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Blood test and vitamins - BIG WARNING to all newbies

W

Welchen

Member
Hi All,

I just thought I would drop a note here about how important blood test are - you really need to keep yourself informed because I've found that most doctor's don't know much about bariatric patients. Vitamins, protein and minerals are SO important. I belong to a few groups on yahoo and there are people there that are 10-20 years out. OSSG Graduates is one. I can't remember the other big one I belong to off the top of my head but I'll post it at another time.

If you don't know - you need to get your blood levels checked at least once a year. To get everything checked it's about 12-15 vials of blood. You really need to pay attention to Vit D/Cal not only for your bones but because if it gets low you'll develop thyroid problems. You also could have severe problems with your teeth - one woman I've followed on the boards had to have 6 root canals in one year. Another didn't take her vitamins and has develop neuropathy and is on Disability. Me? I've got trouble with my teeth, edema (my feet swell all the time), thyroid problems, anemia, and I'm sure a lot of other stuff will show up once I get the results of the blood tests.

You also need to advocate for yourself. My primary doc is out on maternity leave and I went in to see her sub. I brought a list of blood tests - I made a mistake and missed a few I needed but he decided I didn't need some of them. Really ticked. You can download a chart to track your blood tests, get a list of the blood tests needed, and also get the ranges that bariatric patients should have as far as results.

Online groups are good but I also think face to face groups are too. Unfortunately, I find where I live that most of the groups run by hospitals and doctor's are more like sales meetings. I'm going to try and start one locally. I found a good website for local groups based on your zipcode - it's meetup.com. There are all types of groups there and it's pretty cheap to post/create a webpage for one of your own. It's free if you just want to join a group.

Okay, that's enough babbling for now. I had trouble sleeping tonight so here I sit typing at 4 am. Maybe I'm overtired and channeling Yoda, lol.

Please don't take the above as a lecture - I mean well.

Deb
 
Deb-Thanks for the information. A couple of questions. Did you stop taking any of your vitamins / supplements? Why are you going to your PCP to have your bloodwork done instead of a bariatric doctor? I just had my 6 month bloodwork done last week and had an appointment to review them with my surgeon yesterday. He was called into surgery and I had to reschedule for next month so I don't know anything yet. I'm sure if there was something major I would have been notofied by now. I rarely miss a dose of my supplements and vitamins. Besides having bloodwork done by the bariatric surgeon my PCP runs additional blood tests and they exchange results.
 
Hi Deb, Thanks for the post. My surgeon told me that bypass patients can develop para thyroid problems 2-3 years out. After my surgey, I had bloodwork as I was feeling so sluggish. My para-thyroid levels were high, but he said it had nothing to do with the surgery. The endroconologist that I met with put me on high doses of vitamin D and I have to check back in in 3 months. I don't think the doc's are hiding these things, but are learning as time goes on what can happen as a result of the surgery even when taking all your vitamins. I had the sleeve and there is not much known about what could develop down the line. I think that's why it is so important to have contact with others who have had surgery as sometimes you learn more from them than the doctors. I in no way want to discourage anyone who is considering WLS, as it can be life saving for some. Making an infomed decison is very important. I am considered a difficult patient as I am a strong advocate for myself. I insisted on the bloodwork after 6 weeks after my surgery and I was deficient in vitamin a,d, and iron. All of which I am taking. I will be rechecked in Oct. I also will follow up with the endroconologist to see if my PTH level is normal or if further tests are needed. For me this proceeded my surgery, but is not a test regulary given in a physical. My surgeon now tests all his patients for high PTH levels. He no longer does bypass surgery for a number of reasons.
 
Wow, interesting, but I agree with Pat here...I do not see my General Practitioner unless I have something, well...General...to see him about...since I have a thyroid issue and am Diabetic, I've always been monitored by my Endocrinologist with blood tests every 3 months. Now post bypass, I am monitored with my bariatric team/Doctor. Both Doctors are in the same area and share my information. My Bariatric Doctor put me on Vitamin D & B12 prior to my surgery. I am awaiting to see my Endo the first of September, so that he can further monitor my Thyroid and Diabetes...as a matter of fact today, the bariatric Nurse took me off all of my Diabetic Meds, because my blood sugars were continuing to go down. I suggest you go back to your bariatric Doctor to be continually monitored.
 
