Calling for Poet Kelly Please

Hi there.........could someone tell me what this all means?

Basic Panel-------------138

K-------------------------- 3.4-----------I believe this is low ?   it comes in my Multi I believe.

CL-------------------------103----------what does CL stand for?

CO2----------------------29

Glucose-----------------103

Bun------------------      4  -------------I believe this is low , I have no idea what it is or how do get it higher?

Creatinine------------  0.61 ------------I do not know what this?

GFR (Cal)----------    > 90 ------------does this have to do with my kidneys?

Calcium-------------   >8.0 -------------this is low , I was only taking 1200 mgs. 

Vit D-25-Hydrox ..... 55.4

Vitamin B 12-------   >2000

Vitamin B 1 --------    21.2

Folic Acid------------ 18.7--------------is this a little high?    and where do I get it from ?

Iron-------------------  11 ------------    this is low

Tibc------------------161 --------------this is low

Iron Saturation ----7 -----------------this is low

I am missing alot of tests I believe!!!

 

 

Hello,

Here is what VitaLady shares with RNY members. We hope it helps.

Per VitaLady

Not to be construed as medical advice. This list includes labs we have performed as gastric bypass patients.

 

1st Group (Every 3 to 6 months for life, as we are able)

 *8005               Comprehensive Metabolic profile: (sodium, potassium, chloride, glucose, BUN, creatinine, calcium, total protein, albumin, total bilirubin, alkaline phosphatase, aspartate aminotransferase) 10231)

* 7600                 Lipid profile: (cholesterol, HDL, LDL, triglycerides, chol/HDL ratio)

* 84100               Phosphorous – Inorganic: (718)

* 84550               Uric Acid: (905)

* 85025               Hemogram with platelets: (1759)

* 83550               Ferritin: (457)

* 84446               Vitamin A: (921)

* 84052               Vitamin B-1: (Thiamin) (4052)

* 7065                  Vitamin B-12 & Folate: (82607; 82746)

* 83937               Osteocalcin:

* 85610               PT:

* 86141               C Reactive Protein

* 84134               Pre-albumin:

* 10256               Hep panel: includes ALT (SPGT) & GGT)

* 83735               Magnesium:

* 7444                 Thyroid panel: (T3U, T4, FTI, TSH) (84437; 84443; 84479; 84480)

* 7573                 Iron: TIBC, % sat

* 84630               Zinc: (945)

* 8230                  Vitamin D: (25-hydroxy) (680)

* 84207               Vitamin B-6: (Pyridoxine)

* 83970               Serum intact: PTH

* 84597               Vitamin K:

* 85730               PTT:

 

2ND GROUP (Annually, as long as the results were comfortably within normal limits for more than 2 years in a row)

 

* 593                    LDH:

* 83921               MMA:

* 84255               Selenium:

* 82525               Copper:

* 31789               Homocysteine, Cardio:

* 367                    Cortisol:

* 84590               Vitamin E:

 

For diabetics:

*496                     HEMOGLOBIN A1C

 

POSSIBLE DIAGNOSIS CODES

269.2                             Hypovitaminosis

269.8                             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.

 

Updated 2/10/2010

*** DAILY SCHEDULE ***

 

Morning

1 Vitamin C 1,000mg

5 Tender Iron 60mg or 2 Polysaccharide = 300mg (elemental) (see note 1)

1 Copper 2mg

 

Mid-Day

1 Vitamin A 25,000IU

1 Vitamin B-12 5,000mcg

2 Calcium 300mg = 600mg (elemental)

1 B Complex (see note 2) (see note 3)

1 Vitamin E 400IU

1 Multi Vitamin/Mineral (see note 4)

1 Zinc 50mg or 2 each 23mg

 

