The femur is the only bone of the human thigh. It is both the longest and the strongest bone in the body, extending from the hip to the knee. – Medscape

“I am post op 8 to 9 years now. I took all vitamins for first 4 years and quit. I just broke my femur bone in 6 places. I have soft bones. I need to know what I should be taking to get back on target. I would love to talk to someone with the knowledge of the products I need. Something happened and I just stopped taking vitamins. I now have 9 more weeks of non weight bearing on my right leg. Please call me ASAP so I can start to get healthy again. Devastated. I’m only in my 40’s.”

We receive letters like this on average of one per week. This week there were two. This is bariatric reality, not an After Photo of a smiling woman in a bikini that some surgeons like to post on Facebook. Many more of us will have a serious post op deficiency than will ever wear a bikini.

For those who have had a bariatric procedure, vitamin supplements should be thought of as a requirement like insulin, blood pressure or anti-seizure drugs. Is that how you think of them?

We start off strong out of the gate!
We have had over fifty thousand members come through our Support Group message board over the last 8 years. People having bariatric surgery are strong out of the gate, eventually tapering off after a few months and then largely disappearing. A majority initially follow program recommendations; they drink protein, take vitamins, lose most of the excess weight and then they THINK they are done with all this.

There is a period of years where even a complete reversal of behavior does not appear to matter. It’s easy to ignore the permanent surgical changes that have altered all digestive function once the ‘150 pounds in 16 months’ ride is over. Under the surface and silently, nutrient stores are being used up and multiple time bombs are developing. Problems do not manifest unless there is a slip, a fall, an otherwise ordinary accident.

Post op Beer Goggles
A little tired? Who isn’t? Hmmm, is my hair a little thinner on top? Naaaa, it’s just the light in this bathroom. We notice the white marks or ridges on our nails but after a coat of polish don’t see them. We hear of post ops falling and breaking a wrist. Folks post the X-ray of their broken foot on Facebook but we let it slide without the connection. Of the twenty Moderators who have volunteered helping Members over the years, nearly half have broken a bone in a simple fall. One broke both forearms after tripping in her home and holding out her arms so she wouldn’t hit the kitchen island.

There are more bones broken in falls by post ops then you would ever imagine. It’s not a coincidence, it’s not bad balance, it’s not age, it’s not clumsiness, it is that bariatric bones are often soft and mushy. It’s silent, it’s not just calcium but an overall cocktail, it’s widespread and largely preventable.

A pathologic fracture is a bone fracture caused by a disease state that led to weakness of the bone structure. Osteoporosis and Osteomalacia are conditions commonly responsible for this rash of fractures in those having had bariatric surgery. Osteomalacia is derived from Greek: osteo which means “bone” and malacia which means “softness”.

Pathologic fractures are breaks that happen during a normal activity, such as a fall from standing height or less and typically include vertebral fractures, fractures of the femur, and fracture of the wrist or ankle. A normal human being ought to be able to fall from standing height without breaking any bones and a fracture therefore suggests weakness of the skeleton.

There are two main causes of osteomalacia: insufficient calcium absorption from the intestine and or a deficiency of, or resistance to, the action of vitamin D.

Is it the Bariatric Surgery or is it Us?
Taking all of this in, it is shocking that 67% of us don’t take any vitamins after bariatric surgery, 51% are severely iron deplete and 91% are D deficient – the reason for our soft bones. We tell each other on Facebook and the nurses at our surgeons office that we take supplements because it makes us feel good and we almost convince ourselves. It is mind boggling that so many completely ignore what we have been told we must do when we’ve made it as simple as popping a few capsules and drinking a peanut butter protein drink.

Even when someone dies with a deficiency, we search for blame so it doesn’t appear to apply to us. When two bariatric post ops died with B1 deficiencies last December, hardly anyone spoke of it. Crickets were chirping in forums where the day before loud drama reigned over much less important matters, as if silence would not make it bariatric reality.

People were and still are afraid to say these people died because they did not take supplements. The only good can come in educating others of what can happen. One may have been saved with a B1 injection, but a hero couldn’t get through the red tape of her country. The other, just weeks before passing had related to friends she didn’t take supplements, but who knows. Images of these two beautiful faces should be framed and placed in bariatric surgeons waiting rooms (along with all the others) as a reminder that we often write our own bariatric story.

Yabba dabba doo or don’t?
If you take one thing from this piece, it would be to at least chew a couple Flintstones every day, they are certainly better than nothing and good ole Fred & Barney may even save your life… but make sure you don’t trip over Dino as there’s nothing in them to stop you from snapping a wrist. That is truly up to you.

Get yourself some Multivitamins & a bottle of Vit D!