Iron deficiency anemia prior to RNY surgery

I just had my screening labs for my surgery and my serum iron level is 24. Previously, it had been 19 so this is an improvement, even though it's still low. I've been taking oral iron 65 mg ferrous sulfate (the kind you buy at Walmart or where ever) with added vitamin C three times daily for the past few months. He is going to call in a prescription iron/vit C combination pill. Unfortunately, I didn't write the brand down that he's calling in, so I won't know that until tomorrow. I am to take this once daily. Less pertinent but still concerning, my vit D level was 11 so he is calling in a supplement for that as well and I'll have to take calicum. And yes, I do know not to take the calcium and iron too close together.

So, I'm feeling bummed. The nurse said that if my iron does not get up into the 40s I can't have surgery. I get the importance of this, especially given the nonabsorptive nature of RNY, but I'm not sure I can ever convince myself to diet again if I don't get this surgery. And on the flip side, I know that when I had my initial consult with the surgeon that he told me that if I could at least get it into the 20s that he would still do it because he thinks that my levels rising would indicate that my problem isn't absorption but bleeding (damn periods). I'm working with my gyn on my periods, but it's a slow process and he certainly isn't going to yank out my uterus for heavy periods when I have nothing wrong with me except the heavy bleeding.

Any suggestions for increasing iron pre-op would be greatly appreciated. I  will be jumping through my insurance company's hoops until the end of January, so I have some time to work on this. I'll be rechecking the iron levels in 30 days.

Thanks for reading my pity-party novel!!

i'm sorry you are having to go through this, how annoying! Maybe try a different type of iron, I know there are other kinds that absorb better. You can also try uping your food intake that has iron, like spinach. a nice green smoothie with an orange would be yummy.

Thank you! It's a giant pain, and I am trying to get in all the iron rich foods, but there's only so much you can take, lol!

My wife has an iron issue as well.

They didn't want to do the RnY because of it.
So they switched her to the VSG because it doesn't have the same malabsorption problems with Iron that the RnY does.

Scott

See, that's what I thought the MD was implying at my initial consultation, but when I asked the nurse about that today, she said that I couldn't have any kind of surgery if I don't get my iron levels up.

I think it's worth talking to the Dr. again and bypass the nurse.

Scott

I agree, and as I get closer to actual surgery time, that's what I'll do.

I have had chronic anaemia, as part of an auto immune disease, for 30 years. Your iron levels could be brought up to a good level in 4 hours - with an iron infusion - this is no reason to cancel surgery if it's managed now!

Please consider consulting with a haemotologist - they are the specialists in these disorders and won't mess around like your other practitioners seem to be. Managing anaemia really isn't too difficult if you have an expert on your case!

If it is really your periods causing your problems (assuming you have been checked for everything else - ulcers, colonoscopy) then there are measures you can take - Depo shot, Mirena IUD etc or ablation if you don't intend having any more children. Your gynaecologist can help you with these solutions.

My plan is to get the Mirena IUD , but of course it'll take time for that to actually have an effect on my bleeding. My gyn first advised me to take ibuprofen 800 mg twice daily while I'm having my period since that can have the effect of reducing flow, but that's not something I can continue to do after RNY surgery. So, Mirena is the best solution for the moment. If my iron is still low after that, then I'll definitely insist on a referral to a hematologist. It's so funny; my step-dad is chronically anemic and I badgered him to death until he finally went to a hematologist after ruling out everything else, but for some reason I'm dragging my feet on being my own advocate! It's always easier to fix other people's problems, I guess!

Thanks for your advice!

I had one fitted at the beginning of November and I had spotting for about two weeks or so afterwards (nothing like a period - able to use panty liners only). As I have consistently been a 10-14 day girl, this is a really quick result for me - I'm thrilled with it!

It has taken me many years to realise that if I am not well, I am not able to do for others - it is important that you take care of YOU too!