Help-Lab Results not so good

I am almost 4 months out and my surgeon states he does not normally check lab wor****il you are a year out. I was not comfortable with that and went to my PCP and had them do my labs after I got the information from my surgeon that he would look for at 1 year. They faxed the results to my surgeon and and they called and said they found ketones( the level was 3) in my urine (which I thought was good if you are trying to stay low on carbs) and then they said my protein level was low as well. It was a 12 out 20. The nurse said it was not too bad but 12 out of 20 is not good in any math I do. (the protein thingy was the prealbumin test that was ran) I am eating mostly meats, beans and veggies and I have the whey protein that I get from GNC that I add to my yogurt or water at least once a day. And when I track my food intake on fit day I average around 80 grams a day..... So !! What do I do to get my protein levels up? My doctor's office stated I should add protein drinks but I am already doing that. I have used the Body Fortress Whey protein from Walmart too and I have used Isopure. And should I eat more carbs to not have ketones in my urine? Should I be freaking out about the ketones in my urine? I googled it and this is what I found on line Ketones levels in urine ? They are produced in the body when fats, rather than glucose are used to produce energy. ? This substance is an acid which can be harmful to the body if ketones are allowed to accumulate. Abnormal ketones values may indicative of ? Diabetic ketoacidosis ? Insulin overdose ? Insufficient food intake ? Nausea and vomiting ? Starvation ? Strict dieting ? Severe stress ? Severe fever due to infection

If I recall correctly, the keytone levels will be different because you are now what they call malabsorbative. This is normal. You also have to remember that just because you eat foods doen't mean your body processes all of the nutirents from them. They pass through your pouch quickly and some of the nutrients are not absorbed as they were pre WLS. This is very likely why the surgeon does not run these types of tests this early out. I am sure he is trying to allow your post WLS body to level itself out. Remeber that if your DR's office says your protien level is ok, then you have to trust that. They, after all, are the ones trained to handle this sort of thing. My personal opinion is that you shouldn't be alarmed, your body (and mine too) is trying to rethink how it processes your food, and it's freaking out right now over the changes. Smile your ok...PROMISE!

Thanks Lori, I appreciate your opinon and it helps me not feel crazy!!! I am so border line hypochondriac!! lol And I just want to make sure everything is ok. A year seems a long time wait before checking labs....and I had noticed others post that they got labs at the 3 month mark. I will relax a little and try and work on getting in more protein even though I am tired of eating and drinking protein right now!! Thanks again for bringing me back down to Earth!!

Oh my gosh Lori! You look awesome! I am going to try to change my pic today if I can figure out how. Isn't this a great ride? Hugs, Caters

Gosh, another situations where drs are SO different. My dr. does labs every three months for the first year (even on us band patients). It's good you took your health into your own hands and got the tests. Did you get your vitamins checked too (b12, calcium, D, etc?) As you wrote, ketones occur when you're body is using fat for energy vs. carbs. For us, this is a good thing. It's what we want our body to do. The biggest thing you need to do to prevent the bad stuff is to drink your water (at least 2 liters a day). For RNY, shouldn't you be trying to get at least 100 grams of protien daily? Add one more shake a day (30 grams) and you should meet that. Keep up the great work!

Hi Tina; My surgeon recommends 70 grams of protein a day...and I am seeing that getting it from my food is not going to work for me. I have been do the protein shake supplements but only one or two cause I thought the amounts I was getting in my food was enough too. So I am adding two more drinks a day and will see how that goes in the next few weeks. And yes surgeons are so different with this WLS! I wish they were more in line you know? Thanks for your response and have a great weekend!

I wish there was more consistency in the WLS arena as well. It's goofy to me that everyone can be so different. I just double checked and my surgeon recommends 90 grams of protein supplements (in shake form) in addition to your regular food intake for RNY. It sounds to me like you're doing what you need to do to be healthy so as long as you're continuing to feel good, I wouldn't worry about it too terribly much. Just continue to do what you're doing!

Lori said it very well. My doctor has labs done at 6 months. As I understand it, you will get strange and unreliable results prior to that because of the drastic changes our bodies are going through. I talked it over with my PCP and OBGYN and they agreed that was correct. Stephanie, I know your researched your doctor before surgery and wouldn't have gone through it if you weren't comfortable with him. Think about trusting him now too. If you weren't his first patient to do this surgery on, he has experience with this. And not all PCP's are familiar with what best suits wls patients. Most wls doctors who are good with follow up tell their patients that they are their main doctor for the next 6 months. Talk with your surgeon regarding your concerns. Hugs, Katy B

You are right Katy, I do trust him but when the lady from his office called and said my protein was low it kind of freaked me out. Just to be on the safe side, I am going to make an effort to havea at least 3 protein supplements a day and see how that goes. Maybe adding the extra protein will speed up the weight loss too!! And move me out of the 2 pound a week club.

Stephanie, I can't handle the shakes but I found some great liquid protein that I add to water and hot tea. GNC carries a liquid protein that has 18 grams of protein in 3 T of liquid, 90 calories and 5 grams of sugar. I started with it really diluted and now I pour in the whole 3T. It has really helped me get my protein in. It comes in orange and fruit punch. I thought I would mention it since you were needing to add protein and the thought of adding a couple of extra shakes sounds a bit overwhelming to me. Hugs, Katy