Bariatric Patients and Supplements

The following is designed to entertain and inform, not provide medical advice. Always consult your doctor before starting a new treatment.

Inspire.

Welcome back to the Kidney Stone Diet podcast, a show about reducing your kidney stone risk and living your best life. I'm your host and fellow student, Jeff Sarris.

And I'm Jill Harris, your kidney stone nurse.

Perfect. I just noticed a light behind me was flickering. I'm like, what is happening?

Haunted house all of a sudden.

I think I have a ghost. I it does flicker sometimes, so that's my that's my morning chair. I took away the Christmas tree.

Everyone's like, "Thank God, it's June, girl."

Hey, it's it's February 20th, so.

Yes. Yes. Yes.

I mean, we're we're sort of transitioning into spring-ish. I have my window here cracked open just a little bit. It's not hot, it's not warm, but it's like you feel that spring air just a little bit.

We can it's coming. So, that's now my reading chair where the tree was, and so in the morning when I'm looking at emails and stuff, it flickers. I'm like, "Oh," cuz the morning I get up at like 5:30, 6:00, so it's flickering.

And I don't love it. I'm not somebody who doesn't believe in ghosts. I'm also somebody who does believe in ghosts, so I don't know.

But I don't like light flickers for no reason. The light bulb is screwed on tightly. So, I don't know.

I'm up in the air about ghosts, so I don't know what to tell you. So, it makes me a little nervous. Yes.

So, we both have a light on our right side that is going to flicker throughout this, so. We'll see what happens.

People are like, "Well, thank God I'm on Spotify. I don't have to deal with any of your damn lights and your trees and whatever you got going on in your apartment."

Yeah, which, by the way, if you only listen on Spotify, Apple Podcasts, wherever, thank you so much. If you want to watch the video, we're also on YouTube. It's just Kidney Stone Diet on YouTube.

You can find it there. You can obviously find all the links at kidneystonediet.com. And my camera is going a little nuts now, too, so everything is a little a little funny today.

I think you have a ghost as well, okay?

Yeah, I don't know. The camera will move, but now Oh, now it came back down to the to the right level. Okay.

There it is.

But, yeah, what do you say we go beyond the ghosts and we start with a voicemail?

Okay.

Okay, let's go.

Hi Jeff and Jill. This is Lauren from Aurora. I want to thank you guys so much for all your videos.

I've learned a lot from your YouTube videos

Throughout the past year. And most of it I get like bits and pieces that are related to me. And so I wanted to call and get some more specific information for those people who have altered GI issues.

Usually like your information will say, "Oh, you can do this, you can do this, except if you have a GI issue." so excuse me.

So I just wanted to get more specific about that. I specifically had a bypass. I know some other people have issues with oxalate related to other GI issues, but mine is specific to a bypass.

Which I was doing fine with oxalate. I don't have stones, but there was a time when after watching the documentary Forks Over Knives, I decided that I would do like a vegan diet, and my staples were spinach smoothies, almonds after workouts, and

Unsweetened iced tea all day long. So, unlike the kidney stone, there's no like warning, there's no wake-up call, just painless, silent, kidney damage that you have no idea is going on.

So, at that's I'll stop now, but I do want to protect my kidneys moving forward. I don't have stone issues, but definitely need to be aware of oxalate. And so, I just wanted to do maybe a little bit about things specific to that like vitamin C.

Bariatric multivitamins include vitamin C,

And so I'm wondering, you know, at 200% of the normal daily value, should that be something that like we should not take, and then just not take altogether, but do all the vitamins separately to not include C, as opposed to the all-in-one multi?

Questions about collagen, I recently read that collagen peptides and collagen converts to oxalate, and so I was surprised and, again, felt like, "Oh, there's so much I'm finding out like after the fact."

Is whey protein is that different, the way it's metabolized, and collagen is that fine? Is that like for a supplemental protein shake? I know chocolate is not the way to go, but wonder like how is there a way to incorporate

Oh, and I think the voicemail cut off there. Yeah, that's a We have some a wide-ranging question there, so a few things to a few things to dive into.

Well, you know, first let me say before I forget, so Lauren from Aurora, I know exactly where Aurora is. Hello, Lauren! So she's had She said she had a bypass.

I will assume,

But I don't know, so I always am very honest, I'm assuming she meant a gastric bypass. I'm assuming, which is a bariatric surgery, but I don't know. So, let's just put that out there.

Okay, now we do have videos on bariatric surgeries.

We do have videos on this channel on collagen. So, Laura, I'm I'm so we do. And we do have videos on protein shakes, although she brings up a good point because she's like, "Listen, old lady.

