Is Chronic Severe Anemia reason for revision?
I have a lap RNY about 7 years ago. I had sucess with weight loss and then after multiple pregnancy gained some weight back. I am currently about a 29 BMI. I was at one time a 18 BMI. I have suffered chronic anemia that includes multiple iron therapy infusions and blood transfusions. Multiple ulcers and stomach pain. I cannot get my iron up to a decent level. The highest hemaglobin I have seen is 9 after blood transfusions. The hematologist just keeps transfusing and infusing as they don't know what else to do.
I'm exhuasted, have hair loss, headaches, bone pain, extreme fatigue and I want to be able to have some energy. I'm sick of being sick.
Is this a reason for revision? Also what kind of revision? Would it be the sleeve to stop the malabsorbtion issues?
Thank you for your help.
I'm exhuasted, have hair loss, headaches, bone pain, extreme fatigue and I want to be able to have some energy. I'm sick of being sick.
Is this a reason for revision? Also what kind of revision? Would it be the sleeve to stop the malabsorbtion issues?
Thank you for your help.
I do not know your medical background and I will try to be concise.
Your age has a lot to do with anemia, saying that a 85 yr old woman can easily chronically get down to a 9 hgb and do very well , you would not expect that in a 20 yr. old. Severe anemia should have a root cause identified. If you are currently bleeding (ulcer) that should be addressed. If you are recieving iron infusion and PRBCs then you have more than an iron deficiency and that leads me to believe you are actively bleeding. (from what you posted above) Suggest getting a 2nd opinion from a different hem/onc to get to the root cause of your anemia. you should have been worked up for occult blood also. revision question implies that your "severe" anemia is caused from your surgery, before you have any more surgery seek another opinion, someone who can figure out the reason to your anemia, correctly identify it and treat it correctly. Hope you feel better soon....
Your age has a lot to do with anemia, saying that a 85 yr old woman can easily chronically get down to a 9 hgb and do very well , you would not expect that in a 20 yr. old. Severe anemia should have a root cause identified. If you are currently bleeding (ulcer) that should be addressed. If you are recieving iron infusion and PRBCs then you have more than an iron deficiency and that leads me to believe you are actively bleeding. (from what you posted above) Suggest getting a 2nd opinion from a different hem/onc to get to the root cause of your anemia. you should have been worked up for occult blood also. revision question implies that your "severe" anemia is caused from your surgery, before you have any more surgery seek another opinion, someone who can figure out the reason to your anemia, correctly identify it and treat it correctly. Hope you feel better soon....
Thank you for your response.
I have suffered this chronic amemia for about 5 years with over the past 3 getting progressively worse as in needing more blood transfusions and infusions (Venafor). I have had bleeding ulcers but not for 2 years. I have had uclers bleed twice. Now it does not appear that I am losing blood anywhere but my levels just keep dropping.
I am in my early 30's and I have children some very young including a baby and I want to keep up with them. I'm so exhausted.. so exhausted.
Does a revision from RNY to a sleeve or DS stop the malabsorption issues? I'm confused about that. Can my intestines be 'put back together' to resolve the malabsorption issue?
Thank you.
ETA: I seem to always be about a 7 - 8 Hemoglobin and can get up to a 9 with 2/3 units of blood. That doesn't last all that long and I'm back down.
I have suffered this chronic amemia for about 5 years with over the past 3 getting progressively worse as in needing more blood transfusions and infusions (Venafor). I have had bleeding ulcers but not for 2 years. I have had uclers bleed twice. Now it does not appear that I am losing blood anywhere but my levels just keep dropping.
I am in my early 30's and I have children some very young including a baby and I want to keep up with them. I'm so exhausted.. so exhausted.
Does a revision from RNY to a sleeve or DS stop the malabsorption issues? I'm confused about that. Can my intestines be 'put back together' to resolve the malabsorption issue?
Thank you.
ETA: I seem to always be about a 7 - 8 Hemoglobin and can get up to a 9 with 2/3 units of blood. That doesn't last all that long and I'm back down.
There is no malabsorption *due to bypassed intestines* with the Sleeve. However, Sleevers DO still need to take vitamins and supplements, due to the limited amount of food they eat and the limited amount of time that food spends in the stomach. Going from the RNY to the Sleeve would involve putting your intestines back into their original configuration.
A DS is a Sleeve plus an intestinal bypass. It gives a different degree and kind of malabsorption than the RNY, and is NOT likely to improve your iron absorption.
A DS is a Sleeve plus an intestinal bypass. It gives a different degree and kind of malabsorption than the RNY, and is NOT likely to improve your iron absorption.
