Tuesday, July 14, 2015

6 Week WLS Follow-up Appt

Yesterday was my follow-up appointment with the Nutritionist.  The week before I had had blood drawn for labs, so she went over those results with me as well.  The way the 6 week appointment is setup is as a group appointment, so that if we have questions perhaps it will help someone else too.

There were seven of us there I think, maybe it was eight.  For everyone who arrived early, which I did, she takes you back pre-class to weigh you and discuss the lab results with you.  Anyone arriving on time, gets that info after the class.

So after arriving and taking a seat, I was called back shortly for my weigh-in.  According to them, I have lost 27 pounds.  They are going from my post-surgery weight when I weighed an extra 5 pounds due to the IV fluids.  I don't count that extra five pounds, so I say I have only lost 23 pounds by my home scale's calculations.

Then we discussed my labs.  This is where the bad news comes in, but let me start with the good news.  My Vit D is well within the normal range now, so I can stop taking Vit D3 daily.  She said just 15 minutes in the sun, without sunscreen, is enough for your body to produce all the Vit D you need in a day.  I have definitely been doing that with all my walking.  She said I will probably have to resume taking it come Fall/Winter when I am no longer spending a good amount of time outdoors.  I am okay with that.

She said my iron is a little low still, but my hemoglobin is up where it is supposed to be.  So this means they will not be prescribing me additional iron to take, but rather just hope that the iron in the vitamin I'll take will be enough.  At this point she gave me a prescription for a once a day Prenatal Vitamin with Iron.  She said I can take this, or I can take an adult multivitamin with iron twice a day.  I'll go for the once a day, thank you.  Meijer has a free prenatal vitamin program, so even though I do not get my other prescriptions filled there, I will be getting my prenatal vitamin there.

Now for the worse news.  My blood protein level is 12.  It is supposed to be at least 50.  So she told me she wants me off all fruits/vegetables/starches.  I am to eat protein and only protein.  She said some people just need more protein than other people.  This could be the reason I am losing so slowly, my body thinks it is starved for protein and is protecting itself by resisting weight loss.  So I can still have dairy, beans, and meat.  I am not good at saying things without thinking them through, so I just listened and nodded at this point.  (Don't get me wrong, I can blurt things out with the best of them, but not when it is important stuff)

So then the class starts.  The first half is about foods we should/should not be eating.  With an emphasis on starting to incorporate a little fruit/vegetables into our diet.  So basically it doesn't apply to me at all.  The second half is about vitamins.  I should be getting at least 6-8 cups of water a day by now, but I am usually at 5.   I need to start taking 1500 mg Calcium Citrate daily, but it needs to be in no more than 500 mg doses at a time, two hours apart and at least two hours away from our multivitamin due to the iron. Also, I need to take B12 daily.  It can be sub-lingual, nose spray (prescription only), or a shot (which would be once a month).  Then she goes over the multivitamin again with everyone.  There is a short question and answer period.  Then class is over.

So I was previously taking nine pills a day.  With these adjustments, I will now be taking eleven pills a day minimum.  It could be more depending on the type of Calcium Citrate I use, for example, Meijer's Calcium Citrate Petites (because the regular are HUGE pills) offer 400 mg calcium from two pills.  So to get to 1500 mg a day, I would need to have 7 petites.  That would bring my pill count up to 15 pills a day.  Keep in mind that I have to take each pill at least a half hour apart and certain pills have to be taken at least 2 hours apart from each other.  Then there is the fact that I can't take a pill a whole hour before or after a meal, and I am suppose to eat 4 meals a day.  It is rather daunting.  In fact, I am not sure it is even possible without losing sleep.  I think I am going to try some liquid Calcium Citrate, or maybe some chews, that should enable me to keep the pill count to eleven.

Ugh, whoever said this is the easy way to lose weight... let me be a case in point that it is not easy and in my situation not even fast.

Later in the day, as I was struggling to figure out how to get more protein in, I went to FB for help.  Someone offered me the brilliant suggestion of asking my Nutritionist because that is what she is paid to do.  Doh!  So I emailed her.  I explained that I was averaging 74 grams protein/day and had not even ventured into eating fruits or veggies yet.  I told her I had been eating some starches, but I would cut those out.  But I still didn't see how I could have a big increase in my protein.  She emailed me back that she was surprised I had blood work that low if I was eating that much protein a day.  She told me to increase my goal to 85-90 grams protein/day.  Her best suggestion for increasing was to use a double scoop of protein powder when I made my daily shake, because she really didn't want me to eat more than one shake a day.

My car is in the shop today, so I can't go get any of the vitamins I am supposed to have or fill my prenatal prescription.  So all this will begin tomorrow.  Well, I will increase my protein today, just not my pills.  Speaking of, I tried the double scoop protein shake this morning.  It was so thick it made me gag and it took me an hour and a half to drink it all.  Perhaps I will be drinking multiple shakes a day despite what my Nutritionist wants.

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