X-post another COMPLICATION now Anemic!

Hi my OH family: I'm 15 months out Lap RNY
My blood work shows that I am anemic.  I've heard its common after RNY surgery.  I have ITP (a blood platelet problem)  that was diagnosed after surgery also.  I bruise very easily.  I have an appt this Thurs with the hematologist.  I would like to hear from you if you have any advise on how to deal with this.. I'm tired of all these complications, but happy about the weight loss.  I take my vits and iron religiously and NO, Thank you,  I DO NOT LIKE LIVER! lol I hated it as a child, and its worse as an adult!  I even had a friend make it for me and it was tender but tasted YUCKY!  Please help ! Thanks much!  Amy

Amy,
My husband became Anemic and had to go through weekly IV iron infusions, and even with that, it takes quite a while for the blood levels to balance out, it isn't instantaneous, the numbers kind of slowly creep back up, according to the Hematologist.  It was more of an inconvenience having to sit there for an hour or so once a week for 6 weeks, but there are worse things.  Hang in there!

Thanks for the info!  Sorry it took so long for me to respond. Hopefully this week I'll get some solid answers.  Tired of being tired all the time.  I'm wondering if this anemic thing is inherited.  I think my mom went for B-12 shots and Iron,  All I remember was she was tired all the time also.  Anyway, hope your weekend was great! Take care!
Amy in Colorado

I have developed a different type of anemia...NON-Iron-Deficient Anemia, hemolytic anemia.  My RBCs produce like crazy in the bone marrow, but because of malabsorption, they are rupturing far too quickly.  Iron infusions do NOT help...after the one I had in July, my RBCs dropped. 

Get a good hematologist!  Get tested...I had a bone marrow biopsy, which revealed the latest.

Thanks for taking the time to write.  About a week ago, I went to a new hematologist and she seems to know a lot about WLS patients.  She took a gallon (or so it seemed) of blood and the results are still pending.  Did the bone marrow test and all was "normal"  Hopefully this week, I'll get some answers.  I'll ask about the hemolytic anemia.  Also i'll ask about RBC's? (Red Blood Count??)
All this medical jargon makes my head swim!
Hope you get to feeling better!  Again Thanks for the info!
Amy in Colorado

You are welcome!  I have an appt tomorrow at Mayo Clinic (last of a series of appts w/specialists)... this is one with an Endocrinologist who is supposed to specialize in WLS complications...  I have anticipated this appt for 2 weeks...  I'll post whatever I find out from her.

Yes, lots of medical terms... RBC: red blood count/cells...  My RBCs have dropped again to a nice 3.0 (in July) and my hemoglobin is very low too... 9.5...  we'll see. 

Hope all works out well w/you.  PM me if you like.

Lizzie

I don't usually hang out here, but then someone mentioned that vitamin deficiencies are considered a "complication" rather than an expectable AND preventable outcome from any WLS. It's been awhile since that thought crossed my mind.

So, I have several comments on your post.

1. ITP? Seriously? I was dx with this 30 yrs ago! (before WLS) and until recently had not met ANYONE who even knows what it is. I met a person a year ago. She is a customer of mine BUT she has not had WLS. Then, one of my longest term customers (she was a long termer at my very first support group!) mentioned she had ITP. That means, in 30 yrs, you are only the fourth person I've met! Wow. My hema mentioned casually that it is considered to be in the autoimmune family. Whoa. I have one autoimmune, but again, no many have heard of Raynaud's, though I do know dozens of ppl with that one.

2. Hemolytic anemia. Probably not nutritional. Been seeing a hema since 2004. *I* cam convinced I can fix it with a pill. My hema says nope, not that kind of problem. However, when I added copper to my iron, my H&H came back up. Then slipped. My folate had drifted down and so I fixed that and my numbers almost came back, just one was 1 pt out of range (MCV). Then while folate stayed good, the numbers slipped again. I see my hema, and yes, had the bone marrow bx and all that. Seems that sulfa drugs can cause hemolyzing..... because they completely block folic acid! That's dietary, but you can get the folic back in line with high dose supplements. I did that. But ultimately, I stopped taking the sufla drug. The numbers came back up, then slipped again.

I have no patience with this. I am accustomed to addressing something and fixing it. Grrr. I got a new product and while I have had stable iron & ferritin for 13 yrs, my H&H keep falling down. So, I tried this new product just to see. I'm willing to guinea pig new stuff. So, all labs since I started it show my H&H i normal ranges! Yay! But all the other numbers are still wacky. I've now added lots of pills and still haven't fixed it.

My hema thinks I'm just cute and amusing.

I only mention all this so you'd know I've been working on this sine 2004. One of the nutritional components IS B12 and folic, so we want those top of the range. I get my iron via pill, but some ppl need infusions. I prefer my B12 via shot (less than $1/mo) vs pills, way more expensive.

When I first started hemolyzing, there were 5 of us long termers. The only common denominator was WLS. However, we didn't invent hemolytic anemia. One by one, each preson's cause was found. Once had genetic macrocytic anemiaS. Yes, plural. One had another genetic disorder. And so on. So, hemolytic anemia is not an expectable or preventable occurence for US.

3. Iron deficiency anemia (IDA). That IS a guaranteed outcome for WLS. Most docs do not treat it til it shows up, then it's much harder to run thru the various irons on the market before you find one that both works and agrees with you. My doc was a freak in that he started us on one of the better irons even back in the 90's. My dh and I did go into deficiency, but within a year or so, we found an iron more suitable for us. We got our numbers to my target ranges and they've stayed there.

The REASON is malabsorption. It's not something wrong with your surgery. Eating more iron foods won't help. Altho, I'm sure they're good for your wt loss and other things, thet can't deliver iron. Also, for restrictives only, well, all of us can no longer eat a 16 oz steak, can we?

This is one that can be prevented, as far as it relates to WLS.

4. You can pass along my share of the liver, too. I was IDA all my life until AFTER my WLS. No liver for me then or now.

5. Vit D def I don't see mentioned here, but it is also predictable and preventable.

OK, removing myself from soapbox.

This is some good information.  I'm working with my hematologist now to figure out my anemia issue.  It doesn't help matters that I was born with Thalyssimia minor . 
We talked yesterday about doing a bone marrow biopsy to rule some other things out.

I'm going to mention to him about the non-iron deficient thing!

I'm tired of being tired too!!