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i HAD TWO PATIENTS WHO HAD AN ADVERSE REACTION TO CENTRUM CHEWABLE. THEY BOTH COMPLAINED THAT THEY HAD A SEVERE METTALIC TASTE IN THEIR MOUTH. ONCE THE VITMAIN WAS D/C THE PROBLEM RESOLVED. LAST TIME I CHECK THE LABEL IT DID NOT LIST THE %DV, THAT CONCERNS ME. ANYONE HAVE ANOTHER EXPERIENCE WITH THESE VITAMINS? tINA MUSSELMAN RD, LDNgoliveoyl22 <goliveoyl22@...> wrote: Dear Dorothy,My doc recommends Flintstones right after the pt is discharged home. And at one month they can continue with the Flintstones or change to Centrum or comparable MVI.-- Cunhagoliveoyl22@...Message: 7 Date: Mon, 23 Jan 2006 15:44:28 -0000 From: "dorothymclaughlin1"

<dmclaughlin@...>Subject: multivitaminsWhen do you recommend that your Roux-en-Y gastric bypass patients starttaking multivitamins (ex: a few days, 1 week, 2 weeks, etc aftersurgery?)Also, is it recommended that they take a children's chewable for acertain amount of time, then switch over to an adult completemultivitamin? Can these patients swallow pills without difficulty, orwould they get lodged in their pouch?Thank you.Dorothy McLaughlin, RD, CDN

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Our hospital's program says to take 2 chewable vitamins a day for the

first month or so. Then they switch over to specialty bariatric

vitamins. Our program recommends the following vitamins:

Wellness Plus Capsules from www.vistavitamins.com

Building Multiple Vitamins from www.bbviamins.com

Multi-Formula vitamins from www.bariatricadvantage.com

After 3 months, they add calcium citrate with vitamin D, and are told

not to take it with an iron suplpement.

Bledsoe, MS, RD, LD

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Honestly, I do not know why our program waits 3 months to start

calcium. And I am not exactly involved in the decision-making

processes. They have an RD teach a pre-op nutrition class, and I do a

monthly support group for those people who choose to attend. We do

not do anything else with the bariatric surgery patients.

Bledsoe, MS, RD, LD

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  • 4 years later...

Apparently the Flinstones complete vitamins are lacking selenium and

puts the patients (especially RNY and BPD w/ DS pt's) at risk for this

deficiency. Some of the high selenium foods are foods the patients may

have trouble with so they may not be getting enough selenium in their

diet. Not sure yet what implications a low selenium level can have.

Missy Bizzarro RD, LD

Re: MVI

We still use Flintstones as an option for our patients and I was unaware

that this was not recommended. I'll be interested to hear more about

this too. We have recently started selling Bariatric Advantage, as well

as using their pre-surgery program, and our patients have really liked

the products and the option of being able to pick things up when they

are in town for their appointments. I had requested samples of Opurity,

but they were very slow to arrive, so we had already made the decision

for BA by the time we got them. But, I will say that I personally think

the Opurity MVI and calcium supplements taste better than the BA. I

have always promoted Unjury protein and I still provide samples of

Unjury protein and Opurity vitamins to my patients, so they are aware of

other high-quality options.

Kirkpatrick, RD, LD

----- MVI

Date: Fri, 1 Oct 2010 04:56:11 -0700 (PDT)

I recently attended the ASMBS in Vegas, and one of the speakers

discussed discontinued use of Flintstones for an acceptable brand of

MVI's. I've discussed recommending adult standard formulas with our

director of surgery, who is open for the change, but would like to see

research why the Flintstones now are not an acceptable MVI, being that

his postop patients who take them are not showing deficiencies. Does

anyone have any articles proving adult or specialized bariatric MVI's

are more beneficial to the patie! nt???

Also- we are looking to start selling a specialized brand in the

office... any suggestions? Right now i am looking at Opurity,

Celebrate, Bariatric Advantage, and Bariatric Fusion.

Thanks in advance for any information!!!

Joo, RD

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If you owe under $729k you probably qualify for Obama's Refi Program

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We recommend Bariatric Fusion and Optisource because they are

the most complete of the bariatric vitamins. (Look at the iron, calcium,

and B12 content when comparing MVIs). In case you’ve never seen the

ASMBS nutrition guidelines, I’ve attached a copy for you here. Hope

this helps.

