PTH! FIGHT FOR IT! DO NOT let ANYONE talk you down!

You can go to a lab and have blood work drawn and the results sent to you.  You pay the full cost of the testing and no insurance or doctor has to be involved. 

I had a high PHT test and was sent to an endocrinologist.  He did multiple other tests including one where I had to collect my urine for a few days.  After all the testing, he determined that my high calcium and high PHT were caused by all of the calcium that I started taking after weight loss surgery.

He advised me to stop taking calcium supplements.  My tests all went back to normal. 

If I am having a problem and a doctor does not want to jeopardize his status with the health insurance company by being accused of ordering unnecessary tests, then I will pay out of pocket for tests.  Insurance companies "grade" providers on how well they are spending the insurance companies money.  It does not come out of the receptionist's pocket immediately, but it hurts the practice if they are dropped by insurance companies.

I've never had any trouble with my doctor ordering labs for me, and like White Dove, I would pay out of pocket for tests if necessary. The healthcare system can be cumbersome. We must be our own advocates.

My local lab has patient-request/no insurance options the clinic calls pay-for-service.  There are over 50 available tests.  Following are a few examples of the pricing for those wondering ballpark figures:  METABOLIC PANEL (Albumin, Alkaline Phosphatase, Total Bilirubin, AST, ALT, Total Protein, BUN, Calcium, Carbon Dioxide, Chloride, Creatinine, Glucose, Potassium, Sodium) $20;  GENERAL WELLNESS Comprehensive Metabolic Panel, Complete Blood Count, Lipid Panel, tsh $88;  MAGNESIUM $10;  IRON $10; FERRITIN $30;  THYROID PANEL (includes Free T4, tsh) $46;  THYROID STIMULATING HORMONE $28;  VITAMIN B12 $30;  VITAMIN D 25 HYDROXY $70

 "If they accepted money for your surgery, they OWE you the proper lab work."

Not necessarily. Not all surgeons have a follow-up program. I agree that this is TERRIBLE, but the truth is that most WLS patients don't really need follow-up by their SURGEON. in many cases, better follow-up can be gotten from your PCP. That said, it's very important to have or find a PCP who's WLS-friendly and/or willing to LISTEN and LEARN.

I've been lucky in that I've had two very good PCPs in the years since my DS. (You think it's hard finding a PCP who understands the RNY? Try finding one who's even HEARD of a DS! *grin*) Very few PCPs understand that RNYers malabsorb fat, and therefore fat-soluble vitamins A, D, E, and K. And if your D gets too low, forget about absorbing calcium---your body's going to start 'stealing' calcium from your bones, your PTH goes through the roof, and presto! you've got osteoporosis.

They also don't understand that just because your blood calcium is in the normal range everything is A-OK. Which is pretty strange, because anyone with a medical degree *should* know that your body is going to do everything it can to keep your blood calcium in the normal range and the hell with your bones and teeth. If your blood calcium falls too low, your nerve conduction stops working properly and all sorts of bad stuff happens---like heart-muscle misfirings.

My surgeon retired 6 months after my surgery, so---no follow-up possible there. I strongly urge all pre-ops and new post-ops to get a good PCP.

OK... so the newbie (ME) has a ?.... IF my vitamin D is low however my CA is Okay, then I should have a PTH test done to make sure that my bones aren't being depleted of calcium.  Right??

A PTH test will tell if you are getting enough calcium at the time of the test. The only way to really tell if your bones are ok is with a bone density scan, or DEXA scan. It's a simple test, just a specialized x-ray. The ASMBS recommends one before surgery to use as a baseline, and every two years (I think) after surgery.

Yes.  And you should take more D3 to get your D level up.