Confused by my yearly appt. at Dr. Inman

[feeder]

Hey guys, I am the mother of the poster here. Like we all know everyone's DS are different. My cc at 100 with a 30z sleeve keeps me having to stay on protein shakes and many other things to have quality of life. Watching my daughter come out of her DS with such a remarkable recovery was very overwhelming for me giving what I went through and still battle. The happiness inside of me knowing she has a ds that works for her gives me great joy. Her labs are all good besides a little high liver enzymes. I teach her as much as I can, but then again we are so different that I am at a loss for words at times. So when my daughter comes home telling me of this Revision and Vit D, I just thought to myself there must be something else going on here. I have been keeping my ear to the grind stone with as many as her ds patients needing revision or thinking of one as I can find on line or in real life. At both of my daughters appointments with Dr. Inman, one at 6 months out and this one, she was not able to meet in person with her even though she was told it was scheduled with her. I see this as common with Dr. Inman. I on the other hand was able to meet with her every time until I was released after the 5 yr. mark. She follows you for 5 yr. now. So I am wondering if her NP see's everyone after the DS. My daughter told me the NP left the room twice and when she came back said she talked directly with Dr. Inman and this is what she said. Seems to me she has changed how she does things now.

Is there a force driving this quick revision talk that we are not aware of. I am not a happy camper with her office right now or with her. There was no need to be talking like this. My daughter see's my life with the DS daily and knows that a revision may be in my future, but for her, no way! Dr. Inman does not know that this poster is my daughter, we kept it that way. So is this just common talk now revision I mean. Comes out of her mouth w/0 thinking? What on earth could motivate her to have her NP say this. 2 and 2 are not adding up for me. Any thoughts from you Vets?

 

[Larra]

Feeder, I think all of the responses your daughter got here indicate that none of us understand what is going on here. It sounds to us that while the liver enzymes certainly need to be taken seriously and followed to make sure nothing serious is going on, the talk of revision is really jumping the gun. whatever is going on, we don't get it either. If you find out, let us know, but for now we are just as mystified as you are.

 

[southernlady]

Also the Dietician told me my Vit D levels were too high- 103.7 ( standard range is 20-50) when i asked what is the prolonged affects of high Vit D she said it will make your bones turn soft and brittle, any one heard that before? Any insights on why Dr. Inman would want to do a total revision at a year out without major complication other than elevated liver enzymes. Is there something that I am missing in all this, that you vets can shine some light on.

My lab (LabCorp) uses the range 30-100. (So does Quest Diagnostics)

They keep raising the values and most surgeons simply can not keep up.

With that said, my surgeon and his NUT go wacky if mine get over 80...I want mine close to 100 as mine tank very easily. I go a month and will drop 50 points.

 

[feeder]

Laura, will pass on info as I get it. Sometimes things play themselves out and we read about it or find out all in good time. A heads up to all post-op's, make sure when a appt. is made that you ask to see Dr. Inman in person and that your appt. will be with her and not a NP.

 

[Munchkin]

Back in the long ago when the DS was a lot newer and scarier than it is now they went so far as to put a patient on the TRANSPLANT list... She totally freaked out and posted on the boards. The advice she was given is wait and see. Liver enzymes are usually high post DS. That's quite normal. At 1 year post your results don't look out of line to me.

D, yes, too much is toxic but the NIH doesn't worry unless it's over 150. They have seen problems at those levels. If I was in your shoes I would probably cut back some on D. Here's their chart. But know they seem to be raising acceptable D levels quite frequently.

Table 1: Serum 25-Hydroxyvitamin D [25(OH)D] Concentrations and Health* [1]nmol/L**ng/mL*Health status<30<12Associated with vitamin D deficiency, leading to rickets in infants and children and osteomalacia in adults30–5012–20Generally considered inadequate for bone and overall health in healthy individuals≥50≥20Generally considered adequate for bone and overall health in healthy individuals>125>50Emerging evidence links potential adverse effects to such high levels, particularly >150 nmol/L (>60 ng/mL)

Don't let anyone sign you up for a revision or let them scare you into doing something un-necessary.

Good grief. I had never heard Inman's office was this bad!

 

[KathyF]

I would also suggest taking milk thistle. My mother was a liver transplant patient and they had her taking milk thistle to support her liver.

