? I'm 27.
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Old 03-18-2009, 03:14 PM   #3 (permalink)
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My GP insist I have a bone density scan before I had the surgery to have a benchmark to go by. I was told it was not uncommon for GBS patients to experience some bone loss after the surgery.

We were BOTH surprised to find out everything was fine except my hips (which, for being overweight, should not have shown signs of osteopororisis(sp?).

My doctor thought it may have been brought on by my years of guzzling diet coke.... apparently consuming carbonated beverages can cause you to leach calcium from your bones.

YET another reason NOT to drink carbonated beverages....AND to take your calcium (citrate).
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Old 03-18-2009, 07:09 PM   #4 (permalink)
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because of my arthritis I have to have a bone density every year--they don't take long are are painless--highly recommend them to everyone--it is well worth your time
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Old 03-18-2009, 07:27 PM   #5 (permalink)
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i got one of those scales that measures everything. It also measures bone wieght. I noticed right after surgery my bone weight went down a bit (5.6 pounds to 5.2 pounds) but taking my calcium brought it back up. I wonder if this would be a way to keep track at home in between. I'm only 25 and no one has said anything to me about a bone desity test. Should i ask?
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Old 03-19-2009, 12:45 PM   #6 (permalink)
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Quote:
Originally Posted by Songbird View Post
Thank you for the information! How old should you be before you get the scan? I'm 27.
Songbird and Jeanettie:

You should get one now, no matter where you are on the timeframe of surgery. Get one before everyone, then get one a year (or 6 months if you like) postop. Then get one EVERY YEAR. This is a very common complication, whether you are newly postop or years out like me.
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Open Roux-en-Y on October, 2002 - 7 year anniversary is right around the corner
Height: 5'8"
Highest weight: 300 lbs. with a BMI of 45.6
Current weight: 140-145 lbs. and a size 6/8 with a BMI of 21.7
Total weight lost after Roux-en-Y gastric bypass: 160 lbs. POUNDS!
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Old 03-29-2009, 04:09 PM   #7 (permalink)
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I'm adding this here because I put it in the other thread I created on this subject, and it's important information for everyone post WLS.

EVERYONE, TAKE CALCIUM CITRATE ONLY!!! ONLY ONLY ONLY!!!


My doc didn't know this, or at least he didn't SAY it to me. So your doctors might not know about the best form of calcium for us either. There's like 3 or 4 out there. Only take the citrate. It's the ONLY legitimate one for us postop. See all the research and helpful info here on the forum.

I found a really good one after researching here mostly. I get it at Costco. It's cheap and EXCELLENT. Two tablets have the recommended allowances below:

Calcium Citrate-only 50% RDA so take 4 a day for 2,000 mg. You must take them seperate from all your other supplements
Vitamin D - 200% RDA
Vitamin K - 100%
Vitamin B6 - 500%
Magnesium - 20%
Zinc - 66%
Copper - 50%
Manganese - 50%

NOTE: these extra vitamins and minerals are recommended TO WORK WELL TOGETHER WITH CALCIUM. These are NOT sufficient amounts for your daily intake of vitamins, so YOU MUST take OTHER supplements in addition to this calcium citrate (never Flinstones for god's sake).

EVERYONE POST WLS MUST ALSO TAKE THESE SUPPLEMENTS DAILY. EVERY FREAKIN DAY FOR THE REST OF YOUR LIFE:

A QUALITY multivitamin
Vitamin B Complex
Iron 180-200 mg of ELEMENTAL IRON (or 100mg 3 times a day of iron sulfate)
Vitamin B12 sublingual tablets

I get all mine at Costco and these vitamins alone are worth the annual membership fee of $50.00. Not to mention the gas savings.

PLEASE NOTE THAT HERE ON THE FORUM THERE ARE A COUPLE OF OTHER EXCELLENT THREADS ON HERE WITH THE NECESSARY VITAMINS LISTED, AND THE REGIMEN FOR TAKING THEM.
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Open Roux-en-Y on October, 2002 - 7 year anniversary is right around the corner
Height: 5'8"
Highest weight: 300 lbs. with a BMI of 45.6
Current weight: 140-145 lbs. and a size 6/8 with a BMI of 21.7
Total weight lost after Roux-en-Y gastric bypass: 160 lbs. POUNDS!
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Old 03-29-2009, 04:10 PM   #8 (permalink)
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Quote:
Originally Posted by Jeanettie View Post
i got one of those scales that measures everything. It also measures bone wieght. I noticed right after surgery my bone weight went down a bit (5.6 pounds to 5.2 pounds) but taking my calcium brought it back up. I wonder if this would be a way to keep track at home in between. I'm only 25 and no one has said anything to me about a bone desity test. Should i ask?
YES JEANETTIE.
It doesn't matter that you're only 25.
Get a DEXAscan now.
And every year after that.
It will be covered by insurance. If not right away then fight for it.
Your PCP can order it. If they won't then see your surgeon to have them order it.
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Open Roux-en-Y on October, 2002 - 7 year anniversary is right around the corner
Height: 5'8"
Highest weight: 300 lbs. with a BMI of 45.6
Current weight: 140-145 lbs. and a size 6/8 with a BMI of 21.7
Total weight lost after Roux-en-Y gastric bypass: 160 lbs. POUNDS!
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Old 03-29-2009, 04:12 PM   #9 (permalink)
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Quote:
Originally Posted by nittinnana View Post
because of my arthritis I have to have a bone density every year--they don't take long are are painless--highly recommend them to everyone--it is well worth your time
Hey my dear Glad you're having them already.
Please PM me when you see your density drop. If it does.
Please please please take 2,000 mg of Calcium Citrate.
I'd hate for anyone else to suffer early bone loss like me.
It's scary shit because I'm at high risk for easy fractures. Just like a 60 year old.
Nice huh?
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Open Roux-en-Y on October, 2002 - 7 year anniversary is right around the corner
Height: 5'8"
Highest weight: 300 lbs. with a BMI of 45.6
Current weight: 140-145 lbs. and a size 6/8 with a BMI of 21.7
Total weight lost after Roux-en-Y gastric bypass: 160 lbs. POUNDS!
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