I'm asking specifically about whey protein." So, we address protein shakes in general, but I don't specifically go into whey protein. So, basically she's saying, "Listen, girl, is do I know I have to worry about collagen converting over to oxalate, but do what about whey?" Okay, good question, so I'll address that now while I'm thinking it's a good question.

Whey protein, you guys can have it if it doesn't bother you, meaning, you know, can have a little lactose in there, some people can't tolerate it. So, if you want to use a whey protein shake, like she said, anything not chocolate, you can use it. Pay attention to the sodium and sugar in these products.

Nowadays,

Protein powders don't have any added sugar, we could thank keto for that, mostly, but always check, okay? Keto did definitely make us more aware of all the sugar we're eating, so that is the one and only reason I like keto diet.

Otherwise I get a lot of kidney stone patients from the keto diet, folks, just so you know. Okay, let me see what else did she say. Okay.

So, but I will say this about protein shakes. I'll hear people say, "Jill says no to protein shakes." I do not say no to protein shakes. I say, "Do not drink your

Your meals. Do not drink your meals." "But, Jill, I want to lose weight." Well, what's going to happen when you stop drinking that protein shake cause you're so freaking sick of it? All that weight you lost, you're going to regain.

Why? Because you never learned how to eat! Cuz now you're going to go back to food and you still haven't learned portion control, portion control, and triggers and all that.

We must learn how to eat. We must educate ourselves,

And we need to work through our obstacles on that. So, that's what I say. You want a protein whoozy, go ahead.

Sip away, people, but don't use them as meal replacements to lose weight. You will gain it back, you probably have five times, cause everyone does. Okay.

But, you can definitely have whey protein shakes, I don't mind that at all. I use an egg one, I use I use a casein-whey blend in some of my baking stuff, but if I'm just having a protein shake, it is it is an egg protein. That we always link in the bottom.

I use whatever,

Fit and Something, He- Healthy & Fit, I like them. It is higher in sodium, so when I have that, I pay attention to my sodium for the rest of the day. Okay, so there's that.

You can have whey, Lauren. Now, she poses a very good question. Jill,

We, as bypass patients, and again, I'm assuming it's gastric bypass, especially since now she's talking about the supplements, we're told to take supplements. Should I stop taking them because of kidney stones, which, by the way, she's never had. She said she had how high oxalate,

I don't know how she knows that, because if she hasn't had a kidney stone, I doubt she's had a urine 24-hour urine collection, but again, what do I know? I'm not sure of all these things, I'm throwing them out there, though, so Lauren can answer at some point. Vitamins,

Supplements that bariatric patients have been told to take. We, me, Jeff, the internet folks, period,

But I'll tell you right now, as a nurse, I never override a doctor's order. You guys with gast- a gastric bypass, intestinal issues, me with my surgeries I've had on my colon, we have special orders. We have special orders.

So, how you handle this

Is just like this. Dear doctor, I This is Lauren talking. I've had high oxalate.

How she knows this, I don't know. Maybe she did do a urine collection. I doubt it cuz she hasn't had a stone, but anyway.

If she's talking to her gastric, her GI doc,

Who did her surgery, Dear Doctor, I'm petrified I'm going to make kidney stones. I've eaten a lot of high oxalate food. Whether Lauren has malabsorption issues or not from her bypass, she there's a lot of information I don't have on her.

I it I would say to the GI, "I know you're asking me to take vitamin C." A lot of GI doctors want bariatric patients to take calcium supplements, and you'll hear me all the time in the kidney stone world that says, "Don't take calcium supplements."

But if you have malabsorption issues, your doctor may want you to take them. You never stop taking supplements a doctor has asked you to take because of medical conditions, just because of you're worried about a kidney stone, you must talk to that doctor first, because you could be making other things worse. Bariatric patients do not absorb calcium very well, they need may need tons of it, okay?

These are questions for your doctor. I'm thrilled

That she posed these questions so more people can hear this, so they're brilliant, and I appreciate Lauren. But, always go back to your doctor. Vitamin C, we know if you take bigger doses of it, it can convert to oxalate, but with bariatric patients, you may need it.

Now, how do you know if you're having high oxalate from all these supplements? You should do a 24-hour urine collection,

But I don't know if insurance company's going to pay for that, because the diagnosis wouldn't be kidney stones, and that's what they look for when they pay. So, this stuff, it's not like, you know, insurance pays, insurance dictates our care, unfortunately, so there's that. Collagen, like I said, there's a video on it, so make sure you watch that.

Too much collagen can convert over to oxalate. Now,

As I'm getting older, I see how thin my hair's getting. Yeah, I got a lot a lot of little bushy things up here, but it was really It's thinned out a lot as I've gotten older, and I know I'm working with patients my age, and they're worried about their fingernails and they're worried about their thinning hair, so they want to take

All these magical potions and pills that's going to give them a head of hair. Listen, there's no good proof that collagen or any of those supplements increase your hair, so you know. I'm going to I'm going to say this, and I may get so many haters.

