Dances with DS

Things are maniac here.  The washing/ironing/ packing knows no end.   I eat  as best I can but it’s just not great. Better  than a few weeks ago but  I feel I am still in shortfalls.

My days are dysfunctionally empty without Petal. I miss her as much as I did initially and I am panicked that I can’t seem to heal or find closure about her death. At night I can’t sleep without reliving those last awful hours she had. I think if only I could rewrite those hours, if I’d have known there was no hope I would have put her to sleep gently instead.  I try not to express my daily grief as it only upsets my broader circle family & friends, but I also feel they don’t want to hear about my grief as it appears unnaturally protracted. My immediate family are much like me though, we all still float about in this sense of loss. I wonder if this will ever abate, dammit! Or has it cut me so deeply that I will forever have a lame pulse of missing in my heart.  Maybe.

I am very stressed by the forthcoming trip & the fears I have for my mums safe transit though major surgery. These are not good days.

To further freak me out completely Pete had a sudden trip to Canada come up - yes in the first week that I am away. And here is my Zen, on meds, not in prime health but okay. Just okay. I really thought I might lose the plot when Pete told me this. Of all the crap timing. 

A kennel is out. I just can’t do that to him. So we frantically started to look for a home environment to place him in. Luckily there are such places. We found a fantastic agency that does just that and on Sunday we went to meet Fred & Bridget who are at home all day, adore dogs and seem a wonderful couple. Poochi made himself right at home very fast.  I know they are the best dog people we could have wished for to look after him. But I still feel really bad doing this to him. I can’t think about it as it only makes me feel miserable. At least he is getting 5 star care and loads of love. Could be a lot worse.

So I go to South Africa with a heavy heart about this even knowing this is the very best outcome under the circumstances possible for him.  I hope once I am there I can find the strength to help my mum the way she needs to be helped - I shall draw on inner resources I don’t know about - I hope!  The thing is I do love my mum dearly and would not be leaving her to go through this alone on my life. I need to try to lose my anxiety as it won’t serve  her in the least.  How?  I don’t have a clue. I’m just feeling angry because I feel like life is bollocksing me too hard right now. I have a great deal of frustration, mainly because I am a control freak deep down. I have had to drop plans I had on the work front because life is controlling me right now - not the other way around. And nope I am not going with the flow.  The flow is a great big  tidal wave  imo and  here I am throwing rage and sticks  at it! I should  build a raft instead.

I’m tasting how the knocks can drive a person down fast. How one could get selfish and hard…and I don’t want to evolve like that but I see things in myself I can’t stand at times like this.  I’m quite sick of being a drivelling moany stressy wreck now. I’m going to have to get my psyche to higher ground soon. I know I have the choice about how I percieve things. I know attitude is a choice.  But I also know it’s very hard to be ra-ra jolly hockeysticks when one is feeling pushed up against the wall face up.

Maybe when I am back on home soil I will look to the beautiful mountain and find some strength there. Perhaps I will walk along the sea on soft white sand and find energy again.  I know despite my fears and anxiety,  I will love being with my mum and among good friends and family. I know these times with my mum are precious jewels to savour and my focus must be on this fully.  I tell myself between the moments I could just spiral into mental incapacity, that it will be okay. That there is still some bigger plan that I can’t grasp. That I must hold the faith. That above all in my own despair I must not overlook the fact that others are greatly suffering too and that because of this I must be kinder than usual to everyone I meet.

Take care all my friends. If you are struggling as I am, hold the faith because that is all one has at these times.  Hold tight, it will be okay…for both of us. I shall think of you all and hope you are doing well with your surgeries and your lives.x

I will connect with most of you in 6 weeks time again.    

I’ve been determined to push through on the eating front at least. It’s no joke to start losing weight at my stage of the DS game. I’ve written enough times that ‘food is sometimes medicine with the DS’ to have brainwashed myself!

I’m not mad keen on eating but I still love food. This is quite an odd thing really as I always associated love of food with eating. I sit glued to foodie telly programs, but have no desire to taste the food myself. I still enjoy cooking, but sometimes I only take a few spoons to taste then eat what I have cooked the following day. I don’t have urgency to sit down and devour a bowl full. It’s quite strange really and I don’t understand it, but I think it is very much better than being driven by a compulsion to eat. For me, anyway.

So we sit, bowl of food & I. It is sometimes a long sit if I am honest. One bite interspaced with resolve. lol. Inevitably my food goes cold but I still go on chomping away with determination. Gotta do it!

Can’t say I lick the bowl though! What I find interesting is as soon as my body gets wind of too few calories, I start craving chocolate. I know it’s not actually chocolate I crave - it’s calories. The body speaks in strange ways. As volume eating is out for me right now, I find eating fattier food helps me at these times. So do nuts.
My trip to South Africa gets closer by the day. I’m unpacked and disorganised. I have no bra’s that fit. It’s not funny! The boobies are so small they slip out of my old ones now. Leaving me with a lopsided chest sometimes, as one stays put but the other departs south.

I had to get a doctors note to cover my butt regarding the amount of vitamins I need to take daily. In South Africa now vitamins are treated like cocaine…probably due to people trying to hock them as aids cures. It’s not that the government cares a jot for the people with aids, it is just that they sniff a big pie which they will try to control for profit. I better not go there otherwise I start thinking of Mbeki and Mgabes brotherhood and I lose the will to live. But be warned if you are travelling there as a DSer….get a doctors note for your vitamins.

Petals memorial garden is taking shape slowly. In a circle I am planting a beautiful maple tree. Around it I still plan to plant seasonal flowers, but right now there is not the time, it’ll be on hold till I get back.

I’m dreading leaving Zen right now, although my boy is doing okay. Problem is heartworm or no heartworm, he has such a bad heart murmur. I can feel it when I stroke his chest, it’s that bad. A whoosing and fibrilliation that goes beyond the ordinary pulse of life. I’m on borrowed time with him. I hate to say it but I know it. I know Pete will love him & care for him but he’s a mama’s boy. With Petal gone even more so. I cuddle him & fuss over him too much now. He misses her too, he seems at a bit of a loss without little miss personality egging him on everyday. She really brought energy to all our lives. Miss that piece of gorgeous everyday.

After indepth family discussions we feel we must not allow this empty hole in our lives to fester. We know our Zen may not be here for very much longer. We also know Petal is simply not replaceable but the quietness and somberness of our house sans a bullie-dog is fillable. It drives me to distraction how quiet and still the airwaves are here now. No bouncing buckeroo ball in mouth begging for walkies. No dippy mad running from room to room as only a bull terrier can do. No snuffles and wet nose pushing at our arms for cuddle times. The big empty prevails. So, we have begun to look at puppies. It’s very hard and somedays I think I just cannot go there and I should wait much longer. No doubt some people would judge us too for going this route so soon after her death, there are days I judge myself too and feel as though I betray my darling and dare to hope too much. But other days I think my Petal would want us to give our love and care to another dog and to have laughter,mud on the floors, mad fun and bullie-love again. We will see.

My blogs here are about to dry up for around 6 weeks while I am in SA. After that I’ll stop going so off topic, I promise! I won’t combine dogs and ds. I have plans to start another website focusing on French Heartworm Prevention, in memory of my piece of sunshine and all the other dogs we lose to it. I have decided I won’t fall back into bitterness and grief. I won’t. I’ll still ask ‘ Why oh Why my little Petal???  Why us?’ though for the rest of my life and I don’t want anyone else who loves dogs to ever need to live with the same question.

But sheeshpers ….I am getting a bit tired of the gods putting me onto such big missions in my life! What is this thing about me being given the happy tasks of raising awareness. First with my DS here in the UK - now with this Heartworm. ENOUGH!

