In This Issue

* Texas Weight Loss Surgery Summit
* Walter Linstrom, WLS Life Styles Article
* Osteoporosis
* Recipe: Yogurt and Cucumber Salad
* Success Story: Kristine Maier
* Spreading the Word in LaCrosse, WI and Minneapolis

I want to thank Edie Payleitner for allowing me to answer her email in this newsletter.  This is a very important matter that we all can benefit from.

Hi Barbara,
In 1998 I weighed 245 pounds and had my first bone density test which was normal. This week I went in and had another one done. My gastric bypass surgery was in May of 2002 and I've lost over 100 pounds. My test showed that I had definite bone loss, not osteoporosis but osteopenia. I'm 53 years old and osteoporosis does not run in my family. Do you think this is related to the drastic weight loss and bypass surgery?  I take 3 Viactiv for my calcium and multi-vitamins daily and am moderately physically active. I also drink 1 cup of milk per day
Edie

Hi Edie,

Food is one source of calcium.  Milk which you do not like will provide you with about 285 mg of calcium, which is about 1/7^th of the calcium you need.  A better source is yogurt.  It gives you 450 mg in a cup.  But it is difficult to consume enough calcium through food considering that we cannot eat huge amounts and we do not want to gain weight.  The best bet is to take a calcium supplement.

It is excellent that you had a bone scan.  That is the only measure of how healthy your bones are.  I have had people comment to me that they know they are getting enough calcium because they have had their blood checked.  That test only tells you how much calcium you are leaching from your bones, not the thickness or health of your bones.

Your last bone density was when you were 100 pounds heavier.  Nature is a wonderful provider.  It provides us with denser bones so that when we are morbidly obese, our bones are able to sustain our weight; therefore we tend to have thicker bones.  As we lose weight, our bones naturally become thinner and osteoporosis becomes more of a concern and we need to work at keeping our bone density. One of the best ways to help preserve bone density is to take a calcium supplement, but all calcium supplements are not created equal, as you have just found out by taking Viactiv.

You have been taking a calcium carbonate which requires acid in order to be absorbed.  Since we have such a small pouch with very little gastric acid, the calcium carbonate which you have been taking has not been getting absorbed like it should.

The best forms of calcium to take are calcium citrate and calcium microcrystalline hydroxyapatite concentrate (MCHC).  These forms are optimally absorbed on an empty stomach and do not require gastric acid.  You also need calcium that will be absorbed easily.  A big hard pill, even if it is the right kind of calcium may pass into your large intestines without your getting any calcium at all. 

The Calcium that I market is perfect for anyone, but especially good for those of us who have had gastric bypass surgery. It is powdered and you mix it with water and drink it. It is in a citrus base so it is ready to be absorbed before you even drink it. Because it’s powdered, there is no hard pill to break down. 

We tend to think that our bones are inert or dead material, but they are not.  Bone tissue is living and growing material that reacts to what we eat and how well we absorb what we eat. It is wonderful that you are concerned about the health of your bones.  You do not want to eat up later in life thin, but with very brittle bones.

To complement the article above about calcium, here is a refreshing salad made with yogurt.  It is simple, very low in calories and full of calcium

Lebanese Yogurt and Cucumber Salad

3 cups plain yogurt
12 fresh mint leaves
2 cloves of garlic, peeled
salt, to taste
2 or 3 cucumbers, peeled and thinly sliced

Drain the yogurt for several hours in a colander that has been lined with cheese cloth. Discard the liquid. This will make the yogurt very thick. In a salad bowl, crush the mint, garlic and salt together.  Add the yogurt, mix well, and then add the cucumbers.  Chill before serving.

If you have a recipe that you would like to share in future issues of this newsletter, please send it to me at Barbara@wlscenter.com

I want to offer a special thanks to Kristine for sharing her success story with us.  Here is her story:

My name is Kristine Maier and I live in Michigan.  I have been over weight since I was a teenager.  The last time I saw a size 14, I was 9 years old. I, as everyone else, have been on every diet known to man and all of the weight loss medications on the market.

In 1977, at the weight of 265 pounds I joined Weight Watchers and in 18 months I lost  127 pounds and kept it off for 5 years.  In 1981 I got married and got pregnant.  With the pregnancy came complications.  I was diagnosed with a rare blood disorder and was a case study at Michigan State University.  The treatment was steroids.  For the next 5 years and all three of my pregnancies I was on steroids. Needless to say I gained all of my weight back and then some.  

It seemed that after all of the years on steroids I could not lose weight. I was even on Phen Phen and then Redux with only a 17 pound loss.  I was on medication for hypertension, depression, and I had shin splints and heel spurs from all of the treadmill walking I was doing.

Last year I turned 50 and decided to give myself a huge present.  I went to an informational meeting on gastric bypass surgery and immediately set out to acquire all of the information I could gather on the subject. I found a support group unaffiliated with the facility that I was considering and attended all of the meetings to learn the good, the bad, the ugly and the beauty of the surgery.  I asked tons of questions and took a lot of notes.

Out of the blue one day a co-worker, who had had the surgery 7 years earlier came into my office and handed me a business card for Dr.David Kam who had just begun a program at Sparrow Hospital and was now doing the surgery.  I met with him and his staff and decided to go ahead. I began my paper work in March and had my surgery date by May 1^st.  Dr. Kam established a program where we had to be on Optifast for 6 weeks before surgery. It was suggested that we do the Optifast as so many people gain weight before surgery eating things that they think that they will not be able to eat afterwards. Plus it readies us for eating small amounts several times a day and drinking a lot of water. We had to weigh in and meet weekly for 6 weeks with a staff doctor, a nutritionist, a behaviorist, and an exercise coach. It is also required that anyone having this surgery attend support group meetings  for another 6 weeks after surgery with a staff doctor, a nutritionist, a behaviorist, and an exercise coach before “graduating” to a support group that now lends support to others.

I had my surgery on Tuesday, June 9, 2003 at 2pm at the weight of 289 pounds and at 6:00 pm on Thursday, June 11, 2003 I was home.  I walked several times a day.  Sometimes only a few houses past mine and back but I still did it.  I recovered quickly.

In 4 weeks and 3 days I was back to work at both my fulltime and part time jobs with no restrictions. I have had no problems or complications what so ever and I have lost a total of 135 pounds to date.  I still would like to lose another 15 pounds and have begun a more intense exercise program to reach my goal. 

I have begun doing all of the things that I have always wanted to do. I have begun lessons in ballroom dance, I would like to go parasailing and I want to learn to roller blade. I am also thinking about buying a bike. We have many bike trails in my area and the exercise would be great. I out and out ran the other day; actually it was a sprint. 

I was amazed that:
#1. I could do it….
#2. My legs didn’t hurt and
#3. I was not the least bit winded.

I truly do not remember the last time I actually RAN.  I am a thinner person with a “fat” frame of mind.  I still gravitate to the Women’s sizes (some old habits are hard to break) and work my way down.  I still am amazed when I can fit into a size that I only dreamed of. I feel truly blessed.

Kris Maier

Before	After

I love good news.  If you have good news, a success story to share, or inspiration, please send it to me at Barbara@wlscenter.com so that I can include it in future issues.