Hi All,

I know I was ranting but let me clarify a few things. One, what's happened regarding my bloodtests, etc., is my fault. I did stop religiously taking my vitamins and slacked on really pushing for ALL of the blood tests needed. My surgeon only wanted to see me once a year and required calcium and B12 to be checked. When I intially approached him about the other tests he said I didn't need them. This is also a practice that required me to see their nutritionist both pre and post op - she said I could get enough vits from a flinstones vitamin and Tums. I knew even before I had the surg. that that was incorrect. She also said that I could drink milk and get my calcium - wrong. And that I would eventually be able to get all my protein from food. Wrong again.

I did go to a endo. for my thyroid initially. Actually went to two different ones after being out of work for a month because I felt like hell and couldn't explain why somedays I barely got out of bed. I told both of them about the RNY and brought up stuff I learned online. I also asked if could be cause by malnutrition linked to the RNY. I had a similar reaction from a vascular surg. that I went to see because of swelling of my feet that my PCP ran all the tests on but couldn't explain (another RNY patient mentioned it could be linked to a vit. def.) When it came to my teeth, and the problems that have come up, two dentist told me that low calcium/vit D wouldn't be a factor....

I use my PCP for most of my tests because I can usually convince them when specialists don't seem to listen. To be honest, I haven't gone to see my surg. in years. Too embarrassed about the weight gain and he doesn't run a bariatric center, just does the surg.

I guess what I was really trying to get across with this post was don't become lax in following up on the blood tests, etc. I'm 7 years out. The honeymoon stage is WAY over and my main point is that you need to educate yourself to not only advocate for yourself but also educate your doctors. The surg. is not specialty taught in school, at least I don't think so, and surg. can learn how to do the procedure but long term follow up care isn't what it should be.

Did anyone see Doctor Oz's show today where he advocated gastric bypass for diabetics and others with lower weights. I really wish he spent more time on how important after care is to a RNY patient. I know I sound like "don't get the surg."....not at all. I just want people to realize it's not a simple snip and you're magically thin. It's really dangerous if you don't take the vitamins and take care of yourself.

Deb
 
Deb-I noticed you had your surgery in 2005. I think most of us will agree that things have progressed considerably since then and that the bariatric surgeons are much more proactive. Most have bariatric nutritionists on staff and suggest blood work every 6 months. Since 2005 there has been data accumulated in regards to vitamin deficiencies and medical "complications" as a result of bariatric surgery and steps have been implemented to reduce or eliminate them. Calcium citrate is the gold standard these days since it is more readily absorbed than any other form of calcium. As for Flintstone's vitamins, I have been taking them since my surgery and feel just fine, will know my blood work results next month. To be more specific Flintstone's Complete with iron is one of the many chewable vitamins recommended by the nutritionist (2 daily, one AM and one PM). I can now change to a non-chewable vitamin if I want but will wait to see my test results before I make that decision.

Just to give you an idea of how tuned in my surgeon was, he spent an extra hour with my RNY because of a large amount of scar tissue he had to go around from the hernia surgey I had 9 months earlier. He actually had to do the surgery from the opposite direction from what the normal is. He could have switched to an open surgery if he wanted to but had my best interest in mind. He also ran bloodwork in the hospital and noticed a thyroid condition I have but forgot to mention when I filled out my medical history during my first consult. From reading posts from you and others who have had their surgeries a while back I can see how much things have improved over the years. We, as bariatric patients, have to be proactive by following the recommendations we are given by our surgeons, doctors and nutritionist and can't blame anyone but ourselves if we fail to do so. I'm not saying things can't happen even when we do everything we are supposed to do but it will certainly better our chances of not running into problems :) :) :)

Just a little bit of history, WLS was first introduced after WW2 in the form of stomach stapling. Talk about progress!!!
 