As for this blog & my DS website I’ll do as much research as I can while I am away and once I am back we will lift off back into DS world and start to tackle the wonderful world of DS supplementation. Oh the joys!

I’m wondering if I will ever stop alternating between the anger and then the crushing grief that hits me like a cricket ball in the chest everytime I see another ‘mark’ of my Petally. And the girl did leave her mark every where, a bullies puppy jaws know no rest . In the nibbled wicker corner of a storage box I suddenly stop and get a sharp heart pang. Her bed is still in my room I cannot move it and it’s not healthy, but it was so painful to pack up her downstairs bed I haven’t the courage yet. In the garden her tyre on a rope hung, just aimlessly blowing in the wind until my son could bear it no longer and removed it in tears himself. I found her boney ball toy and her rope toy under the living room sofa and had to sit down to compose myself. I suppose I am going through those stages of grief one hears about.

During further research into heartworm I read of a dog brought back from the brink of death by vets who knew how to deal with it in a fast way and I had a rage in my soul a tempest and a ballistic storm all in one. It’s as well my car is not working right now else I may have in my mad grief found myself at the Vets reception screaming blue murder at them for NOT knowing how to save my baby. Somewhere deep down though I know it was too late but if only, if only… plays through me like a stuck record. I have no acceptance of this yet and my days kind of jolt past in broken down fractions of replays of happier days. I smile remembering my little minx, then weep copiously in the next minute.

I feel too much. Way to much. It’s a both a personal blessing because my life is made vivid with feeling in many ways because of this and what is ordinary to others often presents as extraordinary to me, I think. But on the flip side it’s a horrible curse too. When when people tell me of sadness in their lives, of how they lost a beloved sister, child or spouse, I feel selfish & self absorbed in my own current pool of swampy misery…guilty too that in me this loss of my puppygirl continues unabated in unimaginable ways. I keep thinking by comparison my loss is small, but perhaps the brevity of loss is a bit like love…it can’t be measured, nor compared. So I cry for them, me and the whole darned world of pain & loss all in one.

I should count my blessings, I tell myself, but my heart betrays what my mind thinks it should do and I fudge about aimlessly in my psyche.
What touches me is how in the middle of my crazy world right now, strangers reach out. There is a lovely lady in Wales who also lost the most darling puppy of 7 months ( I saw a pic of her baby) to heartworm and she reassures me that I am not actually going mad. That it is a terrible nightmare and that she too felt as I do now. Angry, bereft, cheated, bitter, sadder than sad and frustrated as all hell that so many Vets bump this off as ‘rare’ and not worthy of even putting up notices in their offices of it to warn all dog owners of it’s horrors, nor to do proper research in how dogs presenting as emergency cases could possibly be saved. I shall call her sometime soon to thank her, when I can speak of my Petal without dissolving.

Zenni boy shadows me right now. He always did but now it is more pronounced. He is ever by my side little orange furball comforter. I still have fears for his life too, but they are ebbing a little. He has been on prednicare (a steriod) for 3 days according to plan. The idea is that if the worms release antigens he may be spared toxic death. No problems yet which is a great relief, but I am neurotic - checking his poo for any signs of bleeding, ( oh the joys!) waking through the night when he so much as snuffles in his sleep to check on him. Perhaps I am also fraught and tired from so little sleep.

My day feels like a constant round of remembering pills - my own intake hits near 20 currently in various combo’s for best absorption at the mo. Zen only has two steriods a day but the timing must be on the mark…12 hours apart. I’m aware that by giving him these we are effectively shutting down his adrenal processes and his natural immune function to a degree. Missing a single pill will be bad for his body and once the worming treatment is over we will need to taper off the dose to give his body time to produce it’s own hormones etc again. Dogs pulled off steriods suddenly can die from adrenal failure.
My eating is a little better…though I wonder if my tum has grown smaller with the DS years rather than larger in a weird kind of way. I eat less than I did in year two without a doubt. I feel very full currently on little…but perhaps it is just because for the past few weeks I have made little effort to eat staying with protein rich fluids more often than not. This morning i forced myself to eat two eggs, a rasher of bacon and half slice of toast. I could not eat lunch I felt so stuffed, so I plumped for a fortified banana milk instead. Tonight I ate half a hamburger bun, 2 leaves of lettuce, a slice of tomato and a cheese covered burger patty. I wanted the handful of chips on the side but ate one and had a golfball feeling. So much for that!

I had my birthday on the 12th and it almost slipped past into an oblivion, if not for my family. My family bless them, spoiled me with so much love and tlc. I felt so close to them and thought how amazing they were in this raw grief to create in the middle of it all some celebration on my account. Reflecting on this, I realise somehow over the next weeks I have to turn this corner and start to truly count my blessings in a heartfelt way again. Not just for me but for all of us.

Vet just called his stool tests are negative for A Vasorum.

I want to feel relieved and do a happy dance but the fact is he shows possible clinical signs.

In a comparison of blood versus stool tests, only half the dogs tested positive for A vasorum via stool.

This is because the worm has a shedding cycle & if it is not shedding the stool can show up negative.

So - I still have to deworm. I’m praying the cough & bad skin is not related to A vasorum and that I can breathe a little easier. But I am not wholly convinced. Will see how the deworming goes. Fingers crossed.

As you can see by my tone today I am vascillating through angry moments. I’m caught up in this nightmare worm scenario I swear it’s like a bad sci-fi movie.

I sit daily for hours trying to make sense of this worm. Now Petal she was bold. She was up for a happy gourmet experience of frogs and slugs. It’s highly possible she got her A vasorum neat. Zen is more complex. He is a picky poodly. He’s not into gourmet ideas. He likes his food straight - sausages. Beef. Traditional British fare. No way would he eat a slug, a leaf, a frog even less. He does however love filthy water. I think he got it from doing this. If this is the case what’s to say A vasorum is not infesting Surreys boggy area’s…and water contamination is not a joke.

Randomly I found during my research an Aquatic supply shop talking about A vasorum in among the ads for pond food etc. It struck me as odd. I then found out Aquatic snails can carry the worm. Deep joy, I have a pond. The dogs both drank there at times. On the other hand - it could be your ordinary old garden slug. Or fox poo. I spiral into possible things that threatened my dogs without me knowing. Who knows? We walked her near lakes and boggy streams all the time. The water though scares me as this might be how it is spreading? I don’t know but I wish someone would care enough to find out if this is the case. Needless to say in my angst after reading about water snails I have filled in the pond. I’d fill every lake and marsh & exterminate every slug and nail in Surrey if I could right now. Once I saw ponds and lakes as beautiful things good for dogs to play near and have fun, I saw slugs as pests but harmless - now I see them as infested killer pits of my own despair. How fast things have changed for me.

It’s tempting to poison every slug in sight and lay out the bait in the garden. However, this is not only futile in the bigger picture of A vasorum, it is also very dangerous. Probably more dogs in the UK die from snail bait poisoning than A Vasorum, a sobering thought to bear in mind.  I know slug poison containers often say they are safe around animals, but don’t be fooled. NO slug bait is safe around dogs and the smallest amount can kill a dog fast.

The best one can do is sweep up leaves and garden debris and drown the slugs in beer - yeeugh! Fill in ponds to avoid frogs and avoid attracting foxes into the garden. Research dewormers carefully, find a good preventative for your dogs. Advocate recently released a dewormer that might be effective but I still need to research that.  Stool test dogs regularly.  Don’t be fooled by the fact the dogs seem fine…look especially for things like dogs tiring on exercise faster than they used to. Look for things like dulling coats, loose stools that might come & go as in Petals case which I thought was allergy related. If they cough don’t waste time get them to the vets. Vomiting.  Bleeding disorders might also occur - too much bleeding from a cut or during minor surgery. If your dog seems to have lowered immune function - gets ear infections frequently or just seems off kilter. Test. All these are worth checking out properly. My dogs will now be stool tested 3 times a year at least even though it is not greatly accurate along with recieving preventative care.

