Doyou see an Internist or a general MD?
It wasn't an issue with normal vitamin labs. I had some things that needed to be adjusted and I know what to do for that. My WBC was "markedly elevated" with a bacterial shift. My CRP (inflammation) was really, really high - the kind of high associated with a chronic disease. My total protein was high, but my pre-albumin/ immediate protein source was low. My stored iron/ ferritin was high, but my serum iron & % saturation was low. Ditto on protein & iron - I'm absorbing it, but not using it.
With Steve's help & a lot of digging, I've come to realize that I think my inflammation caused a cascade response that really has nothing to do with the DS or WLS of any type. My dr simply assumed that it was, is what I suspect. There's an underlying chronic disease that's giving me some serious issues with energy/ protein & iron and now all my RBC aren't doing well, either. I *think* I've come to realize that it was from a long-standing cavity that I ended up needing a root canal for, which I had done on Thurs. I put it off until I had a job again, but it was diagnosed at a student clinic with xray in Feb 2010. This could be the bacterial infection that caused the inflammation.
That's all of what my letter outlined to my dr who then wanted to charge me an appt fee to get his opinion on whether that might be a possibility - after I figured it out. All that lab stuff went way beyond my vitamin assessment.
With Steve's help & a lot of digging, I've come to realize that I think my inflammation caused a cascade response that really has nothing to do with the DS or WLS of any type. My dr simply assumed that it was, is what I suspect. There's an underlying chronic disease that's giving me some serious issues with energy/ protein & iron and now all my RBC aren't doing well, either. I *think* I've come to realize that it was from a long-standing cavity that I ended up needing a root canal for, which I had done on Thurs. I put it off until I had a job again, but it was diagnosed at a student clinic with xray in Feb 2010. This could be the bacterial infection that caused the inflammation.
That's all of what my letter outlined to my dr who then wanted to charge me an appt fee to get his opinion on whether that might be a possibility - after I figured it out. All that lab stuff went way beyond my vitamin assessment.
HW / SW / CW / GW 299 / 287 / 160 / 140 Feb '09 / Mar '09 / Dec '13 /Aug '10
Appendicitis/Bowel Obstruction Surgery 8/21/10
Beat Hodgkin's Lymphoma! 7/15/2011 - 1/26/2012 
Ran Half-Marathon 10/14/2012
First Pregnancy, Due 8/12/14 I LOVE MY DS!!!
I think the underlying issue isn't what medical specialty you need, it is whether you have a basic functional, cooperative, respectful working relationship with the person who provides your primary care. It sounds like you don't.
I work with several doctors myself. Every year, my PCP orders the labs my surgeon wants. She reviews them with me at my annual exam, and I also review them with my surgeon (well, usually his PA, since I am healthy) at my annual checkup. I have had the same PCP since before surgery, and while she was more than a bit skeptical at first, she is very supportive now. I cannot tell you how tickled I was a few years ago when - using our medical center's new lab-tracking software - she told me she had checked the TRENDS in my PTH, D and ferritin, and although they were still normal, wanted me to change my supplements to HEAD OFF problems! Of course I already knew this, and had checked the trends myself, but having a primary care doctor who "gets" the issues is priceless.
My PCP agreed that the ferritin issue required proactive consultation with a hematologist (not that I needed her referral since I have a PPO). And my hematologist works with my surgeon, so he also "gets" that we need infusions before the ferritin gets critically low - my second set of infusions were done when my ferritin dropped from 79 to 23, and this time, the same amount of Venofer resulted in my ferritin level going to 221. I also had a GI doctor from before my DS, because of my IBS issues, which - although overall much better than before, sometimes flares up. My PCP defers to him on matters such as colonoscopy (I just had one and got another 10 year pass!), bacterial overgrowth (the PCP prefers that he prescribe enteric antibiotics, if any), and fissures (of course - and the GI guy has agreed with my medical fissure protocol and prescribes the nitro paste for me, which has now cured two relatively minor fissures without surgery).
So I have a team, all of whom "get" the DS, even if they don't understand everything, but who know that it works, that they have to put in a little extra, out-of-the-ordinary effort to understand my particular situation, but who don't seem to mind and are even interested in it. I know that I am fortunate to have this situation, which wasn't as difficult for me as it might be for some to cultivate (I live in a large urban area with LOTS of doctors to chose from; I have a PPO plan; I am very educated myself and tend to get more deference from my doctors than some people might receive; and of course I don't allow doctors to treat me as "less than" EVER), but I try to encourage everyone to also demand that their medical service providers treat them with the same professionalism.
If you are having issues with this kind of treatment (aimed at everyone, not just the OP), I suggest you take a look at - if not print out and use - the letter I wrote some time ago and which Bev has posted on DSFacts.com (http://www.dsfacts.com/conversation-with-your-pcp.html). And by the way, if anyone has any suggestions for updating or improving that letter, please let me know! (For example, I notice that copper is not on the labs list.)
I work with several doctors myself. Every year, my PCP orders the labs my surgeon wants. She reviews them with me at my annual exam, and I also review them with my surgeon (well, usually his PA, since I am healthy) at my annual checkup. I have had the same PCP since before surgery, and while she was more than a bit skeptical at first, she is very supportive now. I cannot tell you how tickled I was a few years ago when - using our medical center's new lab-tracking software - she told me she had checked the TRENDS in my PTH, D and ferritin, and although they were still normal, wanted me to change my supplements to HEAD OFF problems! Of course I already knew this, and had checked the trends myself, but having a primary care doctor who "gets" the issues is priceless.
My PCP agreed that the ferritin issue required proactive consultation with a hematologist (not that I needed her referral since I have a PPO). And my hematologist works with my surgeon, so he also "gets" that we need infusions before the ferritin gets critically low - my second set of infusions were done when my ferritin dropped from 79 to 23, and this time, the same amount of Venofer resulted in my ferritin level going to 221. I also had a GI doctor from before my DS, because of my IBS issues, which - although overall much better than before, sometimes flares up. My PCP defers to him on matters such as colonoscopy (I just had one and got another 10 year pass!), bacterial overgrowth (the PCP prefers that he prescribe enteric antibiotics, if any), and fissures (of course - and the GI guy has agreed with my medical fissure protocol and prescribes the nitro paste for me, which has now cured two relatively minor fissures without surgery).
So I have a team, all of whom "get" the DS, even if they don't understand everything, but who know that it works, that they have to put in a little extra, out-of-the-ordinary effort to understand my particular situation, but who don't seem to mind and are even interested in it. I know that I am fortunate to have this situation, which wasn't as difficult for me as it might be for some to cultivate (I live in a large urban area with LOTS of doctors to chose from; I have a PPO plan; I am very educated myself and tend to get more deference from my doctors than some people might receive; and of course I don't allow doctors to treat me as "less than" EVER), but I try to encourage everyone to also demand that their medical service providers treat them with the same professionalism.
If you are having issues with this kind of treatment (aimed at everyone, not just the OP), I suggest you take a look at - if not print out and use - the letter I wrote some time ago and which Bev has posted on DSFacts.com (http://www.dsfacts.com/conversation-with-your-pcp.html). And by the way, if anyone has any suggestions for updating or improving that letter, please let me know! (For example, I notice that copper is not on the labs list.)
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