Judy Steiner, RD, LD

Bariatric Outpatient Dietitian

Member ASMBS

St. Luke's Health Systems

208-381-7281

From:

[mailto: ] On Behalf Of

Joo

Sent: Friday, October 01, 2010 5:56 AM

Subject: MVI

I recently attended the ASMBS in Vegas, and one of the

speakers discussed discontinued use of Flintstones for an acceptable brand

of MVI's. I've discussed recommending adult standard formulas with

our director of surgery, who is open for the change, but would like to see

research why the Flintstones now are not an acceptable MVI, being that his

postop patients who take them are not showing deficiencies. Does

anyone have any articles proving adult or specialized bariatric MVI's are

more beneficial to the patient???

Also- we are looking to start selling a specialized

brand in the office... any suggestions? Right now i am looking at

Opurity, Celebrate, Bariatric Advantage, and Bariatric Fusion.

Thanks in advance for any information!!!

Joo, RD

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ASMBS Bariatric Nutrition Guidelines.pdf

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according to clinical nutrition week (aspen) 2009

alan shenken discussed selenium and his research showed taht

selenium is necessary for thyroid hormone metabolism, and homeostatis of the redox system

you need at least 20 µg. to prevent keshan disease in adults (http://en.wikipedia.org/wiki/Keshan_disease)

i know i usually incorporate 60µg with my TPN patients unless they have kidney disease (i exclude it)

Miceli MA, RD, LDNSouthern Surgical HospitalSlidell, La985-445-7282 (cell)985-661-2146 (work)

From: "Bizzarro, A Civ USAF AFMC 88 DTS/SGQD" <melissa.bizzarro@...> Sent: Fri, October 1, 2010 9:26:46 AMSubject: RE: MVI

Apparently the Flinstones complete vitamins are lacking selenium andputs the patients (especially RNY and BPD w/ DS pt's) at risk for thisdeficiency. Some of the high selenium foods are foods the patients mayhave trouble with so they may not be getting enough selenium in theirdiet. Not sure yet what implications a low selenium level can have.Missy Bizzarro RD, LD -----Original Message-----From: [mailto: ] On Behalf Of KirkpatrickSent: Friday, October 01, 2010 9:47 AM Subject: Re: MVIWe still use Flintstones as an option for our patients and I was unawarethat this was not recommended. I'll be interested to hear more aboutthis too. We have recently started selling Bariatric Advantage, as wellas using their pre-surgery program, and our patients have really likedthe products and the option of being able to pick things up when theyare in town for their appointments. I had requested samples of Opurity,but they were very slow to arrive, so we had already made the decisionfor BA by the time we got them. But, I will say that I personally thinkthe Opurity MVI and calcium supplements taste better than the BA. Ihave always promoted Unjury protein and I

still provide samples ofUnjury protein and Opurity vitamins to my patients, so they are aware ofother high-quality options. Kirkpatrick, RD, LD---------- Original Message ----------From: Joo <vizal19@...>ba! riatricnutritiondietitians Subject: MVIDate: Fri, 1 Oct 2010 04:56:11 -0700 (PDT)I recently attended the ASMBS in Vegas, and one of the speakersdiscussed discontinued use of Flintstones for an acceptable brand ofMVI's. I've discussed recommending adult standard formulas with ourdirector of surgery, who is open for the change, but would like to seeresearch

why the Flintstones now are not an acceptable MVI, being thathis postop patients who take them are not showing deficiencies. Doesanyone have any articles proving adult or specialized bariatric MVI'sare more beneficial to the patie! nt???Also- we are looking to start selling a specialized brand in theoffice... any suggestions? Right now i am looking at Opurity,Celebrate, Bariatric Advantage, and Bariatric Fusion.Thanks in advance for any information!!! Joo, RD__________________________________________________________Obama Urges Homeowners to RefinanceIf you owe under $729k you probably qualify for Obama's Refi Program<http://thirdpartyoffers.juno.com/TGL3132/4ca5e66fe4023b61b7st02duc>SeeRefinanceRates.com<http://thirdpartyoffers.juno.com/TGL3132/4ca5e66fe4023b61b7st02duc>

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Thanks . Good information. Would anyone be willing to share their

vitamin and mineral protocol that they use at their hospital or bariatric

center. This is something that I am currently working on with the bariatric

surgeon and endocrinologist. Currently, I feel like I am on my own in this

area and would like some standards put into place. Thanks for all of your help.