Zenni went on the dewormer Panacur on Friday but had a violent cough gag on Saturday. I decided he was high risk and it looked like a bad reaction to me. Stopped the panacur. Brick & hard place stuff. I don’t treat him, he will die. I do treat him and he may die anyway. What to do?

Call his vet this morning. Want to make a plan - a kind of here’s what we will do if his breathing shuts down???? After Petal’s death I have to know I am doing all I can plus some. I know Zen is at risk, if the worms create antigens, if they form embolisms, we are in big trouble. He has a BAD heart murmer which SHE diagnosed. Tell her this on the phone, she clearly thinks I am completely over reacting here. He’ll be okay - I must have confused the possible side effects with the immitis strain. It’s a lungworm really not a heartworm like the US one. I know that but what she doesn’t know is it’s not just your bog standard old lungworm. If she’d held Petal in the final hours she’d know that. Still, I doubt myself substansially & I don’t argue. She’s a nice person, don’t get me wrong and I know I am a difficult customer right now. I’m every vets nightmare really, but I have good reason to be. After the call I go back to my collection of researched papers on shitty worm Angiostrongylus Vasorum. Check if I have it right…I have. I can’t play around. Have a panic episode as I don’t know what to do. I spiral and drink three cups of tea in a row then think I might start chucking from pure stress.

Pete remembers we spoke to a very nice Vet, as a complete stranger on the day of Petals death. Go to see him Zenni in arm. Nice guy - best of all OPEN MIND. We arrive, he has already been researching…gives us a paper regarding A.Vasorum. Instantly knows of treatment problems. Swear I could almost hug him for that. Listens to Zens heart. His eyes go up bigtime - I know I say - it’s bad stuff. He says the problem is grade 5 or 6, really bad. I ask if he reckons we are in a risky space here regarding Zen. He is as realistic as me - yup - it’s risky. He must have seen my face falling because he added that Zen has strong lungs. It’s like a tiny glimmer of hope. A glimmer is good right now I’ll hold on to that.

Meanwhile, Poochi is doing a good job of being cute as hell, sits like a good boy and noodles up against Vet’s leg shooting him the lurve-look - doggie language going on. He is saying ‘ Mr Vet you are MY man!’ - I had to laugh. Zenni bless him is a sissy and a flirt!

We discuss his worming plan and we discuss the wormers his practice uses. He questions if the dewormer he has his clients on is safe after we tell him we dewormed our dogs like clockwork. Takes me to the storeroom and we read the brochure in the box. ‘Prevents against the immitis heartworm it says’. We stand there silently. I’m flashing through all the times I dewormed my dogs USELESSLY. THINKING WE WERE SAFE. Yep, right. Its sooooo misleading - on both boxes (the one I give my dogs and his recommended brand) on the box is listed prevents heartworm. What it does not say is what type of heartworm. That’s in the teeny tiny inside blurb. And like most of us in the UK even know there are different types of heartworm. Mr Vet looks at me, I look at him pennies dropping. I just say gently that it is going to be best for his practice to find one that does work against A vasorum. He seems up for it. I tell him I think it’s not so low risk - I have read two reports stating it is endemic in the South East. That I fear we just don’t know how many dogs are actually dying from it - I mean plenty of dogs do die from unknown respiritory causes, epilepsy, heart condition. He gets me.

Mr Vet is an honest man. He’s not treated A Vasorum before. No problem he is going to learn tonight - will help me work a plan to try to diminish risks with Zen Zen. I’m fine with this - give me a learner with a smart mind anyday over someone who doesn’t want to learn and knows little anyways. We play around with possibilities: to put on steriods or not, to consider antihistimines or not - and agree to resume treatment on Wednesday. We discuss the what’s if of Zen going into a trauma. I know the plan - we go two ways. If it is too severe we put my boysie down. If we think he could swing aroung…IV, cortisone, antihistimine, oxygen,??? fast action. Zen will guide me.

My psychic heart just thumps kind of dully since Petally died. I have little verve and now facing this with Zen, I feel bitter. I do. And I am not a bitter person - nor much of a WHY me? type - but suddenly I am. I know my boy has a 50% chance and I might be very optimistic. Poor little guy, he’s got pure good karma. It’s just unfair.

We buy him a ball at the vets. He is so sublimely happy and I think how little it takes to make a dog happy. I think maybe I will take him out for more walks before we start treatment and feed him the best food and do what I can to give him TOP LIFE, while I still can. Okay - in case he dies. He cuddles against me for the ride home and keeps looking at me with that ‘what’s up mum look?’ I cry. Again. Thousandth time this week. I tell him we have to be strong. Think he knows how I am feeling, he cocks his head and listens to my mad ramblings intensely. Then I get little feathery licks on my hands as the tears fall.

And my DS? I can’t cut it right now. My eating is appalling and my bones are jutting. This DS is not a good mix with stress of any kind. And the truth is I actually don’t care. I just don’t. Think depression is biting me hard.

Pete woke up this morning. ‘I had a dream’ he says - ‘worms were eating my brain’.

I don’t know what to say so I just lie there and stroke and hold his hand and wish I could lift Petally up off the floor and put her back in his arms and say ‘babes it’s only a foul nightmare - see here she is….silly billy!’.

Worms have eaten our heart, our dogs hearts, and in our dreams and waking life worms possess us.

It’s nasty.

The above pictures are me with Petal as a pup. I just fell for her hook line and sinker. She opened my heart up right from the very day I first saw her. Instant love! The pics that follow are me with my gorgeous dogs on a happy Christmas day last year. Please note I don’t usually dress like this but I was wearing ALL my new chrimbo clothes and jewels right down to the gloves and boots! Also I seldom post pics of myself nowadays as it’s still like I don’t recognise myself after losing 145 pounds! In one of these pics I am trying to lift my Petally, note my buckling legs lol - she weighed a ton but I would carry her forever in my arms if I could only have her back. My squiffy poochy Zenni (last pic) is currently holding me together, bless his little poodly heart.

I can hardly look at the pictures below right now because I just split my heart everytime . Some like the one of her recently smiling full frontal, and the one of her leaping into the air, and the baby puppy one where she gives the soft toy tiger a look to the side are permanently etched on my brain. I cannot get over this loss right now, the loss of her warm little body, the loss of her presence, the loss of days spent in delight of her progress and just the loss of the astonishing joy-energy Petal was. I am so depleted in my heart right now & sick with sadness. Sorry to go on so - but this is the way I deal with myself when things hit me - by becoming a wreck basically! Here is the photo gallery that shows more pics of our stunning loveable dog: http://mssint.com/petal/

