help with lap band pt

[Guest guest]

Need some help... While I am still researching this topic, I thought

I'd post to see if anyone else had suggestions.

Just saw a pt who had Lap band surgery 12/05- bmi only 35 going into

surgery, vomiting for 6 weeks afterwards, severe dehydration, lost 65#,

no stricture was found but per pt had redo surgery to move the band

higher up on stomach. Was hospitalized for several weeks and found to

have a severe Thaimine def (Wernicke's). She has severe memory loss,

is wheelchair bound and is just starting to tolerate small amounts of

solids. Recent labs are almost back to normal except high ionized and

serum calcium (which was also high 3 weeks after surgery), and high

serum B1. She recieved IM Thiamin in the hospital then was told to take

100mg qd plus her multi.

Currently taking:

-400 mg Max ox bid- mg levels are normal and no more vomiting so she

can likely d/c this

-multivitamin but not complete

-600 mg Thiamin in a fat soluble form per day- husband did research and

found at high doses Thiamin can reduce neuropathy. Fat soluble form is

for better absorption per husband

-eating very little solids but she is taking 2-3 protein drinks per day

I reviewed rules for eating after lap band, proper protein

intake,suggested she take 2 complete mvi until she is eating better but

wasn't sure what to suggest about Thiamin and Calcium. She is no

longer vomiting which I suspect was the initial cause of her vit/min

abnormalities.

Questions:

1. What could be the cause of her high calcium and should she be taking

calcium supplements (she is not currently but doubt she is meeting her

needs).

2. Does anyone have research about high doses of Thiamin, especially in

a fat soluble form? Any suggestions?