Went to the ER...

Thanks for the note Dr. L. I have been having a longer than expected recovery, which I believe is in no small part due to my iron issues. My hematocrit was borderline (33) going into surgery and I was warned there might be wound healing issues. I was thinking external wound issues, which I haven't had other than the other than the occasional spitting stich, but apparently it can affect internal healing as well as I have had issues with seromas and this strange ongoing sensation of pulling and tearing around my waist, hips, and outer thighs when I stand from sitting or standing that has no real explanation other than the thought that there is some slow internal healing going on. If you have any thoughts about that, I'd love to hear them. I had a LBL with BL/aug on Sept 16.

My ferritin is 4, don't know transferrin, TIBC is within normal limits, but iron saturation was low at 3%. My B12 is actually >2000, so I am backing down on that. As a gastric bypass patient, I think sadly the iron issue is a function of the malabsorption because I am inordinately diligent with my iron supplementation, utilizing the most bioavailable, easily absorbed (and expensive!) iron available (Proferrin) and even prior to surgery struggled with my iron levels. I checked back over years of labs and found that my hematocrit had never really gotten above 33, hemoglobin was okay at 11ish and ferritin was hanging in there at 40ish. Didn't check saturations or TIBC. It was never suggested by my doctor that I consider any additional measures to affect my iron and since there are so many different components to determining whether one is anemic or not, I really deferred to my primary regarding the issue.

I guess the lesson here is stay diligent, research A LOT, and be a very strong advocate for ones self.

Thanks so much!! Hoping for happy healing here soon!!

Denise

Hi Denise.  I am a big advocate of aggressively "fixing the fixables" esp. iron issues, well in advance of surgery.  The delayed healing is not worth the risk.  That being said, it can be hard and every patient with every type of surgery has their own deficiencies and responds differently to therapy.

Seromas are from an inability of the skin to stick to the muscle, so fluid builds up.  I keep them drained in an effort to prevent infection but they really don't form much at all in my non-WLS body lift patients.