Have a great weekend? Missy

Re: MVI

We still use Flintstones as an option for our patients and I was unaware

that this was not recommended. I'll be interested to hear more about

this too. We have recently started selling Bariatric Advantage, as well

as using their pre-surgery program, and our patients have really liked

the products and the option of being able to pick things up when they

are in town for their appointments. I had requested samples of Opurity,

but they were very slow to arrive, so we had already made the decision

for BA by the time we got them. But, I will say that I personally think

the Opurity MVI and calcium supplements taste better than the BA. I

have always promoted Unjury protein and I still provide samples of

Unjury protein and Opurity vitamins to my patients, so they are aware of

other high-quality options.

Kirkpatrick, RD, LD

----- MVI

Date: Fri, 1 Oct 2010 04:56:11 -0700 (PDT)

I recently attended the ASMBS in Vegas, and one of the speakers

discussed discontinued use of Flintstones for an acceptable brand of

MVI's. I've discussed recommending adult standard formulas with our

director of surgery, who is open for the change, but would like to see

research why the Flintstones now are not an acceptable MVI, being that

his postop patients who take them are not showing deficiencies. Does

anyone have any articles proving adult or specialized bariatric MVI's

are more beneficial to the patie! nt???

Also- we are looking to start selling a specialized brand in the

office... any suggestions? Right now i am looking at Opurity,

Celebrate, Bariatric Advantage, and Bariatric Fusion.

Thanks in advance for any information!!!

Joo, RD

__________________________________________________________

Obama Urges Homeowners to Refinance

If you owe under $729k you probably qualify for Obama's Refi Program

<http://thirdpartyoffers.juno.com/TGL3132/4ca5e66fe4023b61b7st02duc>

SeeRefinanceRates.com <http://seerefinancerates.com/>

<http://thirdpartyoffers.juno.com/TGL3132/4ca5e66fe4023b61b7st02duc>

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Thanks for the Prothera site, I registered with them. I just recently saw them in Bariatric Times.

Sanam Shahrokhinia MS RD

Cedars-Sinai Medical Center

Los Angeles, CA

From: Musselman Tina <tina.musselman@...>" " < >Sent: Fri, October 1, 2010 7:15:40 AMSubject: RE: MVI

I also like ProThera's bariatric line. www.protherainc.com. THey are higher in most minerals, have mixed tocopherols and use a methylated folic acid.

Tina Musselman RD, CCN St. Hospital, Olympia Fields, IL Bariatric Surgery Program Coordinator Registered Dietitian/Certified Clinical Nutritionist (708) 679-2717 (p) (708) 679-2418 (f) tina.musselman@... www.stjameshospital.org/services/bariatricsurgery

"It's strange, in this country we are crazy about qualitycontrol for our kids' toys, bedding, car seats … but then we will go outand buy the cheapest food we can find." - Kirby (author)

From: [mailto: ] On Behalf Of KirkpatrickSent: Friday, October 01, 2010 8:47 AM Subject: Re: MVI

We still use Flintstones as an option for our patients and I was unaware that this was not recommended. I'll be interested to hear more about this too. We have recently started selling Bariatric Advantage, as well as using their pre-surgery program, and our patients have really liked the products and the option of being able to pick things up when they are in town for their appointments. I had requested samples of Opurity, but they were very slow to arrive, so we had already made the decision for BA by the time we got them. But, I will say that I personally think the Opurity MVI and calcium supplements taste better than the BA. I have always promoted Unjury protein and I still provide samples of Unjury protein and Opurity vitamins to my patients, so they are aware of other high-quality options. Kirkpatrick, RD, LD---------- Original Message ----------From: Joo

<vizal19@...>bar iatricnutritiondietitians Subject: MVIDate: Fri, 1 Oct 2010 04:56:11 -0700 (PDT)

I recently attended the ASMBS in Vegas, and one of the speakers discussed discontinued use of Flintstones for an acceptable brand of MVI's. I've discussed recommending adult standard formulas with our director of surgery, who is open for the change, but would like to see research why the Flintstones now are not an acceptable MVI, being that his postop patients who take them are not showing deficiencies. Does anyone have any articles proving adult or specialized bariatric MVI's are more beneficial to the patient? ??

