Clumsiness & Bruises

Ok so I will be the first to admit that I am clumsy always running into stuff or bumping something. But before surgery I never bruised easily now I have bruises galore. It seems like the littlest things make me bruise now. My last lab work was fine Iron wise....so why does this happen?

Your vitamin K level (which controls blood clotting) might be low.

Lora

hmmmm..okay. I will go dig out my labs to see what they said. Thanks!

How long since you had labs done?  What was your iron and your ferritin then?  What about your vitamin K?

I had my labs done about 3 weeks ago and now looking at it again my Iron was 50 mcg/dL , Ferritin was 56.3ng/mL and vitamin k I am not sure either they didnt do it or its under another name I am not familiar with.

There is a good chance they didn't do it.  It's one of the ones they often don't do unless you specifically ask for it.

Since your labs were just three weeks ago, I don't think there's any way your iron dropped enough in that time to be causing excessive bruising.  I'd call your doc and ask for an order for a vitamin K blood test.

I did some quick googling and it seems other nutritional deficiencies that could cause that are vitamin C, B12 and folate.  I assume your B12 and folate were OK?  I doubt they tested your vitamin C.

Are you on any meds that might have that side effect?

You know come to think of it my b-12 was really low and they told me to start taking that so I got some sublingual b-12. The bruising thing however has happened since oh about a month post op.  The thing that agrivates me the most is I had to do my 6 months of pre-op classes and doctors app pre-op then after surgery I had a 2 week check up, 1 month and 3 months then they said adios see you in a year. So my PCP is the one who did my labs and read them and she openly admitted she doesn't know much about Gastric Bypass. So.... I don't feel very reassured that she knows what my levels should be. And in the town I live in we dont have any Bariactric doctors so... I don't know how to find a doctor who knows enough about bariactrics and what my labs should be. I think she just reads them and compares them to non-rny patients????

Give your PCP a list of labs you need drawn.  If she doesn't know much about RNY, she won't know what labs to order.

Here is the list of what I get done:

CMP
Lipid Profile
CBC with differential
B12
Bili-direct
Ferritin

Iron/TIBC

PTH
Magnesium
Folate
Thiamine (B1)

B6

Vitamin E

Vitamin K
Uric Acid
Vitamin A

Vitamin D (25 hydroxy)

Zinc
Phosphorus
Copper

Selenium

Prealbumin

Sounds like you already know to get a copy of your lab report. 

The normal values they list will all be accurate except two. You want to pay close attention to those two.

It will say something like 211-911 for B12 and you really want your B12 to be about 900-1000, but it's OK up to at least 2000. Below 550, people get symptoms like depression and fatigue. Below 400, people get permanent nerve damage in their hands and feet. I have no clue why they list it normal below that.

It will say something like 30-80 for vitamin D but you really want your D about 80-100.  Lower than that, we are at increased risk for things like osteoporosis, heart disease and some cancers.  It can safely be higher than 100.  If your D is really low, you want to pay close attention to your PTH and calcium levels.  If your D is low, you won’t absorb calcium well, no matter how much you take.  When that happens, your PTH usually goes up so you start leaching calcium from your bones to keep the calcium level in your blood good (because your heart won’t work right if the level of calcium in your blood gets too low).

Most other things, like iron and ferritin and protein, etc, you want near the top of the normal range.

Your PTH, you'd rather have near the bottom of the normal range.  High PTH suggests you aren’t getting enough calcium and are leaching calcium out of your bones.

Calcium is better around the middle of the normal range.  If your calcium is on the high side, strange as it may seem, that’s often a sign that you need more calcium.  It can be an indication that you’re leaching calcium from your bones because you’re not absorbing enough calcium.

This is all true for all people, not just those that had RNY.

 

Thank you soooo much. I copied this to my computer so I can print it off and share it with her next time. I really do appreciate it! :)

I had the same issue. I would not recall bumping into anything, yet I had bruises the size of 50 cent pieces on my forearms.  I asked my surgeon's bariatric nurse and she said to try more vitamin K.  This is a very inexpensive supplement. I got some on special (but 2, get 3 free) from Puritan Pride vitamins.  I began taking one in the AM and one in the PM. Within 2 weeks the bruising was much better.  I then began supplementing 2 AM and 2 PM and the bruising is even less noticeable. BUT, if I do really something that should leave a bruise to my ar, it's still there, although only about the size of a quarter. They go away in a few days too.  Likely vitamin K will improve your issue, but bruises are still likely, only less noticeable.  I began heavily bruilsing around 8 months post op. I'm 5 years post op now, and I'm looking a some quarter size bruises on my left forearm now--I did a project in my shop over the weekend, and then packed it for shipment.  DAVE