Warning: Long post ahoy!
I’ve talked a lot about learning valuable life lessons lately, and recently an interesting discussion came up on the ObesityHelp forums that got me thinking. My blog focuses on the positive because that attitude is what motivates me to continue living this lifestyle. That said, there are some lessons I’ve had to learn in a very hard and negative way.
The discussion on OH I am referring to comes up quite frequently and usually begins with someone asking, “Why do we need to take all of these vitamin supplements after surgery?” or, “Do we have to do it for the rest of our lives?” The short answers are “Because you don’t absorb all the nutrients from your food anymore,” and “Yes.”
This is why:
I was not always committed to this lifestyle the way that I am now. Last year, at almost 3 years post-op, I’d stopped losing weight and assumed that my body was settled at 175 lbs. I looked pretty good and felt alright for the most part. I was a little bit tired some days, but chalked it up to being a college student who was stressed. I’d become complacent about taking my vitamins and since my labs had been alright at my last check-up, I thought I didn’t need them. I’d slacked on my eating habits too. I wasn’t gaining any weight either, so I didn’t focus so much on eating protein and vegetables first at meals.
One day in early March I went over to my university’s health center for an annual exam, and oddly enough the woman who did it happened to specialize in gastroenterology. After hearing about my surgery and successful weight loss, she noted that I was looking a little pale. She thought it would be best to get a check up on my labs, so she took some blood and I went on my merry way.
Within hours, she called me back and demanded that I come see her the next day. It wasn’t just one thing, either. Everything was shot. I had no thiamin, B-12, folic acid, zinc, or vitamin D. Worst of all was my iron. My hematocrit (the percentage of blood volume occupied by red blood cells) was 23% (a normal female’s is between 37-48%), and my iron level was 2 (normal is between 60-160, usually higher in males). She impressed upon me that low levels of B vitamins could do neurological damage, that I was suffering from malnutrition, and I needed treatment immediately.
It hit me all at once. No wonder I’d stopped losing weight, my body was holding on to anything it could get. Suddenly my exhaustion and difficulty concentrating all made sense. The next day, she wrote me prescriptions for some high-intensity supplements, started a course of B-12 injections, and referred me to a hematologist for the iron problem. I’d tried several different iron supplements in the past, but they’d all made me so ill I couldn’t eat.
The hematologist she referred me to was one of the kindest people I’ve ever met. He listened patiently while I told him my history with iron supplements and then suggested I try a course of iron infusions along with an iron rich diet. He explained that the infusions would take several hours because they first give a Benadryl drip to subdue any allergic reactions, a Zantac drip to help with the nausea, a small test-dose of the iron to be sure that the body won’t reject it, and then finish with the actual infusion. All in all, it would take 2-3 hours.
After my second infusion, I was picking up my purse and trying to shake off the drowsy feeling from the Benadryl when I realized that something wasn’t right. My lips felt funny. I looked at the nurse and said, “I think something’s wrong.” After that, the room started spinning and everything turned blurry. Within a minute, there were about 8 people in the room. One kept telling me to keep looking at him. I was going into anaphylactic shock, and I just kept mouthing “please help me.” My blood pressure bottomed and everything went black for a minute before one nurse injected epinephrine into my right arm while another injected an antihistamine into my left. When I could finally breathe again, I just kept thanking everyone. My whole body hurt, but at least I was alive. My hematologist appeared, apologizing for what I’d gone through, but said we’d work on another plan after I felt better. They kept me at the hospital overnight in case I relapsed, which thankfully, didn’t happen.
The infusions did get my hematocrit up to 30%, but with iron supplementing out of the question after such a severe allergic reaction, all I could depend on was me being responsible enough to commit to an extremely iron rich diet. I also had to learn to give myself B-12 injections once a month because the doctors noticed that it helped my iron level go up. I remembered the promise I’d made to myself after having the RNY, to never live an unhealthy lifestyle again. I’d screwed up, but I vowed to get back on track.
It took months for my blood work to start coming back with average levels of most things. My iron was always a little bit low, but not dangerously so. I was also able to lose weight again, since I wasn’t starved for nutrients. Unfortunately, what I did to my body did have some lingering effects. I have a little bit of trouble remembering things that I’ve said and it can be hard to concentrate sometimes. I am fortunate that I came out mostly unscathed, because from what I’ve seen vitamin deficiencies do to some dear friends on OH, what happened to me was mild.
The point of that story is not to make anyone afraid. It is to spread awareness and remind patients that it doesn’t matter if you’re 5, 10, or 20 years out—it’s always important to supplement properly and have regular blood work check-ups (I’m due for one in August).
A tool I have found that helps to give me an idea of my nutrient intake is a program from www.fitday.com. Fitday itself is a food diary website, but in their downloadable program, it is possible to create reports that show how much of certain nutrients and vitamins you’re getting from food. Of course, I remain aware that I’m not absorbing all of that, but it does give me an idea of where I might need to add an extra supplement.
Four years ago, I promised that I would never live an unhealthy lifestyle again. It shouldn’t have taken a bad scare to remind me of that, but it did. Sometimes we have to learn things the hard way.
I learned that 3-4 chewable vitamins, B-100 complex, and vitamin D, along with a (delicious) iron rich diet and a B-12 shot once a month makes me feel fantastic. I wouldn’t have it any other way.