 

[Terri]

I honestly think a lot of it is this NP. Her regular PA is on maternity leave.

 

[southernlady]

Dh's liver enzymes went high post-op...after talking with Michelle (Vitalady), he added Milk Thistle and is now JUST fine (but he is also at goal and 3+ years out)

 

[Sheanie]

There are SO many reasons for liver enzymes to be high that to blame her DS is just irresponsible. Plus, her liver enzymes are NOT THAT HIGH. That's what liver enzymes are SUPPOSED to do during rapid, extreme weight loss. Her body is working to shed the byproducts of fat metabolism. The liver and kidneys are taxed during weight loss. Their response is measured by lab values. I'm sure an ultrasound of our kidneys during rapid weight loss would also show changes. It's our MIRACULOUS BODIES handling what is happening. It's chemistry that we and our surgeons do NOT fully understand yet, or never will.

And her D is NOT too high. @Munchkin , those D stats are alarmist propaganda.

 

[seeker1]

I am going to request to see Dr. Inman for my next appt. I also have to get my liver checked in 6 weeks. I'll voice my concern about jumping the gun to early on a revision and not wanting to go through it unless it is a must, and quite frankly I feel it is not. I will check into milk thistle, thank you! Also thank you for laying to rest the "Vit D is WAY HIGH" I never felt like it was exceptionally high.

 

[Velvetkiss]

I had Dr. Inman and have not met her NP, but I would insist on a visit with Dr. Inman and talk to her and if she says the same thing, then get another opinion. Terri, I had Lon too and she did the same thing to me with the EKG and said I may have had a heart attack and sent me to a cardiologist and the cardiologist explained that with people who are overweight it is possible for false readings because of the way our hearts sit and the fat, she had a much better way of saying it but I am glad like me, yours turned out fine. I just think some people dont have the right education dealing with people who are overweight and than who have had weight loss surgery.

 

[Sheanie]

I had Dr. Inman and have not met her NP, but I would insist on a visit with Dr. Inman and talk to her and if she says the same thing, then get another opinion. Terri, I had Lon too and she did the same thing to me with the EKG and said I may have had a heart attack and sent me to a cardiologist and the cardiologist explained that with people who are overweight it is possible for false readings because of the way our hearts sit and the fat, she had a much better way of saying it but I am glad like me, yours turned out fine. I just think some people dont have the right education dealing with people who are overweight and than who have had weight loss surgery.

EXACTLY. Some medical professionals know JUST enough to be dangerous. I call them Alarmists. They misdiagnose you with the most awful thing possible, based upon the symptoms.

 

[Terri]

I had Dr. Inman and have not met her NP, but I would insist on a visit with Dr. Inman and talk to her and if she says the same thing, then get another opinion. Terri, I had Lon too and she did the same thing to me with the EKG and said I may have had a heart attack and sent me to a cardiologist and the cardiologist explained that with people who are overweight it is possible for false readings because of the way our hearts sit and the fat, she had a much better way of saying it but I am glad like me, yours turned out fine. I just think some people dont have the right education dealing with people who are overweight and than who have had weight loss surgery.

Lon is the NP, so you have met her. There is also PA, Jen, but she is on maternity leave right now.

 

[Elizabeth N.]

Sounds like this Lon isn't the brightest duck in the flock.

 

[Velvetkiss]

Yes Terri, I met Lon as she was the one I saw at the end of my pre op testing and she did the whole EKG thing and said you may have had a heart attack and need to see a cardiologist before we will clear you for surgery. So I did and all was fine, they even did a stress test to make sure and all was good. Elizabeth, Lon doesnt seem very bright with having done this to not one patient but now two. I honestly feel Dr. Inman is great and the nurses on the bariatric floor are great, but I have not been impressed with the people like Lon or the people who run her revision class and I was not impressed at they way they told us in the revision class that Vita Lady schedule for vitamins is too much and over kill and not needed and how their patients do fine on there schedule. They did not like when I asked how they knew for sure that they people they claim are doing well on there schedule really were not just following the advice of Vita Lady and the Vets that have had surgery and just not telling them. Needless to say I am not popular on the lower level of Building 4, LOL and I dont care!