blood work after gastric bypass rny

I'm getting ready for bloodwork just to check things out cuz I am tired all the time. Nap alot. This has been going on for 4 years. Have lost 200 lbs. 5 years out....having stomach trouble also. So getting alot of tests done. I was told a few years back there was a "special blood panel" for people who have had gastric bypass. Also, I "forget" protein alot. Could this cause the EXTREME FATIGUE? I recently lost my son in our housefire, 9 dogs, truck. home, all material possessions, then my little brother and husband, all in 6 months. I am trying so hard to feel better and figure things out. I'm just 57, so too young to be so worn out. My mind wants to get back to life, but I'm always sleepy. I am thankful for any advice. I use to be a member back before my RNY. Bless yas, Vanessa

Oh, Vanessa.  I am so sorry for your losses.  (((((HUGS)))))  

Your family would want you to be healthy and you are honoring their memory by taking care of yourself.

I'll go into my profile and find a list of the labs that my surgeon orders.


EDITED TO ADD:

Parathyroid
Thyroid Function
Comprehensive metabolic panel
CBC with Diff
Lipid panel
HDL
Urinalysis
Zinc Level
B-12
Folate
Transferrin
Ferritin
Vitamin D 25 hydroxy
Magnesium

Wow.  I think your surgeon is missing a lot of stuff.  Why no iron, no vitamin A, no thiamin, no copper?  B6, selenium, vitamin K, vitamin E?

I missed the Vitamin K when I did my cut and paste. 

Nope, the rest of them have never been ordered.  I'm not surprised to see that different surgeons have different protocols for labs though.  There's a lot of variety in their preferences.

Honey, you DESERVE to take a nap or two.  You definitely need to get your blood work done, but
I'd like to suggest you get something for depression.  You've definitely got a good reason for being
depressed, but there is help for you, just something to smooth you out a little.

Best wishes,

Here's the list of what I get done.  I get my labs every six months.

CMP
Lipid Profile
CBC with differential
B12
Bili-direct
Ferritin

Iron/TIBC

PTH
Magnesium
Folate
Thiamine (B1)

B6

Vitamin E

Vitamin K
Uric Acid
Vitamin A

Vitamin D (25 hydroxy)

Zinc
Phosphorus
Copper

Selenium

Prealbumin

 

You have been through hell. Here are some (((((HUGS)))))) I can't even imagine, you are a strong woman and definately deserve a nap.!  I think its wise to see the DR. Im only fresh out of my surgery but, hey it cant hurt to see the DR. Again, Im sorry for your losses, GOD BLESS YOU.

Not to be construed as medical advice, this list includes labs we have had performed as gastric bypass patients. The first group, every 3 to 6 months for life, as we are able. The second group, annually, as long as the results were comfortably within normal limits for more than 2 years in a row.



1st Group



*80053 Comprehensive Metabolic profile: (sodium, potassium, chloride, glucose,BUN, creatinine, calcium, total protein, albumin, total bilirubin, alkaline phosphatase, aspartate aminotransferase) (10231)

* 84134 Pre-albumin:

* 7600 Lipid profile: (cholesterol, HDL, LDL, triglycerides, chol/HDL ratio)

* 10256 Hep panel: includes ALT (SPGT) & GGT)

* 84100 Phosphorous - Inorganic: (718)

* 83735 Magnesium:

* 84550 Uric Acid: (905)

* 7444 Thyroid panel: (T3U, T4, FTI, TSH) (84437; 84443; 84479; 84480)

* 85025 Hemogram with platelets: (1759)

* 7573 Iron: TIBC, % sat

* 83550 Ferritin: (457)

* 84630 Zinc: (945)

* 84446 Vitamin A: (921)

* 82306 Vitamin D: (25-hydroxy) (680)

* 84052 Vitamin B-1: (Thiamin) (4052)

* 84207 Vitamin B-6: (Pyridoxine)

* 7065 Vitamin B-12 & Folate: (82607; 82746)

* 83970 Serum intact: PTH

* 83937 Osteocalcin:

* 84597 Vitamin K:

* 85610 PT:

* 85730 PTT:



2ND GROUP



* 593 LDH:

* 31789 Homocysteine, Cardio:

* 83921 MMA:

* 367 Cortisol:

* 84255 Selenium:

* 84590 Vitamin E:

* 82525 Copper:





For diabetics: *496 - HEMOGLOBIN A1C













POSSIBLE DIAGNOSIS CODES





269.2 Hypovitaminosis



268 Vitamin D deficiency



275.40 Calcium deficiency



266.2 Cyanocobalamin deficiency (B12)



281.1 other B12 deficiency anemia



281.0 Pernicious anemia



280.9 Iron-deficiency anemia



281.2 Folate deficiency anemia



285.9 Anemia, unspecified



269.3 Zinc deficiency



244.9 Hypothryoidism



250.0 Diabetes



401.9 Hypertension



276.9 Electrolyte and fluid disorders



272.0 Hypercholesterolemia

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - -



*579.3 Surgical malabsorption*



*579.8 Intestinal malabsorption *





* Bands or sleeves should not use these codes as they are not accurate.



*Some insurance companies will not pay for any procedure that uses these codes.





LAB TARGETS





This is NOT medical advice, just my own targets for the main blood levels I watch.



Protein: 7's

Albumin: 4's

Pre-Albumin: 20-30's



Iron: 80-100

Ferritin: 200-300

HGB: 12+

HCT: 36+



Vit A: 60- 80

Vit D: 80-120



Calcium: 9.0-9.4

PTH: 20-40



Vit B1: Mid to top of range

Vit B6: Mid to top of range

Magnesium: Mid range (but also go by if we have leg/foot cramping)

Zinc: Mid range



Vit B12: 1000 +

Folate: Top of range



AST (sgot): Below 40

ALT (sgpt): Below 40



We usually want to "meet or beat" pre-op levels. In some cases, higher is better, and in other cases (Cholesterol, PTH for example), lower is better.



The only things *I* don't mind being on the high end of out of range are Ferritin and B12. But that applies to ME.



My doctors don't show interest in any of these until I am out of range. *I* am interested when I begin heading that direction.