Lbl cancelled due to 7.5 HgB

cor p99
on 4/17/15 10:29 am

Need some advice. My LBL was just cancelled due to extremely low Hemoglobin levels. The PS said its way too dangerous to continue at this point. I now have a follow up with my primary care doc on Monday for a follow up. Has anyone else experienced this? If so, what was done? I'm not sure what to expect, thanks for the feedback. thanks!

        
songer48
on 4/17/15 11:24 am

While my hemoglobin was low, it wasn't low enough to cancel my surgery.  You'll want to wait for you appointment with your primary care physician, my guess is that you will start taking iron tablets.  

Songer
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DrL
on 4/18/15 3:54 pm - Houston, TX

Sorry for the cancellation. Uggh.

Low blood counts are very common after many kinds of weight loss surgery, probably because of altered gastric acidity. An acid environment is required to properly absorb iron.  Add to that that women may develop iron-deficiency on their own because of menstrual bleeding, intestinal loss, and decreased dietary intake and you have a lot of female WLS patients at risk.  I test everybody, assuming I will find low levels, and I am rarely disappointed.  

Preparing yourself for surgery (since many doctors seem to not be clued in to this) means getting your iron levels checked well in advance (6 weeks) of surgery. Not just a routine blood count but "iron studies" (whi*****lude ferritin, transferrin, TIBC, and serum iron levels).

Correcting deficiency can take a while, and it's essential to understand what impairs your iron absorption and also what helps it.  Regular old iron supplements are no good on their own in most cases.

Here's a good overview on the subject:

http://www.thedoctorwillseeyounow.com/content/nutrition/art2046.

Hope this helps,

Dr L

John LoMonaco, M.D., F.A.C.S.
Plastic Surgery
Houston, Texas

www.DrLoMonaco.com
www.BodyLiftHouston.com
Needanewbeginning
on 4/19/15 12:39 am - Barrie, Canada
RNY on 05/21/13

That's fantastic advise thank you. I will look into this soon as my brachioplasty is coming up in September.

Annette 

Starting weight: 334 lbs.Starting opti weight: 323 lbs, Surgery weight 303 lbs.Surgery-May 21st, 2013 with Dr Hagen at HRRH Goal weight 165 lbs reached at 13 months. Current weight 156 lbs

     

DrL
on 4/19/15 2:57 am - Houston, TX

Here's one study in a doctor's journal that I guess not too many providers read.  

http://www.ncbi.nlm.nih.gov/pubmed/23918279

They found that Following RNY, 42.3 % of female patients and 22.0 % of male patients developed iron deficiency. They described the prevalence of iron deficiency as "significantly higher in females than males." Also, the further out from surgery, the higher the risk. Finally, "only one patient out of 23 showed sufficient iron absorption."  BTW they used regular iron sulfate, without Vitamin C or directions to take it with orange juice, so no surprise there.

Take home message: be informed that your provider may not be informed.

John LoMonaco, M.D., F.A.C.S.
Plastic Surgery
Houston, Texas

www.DrLoMonaco.com
www.BodyLiftHouston.com
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