Dexascan

Good Afternoon my friends,

I know I have not been around much, but I am lurking and reading.

I want to pass on some interesting information that I think that we can all benefit from.

As you know with RNY and other malabsorbtion procedures we constantly worry about deficiencies and being women we are concerned with bone loss.  When we have our labs done, they do check for calcium levels, but these will show up as normal, as our bodies will suck it out of our bones.  There is a test that is done called a dexascan, this procedure tests the density of our bones and can show osteoporosis (sp).  In most instances, this test is only given to those over the age of 50, or if they are showing signs.  Upon research, I found that in my benefits and exclusions for my insurance a dexascan will be approved for if we are at high risk.  Thus, we classify as high risk due to malabsorbstion.  So, please check your insurance benefits and exclusions and as for this test based on your risk.  This test is important to ensure that we keep our bone density.

I went to my PCM today, and to discuss other issues and I talked to her and asked for a referral, and to note that I am at high risk due to malabsorbtion.  When I inquired about the dexascan several months ago, she said that they would not approve it due to my age so I went back and did some reading and came up with the little loophole.  She was happy to see a patient that is very proactive in making sure that they get the health care that is needed.

Remember it is easier to reverse a deficiency in the early stages than to try and fix it when it is has been happening for sometime.

Thank you for the information.My sister has a thyroid problem, and she keeps up with this and other things. The dr. sometimes gets upset with her since she does study things, and will not always go along with them.

Come in and post whenever you can. We know you are busy with family and school.

Hugs,
LISA

Just wanted to throw this out there...your doc can run a simple lab test to let you know if your body is leeching the calcium out of your bones in order to keep the blood calcium level up. It is called the PTH test (parathyroid hormone). If that number is too high, that means your calcium intake (and probably Vitamin D, too)  is too low. This is something that would show up well BEFORE a Dexascan will show actual bone loss and insurance doesn't ***** about covering it.

Nicolle 

I have been having dexascans every 2 years since my rny and my ins has not questioned it in any way. my Dr just put the diagnosis code for malabsrobtion. Early menopause is another high risk factor. Anyone with a major weight loss is at risk and according to a major study I read bone density loss was the same regardless if the loss was due to gastric by pass or other non - malabsorptive methods. 

 

In regard to testing parathyroid levels. If you have a large bone loss it may be due to a parathyroid problem. the para thyroid is a small gland that secretes parathyroid hormone ( different than the thyroid) that helps regulate the calcium levels in your blood.  the parathyroid will keep your blood levels of calcium high even if your intake is inadequate by pulling calcium out of your bones. If the parathyroid is not functioning properly it will pull too much calcium out of your bones and you will have high calcium levels in your blood, and bone loss. anyone who has bone density loss needs to have it checked. there are some other levels that might be a good idea to check as well. My Dr checks my ionized calcium level. Ionized calcium is calcium that is freely flowing in your blood and not attached to proteins. It is also called free calcium.

Knowing your vitamin D level is also a good idea. the BEST  source of vitamin D is getting 10 - 15 minutes of sunshine with out sunscreen a day - no malabsorption issues there.  I also supplement since we live in a northeern climate where getting regular sunshine may be less likely.  I also eat foods rich in Vit D, Salmon, sardines, tuna, eggs (the yolk)  I am a huge beleiver in getting my nutrients from my foods and not relying on supplements for everything. Yes, I supplement, the minimal I have to. but I do my best to eat with the  goal of meeting my nutritional needs from food and it is very possible. I have had too many issues with supplements upsetting my digstive tract and have reduced the amount I take over the last several yrears - and my labs are doing fabulously, and I feel better. foods have micronutrients that cannot be duplicated in pill form.

since I have adjusted I have had way less issues with kidney stones as well.

 Since I did have some bone loss I am being treated for that. I tried actonyl and had stomach issues and I still lost more bone. so now I am being treated with Reclast - it is in IV form and I only have it once a year.  It is $1200 a dose, but the actonyl was $90 a month so it works out nearly the same over all. The ortho said it will take 2 years  to stop losing bone, and that stopping the loss at my age is the best I can hope for. After much research, talking to Drs, dieticians etc, I believe dietary calcium is best. BUT - remember this, milk you drink contains vitamin D, cheese, yogurt, cottage chees etc - do NOT. so if you rely on those you probably need to supplement . Vit D is crucial to absobing your calcium and your body using it, whether you had gastric bypass or not.

 

when it comes to getting labs and other preventative  treatments you are your own best advocate.  researching medically based literature is your best bet.

good luck!!

 

HUGS!

Val