Pre-op labs

[catecholamine]

Here are the abnormals, since there's literally 4 pages of tests.
Hemoglobin A1C 6.2% high
Vitamin D 21.8 Low (It was at 10, so it's progress)
MCH 23 UUG Low
MCHC 31% Low
MCV 75 M3 Low
Platelet Count 506 MM3 High
RDW 17.2% High
Free T4 1.2 NG/DL High
Prealbumin 17 MG/DL Low
Iron 21 MCG/DL Low
Saturation 6% Low
Sodium 136 MMOL/L Low
HDL Cholesterol 39 MG/DL Low

Urinalysis:
Appearance Cloudy - Abnormal
Occult Blood, Urine Mod - Abnormal
Epithelial SEV /HPF - Abnormal

Doc said I need iron infusions, to up my 50k D3 to 3x a week, drink more fluid, eat more protein. I have zip, zero, zilch idea how my prealbumin is low, I eat tons of meat/eggs. Same for sodium, no clue. But it's barely low.
I'm worried about my iron post-op, because I'm on birth control, no period, so I'm not losing any blood and I eat lots of red meat, why am I anemic? Post op it's probably going to be much worse.

Any feedback?

EDIT: FYI infusions are to be 125mg ferrlecit bid (5 doses total)

 

[Elizabeth N.]

When the red blood cells are wimpy (as in anemia), many things don't get absorbed well. Fixing the anemia (not to mention the source of the bleeding?!) might lead to an improvement in a number of readings. I don't know which ones are most effected in this way, though.

 

[catecholamine]

If I'm bleeding, I have NO IDEA where from. I am on depo, so I don't have periods. I've straight up had to get a blood transfusion once before. I was being discharged from a regular hospital to a psych hospital, and they said they wouldn't take me because I wasn't medically stable because of the anemia. That was like 4yrs ago. A medical doc who did medical stuff for that psych hospital told me he was worried I had a slow GI bleed or something. I told my PCP and he didn't really seem to give a shit so I let it go.
I eat plenty of red meat, don't know why I'm so anemic.

 

[SHales]

If I'm bleeding, I have NO IDEA where from. I am on depo, so I don't have periods. I've straight up had to get a blood transfusion once before. I was being discharged from a regular hospital to a psych hospital, and they said they wouldn't take me because I wasn't medically stable because of the anemia. That was like 4yrs ago. A medical doc who did medical stuff for that psych hospital told me he was worried I had a slow GI bleed or something. I told my PCP and he didn't really seem to give a shit so I let it go.
I eat plenty of red meat, don't know why I'm so anemic.

You don't have to have a bleed to become anemic but they should check it out. Your protein will go down if your are anemic so there's that. Your UA is abnormal for occult blood, etc. Have him tell you what that might be. Also, your numbers may not have been this low at the time, maybe. I would pin your PCP down on this and maybe get a referral to a hematologist to find out the cause, preferably before surgery.

 

[catecholamine]

You don't have to have a bleed to become anemic but they should check it out. Your protein will go down if your are anemic so there's that. Your UA is abnormal for occult blood, etc. Have him tell you what that might be. Also, your numbers may not have been this low at the time, maybe. I would pin your PCP down on this and maybe get a referral to a hematologist to find out the cause, preferably before surgery.

My surgery is in a little over a week... already even pre-registered for surgery.
If this continues to be a problem, I'll get a hematologist referral for sure.

 

[SHales]

My surgery is in a little over a week... already even pre-registered for surgery.
If this continues to be a problem, I'll get a hematologist referral for sure.

You will be ok. Your surgeon will be aware and if anything were dangerous, he would cancel. Good luck!!

 

[huneypie]

On the subject of depo please get a dexa scan as soon as you reasonably can. I was on it for a couple of years and blame it for my osteopenia.

The Mirena coil is the same drug but in far lower dose and still no periods ;-)

If I'm bleeding, I have NO IDEA where from. I am on depo, so I don't have periods. I've straight up had to get a blood transfusion once before. I was being discharged from a regular hospital to a psych hospital, and they said they wouldn't take me because I wasn't medically stable because of the anemia. That was like 4yrs ago. A medical doc who did medical stuff for that psych hospital told me he was worried I had a slow GI bleed or something. I told my PCP and he didn't really seem to give a shit so I let it go.
I eat plenty of red meat, don't know why I'm so anemic.

 

[Elizabeth N.]

But you had blood in your urine. How did it get there? This must be explored if it hasn't been done already.
Were you tested for fecal occult blood? Have you had a colonoscopy? Does your surgeon know about your anemia history and your need for a transfusion? He needs to know all these details.

My surgeon would not have scheduled my surgeon with those kinds of things going on. He would have required that they be fully examined and cleared up before proceeding.

 

[Elizabeth N.]

You should also be tested for hemolysis/hemolytic anemia.

 

[catecholamine]

The nurse practitioner I saw for the visit didn't say anything about the blood in the urine. I dunno. Never been tested for fecal occult blood or had a colonoscopy. I reaaaally want to avoid that if I can. I didn't much go into my history of anemia or anything. They didn't ask.

 

[SHales]

The nurse practitioner I saw for the visit didn't say anything about the blood in the urine. I dunno. Never been tested for fecal occult blood or had a colonoscopy. I reaaaally want to avoid that if I can. I didn't much go into my history of anemia or anything. They didn't ask.

Them knowing about these things IS critical. You should tell everything you know about your health, really! This is a complicated surgery and for your own sake, you don't want anyone going in there blind. Will you see your surgeon again before surgery?

 

[catecholamine]

Nope. I only saw him for the consult, the rest of the time I'm seeing nurse practitioners and stuff. I won't be seeing anyone else before the surgery.

 

[southernlady]

Unless she is specific on seeing HIM about this...she won't see him again until just before they wheel her into the OR...and after that, MAYBE each day she is in the hospital...after that, NADA!

 

[BrianChesteen]

He came to see me before going to the OR. He answered all my questions but that was about it. I did not expect much though. He did keep close tabs on me in the hospital however and made sure my labs looked good before he would let me leave. He even remembered on the discharge notes that he had switched me from liquid pain meds to pills.

They say you can ask to meet with him any time you feel the need. Maybe this is one of those times you might want to do that....before surgery day!

 

[Elizabeth N.]

The nurse practitioner I saw for the visit didn't say anything about the blood in the urine. I dunno. Never been tested for fecal occult blood or had a colonoscopy. I reaaaally want to avoid that if I can. I didn't much go into my history of anemia or anything. They didn't ask.

HOLY MOLY woman!!! You HAVE to tell them all this stuff RIGHT FUCKING NOW. Not doing that could KILL you. Do NOT move forward with your DS until this shit is clarified!