Fifteen (15) vials of BLOOD!

. ....yep, that's right, 15 vials of blood were pulled on me yesterday for about 25 tests (assuming it's based on labels printed and initialed off on)! The lab techies were absolutely flabbergasted that the doc wouldn't break up the lab work, maxing it at 7 or 8 vials, but I'm GLAD she didn't. Actually, Im pretty much RESPONSIBLE for it - I don't have a Gastric Surgeon I can visit for on follow-up care, he's in Washington state. Those that know me, know that Ive NEVER been impressed with the military hospitals/docs (sorry if that offends any). I'm a military brat, from way back - father was a lifer in the army, ex-hubby was an army dude and then of course, my soul-mate is in the Navy. 40+ years of Military living/medical/insurance, etc later and it ALL still SUCKS!!! I've been in VaBeach for 3 years now and have gone through 6 different PCP's. I have to reintroduce my freakn self/case, each and every time I'm seen. Thankfully, I finally found a PCP that I like. She's got a good soul, truly wants the best for her patients, but once again, is clueless to the gastric bypass needs. Fortunately for me, she's willing to TRUST my research - with little to no argument. Good damn thing Im my BEST advocate for long term health, huh? Anyway, I did some snooping around on several other weight loss surgery sights (specifically the OSSG Grads board and the OSSG-Weight Loss Gone Wrong Board) and came up with additional tests that should be run on a LONG term post op which isn't included in the Chem-25 panel I always request. Im going to update my "Lab Work" info on my profile in the next week or two, to reflect the additional tests. IT'll be interesting to see if anything shows up LOW or outta whack. Our bodies are great at "warning" us when something's wrong. If we just take the time to see the signs! I'm one of the STRICTEST people I know, when it comes to taking ALL my vitamins (about 25 a day) and getting in my protein shakes. I put additional pressure on myself because I'm a DISTAL bypass (most RNY's are Proximal) which makes me a higher risk. Regardless, even with my strict self imposed routine, my body is coming up short. WHY, is yet to be determined. I'll have the results back on my labs within 2 weeks - we'll take it from there. Trust me when I say, I haven't missed a day of vitamins in 3 years, 2 months, 2 weeks and a coupla days! Signs of problems: Brittle nails, Hair loss (still), memory loss, chipping teeth, laziness -- a snail has more energy then me, mental confusion, massive drops in blood sugar, black outs, slurred speech, oh and my blood pressure is HIGH again. The last six months have been averaging mid 150's over high 90's. Joy! The doc also ordered a full physical that I go back for in two weeks. We'll review the labs at the same time. Soooooooooooooooooo - for those that might need it? Here's your daily reminder TAKE YOUR VITAMINS AND SUPPLEMENT YOUR BODY!! If you think it's not necessary, you're WRONG! Just that simple. I'm living proof of someone who can absolutely attest to having done it RIGHT and still, my body is coming up short. Have you taken your vitamins today? What about your protein shake, have you choked that back yet? - Lei .

Yessss, ma'am! Rich and I both are very strict on vitamins and protein and that is why I'm sometimes very adamant in replies to questions about those topics. I've seen people suffer from not taking vitamins, not taking the right vitamins, getting misinformation from their own surgeon/nut, not getting enough protein, etc. Some vitamin deficiencies can lead to permanent damage and I think that the vast majority can be prevented with good supplementation and monitoring. Sorry to hear about the issues your having. I hope that your blood work holds the key and that you can get yourself on the right track. Sometimes taking the base vitamins just isn't enough for some. Some have to add extras. Rich had to add iron and extra Vit A to his regiment along the way. Unfortunately, I do not think my PCP is 110% on track with my testing. She does very well but I don't think it is quite good enough. I've had some neuropathy issues and mind you...I had neuropathy from diabetes, neuropathy in my right leg from herniated discs in my lower back so having it isn't unusual for me. She did test my B12 and B6, I think. I asked about B1 and she blew it off. Well, a B1 (thiamine) deficiency can be neuropathy so on my own I added an extra B1. Extra Bs wash out so I know I'm not ODing. Only been on the increased B1 for a week or two. Feet have been sensitive so I hope that means that nerves are improving (as they did when I got my blood sugars down 6 years ago with the diabetes diagnosis). Hate to have to initiate changes on my own - but if I don't do it...no one else will. I get copies of ALL my lab work and put the entries into a chart. I watch for my own trends. While I may not understand it all... I can recognize a trend and do research and ask my doctor about it. My protein level pre-op was 7.5. It went up over 8 after my pre-op diet (low carb) which wasn't a surprise. A month after surgery it was 7.5. Then 3 months later... 7.2. I was noticing a downward trend and that was while getting 2 protein shakes a day. 7.2 is normal but again...it was the trend that caught my attention. So I added a 3rd protein shake each day. Next labs, it was 7.5. Back to my pre-op normal. I like that! Thanks for sending out this post! Great for folks at all stages of this process. Hugs, Kathy

