Anemia..the case canceller !

I've see a few recent posts on this.  Here are my thoughts.

Anemia can increase the risk for blood tranfusions and slow your recovery by making your feel weak and tired and lowering the oxygen-carrying capacity of your blood.

Anemia can occur after any type of WLS surgery and is related to lowered absorption and lowered intake of protein and calories.  It can also occur in individuals who are very compliant with their vitamins and protein !

Anemia can develop quickly and this again may be due to intake issues, but also things like menstrual bleeding, GI bleeding, or other intervening issues (all of which may be more common in WLS patients).  I have had patients with normal labs from 3 months ago, and then this weeks labs are way off !

Anemia may be caused by a variety of deficiencies including iron, folate, B12, or a combination. Other causes are more  rare.  A blood test is usually needed to sort this out.

Anemia cannot be corrected overnight.  You need time to "fix the fixables'  Although the newest iron infusions can go a long way to help iron-deficiency anemia quickly, your body generally  needs time to build the blood count back up.  Think about this when getting your labs done and the timing before surgery.

Physical (cardio) conditioning can counteract anemia to some degree because your body can more easily respond with an increased pulse rate and more favorable vascular tone.  Cardio queens like Shelly M.  fly through their recoveries because of this.  I'd rather operate on a 55 year old spin class nut than a 25 year old couch potato any day !

So hopefully this info will help you be on the lookout for anemia, and avoid the major hassle of delaying your long-awaited transformation !

It also helps to fly through recovery when you have an extremely gifted surgeon working on you like Dr. Lo!

I appreciate this info as I start considering plastics.  Since I saw you featured several times on Big Medicine, I have always wanted you as my surgeon.  I think your work is fantastic from what I have seen on the show and your website. You seem like a wonderful person and a true professional.  I have heard nothing but good things about you.  I am so impressed to see you posting on here! 

Cheers,
Cathy

thanks again Dr. L for your willingness to participate and educate on this board. We need more YOUs!

Thank you for posting this!

As an anemic since long before I had my RNY, I knew that any time a physician mentioned surgery, I had to bring up the anemia.  Plastic surgery was no different.  I mentioned it on my intake form and also had the discussion with the surgeon at that time as well.

At every appointment leading up to the surgery, we always talked about my iron and what steps would be in place to ensure that my surgery would not be delayed.  In between my procedures, my surgeon wrote orders for me for iron infusions even though my iron levels were in the normal range, albeit the low end of the range. 

I also can't say enough about how important it is to have open communication with health care providers and be an active participant in your health care. 

OK Shellymor...I appreciate the compliment...but folks this wild woman wore a pedometer to her second postop visit at 8 days.  Who does that ?

Lisa you hit the nail on the head...good communication is essential...it seems some patients and their docs are taken by surpise by these anemias, and get an unpleasant surpise right before their surgery !

I love the part about the 55 year old spin class nut!! LOL!! That very part reinforces my belief that I have chosen a great surgeon in Dr. Tom Gallaher here in Knoxville.

I, too, have watched you on tv and am amazed at your awesome work -- and jealous that I don't live closer to have you as a p.s.! THank you for your input here on OH!!

 I am also 55 and whats wrong with wearing a pedometer  I was getting in my 10k steps in too after surgery... we get the big picture at OUR AGE !

Thanks for that timely message, Dr. L.

I am a very fastidious supplementor, but after 18 plastic/reconstructive procedures in 4 years (many combined! :) my body kind of crapped out-- it's a lot for a small body to endure, even with minor blood loss---and after this last round my ferritin's a 4 and my RBCs are at 2.9. Just goes to show you that it's not just negligence that causes malnutritive deficiencies.

I am receiving iron infusions every other day now...hopefully I can get my head up off the floor soon!

My iron was low pre-op, but we went ahead anyway-- might not have been the best idea. If a surgeon says, "We best wait"--- then hey, wait. :)

One warning to the cardio queens-- be careful and heed your body's warnings. The lack of oxygen in your blood can be a lot for your working heart to contend with-- in my case, a heart murmur in combination wth the anemia means I really need to give it a bit of rest a while. I switched from aerobics to walking, from weights to generally being active, temporarily.

Hi Jupiter.  You're a good example of the "pull" side of the iron/anemia equation.  A person can only "push" so much into their system over a given time frame.  The WL surgeries (and all types affect different people in different ways!)  just won't allow you to easily load up on some nutrients, vitamins, and minerals.

The surgeries and other forms of illness or stress "pull" down your levels and this goes on daily and can have a big effect quick.  I agree that going into surgery "low" means you have already suffered a depletion and getting back up that hill with the weight of a surgery to heal can be very hard.

I also think some patients go too low on the "weight ticker" and I can tell by looking at their skin, hair, and nails, that they are too thin and perhaps won't do as well with surgery.  A lot of it is subjective, I admit, but it's important to get everybody as "tuned up" as possible !

The cardio helps the circulatory system compensate for lower blood counts so:

Rock on pedo-ladies !