Men...Bone density scan post WLS...

Just wondering if any of you men have had a bone density scan before or post WLS?  My surgeon recommended I get one...My PCP said it was not necessary.  I'm over 5 years post op with no issues.  Yes, we know it's commonly done on women who don't have WLS.  So Men...Have you had one done.  I'm cross posting this on several forums...

Not something I have discussed with my surgeon.  I just had my yearly labs done and Calcium was within normal limits on my supplements.  Could be the Calcium getting sucked out of my bones keeping my blood levels up.  Will have to discuss this.

Interesting question

I had a bone density scan done after surgery. My mother had severe osteoporosis  She became horribly crippled and bent over in her later years.  I was quite "stooped" after loosing my first 80 pounds.  My wife kept telling me to stand straight..  I think I was used to standing like that to compensate for a huge belly I carried.  I worried that with the malobsorption, I was not getting enough calcium and my bones were suffering.  My bone scan turned out to be perfectly normal.. but I'm glad I got it done.. because now I have a base level done.. My posture has corrected itself as I lost more weight..
JOHN

John, I'm in a bit of a Catch 22 situation.  We know of the malabsorption issues with RNY.  But I talked with my urologist (since I've had kidney and bladder stones over the years) and he said calcium can be the trigger that will start a stone...so be careful.  So what does that mean??  How much is too much?  How much is too little?  And what about when I hit 60 or 70 and break a hip??  I take calcium (with Vitamin D) and drink milk and eat cheese.  If I talked to an orthopedic surgeon he would push calcium big time.  Seems like I have to walk a fine line...  

Interesting point about the calcium. My weight loss centre requires us to take 1000 mg of Calcium Citrate daily (for life) and coincidentally I've developed gal stones. (having gal bladder surgery Dec 22). Since gal stones are a side effect of rapid weight loss, who know whether the stones developed due to the calcium I take or because of the weight loss.  With my genetic history of poor bone density (father suffers too) I'm not going to fool around with it.. I'm religious about my daily vitamine regime, in particular the calcium..
John

My doc ordered a bone density scan pre-op due to low Vitamin D difficiency and she thought there was calcium loss as well.  mine came back that there was some loss. I have since upped the D and she will probably do another one in the future

Craig

There does seem to be some flakiness with bone density tests and their interpretation, particularly for us men. My nephrologist did a bone density test on me in his office several years ago (many years before WLS) based on suspicions from some other tests (not fully absorbing vit. D) and it came back as moderately deficient, osteopenia. My PCP is somewhat suspect of the diagnosis based upon the fact that the charts used for interpreting the data are based upon post-menopausal women, so extrapolating that to other populations is not the most valid thing in the world (though it's the best that we have.) Given the amount of resistance exercise and calcium that I was getting in my normal diet, it was worth being cautious about anything that shows that I may be marginal.

Year and a half later, my PCP orders a follow up test at the local hospital outpatient clinic and it came back normal. That's reassuring. A couple years after that the nephrologist does another test in his office and it comes back deficient - full on osteoporosus this time. Discussing this with my PCP again, still skeptical - what can we do to verify or confirm this? He ordered up a bone density test done on a CAT scan, and that came up normal - within a couple months of the previous Dexascan test.

So, take that for what you will - there does seem to be substantial variation in machines and data interpretation. On the one hand, we want to take any indications of problems seriously if we have known issues in the calcium absorbtion area, but on the other hand, the typical drugs used for treating the problem aren't the friendliest things to be on long term.

On the kidney stone front, those can apparently be an issue from either calcium overload, or deficiency. My wife is a DSer and has suffered from them in the past, and maintaining proper calcium supplementation is the major solution for that. My nephrologist was advising against doing any of the WLS involving duodenum bypasses based upon some long term studies of earlier duodenum bypassing WLS procedures (pre-RNY/DS) where there was a relatively high rate of severe kidney problems from that same calcium/oxalate cycle that leads to kidney stones (which I wasn't seriously considering doing, but helped to reinforce that decision.) So, that's another related issue that needs some balance - not too much, not to little.

There - doesn't that muddy the waters some?