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Track Your Bloodwork!

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One thing I would recommend for everyone is that they keep a spreadsheet of all bloodwork results.

If your computer doesn't have spreadsheet capabilities, do a search, there are free templates online.

Just list all the labs drawn then enter the numbers under their respective dates. I highlight anything peculiar in red and print out a copy and take it with me to the docs each time.

My surgeon was/is superb but I quickly learnt that most docs are happy if your numbers are in the "normal" range.

It didn't take me long to work out that "normal" isn't necessarily good. A prime example is my iron dropped 34 points during the first 3 months after surgery. 3 months later it dropped another 9 points putting me just 1 point up from low. No one said a thing about it!

Well, guess what...... 3 months later and I felt like crud and had to go on some heavy duty iron supplements.

The same happened with my vitamin A etc.

The results of a small study released by the American Journal of Clinical Nutrition in May 2008 states:
 

At 3 months out, 34% of us will require at least one specifici supplement in addition to multivitamins.

At 6, that number increased to 59%.

At 2 years - 98% of us will require one or more additional supplements.

Nutritional deficiencies after Roux-en-Y gastric bypass for morbid obesity often cannot be prevented by standard multivitamin supplementation -- Gasteyger et al. 87 (5): 1128 -- American Journal of Clinical Nutrition

I don't rely on anyone other than myself to track my bloodwork results and neither should you.

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Thank you Corrine

for highlighting this VITAL aspect of our surgeries! I quite frankly feel that the little I do is "enough" (compared to my former life!), but indeed ONE multivitamin 2-4 times a week is by no means anywhere near enough!!! I have slipped my vitamins and protein intake these last 3 weeks, don't drink more than 1 glass of water a day.... I have lost the habit and ...

Thank your for your friendly alarm bells!

Cheers,

Vim

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Thank you Corrine

for highlighting this VITAL aspect of our surgeries! I quite frankly feel that the little I do is "enough" (compared to my former life!), but indeed ONE multivitamin 2-4 times a week is by no means anywhere near enough!!! I have slipped my vitamins and protein intake these last 3 weeks, don't drink more than 1 glass of water a day.... I have lost the habit and ...

Thank your for your friendly alarm bells!

Cheers,

Vim

VIM! I have only one thing to say to you.... angry039.gif

Don't make me come over there!

But I hear you sweetheart. There are days when I truly just want to forget that I've had WLS but with a never ending round of daily pills etc., that isn't likely to happen.

Vitamins and supplements are essential if we want to reap the benefits of the surgery we had and the hard work we put into being thinner.

You know, WLS opens a door to a beautiful new world. It gives us a tool which, if used properly, gives us a healthier, happier, more productive future.

I'd be a shame to waste the future YOU created for yourself.

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Corrine.. thank you for sharing with us this hard learned lesson. I don't feel that I'm getting a complete and thorough rundown of tests and I'm trying to cobble together tests with the surgeons office & my PCP but I'm not sure everything that needs to be checked really is. Do you know of a comprehensive list somewhere of what needs to be checked that I might bring to my new PCP?

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Corrine.. thank you for sharing with us this hard learned lesson. I don't feel that I'm getting a complete and thorough rundown of tests and I'm trying to cobble together tests with the surgeons office & my PCP but I'm not sure everything that needs to be checked really is. Do you know of a comprehensive list somewhere of what needs to be checked that I might bring to my new PCP?

I haven't seen a list and the problem is that docs don't seem to order the same set of tests each time.

I had a big one done at 1 year (but there are others I'd like to have included) and I have some other stuff going on so some of these tests are not specific to gastric bypass:

Glucose

BUN

Creatinine

BUN/Creat Ratio

Urea Nitrogen

Urea Nitrogen/Creat

Sodium

Potassium

Chloride

CO2

Anion Gap

Osmolality, Calc

Calcium

Magnesium

Phosphorous

Amylase

GGT

ALK PHOS

TBILI

Albumin

ALT

AST

Cholesterol

HDL

HDL/Chol. Ratio

LDL, Calculated

Triglyceride

Iron Serum

Iron Binding Capacity Total

Transferrin Sat

Prealbumin

CBC

RBC blood

Hemoglobin

Hematocrit

MCV

MCH

MCHC

RDW-CV

Platelets Blood

MPV

Lymphocytes

Monocytes

Neutrophils

Eosinophils

Basphils

Lymphocytes

Monocytes

Neutrophils

Eosinophils

Basophils

WBC

RBC

HGB

Folate

B12

Lipase

25-OH Vit (Sea2)

25-OH Vit (Sea3)

Calcidiol

Vit.A (Retinol)

HGB A1C

T Protein

PTH Intac

HCT

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Corrine!

