Blood work questions

I had my first post-op appointment today at my bariatric clinic. I am 3 months post-op RNY. I am a bit surprised that they did not order many blood tests. Only 2 tubes were drawn. The tests that were ordered are: Albumin, electrolytes, ferritin, TSH and CBC. No Vitamin B12, no vitamin D or Calcium levels either. Is this the norm? My pre-op blood tests required over 10 tubes. I'm trying to figure out why there were so few tests ordered. Is 3 months post-op not long enough for my levels to drop? I won't have another appointment until the 6 month mark. Is that too long to wait to find out if I am taking the right vitamins? Also, can anyone suggest a website for blood tests that is super easy to understand? Thanks Chris 

Your body stores a lot of things, and they really don't drop much, if at all, in 3 months. They really only need to check the things that might be affected by the surgery itself, or double checking something that was low before surgery.

Get copies of all labs. Keep track of everything yourself and watch for trends. Trends can bemore important than the individual numbers.

I agree, it's a bit too early t0 see  a big drop in anything.  I am one of the very few people who can no longer absorb iron after a VSG.  That didn't show up for almost a year.  Wish you the best!

My surgeon didn't require blood wor****il 6 months post op.  However, I see an endocrinologist regularly, so I had mine drawn at 3 months post op as well.  My TSH was the only thing that had changed.  

Thanks everyone. Can you think of any good websites that I could use to help educate myself about blood tests and "normal" levels? Thanks Chris

Hi Chris, 

This is my first post... my surgery is next week... so I don't know a lot about post op stuff, but I am a nurse so I know a little about labs. I will try to help. 

Albumin measures th protein in your blood, it tells the doc more about long term nutrition than very recent. (Pre albumin is a more immediate marker of malnutrition, but what the doc wants is a big picture not a trend, and he can compare pre op albumin to post op and make sure all is "trending" ok...and that you are eating enough protein.

 Electolyte panel tells us ALOT. It looks at hydration and kidney function. The potassium, BUN and creatine are high in kidney failure,  but in dehydration BUN is elevated and Potassium and creatine stay in normal  range. (the normal range is usually ro the right of the result)  There are sodium levels and these can be affected by drinking as well. So he is looking at hydration....he wants to know if you are drinking enough water. Calcium is on this test too, and so is sugar (glucose). There are also markers for liver function. It tells the doctor a lot and if it indicates a problem he can tell what other tests need run or what you need to do. (drink water) ;-) 

Ferritin is an iron test. Lack of iron causes anemia. the iron carries the oxygen in your blood.... it is similar to b12.... but not the  quite the same. How is your energy?( look up   Pernicious Anemia symptoms, that is the kind of anemia caused by b12 deficiency ) I don't think your doc suspects B12 problem or he would have checked it.... but for peace of mind look at the symptoms. I am proud of you for being engaged in your care. 

TSH is thyroid stimulating hormone. It is high when thyroid function is low, it is like the cheer leading squad for the thyroid... it goes up when it is trying to get the thyroid to do it's job. (Think of a parent and a lazy kid.... the lazier the thyroid is the louder/higher the TSH in hopes of motivating it to work)

CBC tells if we have an infection (white blood cells go up....and if they are up, the number of different kinds of white blood cells can tell if you are chronically ill, or if it is acute, it can show allergy, fungus... we are AMAZING....our bodies do such cool stuff. Then it tells how many red blood cells you have, hematocrit which is like the volume of the red blood cells and hemoglobin which is the protein (s) that carries oxygen to your organs. then there are platelets that help blood clot.  With this test he knows a big picture.... and details if there is a problem.

Before surgery they have to check everything, it is for both of you and the doctor. if you have an infection they don't want to open you up and cause more infection. they are looking for anything that might surprise them when they open you. they are also making sure to cover their own hiney, as well as protecting the patient.

I hope this helps a little. I love labs. They help me know what is going on inside my patient. I love nursing/anatomy..so please forgive me if it was long or boring. 

 Keep up the greaT work. Never be afraid to ask questions. bother your nurses with question because we love it bother your doctors with questions because whether they like it or not it's what they get paid to do. I am truly proud of you for being engaged in your care! 

Cathy

Wow, Cathy, thank you for typing this out!  Very informative.

WOW!!! Thank you sooooo much Cathy! I feel so much more confident about understanding my labs.

You really should be teaching this stuff! I agree that our bodies do amazing things. I had a basic understanding of some of the blood tests because I work took medical office administration at college. I actually work in an emergency department. I couldn't ask the nurses that I work with because I haven't told anyone about my surgery. I do attend a support group and there are a couple nurses there that are friends of mine but they never took the time to explain anything when I asked so again Thank-you! You are awesome!

My surgeon's office orders a complete set of blood work at 3, 6, 9, 12 months.  After a year, it's at 6 months.  They draw about 14 vials.

But it's true that you're unlikely to show much difference in your labs at three months.  Keep taking all your vitamins (and the correct type of vitamins) and you should be okay.  

Make sure that you request a copy of your labs every time they're drawn.  Your bariatric clinic will provide you copies, but you have to ask for them.  I created a spreadsheet to track trends over time.

Google the name of any blood test and you'll find several sites that explain the test and the results in detail.