Update: Our Petal was autopsied and found to have Heartworm or Angiostrongylus in her brain & other organs. This is apparently rare although Surrey is known as a ‘hotspot’. Most dogs can be saved if it is caught early enough. Don’t rely on the fact that you regularly deworm your dogs, we do too. Although this is very important for other parasites, some brands don’t prevent infestation. Unfortunately these are the brands you vet will likely prescribe for you - Stronghold and Drontal WILL NOT PROTECT YOUR DOG against Angiostrongylus. Be aware of this. There is not one type of dewormer as far as I am aware that will prevent and kill of all types of worms. You will not see this worm in your dogs stool as you will many other types of worms. I’m still researching the best way forward for future deworming of my pets, having discovered that stronghold was absolutely useless in Petals case. Snails,(both land and aquatic) Slugs, Foxes and Frogs carry the most common form of the disease. (We presume Petal has the vasorum type but there are other types too - rats carry a form of it). If your pet drinks dirty water or has a habit of snail crunching and gets ill: exercise intolerence, coughing, vomiting etc please think of this when you see your vet. In fact think of it anyway even if your dog drinks foul water or has eaten a snail or slugs or had contact with frogs. (I caught Petal chasing hapless frogs in the garden before and my husband mentioned to the vet that she had been found licking a dead one.) I don’t mean to alarm anyone, dogs can possibly live quite a long time with this worm (though eventually it will cause death ), and with the ear infection Petals defence’s were low, but please don’t go through our kind of grief - read about it on the link below and know the symptoms and the treatments. A simple stool test may test positive(but is not guarenteed by any means) and at the very least your vet will be alerted that you are aware of this parasite. Do not let your vet prescribe high dose dewormers for treatment without planning a strategy for your dog that takes into consideration overall health and your dogs weight and age. Deworming Angiostrongylus is not simple… if the worms die suddenly they can cause fatal toxicity via antigen release. They can also form embolisms. Please be careful and research this. Some vets will try to reassure you this is just a lungworm and easy to treat…confusion reigns. It’s not easy to treat if you are not aware of possible side effects of the worms themselves. For more information regarding this virulent life threatening parasite see these links:

http://www.heartwormsociety.org/

http://www.newmaldenvets.com/noticeboard

http://www.blackwell-synergy.com/doi/abs/10.1111/j.1748-5827.2004.tb00261.x?journalCode=jsap

http://www.ncbi.nlm.nih.gov/pubmed/15664523

http://www.blackwell-synergy.com/doi/abs/10.1111/j.1748-5827.2005.tb00300.x

http://www.rvc.ac.uk/AboutUs/Staff/kchandler/Publications.cfm

http://forums.pigeonwatch.co.uk/forums/index.php?act=ST&f=13&t=25895

http://forum.petmeds.co.uk/archive/index.php/t-356.html

We are having Zen our other dog, tested today and are most concerned as Zen has been coughing for an age and despite trying to find the cause (we have had ECG’s & x-ray of his oesophagus done quite recently, but no problems detected except quite a strong heart murmur which is now worrying me.) He was in great health a while ago but his coat looks suddenly dull and sparse (I noticed Petals coat go dull quickly too) so I don’t feel very positive. He coughed through the night and I hear his stool test will take several days before we will know if he tests positive. In the meantime Zen is not on a preventative measure. I called and spoke to the Vets nurse yesterday, asked if I could do anything to prevent the worms progressing like use his regular dewormer? She said to use his regular dewormer, but I have not done so as I fear it may prevent proper treatment (medicine interactions scare me as we thought this might be the case with Petally.). So fear is my middle name today. I feel I might be sitting on a timebomb and am taking further steps today to find out if there is anything I can do for my Zenni interim. Please if you have a moment send thoughts, vibes, prayers for his safety as the treatment in itself carries a risk of death.

UPDATE: I discovered after writing the above that his regular dewormer would not protect him in anyway & I have edited the bit on Petal to include warnings about this. After speaking with his vet she prescribed panacur for him. After Zen had one dose of panacur he became very ill the following day with extreme gag-coughing. I stopped immediately and called her to express my concerns about both the fact that he is a tiny dog with a grade 6 heart murmur and of the worms potentially causing big trouble. She told me to put him back on the panacur and that this was just lungworm. Mmmmm…. I did not agree.

He is currently with a vet who took the time out to research and protect my dog as best he can. We are deworming with panacur and a steriod to hopefully prevent antigen side effects at a very low dose. The panacur dose is quarter that prescribed by the original vet but it is being given over 21 days instead of seven. He is 4 days into treatment as from today 23/04 and so far he seems fine. He did cough a bit more than usual today but I am expecting that and it has not been severe, just a little more often. He is eating and drinking well.

This is not my ordinary blog but in my blog I tell of not just my DS challenges but also my life challenges.

I’m sitting here reeling from shock still and feel as though my heart has been pulverised. I have cried all day. I cannot believe our little doggle Petal is gone. All of 10 months old.

She had an ear infection last week and we took her to the Vet. She inspected her and gave her an antibiotic injection and a pain relief drug. Also otomaxdrops to treat the ear infection. She came home and was very ill but otherwise fine. Nothing like an ear infection to make a dog not it’s usual self. We gave her lot’s of TLC, but some days later she was still in pain. We called the vet who prescribe a drug called rimadyl, a painkiller. She seemed perkier after her first dose. The next few days she seemed to level out. I’d not say she made great progress, but she was not regressing.

She was bought a new toy yesterday and played with it a while which we thought was great. She picked at dinner, so later on I gave her milk. But in the late night she was restless and seemed to be in pain. Pete put her in our bed and lay with her in his arms. At 2 am she started to vomit and fellout of the bed. She vomited several times. Pete woke me up at 5.30 and asked me to come and see what I thought. It was clear she was in a very bad way. She was weak, disorientated, vomited again and appeared lethargic. She had her first seizure. We put her in the car and took her to the emergency vet. She had several seizures in my arms as we drove her there.

The vet told us her other ear was perforated. This came as a suprise as we had not been told of this on our initial visit. She could not confirm if she had perforation of the ear that we had been treating with otomax as it was covered in black gunk. She put her on oxygen, diazapam, a painkiller & IV fluids. By now her problem was clearly neurological. The plan was we would see the neurologist if when they tried to wean her off the diazapam she was not improved. We came home and sat her in a numb funk waiting for the call so that we could prepare to take her to the neurologist. The call came but to our shock & horror the vet told us Petal had died.

I cannot describe our anguish. We researched rimadyl on the internet and found that it has killed many dogs in the US. Pfizer was involved in a huge court case about it several years ago. They settled with the owners out of court and the drug is still on the market. I do not know if this caused our Petals death, (many more dogs seem to do very well on it with no effects)but the symptoms of the other dogs that died are eerily similar. Weakness in the legs, vomiting, dilated pupils, seizures etc. Eventually death. Otomax should also not be prescribed if the eardrum is perforated as it can apparently cause side effects. But this is very very rare indeed, and on normal ears,again it works very well. I’ve used it in the past on other dogs before and it cleared ears very well. It may be that our Petal simply went into shock from severe middle ear infection, maybe encephalitis was caused or did she have an underlying dormant condition?. I also wonder if Petal fell out of the bed and damaged herself …my mind tries to think of everything and anything that might have caused this tragedy. It could be anything really I don’t know, this is the worst part - the not knowing and the shock of it all.All I can say is had we known of the possibilities with both otomax(on perforated eardrums) and rimydal I would not have given them to Petal.Even though it might be they are not to blame at all, imo we should have still been informed of her perforations and of the fact that rimadyl does carry a warning of possible death on it’s info sheet which we never saw. This way we could have made an informed choice and weighed up risks with our vet.

We are desperately sad, shocked and gutted. We took in a seemingly healthy vibrant pup last week, she was full of life and energy. Now she is dead her heart having stopped. When the vet tried to put a tube down to save her blood was present in the tube.

My DS has fallen by the wayside today. I cannot eat and cannot rest. I see my girl’s details in my mind over and over again. The gentlest brown eyes. The spirit and curiosity of her. The absolute love and trust. I see the little seam on her bully tummy - always reminded me of an open WLS cut only it is a godmade thing all bullterriers have. Her bed and toys are as we left them this am. I can’t gather the courage to put them away.

We only had her for 10 months but what a special girl she was. Bright, super exceptionally intelligent, incredibly gentle and loving. She filled our days with light and such joy. I’ll never forget her presence. Not ever. She was my and Pete’s and the children’s baby - we adored her.

I’ll not be posting further this week. I need time to try to make sense of what feels like a bad blow to the very heart of me.