" Now it does not appear that I am losing blood anywhere but my levels just keep dropping." if you are receiving iron infusion and PRBCs on a routine basis that is a problem, not so much wiht the iron infusion but the PRBCs. you state that your hgb usually runs 7-8 (gm/dl) with infusion of 2-3 PRBCs (I will assume you mean 2-3 and not actually 2/3) you hgb should increase to about 12 gm/dl, not 9 gm/dl. If in actuality you are receiving 2-3 units PRBCS and your hgb only increases 2 gms overall, that is an active bleed and nothing to do with malabsorption as it is given IV not GI system so there is no malabsorption, unless you had an active bleed the PRBCs that you had received would keep your hgb up, something is not right with this information, either # of units, original hgb, post hgb, or an ongoing bleed if the information you provided is correct suggest consult with a hem/onc for root cause ID...hoping you find some answers soon and feel better...
I am 21/2 years out of a DS. I hit normal bmi at 4 months out. Took Creon and still on it. I supplement with very high amounts of vits. and minerals. 300,000 dry A and 300.000 dry D3. My d is 147 and A mid normal range, B-12 is 1500. I am telling you this because I have been very compliant and get my labs every 3 months. I have worked with a endo to help me, and her nut. very help full. My protein is 7. Here is the kicker, my hemo doctor was treating the iron issues but not looking at the real issues of the chronic anemia. After 2 years of infusions and them not working for very long and my hbg 9 and can't get it to move, or get me to move for that matter, I find myself at a new cancer doctor who is being very progressive. I have Hemolytic Anemia and she will do a heart test, and when ruling that out will be sending me to Mayo as she says this has gone on to long and something is driving this. I hope you find your answers. I am 51 and can't image taken care of any small children. Be aggressive, don't give up, find some answers. I have been told by both hemo doctors, and a autoimmune doctor, and my primary care doctor that this is not WLS related.
My Iron and ferrittin levels are in the high range so she says I am not Iron defiance, It seems my red blood cells just won't do the right thing, What a journey. Peace Karen
My Iron and ferrittin levels are in the high range so she says I am not Iron defiance, It seems my red blood cells just won't do the right thing, What a journey. Peace Karen
tHANK YOU FOR POSTING SOMETHING THAT IS ACTUALLY HAPPENING TO ME. MY IRON IS REALLY MESSED UP AND I'VE HAD A HEADACHE WITH DIFFERING DEGREE OF PAIN SINCE
FEBRUARY. I AM ON TPN TO GET MY VITAMIN LEVELS UP AND READY FOR A REVISION SURGERY. MY LIFE IS A MESS RIGHT NOW, I HAVE SO MANY MEDICAL COMPLICATIONS IT'S UNBELEIVABLE LIKE WEIGHT AT 110, FATIGUE, CONSENTRATION PROBLEMS, I HAVE NO ENERGY EITHER, WOULD LOVE TO CHANGE THAT,
I JUST HAD SEVERAL TESTS DONE AND THEY FOUND THAT I HAVE A BACTERIAL OVERGROWTH IN MY SMALL INTESTINE, THE LIMB AND STOMACH IS DIALATED WITH AN OBSTRUCTION NEAR THE PANCREAS AND PELVIC FLOOR DISORDER, SO IT LOOKS LIKE AFTER ALMOST 2YRS OF COMPLAINING THAT SOMETHING IS WRONG I FINALLY GET TO TALK TO A SURGEON ABOUT REVISION.
OVER MALABSORBTION SEEMS TO BE A CONDITION THAT IS CONSIDERED REASON TO DO A REVISION FROM THE RESEARCH I'VE DONE.
GOOD LUCK TO YOU AND THANKS AGAIN FOR YOUR POST.
FEBRUARY. I AM ON TPN TO GET MY VITAMIN LEVELS UP AND READY FOR A REVISION SURGERY. MY LIFE IS A MESS RIGHT NOW, I HAVE SO MANY MEDICAL COMPLICATIONS IT'S UNBELEIVABLE LIKE WEIGHT AT 110, FATIGUE, CONSENTRATION PROBLEMS, I HAVE NO ENERGY EITHER, WOULD LOVE TO CHANGE THAT,
I JUST HAD SEVERAL TESTS DONE AND THEY FOUND THAT I HAVE A BACTERIAL OVERGROWTH IN MY SMALL INTESTINE, THE LIMB AND STOMACH IS DIALATED WITH AN OBSTRUCTION NEAR THE PANCREAS AND PELVIC FLOOR DISORDER, SO IT LOOKS LIKE AFTER ALMOST 2YRS OF COMPLAINING THAT SOMETHING IS WRONG I FINALLY GET TO TALK TO A SURGEON ABOUT REVISION.
OVER MALABSORBTION SEEMS TO BE A CONDITION THAT IS CONSIDERED REASON TO DO A REVISION FROM THE RESEARCH I'VE DONE.
GOOD LUCK TO YOU AND THANKS AGAIN FOR YOUR POST.
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