We all know I don't care. I am just stating my opinion,

That's all I'm stating. You are all grown, please do what you feel is best for you. Do what is best for you, but my take on all these supplements and pills that are going to increase our, you know, make our nails stronger, you know, what are we doing,

Rock climbing? I don't know, how strong do you need your nails? I mean, I don't know, I'm asking you, okay?

How, you know, your hair's falling out. Number one, I would say, before you start taking a supplement, you might want some blood tests run. Is this indicative of like thyroid disease?

Do you have something else going on? So, figure that out, that's another question for the doctor. But as far as collagen, and giving you a full head of hair, at some point,

At some point, don't we just need to embrace that we're getting older? I get it, it's it's not for the faint of heart getting older. I see myself, I'm like, "Wow."

But at the same time, because I've because of my stage 4 cancer stuff, I'm like I just feel really grateful that I have a breath. I mean, so what? Maybe I'm going a little bald, okay, so maybe eventually I'll lose a lot more hair, but I have a breath, and I'm going to watch my son grow up, I'm hoping to God, and maybe, hopefully, a little grand baby, no pressure, Nate.

But what I'm saying is, I don't know. I'm just going to push back a little. That's all, I'm going to want us to think about that a little, only because there's so much more to life.

When we're on our death bed, I better shut off my phone, when we're on our death bed,

I don't think we're going to be thinking, "Does my hair look good?" No. No, we're going to be thinking about things like love and time. Did we spend enough time with those people we love?

I can't really think of anything else much more that we would think about, it's not going to be our hair. Now,

If I'm making you feel less than because you're like, "Shit, I'm worried about my hair." That's what I'm saying, you please take care of it. Collagen ain't going to bring it back, but if there's no good research that says that, but if you but you must do what you want to do. The things I talk about as far as kidney stone disease is all based upon science, but some of these like life little things, I just add them in here because, and I do this with my kidney stone prevention course

Students in the accountability calls, these are the kinds of things we think about as we're navigating diet and lifestyle and the obstacles that get in the way of maintaining lifestyle and diet, so we talk about these things. And at the end of the day, when people say to me, "Well, I hate my hips."

I'm like, "You're not going to be thinking about them when you're dying, you just won't, I promise you." Because I've been at a very scary place in my life with my cancer, I just know that those are not things you're going to be worried about, you're going to only be thinking about things of the heart, not your head, not your hair,

And not your hips, none of the H's, okay? So, just your heart, that's the only H you're going to be thinking about. So, I want you to just love yourself the best you can, and that takes practice, you're not going to do it overnight, but I don't want you to worry so much about your hair and you take these supplements that half the time are now on the clearance rack at Marshall's because it's a fad, okay?

So, those are just my thoughts.

You don't have to listen to them, you don't have to you know, believe them, you can certainly do what you want to do. I'm just telling you, maybe, or asking you, maybe to think about this in a different way. And as a woman and an older woman, I know what it's like to look at your hair and go, "What the hell?"

I get it! But we got to also laugh at it and just say, "Well, this is who I am. It's who I am." And that's okay, you know, it's part of the process and that we get to age.

Does anybody know what we're talking about? I think somebody called Lauren, did she call in?

So,

So, collagen, go look at that video. The supplements and bariatric surgeries, you may very well need those supplements, please do not stop them, talk to your GI doctor about it, please. Now, one more thing, no more life lessons, I promise, I just want to close it with this.

I will ask you to push back on this, bariatric patients specifically.

I notice in my practice that when I deal with a lot of bariatric patients cuz they do get kidney stones because they have lower citrate, they have lower urine volume, they have higher oxalate, they have lower pH because of malabsorption issues, okay? So, they got things going on. But

I have noticed this in my practice. I noticed that, and I don't have I don't know, I'm saying I don't know, but are all of you being, you know, are you all on, you know, five calcium supplements a day? Are you all on the same citrate?

Is it a generic order that all bariatric patients are told to take supplements? Is it Do all bariatric patients, are they all told to take this much vitamin C, this much calcium? Could it be that it needs to be tailored more for each person?

Should they be doing 24-hour urine collections or whatever tests needed to see if is this a generic order we're giving you guys? Not me, because I don't I don't give supplement orders, but you know what I'm saying. I don't know, because a lot of patients that talk to me about what their doctors said, it seems like it's kind of like all bariatric patients take this much vitamin C, this much calcium, and just you can ask the doc, "Is this based upon me, based upon just bariatric people in general?" Because maybe you don't need as much as they're suggesting.

Does that make sense? I hope it does. Does that make sense, Jeff?