Evening

2 Vitamin A 25,000IU = 50,000IU

1 Vitamin E 400IU

2 Calcium 300mg = 600mg (elemental)

1 Multi Vitamin/Mineral (see note 4)

1 Vitamin D3 50,000IU

1 Zinc 50mg or 2 each 23mg

1 Vitamin B-9 Folic Acid 1,200mcg

 

Bed Time

2 Calcium 300mg = 600mg (elemental)

1 Vitamin A 25,000IU

2 Magnesium Citrate 140mg=280mg (elemental)

1 Vitamin C 1,000mg

1 Vitamin K-1 1,000mcg (see note 5)

 

With this plan you will be supplementing with the following daily vitamin and mineral dosages: Vitamin A 100,000IU; Vitamin B-

12 5,000mcg; Vitamin C 2,000mg; Vitamin D3 50,000IU; Vitamin E 800IU; Vitamin K-1 1,000mcg; 1 B-50 Complex; 2 Complete

Multi-Vitamin/Mineral; Calcium Citrate 1800mg (elemental); Copper 2mg; Iron 300mg (elemental); Magnesium Citrate 280mg

(elemental); Zinc 100mg; Vitamin B-9 Folic Acid 1,200mcg.

 

*** NOTES ***

Note 1 IRON is to be taken with Vitamin C, together but separated for at least 1 hour from caffeine, dairy, egg,

whole grain, other vitamins, and medications.

Note 2 B Complex is to be a B Complex 50 or higher.

Note 3 Regarding Vitalady Tender B Complex 50: Some customers have mentioned a tingling, rashy sensation

or redness in their extremities and face. This is a common reaction to the niacin (niacin flush) which

may be present for a short time. While doses as small as 75mg don’t usually cause any reaction, some

people are more sensitive. The sensation is short lived and harmless.

Note 4 Multi-Vitamin/Mineral composition should be similar to Centrum®.

Note 5 We suggest starting with 1000mcg K-1, please check with your doctor if you taking any blood thinners

or have any risks associated with Vitamin K.

 

*** REGARDING PROTEIN ***

This list suggests vitamin and mineral supplementation with a schedule. In addition we suggest that protein needs to be

supplemented as well. Since many people struggle to meet their protein needs, the following is our suggestion on how you might

address it. We suggest the use of Whey Protein powdered drinks as the best, most complete and highest bio-available protein

supplement source available.

Using protein supplements daily may help with volume control, appetite and craving control, along with meeting your daily

protein requirements.

Patients choosing this plan should drink 30 grams of protein four to five (4 - 5) times a day for a total of 120 - 150

grams.

   

I understand that you are just passing along what Michelle recommends, but for the benefit of those aho are pre-op or early post-ops and are looking for dosage guidelines, I wanted to say that MANY of the dosages she lists are MUCH higher than what most RNYers need. Several of her daily doses are what many of us take weekly.  Some of my vitamin levels would be toxic if I took the dosages she indicates! 

I think RNYers who have not been given beginning dosage guidelines from their surgeons would be better off beginning with the ASMBS guidelines (see link below) and adjusting upward from there rather than starting with Michelle's guidelines.  

http://asmbs.org/2012/06/asmbs-integrated-health-nutritional -guidelines-for-the-surgical-weight-loss-patient/

Lora

K is potassium.  3.4 is barely low.  The reference range is usually 3.5 to 5.1.  I wouldn't worry about it since it's barely low.  Maybe add a bit more potassium to your diet, like sweet potatoes or bananas.

I think CL is probably Chloride, and yours is fine.

CO2 is carbon dioxide and yours is fine.

BUN has to do with your kidneys and yours is a bit low.  I don't know if it's low enough to be cause for concern or not.  I'd give your doc a call and ask about it.  The creatinine and GFR are also related to kidneys, I think.

Have you increased your calcium citrate now?

Your D is also low.  I'm sure it's in the reference range on your lab report but below 80, we're at increased risk for osteoporosis, heart disease and other stuff.

You don't need your B12 to be that high so you could cut back on that some.

