Has anyone found after surgery that your immune system is compromised?

 It seems like I go from on doctor to the next. I do my vitamins as I'm suppose to, but still I have deficiencies.  I had a blood transfusion in June 2011. Had to have two pints. Anyone else have this? I'm almost 3 years out.  I thought I was going to have more energy but it seems like if there is a bug. I'm gonna get it.  Before surgery, didn't sick so much.  

There is another sleever I met, she just got on the liver transplant list.  Hers was damaged during the surgery. She's been a mess for the last 4 years.  I thought my surgery went well.  I had other issues pop up that I didn't know about like being sick by the gallbladder and other stuff. 

I don't want to discourage anyone from doing what they want to do. I just want to know what kind of trouble are people running into?

Another big thing is I have alot of dental work that has to be done.  All the slimies took a major toll on my teeth.  Anyone else have this?

I didn't have scoliosis but recent bone density test showed my spine is now curved.  I had plenty of xrays and that was never an issue. Anyone else have that.  We can only guess that it might happened during extended hosptial stays.

Did anyone else get depressed around 6 months? Just wondering. Had a friend commit suicide at his 6 month anniversary.  I too tried to commit suicide but it was a year and half after.   I can say don't listen to any bariatric doctor tell you to cut all your pills cold turkey that is suicidal and can cause so many problems.  Definitely don't take them whole in the beginning, make sure you can crush them or get liquid forms of the meds but don't stop any medication just because the bariatric doctor told youtoo.  Check with your other doctors. 

talk to Dochollywood about her dismasceous earth or however you spell it

 I'll do a search on her name. Thanks

Wow that's kinda scary, I am having surgery un a month and hoping for the best results. Sorry you are having struggles.

 It is scary.  I think the blood tranfusion freaked me out the most because I didn't see it coming.  I had been weak but I just felt like I'm doing all my vitamins the last labs I did were good.  I'm just going to keep trucking a long.  I woke up from sleep with cramps all over my body.  My husband rushed me to the ER.  My blood pressure was 62/60 something like that.  It kept going down.  They were waiting for results of my blood work to find out if there was something going on.  I thought I was falling asleep when in reality I was passing out.  I was asked if I wanted a chaplain to come see me.  I'm not a religious person but I didn't even hesitate, I said yes. please.  I felt frantic.   My blood pressure just kept going down.  My husband did the keep your eyes on me focus on me until they got all the wires to get me prepared for the tranfusion.  I didn't even know that so many things could go wrong during a blood tranfusion either.  I was in the hospital 4-5 days.  The result of why I didn't have any blood was a mystery.  It wasn't menstural.  I didn't have a leak or anything.  I take my vitamins because I've heard the horror stories.  They compared me to an alcoholic who has anemia.  They gave me all sorts of shots for my stomach.  Since I had surgery, I hadn't felt hunger.  I don't know what they gave me, but I got 3 shots a day.  My stomach actually grumbled and I was hungry.  I watched the clock waiting for the next meal.  It was the strangest thing.  My mother was in shock because it's been 2 years of not being hungry but eating to stay alive.  There just aren't enough studies out there to get a handle on what happens with people.

I was relatively healthy before the surgery just a few things but nothing major. I don't have the strength I once had.  I feel much older than my years.  The dental stuff was depresssing. My dentist was just beside himself. He couldn't believe it.  

After the transfusion, I had to follow up with a neurologist because the pain in my legs were still there.  No signs of a stroke which is great news but I still need to go back to have an EMG, I think he called it.  I still have an appt to see a cardiologist because they think it was awhile that I didn't have blood pumping.  Now my bloodpressure is up which I never had an issue with blood pressure before surgery or after. It was always the same number all my life.  Now it's really high which is strange.  

Even though all these things happen, I don't know if they happen to everyone.  I do know that the gallbladder thing happens to most people or they already had theirs removed prior to the surgery. 

Now, my doctor says I have white coat syndrome.  I freak out at the thought of going to the doctor or hospital. Tests freak me out.  I get so anxious about it.  I cancel my appointments because the thought of them telling me I'm going to take another medication just freaks me out.

I just wish there were general practitioners that specialized in bariatric patients.  There is so much that they just don't know because your body doesn't work the same.  

I do hope your surgery goes fine and everything goes fine.  Even if you feel fantastic, get your blood work done religiously.  I had no idea I would crash so fast.   I had chosen the VSG because I was told you don't have the same kind of vitamin deficiencies like other surgeries.  I can't say that's a true statement after what I've been through.  