WOW What a list!

And thank you for looking out for me! Yes indeed, this morning the skin under my eyes is "PARCHED"! The first thing I did upon awakening was to reach out for WATER! AND my multivitamin, which I am sipping as I type! Thanks again!

Cheers,

Vim

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Great advice Corrine. I always get copies of my blood work results, but I never thought about doing the spreadsheet.

I think as patients, we have to be proactive about our health. For example, my surgeon (as a matter of routine) doesn't check blood work until the 6 month appointment. I totally disagree with that, as I think too many problems can crop up during that time. At less than 5 months out now, I've had blood work on 3 separate occasions. Thank goodness I have, because I have ongoing problems with my iron, vitamin D, calcium, potassium, and B-12.

I'm definitely going to do the spreadsheet...as soon as I can round up all of my results, which are scattered throughout the house. :o

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Thank you Corrine

for highlighting this VITAL aspect of our surgeries! I quite frankly feel that the little I do is "enough" (compared to my former life!), but indeed ONE multivitamin 2-4 times a week is by no means anywhere near enough!!! I have slipped my vitamins and protein intake these last 3 weeks, don't drink more than 1 glass of water a day.... I have lost the habit and ...

Thank your for your friendly alarm bells!

Cheers,

Vim

Yikes Vim! :eek: Don't sabotage yourself like that.

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I have my 6 mo appt this wednesday and plan to ask my dr for copies of ALL my bloodwork. At my 3 mo appt, I was told my vit D was low and i needed to get more sun and play more golf. I started taking a vit d supplement. Hopefully with the bloodwork we will go over wednesday this will have resolved itself.

What i find weird is that when i went in for my 6 mo post op bloodwork at Quest Diagnostics, I asked if they could send me a copy of the results. The technician said they could only send the results to the doctor. That kinda made me upset, i mean it was my blood in those 9 vials that they took, why cant I have a copy of MY results?

guess I will have to ask my doctor wednesday.

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What a great idea, Corinne! Thanks for sharing and reminding us.

I feel lucky in that, as a Kaiser patient, I signed up at their website, so they email me the blood results. I can click on each one to learn more about it and to see my results from this time compared to all previous times in 3 different types of graphs/tables. I love it! I've learned so much just playing around with everything on their site.

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I have my 6 mo appt this wednesday and plan to ask my dr for copies of ALL my bloodwork. At my 3 mo appt, I was told my vit D was low and i needed to get more sun and play more golf. I started taking a vit d supplement. Hopefully with the bloodwork we will go over wednesday this will have resolved itself.

What i find weird is that when i went in for my 6 mo post op bloodwork at Quest Diagnostics, I asked if they could send me a copy of the results. The technician said they could only send the results to the doctor. That kinda made me upset, i mean it was my blood in those 9 vials that they took, why cant I have a copy of MY results?

guess I will have to ask my doctor wednesday.

What a crock!

I've been on 10,000IU dry form D3 a day and have still only managed to get my blood level up to 42.

To get that amount of vitamin D from the sun on a daily basis, I'd end up looking like a pig on a spit-roast!

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Excellent point, Corrine. I've recently started tracking my labs on a spreadsheet myself. I had my baraitric surgeon send me a copy of all of my labs post surgery. To record them. I also get a copy of all my labs my pcp does. I have my pcp duplicate all of my surgeon's labs plus add in a couple others that I felt were important. I have labs with each physician once a year, 6 months apart from each other.

Here are the labs I get:

Surgeon: (in Feb)

CMP

Lipid Profile

CBC w/ diff

B12

Bili-Direct

Ferritin

Iron/TIBC

Magnesium

RBC Folate

Thiamine

Uric Acid

Vitamin D, 25-OH

PTH

PCP: (in August)

CMP

Lipid Profile

CBC w/ diff

B12

Bili-Direct

Ferritin

Iron/TIBC

Magnesium

RBC Folate

Thiamine

Uric Acid

Vitamin D, 25-OH

PTH

TSH

Copper

Zinc

UA

Stool for Occult Blood

DexaScan

Edited by MiladyB

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Copper and zinc is something I'll ask to be checked next time - thanks for including it on your list Beth.

I found this article "Severe Ataxia, Myelopathy, and Peripheral Neuropathy Due to Acquired Copper Deficiency in a Patient With History of Gastrectomy" interesting: Severe Ataxia, Myelopathy, and Peripheral Neuropathy Due to Acquired Copper Deficiency in a Patient With History of Gastrectomy | JPEN: Journal of Parenteral and Enteral Nutrition | Find Articles at BNET

And that alarms me because I was diagnosed with peripheral neuropathy and was told to increase my B12 and B vitamins. Now, with my folate and B12 levels way in excess of high, I still have the problem!

