Malabsorption after 7 years....

It is very common for levels to drop all of a sudden with no change in vitamin regime. Why? I have no idea....but it does happen, this is why most long term DSers (and RNyers) recommend getting your labs done every 6 months instead of every 12. Vitalady suggests every 3 if your insurance will cover it.

B vits are very difficult for RNYers to get orally because they lose all of their intrinsic factor in the gastric bypass part of the RNY. So yes, I'd go for the injections, and if that's not working getting a prot put in....because low Bs can cause major neurological issues, in addition to low energy, and this might explain part of your weight loss, the inability to process foods, specifically proteins. (ok i'm not a doctor, this is my understanding of this process).

My advice is get whatever the doctors are telling you to get in order to bring up these levels as quickly as possible.

As for the D, you can buy mega doses of D on vitalady.com.

How is your PTH? With the combination of low D, and taking the "wrong" type of calcium...calcium citrate is the new "right" calcium....your PTH might be out of wack...which means your losing bone mass. Nutritonally things have changed in the 2 1/2 years I've been post op......so in 7 years it must be almost a night and day difference.

Hope this helps.

Scott

Scott et al,  
Thank you some very helpful points as well as your heartfelt concern and encouragement,
Yes...you are right, over 7 years the "rules" have changed...and frankly, the "rules" change from surgeon to surgeon.....and patient to patient.    And yes, the viactiv is calcium carbonate instead of the citrate.  A few weeks ago, I had an internal medicine MD write me an RX for a mega dose of Ca. Citrate...which is in a gel cap that I've been poking a hole in and squirting under my tongue.  (It's 50,000 iu's).  Fortunately, at least in my mind, I wasn't going completely without the citrate....as I was utilizing a multi that included the citrate thru the years.
She also ordered something I didn't even know was available....a capsule 2 x's per day that is Chromagen Vit b12, Iron, AND Intrensic factor.  It's and interesting combo and something other's may find useful.    It was an prescription and I had to order it via mail through my health insurance.
I think once I get "things" corrected, it'll be a good maintenance for me.
Now...the para-thyroid.  My  TSH was normal...and they, nor I, thought to consider the PTH.  Good thought...and something I will ask her to add on the my next lab draw this week. 
It looks like I'm going to try the port.  Have tried the injectable b-6 (100mg per day)...only to watch my b-6 level drop from a low 6 to undectable.  So...guess it's not making it's way via my muscle into my system.  Again, hopefully once I get things turned around, it'll be a good maintenance.
To those of you who find my situation scary or dissapointing....please, keep in mind, the life-threatening co-morbities related to being morbidly obese and know that everyone is diffierent.  
Each time one of us has something happen that's a little, or even a lot, unusual....it can pave the way to prevention....as Tami pointed out in her post.  Although, as has also been pointed out by several of you guys....sometimes, it just happens.  Either way, you can learn from my experience. 
Since I work in the medical arena as a Nurse Practitioner...I have no problem asking for what I need...and walking away from provider's who raise an eyebrow when they realize I had an RNY.
I have no problem navigating the system usually....but at this juncture, I've found myself exhausted and that my memory is effected to a degree.  (as far as I can remember...:)  )
And yes....it is oh, so true...once "they" hear you've had WLS....everything seems to get "blamed" on that....(though in this case, I have every reason to believe it's related....but gesh...what if it wasn't?)
Keep reading, keep learning, and keep advocating for yourself and for each other.
Gina-the-fixing-to-own-an-infusa-port-post-op
RNY 12/11/01  320#
today 139#

Oh-

PTH is a good one, my PTH was ~300 (normal is somewhere in the 25-70 range) and I was diagnosed with osteopenia 18 months ago..I will be keeping an eye out for your continuing saga..It feels good to know I am not alone..My whole family is convinced I am going to die any day (I am stubborn..I am one of those that argues with a HCT of 6 and a TSat of 2 that I do not need to go to the hospital..It can wait!)  I did not know of the 50,000Ca Cit!  I have been getting weekly Venofer, but they cannot get my iron above 25..and my Hgb drops about 2 points amonth (I went from a 12 to a 6 in 8 weeks)  And post-transfusion dropped from an 11 to a 9 in a month (On the bright side, my weight has dropped so the menses have stopped)

Hi Gina,

I hope you are feeling better and they have figured out what you need and how to reverse the malnutrition.

This post is late, but I'm a 6 year post op and have the opposite problem, I absorb way too much! I've lost about 260, down from my heaviest of over 600 pounds. So I am pleased with my progress and wouldn't go back to where I started either.

