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:

Iron Update...

The bariatric doc called me back today and confirmed what I already knew (my hematocrit and hemoglobin numbers are in the "low" range and my ferritin is just 6.7). He wants me to do iron infusion therapy to get the numbers back up and start working on finding an iron supplement that will help keep it up once we get it there... They referred me to a hematologist and that office called me this afternoon to schedule that appointment. I will see them on 9/21 and may have the first iron infusion treatment on 9/22. Progress--finally!

Vitamin Info for WLS Postops...

Vitamins are a way of life for WLS postops. We have to take them and we have to take it seriously. When things go wrong, they can go VERY wrong! A fellow WLS postop who tries to help inform the masses posted a great piece over on OH that I thought I'd share a link to so you can all check it out! Check it out and let Andrea know you appreciate it!

What does YOUR pill/vitamin box look like??

I use this one that I got at RiteAid for $4.99...


With extra large compartments and large day-of-the-week compartment labelling, this 7-Day AM/PM Locking Contour Pill Reminder gives you all the capacity you need.
This model also features our patented Adult-Lock device that ensures that compartments won't open unexpectedly, preventing spills.
It also includes new patent-pending ID plates so you can custom label the compartments to suit their needs
Each of the fourteen compartments can hold up to 45 (45) aspirin tablets, making this box large enough for people with more demanding medication regimens.
7 Day, Twice a Day Format
AM/PM Contour Reminder
Patented Adult-Lock device.
Approx. Dimensions 9.3" L x 4.25" W x 1" Deep
Each compartment is approximately 1.7"L x 1.25" W X 1" Deep Rounded Scoop Bottom

As I said, I got mine at RiteAid near the pharmacy counter for $4.99. The one RiteAid sells doesn't have the ID plates/labels as mentioned in the description above from
http://www.diabetesandmore.com/7-Day-AMPM-Locking-Pill-Reminder-2XL--P603.aspx
where they sell for $11.99.

As it says, each compartment holds about 45 aspirin tablets, so I have no trouble getting my 2 multis, 2 b complex, 4 vitamin D, 3 stool softeners, 2 magnesium, vitamin A/D, etc in there for my AM and my PM doses.

I also found it at Amazon.com at
http://www.amazon.com/dp/B001CDXLI2?smid=A23HA0AEY0089W&tag=dealtime-hpc-20&linkCode=asn
That one is $10.99 plus $4.99 shipping.

If you have a RiteAid nearby, check them first! They are definitely cheaper!

I don't put my calcium and fish oils in there as I take those in the afternoon in seperate doses. Those are near my computer and I take them during the day when I sit down to check email. The box above is by my bed. I take my AM vites when I first get up for the day and my PM stuff just before I lay down to go to sleep!

Vitamin D--whether you've had WLS or not!

As WLS postops, we fight various vitamin deficiency possibilities. The fat soluble vitamins are of particular concern to those who've had an RNY as we malabsorb the fats due to our rearranged intestine... Those vitamins include vitamin A, vitamin D, vitamin E, and vitamin K. It is recommended that we take those in their dry form for better absorption.

I know that I, personally, went into my surgical journey already low (almost depleted) in vitamin D stores. The "normal" level these days is anything between 32 and 100, with 100 being the preferred end of the spectrum. Mine was 24 preop. At 3 months postop, I was down to 17. At 6 mos postop, I was down even further to 11. Yes, ELEVEN! Another thing with vitamin D is its interaction with calcium and how being low in vitamin D and calcium can mess with your parathyroid levels as well. Your parathyroid levels will go up if you are low in D and/or calcium as the parathyroid overworks to try and find the calcium elsewhere (like from your teeth and bones--not good!). So, while my blood calcium level registered an "okay" number (middle of the normal range), my vitamin d level was bottoming out and my parathyroid numbers were climbing, indicating that I was not getting enough vitamin d OR calcium and that I was on my way to osteoporosis! SO, I started taking very large doses of vitamin d (about 14,000 iu daily) as well as became very diligent with taking my daily doses of my calcium supplements. Over time, my vitamin d level is climbing (though very slowly) and my parathyroid is dropping back towards the normal range. My dexascan showed that I did not have significant bone loss, but that I need to work on increasing bone density.

What prompted this blog entry on vitamin d??? Well, a dear friend was diagnosed this week with fibromyalgia. She's been dealing with some truly severe pain and thought it was just her arthritis worsening. And, part of the prescribed treatment her doctor has started includes--yep, you guessed it--daily doses of vitamin d! Vitamin d is truly drawing attention lately as being sort of a wonder-nutrient... Being deficient is capable of causing all sorts of things--including joint pain!

So, I wanted to share some links to vitamin d info with you all! If you are not already supplementing this (whether you've had WLS or not), please consider doing so!

http://www.lewrockwell.com/miller/miller25.html
http://www.vitamindcouncil.com/
http://www.fightingfatigue.org/?p=1220
http://www.slate.com/id/2105560/

Sam's Club sells a 400 count bottle of 1000 iu vitamin d tablets for less than $5. They are a small to medium sized tablet and are easy to swallow even as a WLS postop. I also buy my calcium citrate there (630 mgs calcium citrate plus 400 iu vitamin d). Those are just shy of $9 for like 400 tablets (200 doses). Those are a larger tablet, but they are scored in the middle and break very easily if you need a smaller tablet size.