And this one on zinc SpringerLink - Journal Article states:

These results suggest that RYGBP promoted, besides change in body composition, an alteration in the zinc plasma and erythrocytes concentrations which in the medium and long term, could cause problems for these patients.

It's good to see more and more research being done about the potential for vitamin and mineral deficiencies amongst the WLS community. But the sad fact is that not all of us can rely upon our health care providers to keep up with it.

And that's why "I don't rely on anyone other than myself to track my bloodwork results .......".

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In researching something else I found this very helpful information about the realities of vitamin deficiencies post WLS.

Vitamin Deficiency in gastric bypass

Hopefully this is a continuing thread. It's critical information, trust me, because I've been lucky with my bloodwork (so far). Newbies will hopefully search through all of the other threads here about vitamin information.

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Im so glad this thread was brought back up. Im going to start my spreadsheet ASAP.

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Thanks for the info. I have been getting my results but I like the idea of putting them all on a spreadsheet.

My mom keeps telling me not to obsess ...but this is my life at risk and it isn't obsession it is taking control so I can make the best choices.

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Does anyone have a list of what labs should be done? I realize corrine posted a list, but admited there was extra stuff in there. I need a list of what is vital for me to check. Thanks! :)

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Thanks for bringing this up-- I start my consult in a two weeks and its a smart thing to start.

Just a question-- I've asked around,but I'm still not sure

Am I able to call my doctors and ask for time to go in and go through my records(rights wise-- obviously I'm not asking permission:p)

. I just got approved through insurance, and have my consult soon and I have a 10 page question and answer to fill out however my PCP has 17 of my 20 years of life documented; I'd rather have the correct information than have my mom and I guessing at dates and weights.

Thanks again!

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Yes, you have a legal right to review your medical records. Most doctors will be pretty good about letting do this, although the receptionist may not have had this request before and may want to check with the doctor before scheduling a time for you to do it. Some doctors will prefer to sit down and go through the records with you rather than just turning you lose with them, and that's acceptable. Occasionally a doctor will balk at letting you see your records, in which case you just need to remind them that you have a legal right to the records. You also have a right to copies of the records if you want them. They are allowed to charge you a fee for the copies if they want.

Kelly

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Thanks so much for the advice...I have been spending my time with planning what I need to do to prepare for the weeks just before and after surgery, and just trying to get through the hoops for approval that i didn't consider capturing this kind of detail.

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Thanks for the advice I am going to have my Doc run a copper and zinc test next time I go in. It is amazing how some docs dont test everything that they should. We really have to be our own adovcates.

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What an extensive list!

So how often should I get the "full monty"? I have copied and pasted the list into Excel and I plan on giving it to my surgeon pre surgey so I know where I'm starting. How soon should I get these labs after surgery? And then how often?

Also, it would be great to see what each of these mean and what the recommended levels are so that we have some idea of where we should be. I will be researching myself and will post any information I learn!

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What an extensive list!

So how often should I get the "full monty"? I have copied and pasted the list into Excel and I plan on giving it to my surgeon pre surgey so I know where I'm starting. How soon should I get these labs after surgery? And then how often?

Also, it would be great to see what each of these mean and what the recommended levels are so that we have some idea of where we should be. I will be researching myself and will post any information I learn!

Recommendations are usually at 3 months, 6 months, 9 months, 1 year and then yearly. Personally I feel yearly isn't often enough so I have everything checked every 6 months. I see my bariatric surgeon once a year and have all the labs drawn then 6 months later I have my yearly physical with my pcp and have all the same labs drawn. I also make sure both doctors get the results of any labs I have drawn.

If you request copies of your lab results the normal values should be on the results and it will tell you if you are low or high.

Edited by MiladyB

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I plan to have mine done every six months. I think a year is a long time to go if there is a problem and not know about it.

I think it might also be a good idea to get them done before surgery to see where you stand. I know my doc did some pre-op blood work, but I am pretty sure he didn't do everything. Then after surgery, my labs showed my vitamin D was low. But I wonder if it was low even before surgery and I could have been supplementing it all along? But I'm pretty sure he did not check that before surgery. And I never asked for copies of my pre-op lab work.

I did get copies of my post-op labs, though, and plan to make sure I always get a copy from now one. And yes, it will show you on the lab report what the normal range for each test is.

Kelly

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For anyone who is interested in tracking their labs, I have a couple different spreadsheets. One is Excel and the is a WORD document. Feel free to send me a message with your email address and I'll send them your way.

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