R.I.P my Petally. You really were a Petal after all - a beautiful petal floating to the earth on a gentle breeze, for only a short transient time. XxxXX

So your labs came back. And maybe they are less than perfect. Many people will get a deficiency despite strict compliancy. You may wonder how the heck it could happen if you are so good with your supplements. I ask myself this same question. On 3000mgs of calcium and slowly upping the dose, and abundant high dose Vit D daily, plus magnesium, I continue to lose bone according to my dexa & my last labs were a little low on calcium for the first time ever, though both PTH and Vit D are normal! (Go figure!). So I know how this feels! I’m not there yet but I may be a short hop away from osteoporosis. So I ponder this a lot and in no way am I embarking on preaching to anyone.

Juggling precise amounts of doses in an imprecise body is an art form all of it’s own. The body is not a thing we can freeze in time & space and put the same formula of vits/mins into hoping it will remain solid. It might - but then again it might not.It’s one I still don’t have a handle on.Reasons for deficiency may be many, among them:

• One is simply not taking enough of a certain vitamin/mineral.

• There will be times that immune function might be lower and it uses more nutrient supply. Simply not being well, or after a surgery may cause the body to use up supplemental resources rapidly.

• Perhaps there is conflict with the minerals at the absorption sites.

• A synergistic vitamin is missing out of the whole picture or it might be in a ‘low productive’ form eg calcium carbonate.

• There may be a low grade unsymptomatic bacterial overgrowth

• Malabsorption has increased for some unknown reason. (More common is that malabsorption decreases with time, but not always!).

• One may be using medications that are affecting absorption rates or metabolism.
• One may have a strong genetic disadvantage such as myself, regarding calcium metabolism.(And to think I’m probably going to get the good old menopause too in this decade! I could weep! )

The thing is it’s sometimes a silent process. We might start by getting just a whisper of tiredness or feel perfectly fine for quite a while until it suddenly becomes symptomatic.

Then there is the Vitamin quality itself. Do we absorb oil solubles? Sometimes, but only in megamega dose. I do, my labs prove it. However I believe dry forms are the most optimal and I compromise by current supplementation of dry form Vit D. On the other hand it suits me well to consider that the V4L I take contains many many other elements and vitamins in it that a traditional dry based formula would not give me. I once tried to get the conendrum worked out & the truth is if I want to do dry plus everything V4L provides me with I would take way more than 12 vitamins daily. Many of them would need various points of sourcing giving me a nightmare scenario of juggling supplies and additional shipping costs. So it’s a compromise and as I always said not ideal. In my ideal world I would want to see a formula based on dry form ADEK with strong doses of Multi B’s, Vit C, Zinc, Selenium, Vit K2, Boron, Copper, Iron, Zinc, Manganese, Chromium,molybdenum, potassium, lutein, biotin, folic acid. Plus a bone one with Vit K2 (natto based)Quality magnesium, Top form Calcium, Vit D. I get in all the vits/mins I just listed, but it could be better, in my ideal world some kind of formula that allows maximum individual tweaking would be nice. And just in case a nice kindly manufacturer happens apon this - please get plenty of Vit K2 in the supplement, it might just turn around the bone thing, for the next generation of DS patients.

Questions I currently ask myself while pondering the complexities:

What does the average GP know about vitamins? Not very much and then put it in the context of even less understood malabsorption and it’s too daunting for some of them to even try to help us. I felt sorry for my GP last time I visited as she said ‘we must do something about your bones’…then sighed and said it was best dealt with by my surgeon. For years I and many of my DS & RNY brothers and sisters have poured over any tidbit of vitaminology we can lay our minds on. Has it prevented me getting deficiencies. No. It hasn’t. It has however helped me quickly resolve some of them in the past and as a result I feel strangely optimistic about the future.

I say ’strangely optimistic’ , because it is peeving and sometimes it puts one in a head funk to be trying to find solutions for deficiencies. I hedge my bets that the DSer who escapes minor (but irritating) deficiencies longerterm is the exception rather than the rule. This is part of the landscape for many of us. The trick is to try to keep the deficiency in the minor league & that is not always easy. But chins up my friends - I think we will yet win the day & make distal surgeries finally completely safe by learning more and staying on top of new data. Imagine that!

Questions I currently ask myself while pondering the complexities:

Is the vitamin cut out for the job? This is a nice sticky area. Calcium carbonate is an example of that sticky area. As is magnesium oxide. I consider these low grade quality in a DS context. But others may disagree. I have said why enough in the past so I’ll leave it at that. Other things I have thought on - can a so called carbonate turn into magic citrate? ( We have many WLS patients on this NHS version). The jury is out, but personally I’m not convinced. Time will tell.

Ready for more?

Okay, what about synergy. Each vitamin has a synergistic mineral. It’s not always logical to assume because we are low in iron we are low in Vit C or Vit A…but sometimes it is worth giving the partners a little boost while trying to put right the primary offender, specially if the labs are ‘normal but lowish’.

Then there is the question of elemental intakes. 1000mgs of calcium does not mean 1000mgs of calcium. Ditto with magnesium & now it seems this might be the case with strontium too. There is an elemental amount of calcium/magnesium/strontium in each supplement that needs to be figured out otherwise one can be hugely deluded.

We are probably going to discover new vitamins we may malabsorb. I had this unpleasant little experience myself reading up on just how complex Vit K is for example and realising there is not a hope that I absorb Vit K2 - yup it is also fat soluble. Lutien was another wake up call I had in the haze of blunted eyesight which is mercifully much better for taking it now. The problem here is that aside from clotting factor labs for Vit K1, there are no labs for Vit K2. No labs for lutein either.

Sometimes one has a genetic ground to face. In my case it’s a strong family strain of osteoporosis. My bones have consistently been losing density over the past few years according to my dexa. Yet, for close on 5 years my PTH , Vit D and calcium levels looked fine on the labs. I won’t go into it here because I mouth off about the importance of dexa’s way too much as is! But get a dexa!!!(couldn’t resist that it just snuck in, sorry, lol!).

Might sound odd but I am actually doing pretty well on the bone front - by now I would have expected full blown osteoporosis & I am not there yet. Still I feel an urgency to turn this around so I am heeding my intuition.

I have had on-off zinc deficiencies and am dealing with one as I speak. I have had short bursts of iron deficiency that I have resolved, once even unknowingly. When I went to the local hospital to seek help with my bowel obstruction they did labs. The young doctor came back and asked me a strange question: ‘Did you have an iron transfusion?’ WOT!!!? I was puzzled until she explained that my GP should have done one as my iron levels had been extremely low. It’s amazing what went through my mind - I instantly felt dogtired and faint until she re-assured me that amazingly enough my iron had corrected itself. Phew! So there we go. I had not been informed. Then I remembered feeling tired and how for a month I had taken additional iron daily. But only for a month and this was a good 4 months later & the iron was fine. Maybe I was just lucky. My last labs a few months back look fine iron wise.

I learned something through my iron and zinc deficiencies. I learned that there will be some deficiencies I will be more prone to on my DS journey. It’s highly likely they will come and go. Provided I jump them as fast as possible I will probably not need everlasting supplementation (except for the bones stuff, but that’s another story!) - just on and off tweaking. Take my first zinc deficiency. I had it in the early days of my DS and I worked with it for many months until it looked stable and some time beyond the stability point too. Then I stopped the solvazinc but still took daily zinc in the V4L formula. I had around 3 years where my zinc labs looked fine.

Don’t despair if you have a deficiency. I was dead depressed when I got my first one, but the years have passed and I’m mellower about it emotionally now. I’m not malfunctioning. My life is still 96-98% quality. (And the 96% is momentary will divulge that later!)

No deficiency is going to keep me down, so join me if you have them, in beating it the best you can. You are not alone.Tackle it from every angle possible. We have so much to live for.