Damned Vampires! BUT....as long as it gets to the bottom of what is going on with you. But, it's interesting that this is coming up. I read on-line last night about a patient who found out that her bones are deterioriting even though she is taking her calcium. Definate wake up call for me to make sure that i take ALL of my vitamins EVERY day. As always, thanks for the info and see ya tomorrow. Jill 263/186 (STILL)/145

I'm a big touter of calcium. I had elevated calcium prior to WLS due to a growth on a parathyroid gland (they regulate calcium levels). Because my level was forced high... the calcium was coming from my bones. Oh joy! Anyway, I can tell you that a serum calcium level blood test isn't enough to determine if you are doing well on the calcium front. PTH (parathyroid hormone) needs to be checked too. You can have a normal calcium but elevated PTH. What that means is that your parathyroid glands are working overtime to keep your calcium level normal (that's their job) and if you aren't taking in enough calcium... they will steal from your bones to keep the blood level normal. So a normal calcium and elevated PTH usually means you need to increase your calcium intake. Also, Vit D is important for calcium absorption so that needs to be check with your blood work too. This calcium moment brought to you by the American Dairy Farmers Association. Got milk? Moo... Kathy

AMEN, Kathy!!!!!! Ive seen people get pissy with you about CALCIUM and the information you share, but then again, some people STAY PISSY, so I guess that's not saying much. Back to the conversation of CALCIUM - you are absolutely RIGHT ON, discovering you're short in calcium is not as simple as blood tests, a DEXA SCAN is required to truly measure the deficiency! Oh, and anyone that still thinks CALCIUM CARBONATE IS OKAY? ..and you're an RNY patient?!? DO YOUR RESEARCH!!!!!!! Do NOT, not not take the word of your surgeon or the word of people on a message board, yep, MINE included. BUT.... I promise ya', IF YOU TRULY DO YOUR RESEARCH? You WILL switch from Carbonate to CITRATE! For the record, my surgeon was a happy camper TUM's poppin' calcium kinda guy. Ive never ever agreed with him and have always supp'd with citrate, 1500 mg for the first year or so, 2000 now, daily. One more thing, while Im standing on this milk crate - AS LONG AS YOU WERE NOT DEFICIENT BEFORE SURGERY, you labs will COME back "great, perfect, awesome, yada yada yada" for awhile, regardless of if you're supplementing with vitamins. It's STORED nutrients that's showing up "good" for now, with time, they will and DO deplete. It's up to YOU to keep filling the stored levels, daily. Mooooooooooooooo-ing right backatcha!

I had a bone density scan a couple of years ago because of the elevated calcium and PTH levels (both mine were elevated due to the tumor) and it was fine. 2.5 years later... osteopenia. And that is from the tumor's existence and not impacted by WLS with adds a whole other component to it. The good thing is that the tumor is gone and my levels are now normal. Now I get to fret over calcium issues like a "normal" WLS post-op. They have me on 1500 mg right now but luckily with my history... I get my levels checked more often so I should be able to see if I need that upped sooner rather than later. Thanks! Kathy

Hi, Lei and Kathy! I need you girls to be my tutors! I'm the WORST at getting all my pills in. I'm making an effort to change that, though, I promise! Let me ask you this: My doc doesn't want me going over 1500 on calcium, and I get it all in my multi, hair and nails, and daily latte drinking. Is that enough? Should I just go ahead and take the calcium citrate, even though that would put me at over 2500 for the day? I plan to ask my nutritionist, too, but I really trust you guys and want your opinion. thanks! LB

