Q: What is the importance of drinking adequate daily water?

A: The magical number we recommend as a minimum intake for the day is 64 ounces (8 cups) of water, but we prefer you to be well above that. Water helps with a multitude of ills: Dehydration, nausea, hunger, low energy or fatigue, kidney stones. When encountering a physical or emotional difficulty post weight loss surgery, often our answer will be to you is: Drink more water!

Bored with the bland taste of H20? There are ways to spice it up! You can try adding diluted sugar free flavoring to your water, like Crystal Light, or Propel. Do be aware that artificial sweeteners can increase your appetite. You can try squeezing lemon or lime juice into your water, or adding sliced cucumbers.

Cheers!

Q: What are the labs required to have drawn annually post weight loss surgery?

1. Comprehensive Metabolic Panel
2. Lipid Profile
3. CBC with diff
4. Vitamin B12 level
5. Thiamine (Vitamin B1) level
6. Folate
7. Hemoglobin A1c

What are the labs required to have drawn annually for Duodenal Switch patients?

            All of the above labs, PLUS….

1. Vitamin A level
2. Vitamin D level
3. Protime

Q. What vitamins and minerals should we take pre- and post-operatively?

A. 1) Multivitamin: One/day, we don’t recommend a certain brand, but do know that Centrum is a popular one amongst our patients. For about two weeks after surgery, this pill should be chewable or liquid. Taking children’s vitamins is okay, as long as you take two pills (or the recommended adult dose as indicated on the bottle). Using a gummy bear multivitamin is okay, but do be aware of extra added sugar. Take it at a time that can become habit for you.

2) Vitamin B-12: 500-1,000 mcg/day. Take sublingually (a small pill that is placed under the tongue and absorbed directly into the bloodstream) daily or by intra-muscular injections, monthly. Take at a time that can become habit for you.

 3) Calcium: 1,200mg (pre-menopausal) — 1,500mg (post-menopausal) daily, but it is best to take in smaller doses 3x/day. Hence, 400-500mg 3x/day (at each meal). Do not take your calcium supplement until you are drinking at least 64 ounces of water. For the first two weeks after surgery, this pill will need to be chewable. Calcium Chews are okay to use, but be aware of any extra added sugar.

4) Iron: This may be prescribed by your surgeon at a later date, if needed. Usually only needed by menstruating women. Take at a time that can become habit for you, but with one stipulation: Iron must be taken at least 2 hours apart from the calcium supplement. They compete for absorption sites.

Q. What should I do to treat constipation?

A. A normal bowel movement is defined as once every three hours to once every three days. If you are outside this time frame, and are not experiencing severe abdominal pain, here are your options:

1) Drink plenty of water; at least 64 ounces, preferably more.

2) Physical Activity: Get up and move! Exercise! This stimulates peristalsis (movement of the GI tract). So get that heart rate up!

3) Use an OTC (over the counter) laxative, such as Colace or Milk of Magnesia. This should not be used regularly, but in times of “desperate need.”

4) Occasionally add a little bit of simple sugar to your diet. “A little bit” is    defined as the size of a strawberry, twice a week. Simple sugars can include     fruit or applesauce.

Q: What is the recommendation for the use of drinking straws? 

A: The use of drinking straws can be highly debated. Some say: Avoid them. Why? It is easy to inhale too much air when using a straw for consuming water, and can consequentially cause gas. Others say: Use them. Why? Patients have said they can drink a significantly greater amount during the day with the use of a straw.
 
A hot topic on our online forums has been about Camelbak water bottles. The apparatus utilizes a pressurized straw system, eliminating air from being inhaled while drinking.  Many patients rave about the Camelbak, claiming that despite past problems of drinking enough water, when using a Camelbak they now exceed 64 ounces a day.