Are you getting the right LABS done??

Lots of people get labs done after WLS. Do they get the RIGHT labs done though? Some yes, but most NO. Vitalady Michelle created a thorough list of post-op labs that any WLS postop should take to their doc (whether their PCP or their WLS surgeon) and request that they be run AT LEAST every 6 mos. If you have insurance that will cover it, go for every 3 mos. Do not go more than a year without a complete set of labs though! I'm borrowing the list via copy/paste, but this is the list that Vitalady and Andrea both share regularly with fellow postops:

*80053 Comprehensive Metabolic profile: (sodium, potassium, chloride, glucose,BUN, creatinine, calcium, total protein, albumin, total bilirubin, alkaline phosphatase, aspartate aminotransferase) (10231)

* 84134 Pre-albumin:

* 7600 Lipid profile: (cholesterol, HDL, LDL, triglycerides, chol/HDL ratio)

* 10256 Hep panel: includes ALT (SPGT) & GGT)

* 84100 Phosphorous – Inorganic: (718)

* 83735 Magnesium:

* 84550 Uric Acid: (905)

* 7444 Thyroid panel: (T3U, T4, FTI, TSH) (84437; 84443; 84479; 84480)

* 85025 Hemogram with platelets: (1759)

* 7573 Iron: TIBC, % sat

* 83550 Ferritin: (457)

* 84630 Zinc: (945)

* 84446 Vitamin A: (921)

* 82306 Vitamin D: (25-hydroxy) (680)

* 84052 Vitamin B-1: (Thiamin) (4052)

* 84207 Vitamin B-6: (Pyridoxine)

* 7065 Vitamin B-12 & Folate: (82607; 82746)

* 83970 Serum intact: PTH

* 83937 Osteocalcin:

* 84597 Vitamin K:

* 85610 PT:

* 85730 PTT:

2^ND GROUP

* 593 LDH:

* 31789 Homocysteine, Cardio:

* 83921 MMA:

* 367 Cortisol:

* 84255 Selenium:

* 84590 Vitamin E:

* 82525 Copper:

Glad that is over!

So my knee work DID get done this time... June 29th, I had my left knee scoped again. I had already had it done back in August 2009, so not quite a year had passed and it has been painful for a long time already. The orthopedic surgeon thought I might have had a bone chip floating in the joint (my knees are both bone-on-bone) and that this bone chip was chewing up the meniscus that I have left each time it was caught against the bone in the joint... Well, he didn't find any bone chips, just more shredded meniscus. I see him on the 9th for the "full report" but it doesn't sound like he really found a cause for this new damage.

On another front, I had my full labs done on June 22nd and will get those results today or tomorrow in the mail. I'm hoping my iron is at least 100 or higher (ferritin level). I won't be on it because I'm pretty certain it won't be, but we'll see!

Confession is cleansing, right?

Starting weight for me was 410 pounds in 2006. These days, I range from 202 to 208 MOST days. That is a 200+ loss. My all-time low was 197. I know I will never see my goal of 185 without removal of LOTS of excess skin/tissue. But, I have also gone from a 36W or a 4X or 5X to a 14/16. I can also wear mediums in some stuff and larges in others. That is HUGE--being able to shop locally for all types of clothing! Trying stuff on in front of a mirror instead of shopping from a catalog... You all know what I mean!

I'm dealing with iron deficiency and will probably start iron infusion therapy soon. I'm getting my vitamin D up finally--51! I was down to 11 a year ago!

I have fallen off the calcium supplement wagon and only recently realized it. I hadn't taken a dose in almost two months! I had a routine before we moved from WV in June. I took them without fail, twice a day, EVERY day. Then, packing, moving, getting settled--my routine as broken, my supplements not located where they had been... Ugh! I just got them back in their place, took a dose and will start working to get back on track there.

I still battle DAILY with constipation.... How about you guys?? Had both knees scoped this past month and with the pain pills, that was even worse. Just getting back to normal (for me) now.

Eating....not sure I want to discuss that! LOL Confession time... I'm eating too many carbs (mostly complex, but still too many) and not really enough protein. I have changed my night-time snack from carbs (junk food) to nuts and or cheese, so hat is progress I suppose. But, still need to really get my eating back on track.

I moved from my home of the past 10 years, and my really strong WLS support group in June. I am back close to my immediate family, but they are not exactly the most wls friendly folks. Their eating habits are atrocious! And, they do NOT want to hear about it either. I have no support group here yet either. Heck, I only just found a new doctor Aug 27th! I'm still sort of stuck between home in WV and my interim home here. We are renting till we find/buy a house and go through another huge move. Everything seems sort of "in limbo" if you know what I mean. I think that is part of what has me so off track in everything.

Dr. Shieh, my new bariatric doc AND Labs results...UGH!

I saw Dr. Moses Shieh on 8/27. He seems to be a knowledgeable bariatric doc and even has a lab routine I can live with. I as impressed at his list of periodic labs as compared to what so many other docs request. He was happy with my surgery outcome and the fact that I've lost and kept off over 200 pounds. We talked about my iron concerns and he seems to agree that iron infusions are going to be necessary to get my numbers up again. He does want to start trying all iron supplement options again though and find one I can tolerate long term so that we can keep the numbers up once we get them there via infusions.

He ordered my labs and was going to do an EDG scope on 9/2 but had a family emergency and had to leave town, so the scope was cancelled for now. I had told him that I had reason to think my stoma may be enlarged and allowing food to pass more quickly than it did originally.

My lab results showed that my HCT and HGB were both low (lower than in Feb 09) and my Ferritin is at 6.7. It was 5.4 in February, so all the attempts at supplementation and the single dose of IV iron did practically nothing. Now that I have insurance again, I am hot to get that iron infusion therapy going. I am not going to take any chances on losing insurance again and not being able to pursue that option. I am sick and tired of being sick and tired! I feel SOOOOOOO tired all the time with my iron in the crapper!