What's the reference range for B1 on  your lab report?  If they use the same test my lab uses, your B1 is super low.  I'm wondering if it's a different test.  Is it low according to your lab report?

Your folic acid is fine.  It's one of the B vitamins, B9.  It might be listed as folate on your multi label.

Yeah, your iron is super low.  How much do you take and what kind?  I don't see a ferritin level.

Yeah, you are missing some tests.  Did they do a CMP?  I don't see total protein or albumin.  What about a PTH?  Vitamin A?  Zinc?  Copper?

Kelly, thanks!!!      I just realized something and this could make a BIG difference?

I had these labs taken while I was in the hospital in June for Surgery.

I had surgery the night of June 14th and the paperwork says the dates for these tests

were June 18th and June 20th.....Although they drew lots of blood for various tests, I asked them to run a Bariatric Lab , I guess they didn`t do all of them... :(

I was in the Hospital a week for Emergency Surgery Friday Night June 14th for a bowel obstruction,

a hernia I think is another word , anyways, at 1 point I could not have anything to eat or drink.......

and when I was allowed to eat I had no appetite, in that 1 week I lost 8 lbs.   

I was very sick, part of the small intestine had become strangulated and was already dying.

There was leakage and I had to have invasive surgery. I went to my local ER the night before but they sent me home with a wrong DX.....then next day I was sent by Ambulance to the Bariatric Hospital.

So could all of that thrown off some tests?        I would think so?    the link below is what I had, but I also had some complications. 

http://en.wikipedia.org/wiki/Volvulus

B1 reference range on this paperwork says  8.1-32.9  nmol/L     No it is not flagged as Low.

As far as my B12, I take 500 daily , last year labs showed real high B12 , and she had me stop for awhile but I do not remember how high......

And I was taking a B -complex but this board said don`t bother unless Labs dictated it...........so if B 1 is low would I take a B complex or just an individual B 1?

I also used to take Vit C with my Iron but stopped the Vit C.

Iron and Calcium are the only 2 that need to be spaced apart?    Can D be taken with anything?

 

 

    

 

Well, there isn't a certain list of tests called a "bariatric lab," so they probably didn't know which labs exactly you wanted.

I'm sure the fact that you were very ill could affect some of the tests, including the kidney stuff.  It shouldn't affect the vitamin and mineral levels much.  Not eating for a long time would affect those, but they don't usually change in just a few days or a week.  If you were having any internal bleeding, that could affect your iron level, though.

Your B1 is fine then.  I think there may be a couple different ways to test that one.

Personally, I would drop back on the B12.  Maybe take it for two days, then skip a day, then take it two days, then skip a day.  I wouldn't stop altogether because then it could end up dropping too low.  It's usually not dangerous for B12 to be high, but why take more than you need?  I personally prefer to take as few pills as possible, plus it saves money.

Since your B1 is OK, you don't need to take extra and I don't see a need for a B complex unless your labs show you need extra of some of the B vitamins.  It wouldn't hurt you to take one, usually we just pee out any extra B vitamins we don't need, but why take something if we're just gonna pee it out, you know?

Vitamin C helps you absorb iron.  Since your iron is really really low, I'd take C with it.  You need 200 mg C for every 30 mg iron (elemental iron) in order for the C to help you absorb the iron.  And your iron is really low.  How much iron do you take right now?

The iron and calcium need to be at least two hours apart.  Also calcium needs to be in doses of 500 to 600 mg, because we can't absorb more than that at one time, and those doses need to be at least two hours apart.  The D and other vitamins can be taken with anything you like.

I have been taking 50 mgs of Iron

That's slightly less than the ASMBS recommends for menstruating women, but with your iron so low, I would definitely increase it.

Because of the cir****tances surrounding your last labs, I would suggest talking to your doctor about repeating the labs before you normally would.  Not immediately, of course, but also not waiting for another 6 months, either.

Lora

Thanks Kelly