Recommended labs--is there a list somewhere?

Hi!  Can anyone direct me to a good list of all the blood labs I need to have done post-RNY?  I have searched the site, but I am not finding this.

i have seen a lot of discussion on OH about how PCPs and also WLS surgeons may not really order the complete set of labs we need.

I am 7 mos since my RNY surgery.  My surgeon orders NO labs until a year after surgery, unless there is a troubling symptom.  This has concerned me, because I see many OH members who have labs at 3- and 6-month intervals.  

However, next week, I have my annual physical with my PCP, who I expect will order standard blood work as part of my physical. I assume that his standard-ordered blood work probably does not include all the things that we need to track after surgery.  But I plan to ask him to include all the vitamin/other post-WLS labs as well, to help me see what is happening in my body.  He is such a gracious person, and has been a great supporter of my surgery, so I believe he would include these labs if I request them.

i will also ask him to approve a bone scan.  I am 51 now, so I think I would qualify for this anyway.

Thanks for any help on this!

 

This list is from Vitalady, and is close to what I use (although some doctors don't think there is any reason for most people to have PT and PTT checked (blood clotting ability)):

*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:

 

You may also want selenium and copper checked.

Lora

TO EVERYONE AND ANYONE IN WLS WORLD...  Friendly suggestion:  print, file, and remember to take this recommended lab test list to your next medical appointment.  Friendly idea:  print extra copies to hand out to fellow support group members at your next meeting.  Friendly question:  what happened to poetkelly postings?

Lora, thanks very much.  This is perfect.

What is Osteocalcin?

It is a special type of protein found in bones.  My surgeon, my PCP, and the surgeons I work with don't ink it is a necessary test, so that is pretty much the extent of what I know about it.

Perhaps someone else knows why some surgeons think it should be checked after gastric bypass.

Lora

I also wanted to add that, unless your pre-op labs showed something, many doctors believe that there really isn't any reason to have 3 month labs because for many things your body is still operating off of your pre-op stores.  

Some maintain the same thing about six month labs, but I personally wouldn't be willing to wait a year because our levels can drop quickly.

I think having your PCP order them is an excellent idea.

Can ask if you know why blood clotting ability would be important or changed from WLS?

It is usually related to seriously low Vit K. When your about K is too low, it impacts the bloods ability to clot (and Vit K injections -- it is kind of a bright yellow-green, LOL! -- are used as an "antidote" for people whose blood thinner dose is too high and/or their PT/INR clotting time numbers are too high).

Vit K deficiency doesn't seem to be terribly common, and is usually minor (they just add a Vit K supplement), but it can be serious.

My dietician told me that K is absorbed in the portions of the intestine that isn't bypassed, and K is absorbed well in the large intestine, unlike most vitamins. That's why deficiencies seem to be rare.

My guess is, vitamin K deficiencies are supposed to be rare, because K is rarely tested. If they never test for it, it must be ok, right?

Most K comes from green leafy things. Care to guess if mine is high, or low?