Also- we are looking to start selling a specialized brand in the office... any suggestions? Right now i am looking at Opurity, Celebrate, Bariatric Advantage, and Bariatric Fusion.

Thanks in advance for any information!!!

Joo, RD____________________________________________________________Obama Urges Homeowners to RefinanceIf you owe under $729k you probably qualify for Obama's Refi ProgramSeeRefinanceRates.com

The information contained in this e-mail and any accompanying documents is intended for the sole use of the recipient to whom it is addressed, and may contain information that is privileged, confidential, and prohibited from disclosure under applicable law. If you are not the intended recipient, or authorized to receive this on behalf of the recipient, you are hereby notified that any review, use, disclosure, copying, or distribution is prohibited. If you are not the intended recipient(s), please contact the sender by e-mail and destroy all copies of the original message. Thank you.

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Check out Opurity Multi for by pass and band patients. I think they taste very good. Calcium citrate chewables are not chalky either. I think the website is opurity.com. Litchford PhD RDSent from my iPhoneOn Oct 2, 2010, at 8:24 PM, Pam <shahrokhinia@...> wrote:

Thanks for the Prothera site, I registered with them. I just recently saw them in Bariatric Times.

Sanam Shahrokhinia MS RD

Cedars-Sinai Medical Center

Los Angeles, CA

From: Musselman Tina <tina.musselman@...>" " < >Sent: Fri, October 1, 2010 7:15:40 AMSubject: RE: MVI

I also like ProThera's bariatric line. www.protherainc.com. THey are higher in most minerals, have mixed tocopherols and use a methylated folic acid.

Tina Musselman RD, CCN St. Hospital, Olympia Fields, IL Bariatric Surgery Program Coordinator Registered Dietitian/Certified Clinical Nutritionist (708) 679-2717 (p) (708) 679-2418 (f) tina.musselman@... www.stjameshospital.org/services/bariatricsurgery

"It's strange, in this country we are crazy about qualitycontrol for our kids' toys, bedding, car seats … but then we will go outand buy the cheapest food we can find." - Kirby (author)

From: [mailto: ] On Behalf Of KirkpatrickSent: Friday, October 01, 2010 8:47 AM Subject: Re: MVI

We still use Flintstones as an option for our patients and I was unaware that this was not recommended. I'll be interested to hear more about this too. We have recently started selling Bariatric Advantage, as well as using their pre-surgery program, and our patients have really liked the products and the option of being able to pick things up when they are in town for their appointments. I had requested samples of Opurity, but they were very slow to arrive, so we had already made the decision for BA by the time we got them. But, I will say that I personally think the Opurity MVI and calcium supplements taste better than the BA. I have always promoted Unjury protein and I still provide samples of Unjury protein and Opurity vitamins to my patients, so they are aware of other high-quality options. Kirkpatrick, RD, LD---------- Original Message ----------From: Joo

<vizal19@...>bar iatricnutritiondietitians Subject: MVIDate: Fri, 1 Oct 2010 04:56:11 -0700 (PDT)

I recently attended the ASMBS in Vegas, and one of the speakers discussed discontinued use of Flintstones for an acceptable brand of MVI's. I've discussed recommending adult standard formulas with our director of surgery, who is open for the change, but would like to see research why the Flintstones now are not an acceptable MVI, being that his postop patients who take them are not showing deficiencies. Does anyone have any articles proving adult or specialized bariatric MVI's are more beneficial to the patient? ??

Also- we are looking to start selling a specialized brand in the office... any suggestions? Right now i am looking at Opurity, Celebrate, Bariatric Advantage, and Bariatric Fusion.

Thanks in advance for any information!!!

Joo, RD____________________________________________________________Obama Urges Homeowners to RefinanceIf you owe under $729k you probably qualify for Obama's Refi ProgramSeeRefinanceRates.com

The information contained in this e-mail and any accompanying documents is intended for the sole use of the recipient to whom it is addressed, and may contain information that is privileged, confidential, and prohibited from disclosure under applicable law. If you are not the intended recipient, or authorized to receive this on behalf of the recipient, you are hereby notified that any review, use, disclosure, copying, or distribution is prohibited. If you are not the intended recipient(s), please contact the sender by e-mail and destroy all copies of the original message. Thank you.

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