Need some help with blood work...please

Kim, anemia is a definite potential problem as a post op RNY patient.  I've read before somewhere and I wish I could put my hands on it right now but that at 3 years post-op it's very common if iron isn't being supplemented and all of the iron labs aren't being taken and monitored.  For some reason the percentage of 28%-30% rings a bell, don't hold me to this though, I can't be positive. 3-4 iron pills per day IMO will NOT help you at this point.  You need iron infusions and will probably need more than 1 infusion.  I'm not a doctor and don't want you to go rely on any answers you are receiving here but you do need to be pro-active and insist on getting the ferritin level up as quickly as possible. A hematologist is a specialist and will be wanting to help you quicker, again IMO, than either your PCP and your cardiologist.  If I was in your situation I'd definitely be asking for a referral (if required) or calling around ASAP.   You won't feel better until you get your iron level up and this might take some time and then heavy supplementation of iron with vitamin C for better absorption daily.

Yes, it is an expectable and largely preventable problem after surgery.  Iron, calcium and vit D are the hardest battles we fight.  But not as hard asthe battles we fought with our weight!

Hey Dana, So happy to see your smiling face again. Hope all is going well with your recovery. Kim needs to get to a hemo dr A.S.A.P don't you agree...

Hey lady, I've missed chatting with you.  I'm doing pretty good, tired still but feeling good and looking pretty good, lol.  I get the stitches out on Tuesday and then I'm sure I'll feel much better still. If it was me, I'd be finding a hemo ASAP, she'll get better answers and quicker results as I believe they'd be infusing her in a day or two after her appt.   Isn't it amazing how doctors just sit back and wait, it drives me crazy.  I'm a research guru and always reading everything I can about post-op and vitamins.....I'm faithful taking my vits and getting those labs and track them for sure.   I've had my surgeon and my PCP say "Oh everything is fine"and look at my labs to see something drop significantly.  That's why I put them in a spreadsheet and supplement as I see needed. My Vitamin D is down "but within range - low range" and when I talked to my surgeon he said it wasn't anything.  Yet, my legs where hurting, bone hurting and research showed that as a sign......commits were to see an ortho *shrug*.  Well, being a hardheaded cajun, I started taking additional vitamin D about 4 weeks ago and when I was thinking about it this week my legs don't hurt.  And, this also has me concerned about how my body is absorbing the calcium (and yes my serum calcium is fine, but am I????). My insurance won't pay for a bone scan until I'm 50 yo but I am going to consult with them after I get pass the next couple of weeks of healing and see what I can do to convince them I need a bone scan.  Osteoporosis runs on both sides of my family so I'm definitely susceptable.  I may just pay for one anyway, I think it's about $300. Oops, sorry I got carried away.......WE have to be proactive, we have to demand the test that are needed and we have to research, research, research and convince our medical team of what test need to be performed and when. Ok, off my soap box *sigh*.

Dana I agree we need to be well versed on our own conditions because our dr's can't and aren't in tune with out bodies, heck some don't look at those labs...the girls in the office gets results and stamps docs name on  it and I am left holding the bag waiting to hear from them...I don't do that anymore I call everyday if I think it time for results to be bac****ep records of all my blood work which is becoming much more often with my iron problems...time between fill ups is getting shorter but I am concerned they gave me too much this time so I will insist they do testing in between sessions which is what they always did....however these last 7 treatments they did no blood work in between and as a result my iron was 348. I will never let that happen again. Same with the vitamins, I am very careful to get all my vits and extra supplements. It's expensive but its the only way to live a healthy life. I am so happy you have this step of plastics behind you. I know how great mentally you are feeling. Been there and life is good. Keep in touch...

How much D did you add?  Dry D3? Scans are not expensive, at least here.  If you negotiate a cash price with a small company, well under $200 would be right.  So, I understand when insurance won't pay, but many times, we don't have to sacrifice our health to play insurance games.  

Michelle, yes dry D3.  I'm taking 3 of the 5,000 IU per day.  I've been quiet surprised at how much better my bones/legs feel already.  My level was 39 (lab range 32-100) initially.   My PCP wants me to have a bone scan, I'm going to try to convince my insurance to pay for it, if not I'm willing to pay a couple hundred dollars.   Both of my grandmothers were diagnosed with osteoporosis and one grandmother (before passing away) had broken a hip, leg and then her back by falling down.  My mother has osteopenia (sp?), yes I'm worried. What you do think on the D-3 and the amount I'm taking?  I'll ask my PCP next month when I go to re-run my vitamin D to see where it's at.

A hint about the bone scan issue. My Dr submits it to the insurance with  a diagnosis of malabsorption. having malabsorption places you in a high risk category for osteoporosis. having a small frame and being female are also risk factors.  My insurance  BCBS has not questioned it, and has paid every time. I would have the test even if I had to pay it. I lost 10% on my bone density score in 1 year and had to go on actonyl. I am less than 50, I was 42 when I had my RNY.

Kimberly,

I am also having ferritin problems.  My surgeons office said it was low at 4 and to supplement with ferrous gluconate which didn't help much.  I called them 3 weeks later and said I was having bad chest pains and didn't feel good at all.  They told me to call pcp and that I'd probably need a blood transfusion then iron infusions.  They asked if I was bleeding anywhere because my levels hardly went up after adding supplements.  I thought that they went really quick from 'change your vitamins' to 'oh well, see your pcp and get a blood transfusion!.'  BTW I was originally on Bariatric Advantage multi for distals and an iron chewable.  Didn't work, I guess.  Anyway, the soonest I can get in to see the hematologist is April 11.  My pcp, who has seen this before and he said the incidence of bad labs is increasing with his gbp patients the further out they get, said that if my chest pain is bad to go to the ER.

Anyway, I can't wait till the 11th!  I want to feel better!  My skin kinda breaks out, I feel wiped out all of a sudden most days, I can't seem to lose any weight--I think because I crave food, especially black pepper and peppermints, my sex drive is zero, and I am very moody!  Such a joy to live with.

I'll post back later with the results of my appointment.

Amy

Amy sending prayers and good thoughts your way. Those chest pains in my opinion are the warning sign and if you can't wait till the 11th go to ER and a hemo dr will be called in immediatley after your labs are done. Shame on your primary!!! I feel your pain. If you read above you know I go through this every 3 to 4 months however this was not a problem encountered "after" gastric. I have always had stored iron problems and blood disorders such as myleoprofliferative syndrome which affects the platelets. I am so thankful I have a hematologist whom I was seeing many years prior to RNY or I am sure this would all be blamed on the surgery.  Good luck, please come back after you see the dr so we know what your problem stems from...also this morning I emailed Kim since I forgot to ask her if she was getting her B12. I am on 1000mcg injection once a week, my hemoglobin has not gone below 11 since we changed injection to once a week. I am told this is a life long commitment with B12 post surgery.