Yeah, it absolutely does. And that is the thing, we don't know what we don't know. So, going in and having these specific questions to ask, I think, is helpful in itself.

I mean, you might you might not have an answer because you that's not your area, but knowing to ask the doctor these things is helpful.

Right, because when you go to the when I go to the doctor, I know they're like, "Take 3,000 of vitamin D." "Well, where'd you get that from? We didn't even do the blood test yet." "Oh, well, yeah, we'll do the blood test and then." So, I'm just saying from my own care, and I have top A-plus care, and a lot of my I'm dealing with thousands and thousands of patients a year, they tell me a lot of things.

And so, they'll be like, "My doctor told me to take" "Well, did what based upon what?" "Well, I don't know to tell you the truth." So, we as patients, I come to my students and patients way more with a patient point of view than I do with a nursing point of view, because I know as a patient what we're told and how it's all kind of like,

You know, just kind of generically thrown at us. Just like the oxalate list are generically thrown at us, or this list, this list, you didn't even do a urine collection, do they have high oxalate, are they even making calcium oxalate stones? I mean, right?

So, you know, it's it's tough, we need to get specific help for each of us, and that's why that's what I do for a living, right? So, if she called me and had a private consult, I'm going to be very specific with her. I'm not going to give her generic advice, I have to listen to her, her likes, her dislikes, her other medical conditions, and then we formulate a plan of action for her.

And when I talk So, that's Lauren, when I talk to Sammy next, totally different phone call, and that's how healthcare should be, but that's why I don't work at a hospital anymore, because there's no time for that, right? So, we owning our own business here, Jeff, we can do whatever we want and spend as much time as we want, so we do, because that's how it should be, but that's just not it's not cost-effective, obviously, right?

Yeah. Yeah, it's just a different system. The system we've built, the little universe, if you will, that we built here, is what you have seen from the inside, from the patient side, from being a nurse, and just seeing where you can add in a way that's really needed.

So, that's Yeah, that's why all of this exists.

Yes. Absolutely, yes.

Yeah, so.

I think I got all her questions. I think that's it. Yeah.

Which is really good, and yeah, we really appreciate the question, even though some of it is directing to other videos, it's very helpful because we are in the hundreds, 130-ish episodes now, so I mean a lot of people jump in at any point, and to know that, "Oh yeah, we touched on this. We maybe it's 50 episodes ago, maybe it's 100 episodes ago," but there's different things that we can reiterate, we can send you elsewhere, and yeah, just we have a large and growing breath of information, podcast episodes, the website, kidneystonediet.com, and all these things that, yeah, we just want to direct you to whatever can help you along on your journey.

And let me say this, cuz a lot of people, people my age, which that's who I'm working with every day, you know, when you're on this YouTube channel, look for the little micro, magnifying glass right by the title, and you can search for what you put collagen, Lauren, go up there, press collagen, so you're not scrolling, scrolling, scrolling, and the collagen video will come up so you can see it, so always use that magnifying glass.

It's super helpful to find what you need, okay? If you just put in oxalate, you'll just get all the oxalate videos. If you put in salt, if you get, you know, whatever, it's a lot easier to manage it that way, too.

That's what I do when people are searching. They're like, "Jill, what about collagen in the Facebook group?" So, then I go, and I put in the magnifying glass, and, you know, I get collagen, so search that way through the channel, people.

Yeah, you can search on YouTube, you can search on the website, if you just click the little menu, it'll pop out, you'll have a search box there, it'll go through everything on-site, too.

Or even Google.

Yeah.. Yeah, plenty of information out there, and as long as it you're coming through Kidney Stone Diet, you know that it's 100% backed in science. So, yeah, thanks again for your question, Lauren.

If you if you're out there with a question, the number is 773-789-8763, and we would love to feature you on a future episode. And if you want to dive deeper, again, the website is kidneystonediet.com. You can find the prevention course, the meal plans, all the free information and resources, and all those links are down below in the show notes, in the description, wherever you're listening or watching right now, and we appreciate

Oh, Jeff, wait! We got because we have people signed up for Patreon, so, go ahead, take that away, that's

Yeah, so you'll find the link to the Patreon down below. People have asked how they can support, it's this is purely just if you wanted a different way to support the channel, what we're doing, Kidney Stone Diet, the platform in general, it's patreon.com/kidneystonediet. And we just wanted to shout out Alan, who is a new patron this month, and we wanted to thank him and everyone else for their contributions and their help to help us reach more people.

And if you're out there listening, watching, I mean, clearly, you are, but if you just give it a thumbs up, share it, subscribe, like all of those things help us reach more people. So, yeah, thank you, Alan. We will wrap and see you next week.

Thanks, Lauren. Bye. Thanks, Alan!