Newby DS'r in vitamin trouble - now with lab numbers

EricW

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Feb 20, 2015
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I made an earlier post on this thread describing my situation so I will skip right to the numbers. I apologize for the results being a little hacked together. Page 1 is from last week but incomplete (unknown to me) and page 2 is from late January and might have some of what page 1 is missing.

My PCP told me yesterday that she did not order all the labs on my list (VitaLady's) because she felt she could not justify them. I was very clear early on that many things about my situation may not make sense in the typical medical or bariatric world but that I just needed her to follow along and trust the information I was researching. I even offered a month ago to pay her privately for her time to learn about the DS and get up to speed. She said there was no need to do that and that she would work with me. Long story short we had a bit of a melt down as she took the position that the blood lab IRS may come through the doors and audit her orders and she was afraid that she couldn't justify them as she didn't really understand them. I took the position of I am the one paying even through insurance to have them and since I am paying I want what I want and know it is in my best interest. I really get the feeling she works for my insurance cost controllers more than for me. Bottom line is I am trying to find a new PCP as I type.

So, attached are the results that I have. I have begun assembling my vitamins based on what I have learned and now just need a little help with dosages and any conflicts. I know there are some iron conflicts and that D is to be taken with calcium. Anything else? What are the possibilities for infusions? Are they a good idea/option? I know iron is possible, what else is? Any advice is appreciated. If there is more I need to gather or divulge please let me know. Thanks so much. EW
 

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You are definitely anemic and need an iron infusion. Do you have a hematologist?
There are a lot of important things missing and her position on not being able to justify ordering tests is absurd. You definitely need a new PCP. The justification is a diagnoses code for malabsorption. It's not rocket science.

While its pretty obvious what you need to do, I'll let those with more experience answer you, cause I'm still a newbie!

But I will say all things considering it could be a LOT worse. You can definitely turn this around and get back to good health. Good luck!
 
You need iron infusions, a metric crap ton of D, and a lot of bone related supplementation: calcium, D, K, boron, magnesium. You need a bone density scan yesterday..

You also need a new PCP, because you need a LOT more labs done.
 
I expected worse, but hate your PTH. It means you're leaching calcium from your bones and teeth to maintain your serum level, which means if this has been the case for all of these years post op, osteoporosis must be suspected. It doesn't mean you'll snap an arm rolling over in bed tomorrow, but it's an insidious problem that will effect you down the line if not corrected now. The bone density test will tell the tale. The iron deficiency is very common , though normal levels are easily achievable. The B12 deficiency is BAD because it's completely unnecessary! Go immediately to your doctor and demand B12 injections monthly. Call her today and have her call it into your pharmacy so you can take it tonight. Mine costs $4-6 per month and self injecting it is a breeze. I'm an RN so used to needles, but anyone can do it. It's the easiest vitamin to control for this very reason. Many people, "regular folks" ,develop a B12 deficiency as they age because their bodies produce less and less of the intrinsic factor required to metabolize B12 in foods. We DS'ers are almost guaranteed to have a problem absorbing B12 even though it's water soluble. Take the shot today! Easiest fix of them all. A B12 deficiency is a VERY dangerous matter, as it could result in an erosion of the myelin sheath surrounding your neurons and a reduction in general nerve conductivity. At severe low levels, one basically develops Lou Gherigs disease. 'Nuff said there. Get some dry D3 (I use Bio tech's) and the other vitamins TODAY. Use the guideline for taking what, when, and in what combinations found on the Vitalady section here. No kicking yourself in the ass about the past, but you need a strong, hard, and continuous ass kicking from yourself to be sure to set things right in the future. Go get 'em tiger!! I know you're going to be just fine. Another thing. Notice how these nice folks took the time to try to help you here? PLEASE pass that same benefit to others. You have valuable experiences to impart that are very likely to be helpful to the many good folks staggering to this site hoping desperately for answers. Be a resource for others Eric! We are a VERY small community worldwide. There is a TON of disinformation out there, as I know you know. Please help save a life and give folks who have bravely chosen to try to reclaim their lives through the DS surgery a fighting chance. I know you will. Best of luck to you brutha Eric! :D
 
Thank you all for the comments and direction so far. I am copying comments to take with me as I go find a new PCP. I have a couple good leads as I went back to the blood lab and talked to the gals there explaining my situation and need for an open minded doc. I just want to restate that if I am not on here or responsive for a few days or even a week at a time it is not because I don't appreciate the help or care. My work often has me traveling to very remote locations and sometimes into Canada where data transfer can be sketchy/spendy. I am learning and reading as fast as I can when I have access but a lot of the times I don't.

I read Diana's intro letter to new PCP's last night and made it up to fit me. I will take it and my results and these comments and go on my hunt. I also saw her printed list of labs from Pacific Laproscopy. Is this what I need to be asking for or is there more since I am so far behind? I am trying to clear my schedule for a couple days at Pac Lap to get them on board (not that they are not, it's all me ignoring their info over the years) so is there anything else I could be doing pre-visit to the man (Rabkin) that will optimize my visit with him.

I will try to get a bone scan done, I will need to find where the nearest location to me is that can do it.

I see the number 50,000/day show up a lot when talking about D3. Is this a good start point for me? I have been doing 10,000/day for a few weeks now until I learned more.

