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Dear (Once Was) Flabby

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• Dear (Once Was) Flabby

Gut questions? We've got answers.

Email your questions to Christine LaBrecque RN, BSN, Director/Program Coordinator

Question:

Help! I have been losing my hair since the operation. I didn’t think much about it because, after discussing this at the support groups, they said the hair loss would stop and eventually it would start to grow back. My weight loss book has a section about losing hair and options to try to reverse the process, and it mentioned Nioxin recharging complex food/dietary supplements for healthy growth of hair, skin and nails. I’ve been taking it since two weeks before my operation, and my hair dresser has noticed my hair becoming real thin… I even have a bald spot on the side of my head! Do you have any suggestions on how to fix my hair loss? Is there a specialist or a product that can help? I feel fine, other then this issue, but I’m afraid to let it go untreated too much longer.

Answer:

Your surgery-related hair loss should slow down and start re-growing at about nine months after your operation if you follow a couple rules:

1. You need to get enough protein. The longer you deprive your body of the necessary amount of protein (at least 70 gms, or the amount recommended by your nutritionist), the longer your hair, skin, and nails will suffer. Your body uses the protein you ingest to take care of the muscles and major organs in your body first, including your brain and heart. If you are lacking in protein, not only is your hair suffering, but the rest of your body is, too.
2. You need to be sure you are ingesting enough liquids (one of the last place your body hydrates is your hair!) and taking your vitamins, especially the B vitamins.
3. We also recommend are extra zinc or extra biotin supplements, which are reported to specifically help strengthen your hair. There are over-the-counter vitamin formulas that contain zinc, biotin, B vitamins, along with other micronutrients and minerals. This is an easier way to get in the extra supplements in a combination pill.
4. Keep in mind that there is a three-month hair growth period, which is why some people don’t start to notice hair loss until about three months after surgery. You will start to see less hair loss and some re-growth around nine months post-operation. Please note the Nioxin formula that you mentioned will thicken your hair, or make the hair strands appear thicker, but may not affect the re-growth stage like the above mentioned suggestions.

Question:

I am having some pain after eating, and sometimes after drinking. Should I be concerned? — Pain-in-the-Pouch

Answer:

Dear Pain-in-the-Pouch, There could be many reasons why your pouch might hurt after eating or drinking. Most of them have to do with getting used to your new eating and drinking behaviors. Remember that you must chew each bite slowly and carefully, and take at least 30 to 45 min for each meal. Sometimes in the hustle and bustle of everyday life, we forget to chew or to eat slowly. This can cause your pouch to hurt if it is too full, or it has big pieces of food trying to get through. You also need to make sure that you do not drink for 15 minutes before each meal, during your meal, and for 60-90 minutes after. Sometimes even the slightest sip of water is enough to irritate your already full pouch. It is also very important to remember that you should be avoiding alcohol, smoking, caffeine, and carbonated beverages. Any of these substances, even in very small amounts, can irritate your pouch and can lead to gastritis and ulcers. Ulcers are very dangerous after bariatric surgery of any kind, so if your symptoms do not resolve after even a few days, you need to call the clinic and speak to one of your providers.

Question:

I just received a prescription for Vitamin D. Why do I need to take an extra Vitamin D supplement? Down in the Dumps with low vitamin D

Answer: 

Dear Down in the Dumps, You’re not alone! We are finding many of our patients with low vitamin D levels. Vitamin D is a nutrient found in fortified food sources including fatty fish, fish oils and milk. Just one cup of vitamin D-fortified milk supplies about 25% of the estimated daily requirement in adults. However, only a few foods naturally contain significant amounts of vitamin D, which can hinder proper consumption. Vitamin D’s primary job is regulating calcium and storing it in our bones, but it also has other protective health benefits such as cancer prevention, boosting the immune system and warding off infections. It can also prevent inflammation in the body, which has been linked to heart disease and high blood pressure. Vitamin D also needs ultraviolet (UV) rays from sunlight to trigger vitamin D synthesis in the skin. Factors such as season, latitude, time of day, cloud cover and sunscreen directly affect UV ray exposure. For example, in New England, the average amount of sunlight from November to February is insufficient to produce significant vitamin D synthesis in the skin. Research suggests that 5-30 minutes of unprotected exposure between 10:00am and 3:00pm at least twice a week will provide most of the vitamin D you need. Unfortunately, this means that the prime hours for vitamin D formation occur when most of us are indoors at work! Remember that sunscreens with an SPF greater then 8 will block UV rays, but it is still important to routinely use sunscreen when exposure is longer then 10-15 minutes. Because we live in a reduced sunlight region and you may be lacking in the nutrient in food and routine multi-vitamins, it may be necessary to prescribe an extra helping of vitamin D.

Question:

I had weight loss surgery over two years ago. I did well the first year, losing 87 pounds. The last several months I've noticed I'm slipping back into my old habits. I've gained 16 pounds and to be honest, I feel like a failure. I'm too embarrassed to come into the clinic. What should I do?

Answer:

First thing - please know that you're not alone! As you know, bariatric surgery is just a tool to aide weight loss, and it is perfectly normal to find yourself "hoping" the weight loss journey would be easier. Many patients find themselves wrestling with old habits and even weight gain. This is the time you need help the most. You are not a failure, just in need of some good problem-solving. This is the role of the clinic staff - to help people like yourself solve weight management challenges. This is also a good time to join a support group and connect with others who share your same struggle. Whatever you do, don't let embarrassment prevent you from getting back on track.

Question:

I had weight loss surgery four weeks ago and I am having a difficult time getting in my fluid and protein. I find it very difficult to drink even water at times. Everyone at support group seems to be doing just fine, what is wrong with me?

Answer:

Nothing is wrong with you, but you should call the clinic and speak to our nurse practitioner Lisa Dutton just to be sure. It often can be very difficult to get 60 ounces of liquid and 60 grams of protein in during the first six months after surgery. Water (especially cold water) can irritate a new pouch. Try room temperature water and add a lemon wedge. Take the time to journal everything you are eating and drinking; often you are doing better than you think. Don't be afraid to go back to all liquids and your protein drink for a few days, try to puree all your food until it gets easier, and most of all be patient and don't panic. It does get easier.

Never, never, never give up. ~ Winston Churchill

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