Pat,

I'm glad to hear that surg. info had improved. Still not sure about the Flintstones regardless of the iron or not but maybe they developed that for bariatric patients. I do, however, think that it can be a dangerous not to educate yourself. This surg. effects ALL type of medical doc's and I think it's too new, still, for side-effects, etc. to reach them. I find myself educating my OB, vascular surg, psch., eye doc., dentists, etc. Whenever something comes up with me healthwise my first thought is it related to my surg.? As seen with the Dr. Oz show this week where he all but had a commercial for RNY - the broad medical community isn't all that informed. I gained my weight back - SEVERAL doctor's have said they didn't think that could happen.

I don't mean to come across as a negative Nelly....just want people to stay aware of stuff. Coming to boards like this and others, going to group meetings, is the best way because the population of bariatic patients has grown and now the boom is aging a bit. I think more and more issues will come out and that special circumstances for bariatric patients, and knowledge of them, will be key. As far as the blood labs? Those are tricky. Low reading of some things are predictors of larger issues...like you'll have trouble if you don't have ferritin and iron checked. Just checking iron isn't a way of seeing it's heading for trouble.

It's getting better, you're right, but there uniformed health professionals out there. And yes, it is the patient's responsibility to follow recommendations....my cavate is it's also the patient's responsibility to educate themselves and question those recommendations sometimes.

Deb
 
Okay, my interest is perked. I'm planning to use Unjury vitamins even pre-surgery once I see the nutritionist. I'm also planning to begin taking Unjury's protein products at that time. Which vitamins do I need to take? How often should my doctor order blood work and what bloodwork should he order? Should my bariatric surgeon tell me at some point prior to me being discharged from the hospital after the surgery. I've always had good teeth and want them to remain in good condition. I certainly don't want other health issues to appear simply because I failed to take the right vitamins and minerals. Would someone give me some good advice?
 
Barbara-Don't go out and buy anything just yet. After your blood work is done your surgeon or nutritionist will tell you exactly which vitamins and supplements you need. They will also recommend brands that have proven to work after bariatric surgery. They will probably recommend that you use a chewable multi vitamin for a while after surgery then you will be able to switch over to a non-chewable if you want. You will definately be on calcium citrate because it is absorbed the best compared to other calciums. There is a wonderful tasting chewable calcium citrate "caramel" that you can use if you want. The name escapes me at the moment but when TwoMas reads this he can tell you, he uses it too.

My surgeon does complete blood work every 6 months but more often if there are any issues. He said it used to be done every 3 to 4 months but historically there in not significant enough of a change so it's now done every 6 months barring any issues. Your PCP will also do additional blood work especailly if you are diabetic, have cholesterol problems or take medications that require blood work review.
 
It sounds like I'm getting ahead of myself. I'll wait until I see the nutrionist. It's good to know, too, that the complete blood workup is only done twice a year. Thanks so much.

Barb...
 
Where to find info on forms, blood tests, etc

Okay, I received a few emails asking for more info. If you go to yahoo groups and find Gastric-Bypass Info Central they have a ton of great info in their files section. You will find lists of suggested blood test, blank journal forms, blank bloodtest trackers, articles, auestions for RNY surg and Plastic Surg. There are members of that group who are 20 years, yes I said 20 years, out from bariatric surg. It's a good resource. I just hope the webmaster doesn't delete this post because it mentions another group.

Hope thie helps,

Deb
 
They won't, I post other bariatric sources here all the time, the main point of this forum is to help us. Thanks for all the good info. :cool: Tom
 
Barb-I did the same thing before surgery and ended up with vitamins I couldn't use immediately after surgery. I can use them now because I'm completely healed but if I knew then what I know now I wouldn't have bought anything. You may even be able to get everything you need at the hospital pharmacy before you are discharged. This option was available to me, it came in handy since I didn't feel like going anywhere for about a week after I came home.

The blood draws may seem daunting but they only require one needle for all the vials. They don't poke you seperately for each vial so it's no different than having a small sample drawn. If you keep your eyes closed you won't know the difference :)
 
Believe me - I'm not afraid of needles. I've had enough blood work over the years to satisfy any hungry vampire. I've also had several spinal injections due to me back problems. The needles are longgggggggggggg. They're not exactly a walk in the park, but they're far from being unbearable. You've given me so much good information, I really appreciate it.
 
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