More bloggings to follow on the subject…just getting my head together about it all! I’m dragging my feet in the vitaminology department because:

I want to blog about (well nearly)fun stuff and the world out there quite aside from my small life.
I want to tell you about TODAY, how we walked the dog-persons along the beautiful canal, about how the light was dappled and we are on summertime hours even though I can’t for the life of me feel any summer yet, about how I am sick of the global warming theory as a DIRECT result of low Vit D.

Seriously though read this 1st link below…at last at last some common sense about Global warming. I love this planet as much as anyone else but the global warming religion is scary stuff - blogged about it before. Armegeddon has found a new place to reside in the global warming hysteria that people like Gore perpetuate. I find it all way more terrifying than the b/s they spout in their drive to CONTROL! The issue is not global warming - it’s control freak nature. I trust nature to find it’s own way. It’s too big for us puny stoopid little humans. Support nature by all means - I’m all for that. Quit dumping rubbish, plant flowers and trees in your garden, celebrate it’s beauty and diversity, but this fear mongering is crazy stuff.

I ask myself WHY is why is this link below not mainstream news globally???

http://www.heartland.org/Article.cfm?artId=22866

http://www.climatescienceinternational.org/index.php?option=com_content&task=view&id=41&Itemid=1

I digress though. I forget to add that I was moving it down the canal path, I can move it so well now I still can’t get over my own DS gratitude. I don’t want to dwell too long in the challenges of falling off the camels back, deficiencies, farty stuff but part of me feels it’s gotta be said & then I can move on.  I will get there on the vitamin thing - I promise. It shall be written and hopefully it won’t come back to bite me on the rear. But forgive me the odd wildly random diversion - life is sweeter that way.

Now….off to go count out tomorrows dose. I think they should zoot up these vitamins tbh, like put little faces on them or something. I fancy mine posing as little pink pigs with wings on them, don’t ask me why. Think it might put the fun back into it if I had some good visual material instead of facing a VitK2 capsule that looks not unlike a baby rabbits (or small guinea pigs) dropping. Maybe they could have an educational quiz on them like ‘guess the miniscule amount of elemental magnesium in this whopping big capsule’ Or what about pertinent reminders: ‘ Did you remember your 2 liters of water today?, ‘One more helping of carb will give you gas all night!’ or just plain old ingratiating encouragement: ‘well done for being so compliant!’ Ah, the joys!

I had an interesting chat with a cardiologist yesterday after writing about Vit K2. He is using K2 for his heart patients and I was able to ask him about the interaction of Vit E and Vit K2. He said that for Vit E to cause blood thinning it takes a very high dose and that the dose I take daily (460iu’s) would have no detrimental effects in conjunction with Vit K2.

So today I continue with the K2, onwards we go.

After 10 000 thoughts on the subject, I’m in need of a decent weekend! I need to not think and so I shall get on with restoring a few of the antiques that are yelling out for TLC. I walked through my garden this morning and was aware of it needing work. All the tulip bulbs I planted are out and they have buds! The maples are full of soft spring leaf, they are so beautiful that for a while I went into gazing mode. I have avoided the garden as I get sooooo cold out there, but today I’m going to put my thermals on and start to do some work. This year I want to remove the plants in one of the over grown beds and replace them with a mini wood of silver birch trees. I love all plants, but trees remain the true love of my life. My garden is like a strange wood as it is!

I hope I can do some work on it before I leave for South Africa. I feel that my muscles have slightly diminished recently, I feel frailer and a bit weaker than I was this time last year on the muscle front, so it will only do me good. It’s felt like a long winter to me!   Speaking of South Africa, although my mum is in good nick I am scared when I think about this next leg of the journey. Last time I was strong and I held things together. I was brave, I never cried infront of my mum once about her condition. (Just by myself on the loo in the hospital!) But this year I don’t feel strong anymore. It worries me. I just tell myself to lay off the fears. There are so many in my life sometimes, perhaps this is true for many of us. I’m afraid if I break, it will not be reversible. Comes a point I hand it over to a greater plan. But I have to remind myself to do this!

Last week Pete bought me an early birthday present. He spoils me rotten this man & I am a lucky person. I found a very unique and rare Japanese Butsudan for sale. I have been a keeper of Antique Buddha figures since my late teens and I have never had the joy of finding a Butsudan in the flesh, although I have had the priviledge of standing in front of many wonderful historical Temple Altars in my past. I was pathetically excited. I felt the way a butterfly enthusiast must feel standing in a rain forest watching clouds of rare butterflies flying up into the canopies. I feel like that every time I put flowers in our Butsudan. My oldest boy, Lukey and I went to collect it last week. In the car!!! It only just fitted in but we managed - me wodged into a gap on the back seat. I was grateful for once that I have a very skinny butt!

http://en.wikipedia.org/wiki/Butsudan

Now it stands in our living room and gives me a sense of joy each time I see it. It’s incredibly intricate - must have taken an age to carve all the bits and pieces and to gild them. It has presence. I think it was well used and loved in the past.

I am not Buddhist. I might as well add that, as people often ask me this question. I have studied almost all the major religions and have a deep love and respect of all ways of wisdom. But I can’t affiliate with only one religion. I just find that too narrow and too fraught with identification & labels. I hasten to add that I am absolutely not against one way being the best way for others. It is just not for me. My way is my own way! Sometimes I connect with Sufism, other times Buddhism, sometimes I connect with original forms of Christianity, other times it is Taosim, Zen or Hinduism for me. I don’t rest in one place.

Years ago when I used to visit a great and highly respected Sanussi (Medicine man) in Africa, he threw the bones for me one day as a special gift. He started to laugh when he was looking at the patterns they had formed. Among many other things, he told me that I was a bobbing cork on the great wide ocean and that this was the way it would always be for me.

A bobbing cork. ( Thrills the ego that one - LOL ) Mmmmmm….

….but he was absolutely right!

Well, onto more personal issues!

I haven’t stopped obsessing about this osteoporosis stuff. I’ve tried to research it the best I can. I don’t have osteoporosis YET. However as much as I try to keep the wolves at bay, I know I am sliding and I have a little time in which I can hopefully stall progress to the full blown mcoy & I want to go there yesterday!

It’s not that nothing is being done about my situation. I’m just impatient as usual. I am being well monitored currently with frequent labs and yearly dexa’s. My lab situation is as follows regarding calcium : Vit D is normal, PTH is normal, calcium was a little low, for the first time in all the time I have been a DSer. I’m supplementing appropriately & in traditional DS ways daily, calcium citrate and magnesium & Vit D plus plus!. But due to a genetic propensity for osteoporosis in my family, I have a more complex bone story than most DSers. In the next three months or so I may be seeing a bone specialist with whom I will discuss the in’s and out’s of what I discuss below.

I stress that what I write is speculative and highly layperson, that’s the nature of many blogs. My bloggings are largely intended to (hopefully) sort my own stuff out and reflect how I do this via constant enquiry. I don’t believe enquiry and questing for more new knowledge ever hurt anyone. I believe we all need to do this when we have a major surgery, imo - it comes with the territory. That said, bone metabolism is serious stuff. Think about it, do even more research using various sources, do your own enquiry. Then discuss it with your specialist. This way we can all gather more useful info and try to find out what is hype and what is not.

There are two vitamins that currently interest me regarding malabsorptive patients. We all know the general fat solubles that we don’t fully absorb, Vitamins A, D, E, K. However as usual it’s not that simple.

Vit K for example has various forms. Like most of us I knew about bog standard Vit K1, the one we get from dark leafy greens and plant oils. What I never gave much thought to was Vit K2. I knew it is synthesized from Vit K1 to a degree , but that was about it. I stumbled on Vit K2 while I was driven to research how best to stabilize my bones and it has set me thinking.

A decent vitamin supplement should provide some K1 and K1 can synthesise to K2 in our intestines, but is it enough? Does it synthesize adequately to K2?

