Recommended labs--is there a list somewhere?

Pokemom
on 7/31/15 10:23 pm
RNY on 12/29/14

Hi!  Can anyone direct me to a good list of all the blood labs I need to have done post-RNY?  I have searched the site, but I am not finding this.

i have seen a lot of discussion on OH about how PCPs and also WLS surgeons may not really order the complete set of labs we need.

I am 7 mos since my RNY surgery.  My surgeon orders NO labs until a year after surgery, unless there is a troubling symptom.  This has concerned me, because I see many OH members who have labs at 3- and 6-month intervals.  

However, next week, I have my annual physical with my PCP, who I expect will order standard blood work as part of my physical. I assume that his standard-ordered blood work probably does not include all the things that we need to track after surgery.  But I plan to ask him to include all the vitamin/other post-WLS labs as well, to help me see what is happening in my body.  He is such a gracious person, and has been a great supporter of my surgery, so I believe he would include these labs if I request them.

i will also ask him to approve a bone scan.  I am 51 now, so I think I would qualify for this anyway.

Thanks for any help on this!

 

Cicerogirl, The PhD
Version

on 8/1/15 6:39 am - OH

This list is from Vitalady, and is close to what I use (although some doctors don't think there is any reason for most people to have PT and PTT checked (blood clotting ability)):

*80053          Comprehensive Metabolic profile:(sodium, potassium, chloride, glucose,BUN, creatinine, calcium, total protein, albumin, total bilirubin, alkaline phosphatase, aspartate aminotransferase)  (10231)

* 84134          Pre-albumin:

* 7600            Lipid profile: (cholesterol, HDL, LDL, triglycerides, chol/HDL ratio)

* 10256          Hep panel: includes ALT (SPGT) & GGT)

* 84100          Phosphorous – Inorganic:  (718)

* 83735          Magnesium:

* 84550          Uric Acid:  (905)

* 7444            Thyroid panel: (T3U, T4, FTI, TSH)  (84437; 84443; 84479; 84480)

* 85025          Hemogram with platelets:  (1759)

* 7573            Iron: TIBC, % sat

* 83550          Ferritin:  (457)

* 84630          Zinc:  (945)

* 84446          Vitamin A:  (921) 

* 82306          Vitamin D: (25-hydroxy)   (680) 

* 84052          Vitamin B-1: (Thiamin)  (4052)

* 84207          Vitamin B-6: (Pyridoxine)

* 7065            Vitamin B-12 & Folate:  (82607; 82746)

* 83970          Serum intact: PTH

* 83937          Osteocalcin:

* 84597          Vitamin K:

* 85610          PT:

* 85730          PTT:

 

You may also want selenium and copper checked.

Lora

14 years out; 190 pounds lost, 165 pound loss maintained

You don't drown by falling in the water. You drown by staying there.

selhard
on 8/1/15 8:00 pm, edited 8/1/15 8:08 pm - MN
RNY on 11/26/12

TO EVERYONE AND ANYONE IN WLS WORLD...  Friendly suggestion:  print, file, and remember to take this recommended lab test list to your next medical appointment.  Friendly idea:  print extra copies to hand out to fellow support group members at your next meeting.  Friendly question:  what happened to poetkelly postings?

Pokemom
on 8/2/15 5:36 pm
RNY on 12/29/14

Lora, thanks very much.  This is perfect.

Katie_Kat
on 8/3/15 12:41 pm
RNY on 06/10/13

What is Osteocalcin?

Katherine     

RNY 6/2013

S/W  256

C/W  126

Cicerogirl, The PhD
Version

on 8/3/15 3:20 pm - OH

It is a special type of protein found in bones.  My surgeon, my PCP, and the surgeons I work with don't ink it is a necessary test, so that is pretty much the extent of what I know about it.

Perhaps someone else knows why some surgeons think it should be checked after gastric bypass.

Lora

14 years out; 190 pounds lost, 165 pound loss maintained

You don't drown by falling in the water. You drown by staying there.

Cicerogirl, The PhD
Version

on 8/1/15 6:42 am - OH

I also wanted to add that, unless your pre-op labs showed something, many doctors believe that there really isn't any reason to have 3 month labs because for many things your body is still operating off of your pre-op stores.  

Some maintain the same thing about six month labs, but I personally wouldn't be willing to wait a year because our levels can drop quickly.

I think having your PCP order them is an excellent idea.

14 years out; 190 pounds lost, 165 pound loss maintained

You don't drown by falling in the water. You drown by staying there.

NYMom222
on 8/1/15 10:02 pm
RNY on 07/23/14

Can ask if you know why blood clotting ability would be important or changed from WLS?

Cynthia 5'11" RNY 7/23/2014

Goal reached 17 months. 220lb Weight Loss
Plastic Surgery Dr. Joseph Michaels - LBL and Hernia Repair 2/29/16, Arm Lift, BL, 5/2/16, Leg Lift 7/25/16

#lifeisanadventure #fightthegoodfight #noregrets

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Cicerogirl, The PhD
Version

on 8/2/15 3:48 pm - OH

It is usually related to seriously low Vit K. When your about K is too low, it impacts the bloods ability to clot (and Vit K injections -- it is kind of a bright yellow-green, LOL! -- are used as an "antidote" for people whose blood thinner dose is too high and/or their PT/INR clotting time numbers are too high).

Vit K deficiency doesn't seem to be terribly common, and is usually minor (they just add a Vit K supplement), but it can be serious.

14 years out; 190 pounds lost, 165 pound loss maintained

You don't drown by falling in the water. You drown by staying there.

Grim_Traveller
on 8/2/15 6:45 pm
RNY on 08/21/12

My dietician told me that K is absorbed in the portions of the intestine that isn't bypassed, and K is absorbed well in the large intestine, unlike most vitamins. That's why deficiencies seem to be rare.

My guess is, vitamin K deficiencies are supposed to be rare, because K is rarely tested. If they never test for it, it must be ok, right?

Most K comes from green leafy things. Care to guess if mine is high, or low?

6'3" tall, male.

Highest weight was 475. RNY on 08/21/12. Current weight: 198.

M1 -24; M2 -21; M3 -19; M4 -21; M5 -13; M6 -21; M7 -10; M8 -16; M9 -10; M10 -8; M11 -6; M12 -5.

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