Hey, LB! You probably won't absorb the calcium that is in the multi, hair/nails and latte so it is important that you get the 1500 mg from calcium citrate. I wouldn't count the other stuff. You wouldn't be getting too much by taking 1500 mg from supplements alone. Whether 1500 mg would be enough would be based on blood work after you've been taking that amount for a while. They'd have to check serum calcium, parathyroid hormone (PTH) and Vit D to be sure that you are getting enough. We definitely want you getting all your vitamins in - it is really important! Kathy

Hello Lacey - Im going to go one step further (just read Kathy's reply to you) and flat out say, you will NOT absorb the calcium in your multi/hair/nails vitamin. LOL, Kathy was at least politcally correct and said you "probably" won't. Im a stickler about CALCIUM and the types WE should be using! I don't back down on it and I don't go with the standard "ask your surgeon" ... sometimes, in life, we have to take a stance and be our OWN advocate for long term results, this is one of those situations. I was just telling my VaBeachGirly-friends in an email, even at 3 and 4 years PostOp, we are considered NEWBORNS!!! "WE" are the influx volume that statistics will be created from. Right now, numbers and stats that are 10, 15 and 20 years out are damn near impossible to find. So pretty much the "learning curve" is US and even our doctors are learning, changing, adjusting and conforming with time. My doctor was FINE with TUMS - then he progressed to CALCIUM CARBONATE, now ...almost 4 years after my first visit to his office, he's got a book coming out that he sent several chapters home with me to "read, proof and make suggestions" ...guess what's ALL in the text now, when it comes to Calcium? He absolutely INSISTS on citrate. Heck, the entire medical world is FINALLY starting to agree that even the "normal human" without the rerouting of their intestines STRUGGLE to absorb carbonate. So common sense and logic dictates if my sister, who's never had the surgery can't absorb all of the carbonate, there is no way in hades, I CAN! Take your citrate, please please please, take CITRATE!!!!! You are very young Lacey, your bones need all the help you can possibly give them over the next 60+ years, do NOT start cheating them now at this early age. If youre still not convinced or sure that CITRATE is the way to go? Then do yourself a favor and ERR on the side of caution. YOU owe yourself that much. IF you do your research, you'll see that there are NO reports out there "questioning whether or not we absorb citrate" but hundreds that question carbonate. CITRATE is cheap - 400 tablets at Sams Club cost about 9 bucks. Two tablets = 600 ...I take a total of 2000, spaced every two hours apart, with NO iron! Good luck to you ....and do yourself a favor okay? EVEN if you ask your NUT and/or your DOC and they say "Carbonate" is okay? DO THE RESEARCH YOURSELF, you are worth it. Hugs - Lei Here is a link to Vitalady's site. She's a 12 year post op (her and hubby) and she took CARBONATE the first 6+ years of her surgery and her body/bones/health paid for it. http://www.vitalady.com/faqs.htm#why_calcium lol, this may sound crude, but IF I can learn from others mistakes? Im gonna! I hate that she ended up with medical conditions (life long) over it, but I know she shares that information so that others following in her path can change our statistics.

I thought I was doing bad the last time I had labs run and they took 5 vials! Normally its about 3 or 4, when she started in with that 5th one, I thought my goodness, I'm gonna pass out! Everything came back normal, for some reason, my PCP Practice has been actually sending paitents a copy of the report now, for the 1st couple of years, you got nothing. Then they started sending you a post card that basically said "your labs were within normal ranges" thats it. Now they are sending a whole report, they must be making more money or something to afford all that paper! My PCP wants to run another batch of tests (another 5 vials) when I have fasted. I hate that! I am a big breakfast person. So every work day, I get up, forget I need to have the blood drawn, and start in with breakfast. About halfway through my morning shake, I think "damn, I still need to have that blood drawn!" I have a couple of days off next week, so I plan to do it then. I filled out my paperwork for my new insurance today. It is listed in the book that mordbid obesity surgeries are not covered, but when I look up my Surgeon, he is in there. The only time he does anything other than GB is when a patient requires something like a gallbladder removal. He doesn't do just general surgery on anyone. So why is he listed? WEIRD!