I’m not convinced. I am concerned about Vit K2 and whether we can produce enough of it. If ordinary people have deficiencies (see the first link below) then this is a real concern for WLS patients, surely? Vit K2 appears to play a vital role in our bone metabolism (more directly and more potently than Vit K1, it seems).

As usual I tried to find out more about the cons of Vit K2. And there are big cons (in both meanings of the word!)out there in the vitamin world, coral based calcium comes to mind .

In any event, I could not find any medical papers that stated it had not worked during a trial. I could not find anything about potential side effects of overdose. If the link below stating that it is going to be added to milk in the USA is true, I presume it is indeed safe.( Idid I might add, have a temporary side effect but more about that below in my little tale of starting Vit K supplementation.)

Note: It should not be taken with anti-coagulant meds such as warfarin without consulting a GP first.

Also - I know Vit E can affect clotting of the blood but I have not yet researched how Vit K & Vit E interact.

Aside from benefits for the old bones, I would hope that the anti inflammatory role Vit K2 plays may also help DSers & RNYers who have gut/bowel problems. It may help UTI’s as well? Could lack of it play a part in Chrohns disease? Who knows. But it is all worth thinking about.

I also worry that the ‘clotting test’ commonly performed to check out Vit K levels is enough to know if we have a deficiency. It might not be (again based on the info in my first link below.)

There is a tendency among DSers to write off Vit E & Vit K as ‘lesser’ than Vit A & D…I fess up I was willing to see these as less important too - until I started researching it. I think we all need to know about Vitamin K2 as we may have several factors against us for it’s natural absorption and we might be highly deficient on account of our malabsorption:

• Firstly stomach removal might affect it’s absorption, in a cancer trial where stomachs had been partly or fully removed, the patients developed osteoporosis due to lack of Vit D…..if it is possible with Vit D is it also possible with K2?? ( I better quantify that this was full removal of the stomach - and we only get part removal. The study below was done on rats and is food for thought.

http://sciencelinks.jp/j-east/article/200403/000020040304A0026938.php

• Secondly our shortened intestines coupled with any bacterial overgrowth (even low grade) might very well inhibit our natural production of it. It is an intestinal bacteria.
• Thirdly, many of us have fat malabsorption to greater or lesser degrees. Like Vit K, Vit K2 is also fat soluble unfortunately.
• What about use of flagyl? Does it affect K2 levels? Should we supplement during or after flagyl use, even if we are not dealing with a bone challenge?
• Last, but not least I doubt (particularly as we malabsorb Vit K 1) that we can eat enough veg containing K1 to allow enough conversion of K2 in our intestines.

Studies show it has effect on both bone health and heart health & there is further speculation about it regarding liver cancer and other diseases. Obviously more research has to be done and hopefully it will be. It will be interesting to see if the osteoporosis drug companies don’t start releasing some ‘anti’ papers !

Vitamin K is found in foods such as fermented cheese products, beef liver, chicken, butter and a fermented soya bean Japanese dish called natto - which I think I will skip as I hear it is slimy and smells of ammonia! Not for me!!! Cheese is going to be a better option for me - it seems cheese that undergoes fermentation is highest in Vit K2 - bring on the gouda! Cottage cheese also has it apparently. It might be a great option for RNYers and people who like it . I have found various foods listed that have it and yet these differ from source to source, so it’s difficult to be conclusive about it. As far as I know cottage cheese does not ferment, but even so, it’s good food for all surgery types. Try to verify VitK2 sources for yourself. While I will supplement with a natto based supplement as I have the bone thing going on and need to take a huge dose, I also will make a point of eating daily fermented cheese snacks to get it via food. Maybe liver & chicken will be more regular choices in my diet. As WLS patients we can’t go wrong doing this - we’ll get extra protein at the very least.

Q. How do you know if a cheese has been fermented?

A. Apparently any cheese that has holes in it has undergone fermentation.

My DS friends in the USA might be really pleased to see this: (Oh how I wish the UK would move faster on such issues!!! (Doing small frustrated muttering number!)

http://www.nutraingredients-usa.com/news/ng.asp?n=83042&m=1NIU205&c=[emailcode]

My little tale of starting on Vit K2:

I went to Boots and bought the Vit K2 a month ago. At night I lie wake fretting about the bone scans.. I actually don’t know how to do more calcium as the constipation already is gruelling.

A few DS surgeons are saying we must go for 4000mgs plus a day. But I wanna know (as usual), if we take this amount, and it is not being properly assimilated by the bones - where does it go? Is aIl the excess excreted via stool? What evidence is there that excessive calcium does not cause the body harm? I know it can circulate in the blood stream and make the labwork look a-okay when the reality might be that the bones are losing density. This is true of me. Apart from my last lab, all my other bone labs have come back looking good…but my bones…sigh.

Anyway I might try hedging the calcium figures up a little more despite my questions. I’m not looking forward to further constipation effects.

MenaQ7 (a brand of Vit K2) is not cheap - it’s another expense to consider. I had a lump in my throat not caused by over eating when I realised how much it would cost. I was so grateful for the 3 for two offer I nearly hugged the teller. I’m almost worried in a weird way, that it will work for my bones. How ironic is that. If it does - I’m worried that people won’t be able to afford it. It’s going to bite my budget hard, but I honestly feel it would be a waste not to take advantage of my dexa scans as fully as I can. And they will tell the tale for me about whether or not Vit K2 is as viable for malabsorptive patients as it seems to be for ‘normies’.

When I started K2 supplementation it felt like eating gold. But only for a short while. Firstly the pill is a hard little nut of a thing. I decided for best effect I would have to bite the casing. The taste is somewhat vile, but I can’t risk the pill does not dissolve. Next, I bloated up considerably and as nothing else had changed, I chalked it up to going into supplementation guns blazing. I researched but could find nothing about VitK2 related overdose. In fact nothing about overdose at all as it seems there are no side effects. 4 days into it and looking like a rotund Russian doll, I thought about chucking it in. Then I remembered my own good advice of the past : Start off slowly when introducing anything new! So I backed down on 150mgs and did 50mgs for several days, then 100mg and I am up to 150gms with no side effects currently.

A strange thing which I am freaking a little about is that I now have brown poo that looks nearly like a normies number two. It still is stinky but it has a normie under current whiff which is also scary. At first I panicked as I thought I might be giving my malabsorption away. (And despite the extra vits, I treasure my malabsorption I truly do, as you all know.) But it still floats & smells mainly DSey, so I think it’s okay.

I’m thinking therefore that my luck might be in and that I am absorbing some K2. I truly hope so. Time will tell.

http://www.springboard4health.com/notebook/v_k2.html

http://www.americanwellnessnetwork.com/index.php/Something-Exciting-Vitamin-K2.html

http://blogs.webmd.com/integrative-medicine-wellness/2007/11/vitamin-k-keeping-calcium-in-your-bones.html

http://www.webmd.com/food-recipes/features/featured-nutrient-vitamin-k

Amounts of Vit K1 in foods:

http://www.dietitian.com/vitamink.html

A little about Vit K & Cancer:

http://www.encyclopedia.com/doc/1G1-107835437.html

DEXA stuff:

I always believed in pref pre op Dexa scans for Bypass patients both RNY & DS. My own experience continues to convince me. For a long time my calcium blood labs tested as normal (not a surprise to me I might add as previous research I did shows this is common.) Only my most recent one shows a slightly low amount in my bloodstream. The last one 6mnths ago was normal. Meantime the dexa is confirming continuing bone loss.

What does surprise me is that my Vit D & PTH still look normal range despite the drop in blood level calcium, or maybe it is causing the drop, perhaps the calcium is actually being utilised! (Ever the optimist!). But hey - I am not complaining, Vit D & PTH normal is good news! Obviously despite my feelings about adding more undirected calcium into my diet and my constipation, I will do just that. But I don’t want the stuff circling around my blood stream being underutilized by my body.