I am sorry that you are going through all this. While it isn't as common for sleeve patients to have so many problems with vitamin deficiencies, it can happen. While you dont' have the malabsorbtion problems that us RNY patients do - you still dont' eat nearly as much as you used to, so you dont' get all the vitamins from food like you did and you do malabsorb B12 since you no longer have the part of your stomach that makes intrinsic factor.

What vitamins are you taking and how much? You should be taking a good multi vitamin atleast once per day, preferably 2 times per day. 1500mg of calcium citrate per day in 3 daily doses and it must be calcium citrate not calcium carbonate. You also need a good iron supplement - preferably carbonyl iron -if your iron has ferrous in the name, you probably aren't absorbing it. You should be taking sublingual B12 daily or B12 injections as well as vitamin D3.

as far as your immune system goes - when you become anemic - you can get sick more often. You also have to look at your CBC blood test - check out your WBC, Neuts and Lymphs - these all have to do infections - both bacterial and viral.
Did they look for the cause of the loss of blood? Just being anemic shouldn't cause you to need that much blood. Did they do an endoscopy or colonosopy to see if you are bleeding in digestive tract?

As far as your teeth and bones - this has to do with your calcium and vitamin D. You need to get your calcium, vitamin D and PTH levels checked. If you aren't taking enough calcium and/or vitamin D, your PTH will be too high, meaning you are leaking calcium from your bones leading to osteoporosis. I don't know if your spine can actually curve at this stage of the game - you might want to look into that - that is usually something that happens when you are young before you stop growing. Once you stop growing, I don't think your spine can curve in sense of scoliosis -you can get osteoporosis and you get a hump back - a curve in the upper back from due to fractures in the spine. Dental problems are also due to lack of calcium.

I do hope things improve for you and that you are feeling better. If you have any questions, fee free to PM me, I would be glad to recommend some supplements for you

I'm glad you pointed out the vitamins/supplements.  I do them religiously because before surgery, I read all the worst that could happen if you don't take your vitamins.  Prior to surgery, I attended some OH support groups in my area.  Most had the RNY, so they really stressed the important of vitamins.  I got on vitamins before surgery, so that I could form a habit of taking them. After surgery, it was a major adjustment trying to get them all in but after awhile I figured out a way. 

This is my vitamin/supplement regiment:

 Chewable Iron 29mg 2x a day First thing in the morning (Bariatric Advantage Passion Fruit)
               - I switch out when I get bored and do the Iron Chewable bite 30mg w/vitamin C (Bariatric Advantage Chocolate Raspberry)

Chewable Multi-Vitamin 2x a day with Vitamin 3, Complete B Complex
     
      - I've never looked up what the Vitamin D3 was for but now that you have mentioned I’m going to go learn more about it.  (Bariatric Advantage Vanilla)
     
     - I take it with a breakfast meal replacement shake because it also has a lot of vitamins. 24G Protein (Advocare Meal Replacement Vanilla.  It was the shakes the bariatric doctor had me on before surgery and after surgery) I don't tolerate milk well so I do it with water and it works for me. Sometimes I change the flavor a little with syrups/flavorings or fruit

  

 Chewable Multi Formula High in Vitamin A, D, E & K 1x a day 
     
    - This is a recently added vitamin I take once a day. I’m waiting to confirm with my doctor that this isn’t an overkill (Bariatric Advantage Tropical which I’m not crazy about the taste

Chewable Calcium Citrate with Vitamin D 500mg tab 3x a day so yes 1500mg (Bariatric Advantage Mint)
           - I had been taking Citracal Calcium Citrate w/Vit D 3x a day (1500mg) but I moved to Chewable after the blood transfusion, so I was on this for 2 years and 7 months



B12 Sublingual (GNC Cherry Flavor) 1x a day 
     
     - Before transfusion, I was told to take it 2x a week

Prescribed Vitamin D 2x a week (not chewable)



Prescribed Lovaza (Omega-3) 2 x a day (not chewable)
   - Before Lovaza being prescribed, I took "Omegabrite" which doesn't have the fishy after taste, but can get expensive.  Lovaza being presribed I can get them through insurance

Prescribed Folic Acid 1mg 1x a day



Sometimes, I'm just don't feel like eating or messing with making something, so drink a protein shot.  If I'm missing something, please do share.  

