Problems, and cant get any answers from doctors

1000 IU dry D3 won't do hardly anthing.  With RNY and D deficiencies, you have to be agressive. I had an 8 for my post op D levels. 6 months on those script 50k IU (they're D2) and my D levels rose to a 14. Nomral starts at 33.  I'm 5 years post op.  I took 4 of the 50K IU dry D3 from vitaladay per week for 2 years.  I had labs done this past October.  My D was a 65.  My research seems to show that long range optimum health is 50% better when your D levels are 80-90 as a post op. I now take one of the 50K IU dry D3 daily now.  Each patient is a little different in the D needs, but I'd start at 4 per week, and get retested in a couple of months. You can adjust up or down at that time. DAVE

How low is your D?  We need it at least 80 or we're at higher risk for stuff like osteoporosis, heart disease and some cancers.  If yours is really very low, 1000 or 2000 IU is not nearly enough.  You need more like 50,000 IU D3 per day for a couple months, then get your level tested again.  I order mine at vitalady.com.

Problems with the pancreas can sometimes resemble gall bladder issues, I've been told.  But there's really no way for anyone online to tell you what's causing your pain and nausea.  What have the docs done to look for the cause of the problem?  CT scan?  Ultrasound?  Start insisting they look for the cause of the problem, and be persistent.

They never said how low. I was told I was deficient and that also my white blood cell was high said that could be due to a virus but I hadnt been sick. I feel lost without my surgeon, at least before I was able to have all bloodwork forwarded on to him and I felt he knew what to look for. Now I have no clue what to do, other than beg my new primary doctor to refer me to someone who has more knowledge with gastric bypass.

As far as tests, they really havent done a thing for me. Every time I am seen I see someone else. Military clinics on post are a joke for real. I was referred to have an x-ray, thats all they did for me. And I was told it's likely gas to try taking gas x, which I have taken often but I still dont get any relief.

Well, ask how low.  If you don't know how low, you don't know how much you need to take.

It's always a good idea to get a copy of all your lab work.  It's good to see the results for yourself.

I would also recommend using products from www.vitalady.com.

As you don't have a bariatric surgeon or family practitioner that you can depend on - it is incumbent on YOU to be your own advocate.  Be familiar with the "anatomy" of your type of weight loss surgery, where vitamins & minerals are absorbed, what normal lab values (not the normal listed on the paperwork) are for your particular type of surgery.

Do research.  Use OH more often. Go to weightlosssurgeryvitagarden.com - Andrea has her own lab manual that is for sale and she helps you figure out what  you need to do.

You just cannot depend on most MDs.  They have little education on bariatric surgery and our special needs.  I find that I'm often the one that educates them - not the other way around.

I really appreciate all the feedback. I agree with feeling like I need to educate the doctors. Most primary doctors dont seem to have a clue about how different we are after having this surgery, and how different our needs are.

WOW! You sound like me! I had my RNY in April of 2010..had some issues..this Feb. had bad gallbladder pain so they removed that. Pains continued..had my appendix out in May. Still pain in my right side, near ribs and middle of my stomach. I have been through every test, all normal, bloodwork fine. My surgeon and GI point blank told me they don't know what to do with me now. My GI recommended 2 docs at hospitals in  NY and PA, I have an appointment July 6th with one of them. I need to know what is causing this also..I know I'm not crazy! Hope you are feeling better!

Hello,

I know exactly what type of pain you're talking about on the LEFT side (the pouch side) for the first year (and still do at times). 

I went to local doctors and felt like I had to educate them too.  So I decided to do a "study" on myself.   I wrote everything down that I ate and did on a daily basis (and still do).  After about two months, I realized that my body goes through this when I eat anything with sugar, high carbs (sometimes it's even two or three days after) and also when I didn't work out for a few days in a row.

Even though I thank God I am maintaining my weight, I at times struggle with not having energy, get dizzy at times.  I did research and research and found this very interesting and informative blog from Lisa N. about the same symptoms we have ---->  http://www.obesityhelp.com/member/lisanelson_2/  

... I too also started to increase my vitamins, and it's been helping a bit. 

