Question about follow-up care

Hello Everyone! I haven't posted here in awhile so real quick my name is Stephanie, I'm a little over 4 months post-op and I live outside Davenport Iowa. My question is regarding follow up care. My surgeon (Dr. Seigert in Rock Island, IL) doesn't do lab work for his post-op patients. He requires that you get that done through your general practice doctor and Dr. Seigert really doesn't believe that you need to have regular labs done anyway. He told me that the only time I should need my labs checked is if I'm having a problem (like an illness) that my general doctor would treat normally anyway. I asked him "are you saying that my general doctor should just treat me as he would any other patient?" He said "yes that's exactly right". I don't really agree with him on this, but I am wondering if this is common with follow up care from surgeon's? Also, I did go see my general doctor last week because my hair is falling out in huge amounts, alot more than seems normal for a post-op. I have started noticing bald spots already and I'm concerned as to what will happen if the hair loss doesn't slow down. I was also concerned because I have started get really dry patches of skin on my face that have become swollen and cracked open. I use a cream on the spots and humidify the heck out of our home but they don't get any better. I asked the doctor if this (skin problems) and hair loss could be a vitamin deficiency (maybe vitiman A or E?) and could he check for that type of thing in his labs. He did look at my hair and said that yes he saw significant loss but that he thought this was normal due to the surgery putting stress on my body. He said that the only labs he felt were neccessary was a Thyroid level (since I was borderline low-thyroid before surgery). He felt certain that since I was taking a multi-vitamin daily that my vitiman levels would be fine. SO what type of lab tests do your doctor's routinely check on post-ops? I was expecting a full set of labs but all he ordered was the TSH.

It seems odd to be considered "normal", doesn't it?! I asked my surgeon the same question, and he said the same thing- if he thinks you are having a problem, he'll do labs- otherwise, nothing routine. So far, all of my labs have been within normal parameters. I experienced hair loss at 4 months, too. It seems to be filling back in rather nicely- not red, or even curly! Of course, since it's going gray and I'm a brunette, I guess red and curly was too much to hope for. Alot of people suggested increasing my protein levels, and taking a "hair and nail" vitamin. Both seemed to help. Good luck, and keep your spirits up- sounds like you're doing all the right things! Jeri H. Coster/7-11-03 -95lbs.

Hi Stephanie I would recommend regular lab work. I am not a health care professional but my nurse practioner definitely agrees with this also. I get mine done during my yearly checkup (pap smear)... anyway that's how I found out I have a Vitamin B deficiency. If your gen practioner does NOT feel comfortable treating you should find someone who is. My nurse practitioner has been great and gives me all kinds of advice and literature. Paula

I am a strong believer that we should have regular lab work done. It is so important so we know if there are any defincencys (sp) that are found then the right supplement can be taken and things can be improved over a short time. Isn't any of your doctors committed to a life time of regular visits and blood work? That is one of the things that my doctor told me in the very beginning. He is there for me for the rest of my life since this procedure is very drastic. He will be monitoring my blood work for years to come. The first year blood is drawn every 3 months and then after the first year it is every 6 months and then yearly after that. Are you concerned that your doctor has not made this committment to you? I hope that this helps. Stephanie Open RNY 6-18-03 -115 pds. (at least)

My doc in grinnell says dont need labs there either. the only labs I had were right before surgery. However, I do see a regular physician on occasion, and I had a bladder infection a few months ago, and I talked her into doing a full lab runup, just because. Not one single thing bad in the bunch! LOL woooohooo Now, since you are having troubles, yes I think you should insist on some other labs. it is your right as a patient, and hell, you are paying for it! Judi

Stephanie, The doctor that sent me to my surgeon is my bariatric doctor and he said that I would have to commit to seeing him every year and having blood drawn then until either I die or he dies. My friend who had this surgery 10 years ago still sees her doctor every year for lab work. I think it is important I would be a little worried if someone was not checking on me. I know that every doctor is different but I'm glad I'm going to be checked by someone who knows about this surgery and how it changes you. I would not trust someone who does not have experience with gastric bypass patients. This of course is just my opinion and so far I've had no problems at all but I'm very new at it also since I just had my surgery 12/8. Ann

I would feel alot better having someone check my labs and I don't see why some surgeons and general practice doctors have the opinion that we don't need them. Our bodies are changed forever and it can't hurt to check on things. The thing that gets me is Why wouldn't they want to do them? You'd think they'd want the money for the doctor visit and the lab work. My insurance and myself will be the one who pays for it! And if it's some sort of HMO thing where they need to justify it then I wouldn't think it would be very hard to justify any sort of tests after a major surgery like this! If anyone knows a good general practice doctor in the Davenport area who is familiar with gastric bypass and has no problems checking labs PLEASE let me know!

Thank you!! I have the same issues. I have a few (as most of us do) other chronic health problems. The surgeon seems to think the GP will follow up with me, but he isn't either. I got pretty sick about 2 months after surgery, I didn't know what was wrong, but I was sick. I finally got it down to an impacted abcess wisdom tooth that had to be taken out. The surgeon hasn't ordered any lab work since I got out of hospital. When I see him, they don't take bp or temp, just weigh me. I get the impression that if I have any complaints to go see the regular doc. I'm a new patient of his, and he only deals with whatever complaint you come in with at the moment. So, bottom line, no one is paying attention to chronic problems except me. Am I expecting too much?? Surgeon also told me I didn't need to do protein drinks or bars, I would get all I need from my diet. I have had food problems for the last 3-4 yrs, can't eat a lot of things, have severe Gerd, can't eat any processed foods, no seasonings, no acid foods, no salt, etc. I ask questions and he tells me to call the bararic counsler. So I feel like I'm out here alone and it's hit or miss on what to eat.

On a lot of the message boards, follow labs are important. I found this on WLSsuccess.com it was part of an advertisement, but I think it is probably accurate. FIRST 4 MONTH BASELINE PLAN After 4 months, lab tests are required to review that the below regimen is working for your system. It may at that time need to be adjusted to better suit your body, then plan on another set of labs every 4 months thereafter to continue to monitor your protein/vitamin levels.