With a history of genetic osteoporosis, I doubly feel a dexa must be done before a DS surgery as in my own experience, it may complicate the whole matter.

Add to this the fact that many WLS patients get WLS in their late 30’s and 40’s - and we are heading for menopause in our fifties, when bone loss often naturally accelerates. I don’t think we can underestimate a Dexa Scans role in giving us the best indication of bone health that technology affords us at this point in time, but just my opinion. Some medical people argue it as a requirement and point out some drawbacks, but what else is there? Blood labs can be even more uncertain and if I had only had blood labs, I’d not have known that my bones are losing density. (Sometimes I do think that ignorance is bliss, though probably not longerterm!)
Some patients do tell me that getting a dexa can be very difficult & some are outright refused the privledge. I don’t know if it might be of use but perhaps a visit to the dentist might help. (What!?, I hear you cry! ). I knew my bones were possibly losing mass before I had my first dexa.How? My dental x-rays showed minor bone loss in my jaws at the time. It’s not accurate and this is speculation on my part. Remember you can lose bone in isolation on your body, but it might be the only way to convince your GP that if you have bone loss in your mouth, you might have it elsewhere too. Besides you need to know the state of your teeth as these are sometimes affected by WLS too.

(BTW - another good reason to think on Vit K2 might be dental health. Think it was mentioned in one of the links below, or I read it somewhere. It might play a role in reducing gum disease. One thing in Africa that always struck me as amazing was the prevalence in rural areas of lovely straight strong white teeth, despite lack of dentists and technology. Now, by comparison just gander over the WLS forums where probs with teeth are sometimes discussed… Argh!!! I think too much!).

STRONTIUM:

During the course of my wading through piles and piles of potential misinformation and some more valuable info, I come across the fact that strontium is available in the UK on the NHS.

I found out that it does have side effects among them quite strong allergic reactions. Also that it needs to be considered with caution. Some feel that there is still a lot that needs to be learned about it. (See links below for various plus/minus opinions. ) But for now, I am still interested and think that although I am not yet confident about trying it (don’t want to feel like a lab rat yet ;-)  erm, I forgot I already am one albeit a willing rat by proxy of my DS ), it’s worth keeping an eye on. The thing is we are not just talking about potentially stopping bone loss, it appears that strontium will also lay down new bone.

Only thing about the NHS source of strontium is it’s peppered with aspartamine. And wot’s the ranelate then?   Mmmm. Reading the veritable side effects - it read a bit like the list of aspartamine toxicity to me.  Reminds me of when deflatine decided to include sorbitol instead of sugar in it’s new formula. If you don’t know - sorbitol is sometimes associated with gastric distress!!! Where are their heads??? It’s probably all down to how cheaply they can manufacture something. Anyway if I decide to supplement with NHS strontium, I would have to accept the dayum aspartamine. I can’t afford not too unfortunately.

On the surface Vit K therapy looks less prone to side effects than strontium at this point in time. I think I will lay off strontium supplementation until I have had a consult with a bone specialist, but not by a long chalk am I closing the door on it. I have written about strontium here in the hope that others might know more about it, if so please e-mail me. (My e-mail contact is in the right hand sidebar.) Meanwhile I might just start munching more brazil nuts daily as they are apparently a natural source of it.

Stontium is also found in sea water but I think I will give this source a miss. (Yuck!)

Hopefully if K2 works & becomes more mainstream, it will be cheaper in years to come, or at least added to diary products world wide. Hopefully strontium will be as viable as I hope, but the jury is out on that one. For now I am organising my daily intakes of Calcium, magnesium, Vit D, zinc, VitK2 plus more, the best I can. Deep joy!

Here are a few more links about Vit K2 & strontium for those of you that are interested:

http://www.bmj.com/cgi/content/full/330/7505/1400

http://jcem.endojournals.org/cgi/content/abstract/87/5/2060

http://www.annalsnyas.org/cgi/content/abstract/1092/1/403

http://www.clinicalanswers.nhs.uk/index.cfm?question=7082

http://www.expertopin.com/doi/abs/10.1517/13543784.13.7.857?cookieSet=1&journalCode=eid

http://jcem.endojournals.org/cgi/content/abstract/90/5/2816

http://jcem.endojournals.org/cgi/content/abstract/jc.2004-1774v1

This is a debate about how excess calcium may affect our vascular systems. I’m open minded about it - but on reflecting the paper concerned I must say it didn’t wash well with me for several reasons, some of which the debate includes. I popped it here as I thought the one on Vit K2 and the snippet on magnesium were thought provoking.

http://www.bmj.com/cgi/eletters/bmj.39440.525752.BEv1#188835

SO WHAT ELSE MIGHT WE NEED FOR BONE HEALTH?

It was my DS friend Mellie who first pointed out to me, several years ago, the possible importance of adequate magnesium in bone metabolism disorders. She went on to develop a CalMagD supplement for us, which I take in conjuction with the calcium I get in V4L. ( The link is on the right side of this blog, first in the box.) As an aside, I have always questioned V4L’s formula of both iron & calcium in the same supplement. It might be neccesary for DS patients on V4L to bear in mind that down the line they may need additional calcium supplementation. (Keep watching your labs, get dexa’s if possible). If you are not taking magnesium ( check your vitamins -it’s sometimes included) discuss this with your specialist to work out beneficial ratio’s for your individual needs. Please read all the contra-indications in the below links too.

I’m learning magnesium also absorbs differently according to the type it is, not only that but it also has an elemental doasage. Currently I am on mag oxide (in the V4L)  & mag citrate (in the CalMagD). I recently read the oxide is not great at doing it’s job. Citrate is a good middle road choice it seems. It’s actually supposed to have  laxative properties, so maybe upping my dose might actually help my constipation. MMMmmm. I can but hope!  Magnesium citrate might be a good choice for constipated WLSers then.

http://dietary-supplements.info.nih.gov/factsheets/magnesium.asp 

 http://lpi.oregonstate.edu/infocenter/minerals/magnesium/index.html

http://www.ncbi.nlm.nih.gov/pubmed/18048993

http://jcem.endojournals.org/cgi/content/abstract/91/12/4866

http://www.spineuniverse.com/displayarticle.php/article1080.html

INULIN & OLIGOFRUCTOSE(FOS):

Interesting one this. I have always felt intuitively that trying to supplement on a gut that is not in fundamentally good health may hinder nutrient absorption. Note that initially inulin supplements might cause temporary bloating.

Foods high in inulin: dandelion, chicory, onions, artichokes, bananas, asparagus, garlic, leeks.

http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=686772

http://www.ajcn.org/cgi/content/full/82/2/471

http://www.nutraingredients-usa.com/news/ng.asp?n=70789-orafti-prebiotics-inulin-bone-health

http://www.drugs.com/npp/chicory.html

BORON & SILICON

http://www.spineuniverse.com/displayarticle.php/article1083.html

ZINC & COPPER:

http://www.spineuniverse.com/displayarticle.php/article1084.html

LUTIEN:

This is not connected to Bone metabolism, but thought I would mention it here anyway as I think it’s an important one.The other nutrient (that possibly no one told you about) is Lutien. This plays a role in vision & eye health.

Yup, I supplement this too. Have done for quite a while. I will blog more about it in my following blog which will start with Vitamin A.

I thought I would compile a list of important Vitamins and try to top up my own knowledge again. Got to do it as part of updating my website anyway, knowledge about them moves on. So, if you are interested, keep ploughing through my ever voluminous blogs!

As usual, please note that you should consider consulting with your surgeon when introducing higher or lower doses of vitamins, or if introducing new vitamins as you may be on other meds that could be affected by supplementation or have different health issues than me.