You are in my prayers, please keep us posted often and let us know how you feel!
 

First, I'm going to agree with everyone about the D3-50. About the size of a benadryl, it is not oil. And cheap, very cheap.

I'd suggest daily for the 90 days, because we don't know where you are. GET THE COPIES.

Here's the list of labs to beg for, ok? I can send you a fixit list that covers the deficiencies you likely have, but get labs, get copies, file them. Get your op report while you still can demand it from the hospital.

About the abdominal pain. Make notes, be very specific. Don't answer me as I'm not medical, but I can tell you on our long term group, "SBO" or small bowel obstruction can take 2 yrs to diagnose, or you don't live that long. It's very serious, and there are plenty of studies out there today that say: "Treat it AS IF and treat it NOW" vs the usual medical thing of, "Well, it's probably gas or you ate too much or you ate too fast" - you know the drill.

The pain:
1. how long after eating?
2. liquids, too? If not, a barium liquid swallow won't help
3. burning, stabbing, spasm, waves, dull achey -what does it feel LIKE?
4. is the onset sudden or does it kinda creep up on you?
5. does changing position, lying on your left side, hot or cold packs change anything?
6. taking antacids or anti-spasmodics, such as Levsin, change anything?

Describe this thing on paper as if your life depends on it. If your child was ill, think of the kinds of things you'd have to evaluate so to know if he goes to ER or can see his regular doc tomorrow.

You want to give your team as much info as possible, because if you go in pain, your mind is most likely blurred by the pain.

Oops, forgot the labs:





Not to be construed as medical advice, this list includes labs we have had performed as gastric bypass patients. The first group, every 3 to 6 months for life, as we are able. The second group, annually, as long as the results were comfortably within normal limits for more than 2 years in a row.



1st Group



*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:



2ND GROUP



* 593 LDH:

* 31789 Homocysteine, Cardio:

* 83921 MMA:

* 367 Cortisol:

* 84255 Selenium:

* 84590 Vitamin E:

* 82525 Copper:





For diabetics: *496 - HEMOGLOBIN A1C













POSSIBLE DIAGNOSIS CODES





269.2 Hypovitaminosis



268 Vitamin D deficiency



275.40 Calcium deficiency



266.2 Cyanocobalamin deficiency (B12)



281.1 other B12 deficiency anemia



281.0 Pernicious anemia



280.9 Iron-deficiency anemia



281.2 Folate deficiency anemia



285.9 Anemia, unspecified



269.3 Zinc deficiency



244.9 Hypothryoidism



250.0 Diabetes



401.9 Hypertension



276.9 Electrolyte and fluid disorders



272.0 Hypercholesterolemia

- - - - - - - - - - - - - - - - - - - - - - - - - - - - - -



*579.3 Surgical malabsorption*



*579.8 Intestinal malabsorption *





* Bands or sleeves should not use these codes as they are not accurate.



*Some insurance companies will not pay for any procedure that uses these codes.





LAB TARGETS





This is NOT medical advice, just my own targets for the main blood levels I watch.



Protein: 7's

Albumin: 4's

Pre-Albumin: 20-30's



Iron: 80-100

Ferritin: 200-300

HGB: 12+

HCT: 36+



Vit A: 60- 80

Vit D: 80-120



Calcium: 9.0-9.4

PTH: 20-40



Vit B1: Mid to top of range

Vit B6: Mid to top of range

Magnesium: Mid range (but also go by if we have leg/foot cramping)

Zinc: Mid range



Vit B12: 1000 +

Folate: Top of range



AST (sgot): Below 40

ALT (sgpt): Below 40



We usually want to "meet or beat" pre-op levels. In some cases, higher is better, and in other cases (Cholesterol, PTH for example), lower is better.



The only things *I* don't mind being on the high end of out of range are Ferritin and B12. But that applies to ME.



My doctors don't show interest in any of these until I am out of range. *I* am interested when I begin heading that direction.