I do need to learn more about blood work because obviously I was missing something or else I wouldn't have ended up with a blood transfusion.  

I was doing blood work every 6 months.  
I was told the blood work looked fine.  
I had not been told I was anemic.  
Blood work always came back fine.  
Can you tell me more about blood tests or point me to a resource where I can read up on it? 

The blood loss has not been found.  
I was told it was either a very slow leak or it was nutrition related.  
I'm not sure of what the unit of measurement is but the anemia scale the point range is 8-10 they recommend a blood transfusion.  
As a female I should be at 12-14, but when I went into the ER I was 7.8.  
Pathology didn't find blood in my stool
Educated Guess of the Physcian attending to me was that it was nutritional deficiencies.  

Current Status:
  

I'm waiting for an appointment with gastroenterologist to check for other issues.  (In the middle of switching insurances so there was a hold up in that area)


Hospital GI Tract was fine.  Sonogram of Kidneys and other organs looked fine

I saw a gynecologist to rule out bleeding, but everything came back normal there (sonograms & blood work) My menstrual is so much better after the surgery.  It's on a normal schedule where as before I had either problems starting or it stopping.


I saw a neurologist to make sure it wasn't a tumor, clot or signs of a stroke.

I'm waiting for insurance approval to see a cardiologist. 

Lupus or leukemia ruled out 

Waiting on xrays I've had of my back throughout the years to check against the scoliosis xrays.  



Thank you for taking the time to support me and verify I'm taking all the right supplements. I do appreciate it. 

CC



And to anyone who is looking at my vitamin regiment, it might seem like an advertisement for Bariatric Advantage or Advocare but that's just what I've found that I like and or can tolerate.  I am not a spokesman, sales person nor do I make money off of those products.  

I am so sorry you are going through all of this!

May I ask what doctor was following you initially? Was it your bariatric doctor or your PCP ?  Did you get copies of your labs and track them or did they just call and tell you all was well, until it was not? 

Your blood work that came back fine, was that just hemoglobin and hematocrit, or was that your ferritin also? 

I only ask because I had asked my PCP (my bariatric surgeon is in Mexico) for copies of my 1 year laboratories, they called and said everything was fine, but my protein was 1 point below low normal (it had been midrange normal right before surgery), my ferritin was in the toilet, my folic acid was plummeting, my calcium was low, and I infuriated me that I honestly am not under the impression that anybody ever even LOOKED at it, aside to make a copy and send to me.  Since then I have been tracking my own labs and trying to share with whoever will listen that we have to advocate for ourselves.

I really hope they can find an answer for you.  It really gives me frothy fury that we put so much trust into folks who, while they are human, we put them in charge of our health - and we really ought not.

Please do let us know what you find out, and I will be bookmarking this thread to watch out and see if you come back to tell us good things~! 

I am glad that you have had such a thorough work up.  I can say part of your problem is that you aren't taking nearly enough iron and what you are taking is the wrong type.  You won't absorb the iron you are taking - it is combination of ferrous fumerate and carbonyl iron with very little vitamin C.  You need to take large doses of carbonyl iron only with large doses of vitamin C.  29mg is nothing,and that isn't even all carbonyl.  With levels like yours, you need doses like 180-240mg of carbonyl iron with vitamin C- 200mg of vitamin per 30mg of iron.  If you go to vitalady.com, she has carbonyl iron called tender irons - they are capsules and highly absorbable. They have the necessary vitamin C already in them. They come in chewables but much smaller dosage and there is no C in them. 

You mention taking B12 but not the dosage?  Being anemic can be due to iron, B12 or folic acid.  You really need a full set of labs to know what is going on.  YOU said your labs were normal - not anemic but what was your ferritin?

Your multis are overkill.  Taking the main  multi 2 times per day is fine - but the ADEK isn't necessary for sleeve patient.  You don't malabsorb AE or K, so you dont' need extra of these and it can actually be dangerous to have too much A and K.

These are the labs you should be getting done"

CBC, comprehensive metabolic panel, lipid panel, iron, TIBC, iron sat%, ferritin, B12, B1, folic acid, PTH, vitamin D3 hydroxy, magnesium, selenium, zinc, phosphorus

You should also get a DEXA scan - bone density to rule out osteoporosis.

Wow this scares me.  I need to get my blood work done again.  Thanks for the reminder.

I am so sorry you are going through this, glad there are so many knowledgable people here to asisst you.

Take extra special care, I hope everything works out for you.

Big hugs,

Cindy