When I read your posts, I couldn't help thinking of another woman who became very ill and her bariatric doctors totally missed the fact that she had cancer. Not a single doctor even thought to look for something else as a possible cause. She went through consult after consult, all the doctors looking only at the bariatric surgery as being the cause of her malabsorption issues and all her other illnesses. Multiple surgeries and feeding tubes.

Unfortanately, they found the cancer too late and she passed. Perhaps you know who I am talking about? She posted extensively on this site about her struggle. If you want to know whos profile it is, I can send you a link.

The ONLY reason I bring this up is because sometimes the gastric bypass is blamed for all our issues, just as the fat used to be. If you are still suffering, please please go to another doctor and get tested for other causes beyond what would be caused by having weight loss surgery.

Be well and good luck.

-edessa

Well--

I am going through the identical thing (and strangely enough, I am 2 semesters from completing my Practitioner program !).  On the downside for me, my insurance EXCLUDES everything related to gastric bypass.  I am hoping a lot of my issues are related to my kidneys (I hve PCKD), but I am getting ready to see my doc after a month of vomiting and diarrhea (I know..too long to  wait, but I thought it would resolve) and a weight loss of about 20 pounds this month (I am now a BMI of 17).  Hopefully, you will get some relief, and I am sad, in a sick way to see that this happens so far out...I was hoping it got better as time goes on..Thanks for your post..

Diane

Dear Gina, I just want to wish you well. I do hope a solution to what you are experienceing can be found and soon so that you can be healthy and feel better.

I will be looking for your posts and progress. Thankyou for sharing your story, it is important for us all to be aware that things can happen even when we do everything right.

Wishing you all the best.

Sher

Gina,

Thanks for your post. I'm so sorry to hear that you are struggling so and have to admit it's a bit frightening because you have been both compliant and vigilent. I had my RNY about 16 months ago and my husband will be having his in a couple of months. Like you, we are doing this to ward off the health issues surround our morbid obesity. I hope that we will escape the difficulties you are experiencing and I hope that your Dr's will be able to find out what's happening. I do think that people and Dr's view WLS with nearly the same 'contempt' as they do obesity, with the 'you did it to yourself' attitude. I also think that many people and Dr's are as quick to assume the WLS is the culprit for whatever ails you now, as they were to assume that the obesity was the culprit before. I guess what I'm saying is that it must be very hard to get people, including those in the medical community to look at then past the WLS to look for answers. Of course we want the to look at the RNY, but we need them to look past it as well to be sure that they aren't assuming something, instead of looking for another issue.

Wishing you all the best in your quest for a healthier life,

Barb

Hi, I am too watching what your end result will be. i am 5 years out in November and i just started having problems with my teeth. I will be skinny with no teeth. LOL
i can get false ones if i have to.
I have religiously taken my hand full of vitamins every day. i do not miss.
My levels also got off in one 6 month time period.
I also preach take those vitamins. My girls also had RNY and i know they miss months taking their vitamins,.
i preach vitamins everytime i see them.
My D was borderline. I have gotten the dry and i am taking it.
They seem to think my body is pullling my calcium from my teeth. we will see what the specialist has to say.
He is not up on RNY.
He did a test to see if i was malnourshed. I have gained 25 pounds since he put me on thyroid meds to slow my thyroid down and i said: Do i look malnourshised. He was proven wrong . when the test came back it was just fine. He has read just enough to be dangerous and against RNY because of the mal absorption problems.
I am going every 3 months now for blood work to monitor my thyroids and we check evrything then.
I am asking him to check this PTH when i go soon.
I take citrate also.
Hang in there , we all know how the public can easily say, you decided to do this..
I will fire back at them also.
You will find the solution to this. Hang in there.
Deb

Hello there.  I often lurk on ALL the boards and just wanted to step into your thread and commend you for standing strong to YOUR surgery and advocating for better HEALTH for yourself.  I am sorry to hear of the myriad of problems you are having.  I don't know about your eating habits etc, but is it possible to just take down the intestinal part of your RnY leaving your stomach?  I don't profess to know about the intestinal aspect of your surgery, but is it possible for that to be undone leaving you with a restrictive stomach, so that the vitamins you are now malabsorbing will be able to be absorbed?

Good luck to you and I hope that you are able to resolve these issues and maintain your weight loss.

Ms Shell

Hi Gina,

I just wanted to say that I hope everything works out for you.  I am not that far out yet, but your post could help me in the future.  I will be praying for you, Good-Luck!!!