come one, come all..Pre-Op Labs (advice please!)

Hello everyone!!

A little background..I am currently pre-op and hoping to have surgery in late august/first week of september.  I am a Dr. Stewart patient and my last visit of the required 6 month visits is on the 28th of this month..wow have the 6 months gone FAST! I have completed everything required for insurance and I only have one thing left on the list for Dr. Stewart and that is the endoscopy.

I had labs done in January with my PCP before I had ever gone to Dr. Stewart and unfortunately, that lab work is no where to be found in my apartment..and I have torn this place apart. Lucky for me, my PCP office is directly next door to Dr. Stewart so I will just grab a copy when i go in for my last appt on the 28th and add it to this spreadsheet. I know on those labs, my cholesterol was normal, my b12 was low low low (200 range) and my D was also low (don't remember how low, though). Those three things were the only memorable standouts from those labs because of cholesterol being normal (yay!), and B12 and D being surprisingly low.

Anyway..On to my most recent labwork that was ordered and required by Dr. Stewarts office.  Some labs that VitaLady has on her list were not on mine and those are obviously blank on the sheet.  The first set you will see on the spreadsheet is just VitaLady's lab requests and her reference ranges and then my results.

Below that is just the list of all labs given to me and the results. I repeat the labs included in the VitaLady section and they are italicized. The references ranges in these sections are according to the lab report.

Here are the labs:
https://spreadsheets.google.com/spreadsheet/ccc?key=0AgLujtcNKz0qdE5WaXQyMDdRaUVlZ0N0WVBwa3loVUE&hl=en_US

(P.S. if anyone wants a google doc's tutorial let me know..it is very helpful, especially for lab work!)

What I see:
 - Vit. D is obviously terrible low. To bring it up, I started on a 50k IU daily capsule of Vitamin D and will most likely get the vitamin D shot from Dr. Stewart to further help. Thank you to all *****commended the 50k IU capsule daily, as Dr. Stewarts office recommended 5k which would not be enough to bring me up a ton in time for surgery.

 - B12 is still low but it is definitely UP from my first set of labs (not on sheet, but will be added later). I have a B12 pill..not 100 percent sure of dosage but I know it is in the 12,600 percentage of daily value range (or up there somewhere).

 - Iron and Iron saturation..Oh, my poor iron. My iron saturation being at 16 is obviously concerning..and so is my iron being at 55.  I spoke with my mom and she told her her iron has run low since her teenage years..hereditary? possibly.  Kayla posted in my other thread that it is something I will definitely need to keep a close eye on and I agree! It worries me that it is this low as a pre-op.  My question is, what can I do to get this up before surgery in a month and a half? What are my options?

If you have any advice or questions, please fire away! I am all ears and eager to learn :)

Thank you!

Without looking at the results yet: GET IRON INFUSIONS NOW. Get everything related to iron way way up before you go under the knife.

Increase your protein intake significantly, too. It will help a bunch of stuff, from micronutrient absorption to carb cravings.

Yes ma'am!!

Where do I even start concerning iron infusions? I'm not sure my PCP will be entirely supportive. She is hard to read..and obviously my iron is LOW but not technically off the charts low YET..but it WILL be after surgery for sure. I do not require a referral to any specialty doctor with my insurance so should I just go to a hematologist rather than go to my PCP first?

If I were in your shoes I'd tell my PCP, "I've been talking to lots of DSers and they tell me that I MUST get my iron into excellent ranges before surgery. This is all about preventing big problems. I want to go straight to bigger guns and not dick around with intermediate things that don't work as well. I want infusions. How do we make this happen?"

See, you are a consumer of services. There is no reason for your doc to refuse this input. I'd give it a try before going on a hunt for a specialist of a stripe that's hard to find in many regions and very tough to get in to see. You can always work your way up the food chain if she's not cooperative.

This is not an unreasonable request. I had total strangers of docs agree with this and got two iron infusions in a place where I am but a guest.

Well, I know I may be flamed for recommending this, but my labs are great and I think it is because I have been juicing because of my kidney issues.

Got my lab results back today, visited with Sue today, and the only thing I need to up a little is my D. So I think this recommendation is valid.  Especially since you are preop.

Well, I have been drinking organic carrot and apple juice.  Equal parts, twice a day, about 16 oz total.   Read alot about the Gerson Therapy because of a family friend with cancer and decided to add some juice to my diet as it is easily absorbed, and quickly absorbed.  That being said, it has carbs that are absorbed.  But all the vitamins seem to be absorbed too and that is a great benefit for me.   I think my labs show that, because I sometimes miss my vitamins.  (you know you get busy or whatever, I am not perfect and admit it)

Fresh juiced is best, but I do the Odwalla or Bare Naked Carrot Juice mixed with organic not from concentrate apple juice from Sprouts.

Read about the therapy at www.gerson.org to see why I recommend it. 

The two things I'd bench mark before surgery are PTH and a bone scan. With your D being low, I'd want to know where my PTH was before surgery. If you know your bones are headed in a downward spiral you know how agressive you need to be with the D, K and Calcuim.

I definitely agree. My PTH was listed in the labs and it is currently 32.  I do want to get a bone scan before surgery, do I just need to ask my PCP for this?  My calcium is also listed and is (currently) fine.   As I mentioned, I started on 50k IU a day of D which should significantly bring me up before surgery, and I will probably get the vitamin D shot too.

Thanks!

You may want to ask your doctor about getting B12 shots instead of the pill.  I have low B12 (129) and had to get daily shots for a week, then weekly shots for a month, then monthly after that. 

Did you have physical symptoms with your b12 that low? I only ask because I have a co-worker (not wls related) who has had a terrible time and is currently giving herself b12 shots per her doctor's instruction.

If the above question was for me, I didnt really have any symptoms that I could pinpoint at the time.  I just got a new PCP and she ordered a bunch of labs as part of her awesome care plan.  Once I started the shots, I didnt realize that I felt as rundown as I did when I had B12 energy to compare it to.  

My PCP said my Vit D was also super low (8), so Im doing that 50k pill once a week in addition to MVs and Calcium w/ D pill.  She was saying that would help with the energy level too.