I do not have a hematologist. We do have a mechanic in town (1200 people) now that does work on air conditioning I hear. Sorry, got a add a little humor to this once in a while. I am sure I need a referral for a hematologist and I can't even get one for a D test at the moment. lol.

Again, I do appreciate all the time and caring to deal with me. I know that all on here have many choices in life as to how to spend free time. I do recognize and appreciate the choice to spend it helping me. I will do my best to not waste your time/effort or let it be in vain. I am very much a pay it forward kinda guy and look forward to sharing more about that once I have cleared a few hurdles.

Sincerely, Thanks Again. EW

ps....Elizabeth, I have not heard of Boron. Do you supplement for this, and is it monitored by a blood lab? I would have guessed it to be a boring politician. lol.
 
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EricW take a look at the thread "We have to get organized" under this section.I I put some info there that might help you. There are rules about what vits and supplements work together. Learn them. Definitely up yourself to 150,000 of D3. You have to find a PCP that will listen and learn from you. You have to be your own advocate. It's hard, it's time consuming, it's your health. My best wishes to you.
 
The state of Washington does not require a doctor to order labs. Your insurance company might, but Pac Labs should be happy to do what ever you ask of them. An odd thing is that my recent tests were all flown to your side of the state to be run. Most of the tests are not even than expensive, but I would ask first.

I will attach a bunch of useful documents that I've gotten from around the net, mostly here.... In case of disagreements between the documents, come back to this forum and ask.
 

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  • BG - master labs - Copy.xlsx
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  • duodenal-switch-patient-workbook3.docx
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  • Iron Deficiency and Anemia in the Bariatric Patient 2014.docx
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  • Generic Bariatric Lab Order.pdf
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  • VitaLadysLabsandTargets_11-2009.doc
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  • BloodLabMeaning.pdf
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  • VitaLady VitaSchedule.GIF
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Thanks a ton Brandy. Just getting back to the world so I will read/print them later on. I too found some interesting lab stuff. One company Labs Direct claims to order what ever you want as long as you are self pay. Sounds like I can have it done in Spokane. I think the bottom line is to call Rabkin but I have been too chicken to do it until I have some firm dates I can show up there. looking at early April right now. I may self pay for the labs Diana had posted just to get a baseline that is complete. There is one lead locally for a PCP that may be able to take direction. I'm on that tomorrow. Thanks again for you time. EW
 
"EricW take a look at the thread "We have to get organized" under this section."

Thanks Razbry, I'm on it as soon as I can. Take care. EW
 
Thanks a ton Brandy. Just getting back to the world so I will read/print them later on. I too found some interesting lab stuff. One company Labs Direct claims to order what ever you want as long as you are self pay. Sounds like I can have it done in Spokane. I think the bottom line is to call Rabkin but I have been too chicken to do it until I have some firm dates I can show up there. looking at early April right now. I may self pay for the labs Diana had posted just to get a baseline that is complete. There is one lead locally for a PCP that may be able to take direction. I'm on that tomorrow. Thanks again for you time. EW
http://bariatricfacts.org/threads/did-you-know-you-can-order-your-own-labs.2068/
 
One other reference, but it can be dense to get through is http://asmbs.org/resources/integrated-health-nutritional-guidelines.

One other thing I think would help greatly. Forgive yourself. You are not the first or the last to fall down. I think the few people here that haven't had problems are thinking "There but by the grace of god go I." Hold your head up high cuz you are back on the horse and heading the right direction.
 
I expected worse, but hate your PTH. It means you're leaching calcium from your bones and teeth to maintain your serum level, which means if this has been the case for all of these years post op, osteoporosis must be suspected. It doesn't mean you'll snap an arm rolling over in bed tomorrow, but it's an insidious problem that will effect you down the line if not corrected now. The bone density test will tell the tale. The iron deficiency is very common , though normal levels are easily achievable. The B12 deficiency is BAD because it's completely unnecessary! Go immediately to your doctor and demand B12 injections monthly. Call her today and have her call it into your pharmacy so you can take it tonight. Mine costs $4-6 per month and self injecting it is a breeze. I'm an RN so used to needles, but anyone can do it. It's the easiest vitamin to control for this very reason. Many people, "regular folks" ,develop a B12 deficiency as they age because their bodies produce less and less of the intrinsic factor required to metabolize B12 in foods. We DS'ers are almost guaranteed to have a problem absorbing B12 even though it's water soluble. Take the shot today! Easiest fix of them all. A B12 deficiency is a VERY dangerous matter, as it could result in an erosion of the myelin sheath surrounding your neurons and a reduction in general nerve conductivity. At severe low levels, one basically develops Lou Gherigs disease. 'Nuff said there. Get some dry D3 (I use Bio tech's) and the other vitamins TODAY. Use the guideline for taking what, when, and in what combinations found on the Vitalady section here. No kicking yourself in the ass about the past, but you need a strong, hard, and continuous ass kicking from yourself to be sure to set things right in the future. Go get 'em tiger!! I know you're going to be just fine. Another thing. Notice how these nice folks took the time to try to help you here? PLEASE pass that same benefit to others. You have valuable experiences to impart that are very likely to be helpful to the many good folks staggering to this site hoping desperately for answers. Be a resource for others Eric! We are a VERY small community worldwide. There is a TON of disinformation out there, as I know you know. Please help save a life and give folks who have bravely chosen to try to reclaim their lives through the DS surgery a fighting chance. I know you will. Best of luck to you brutha Eric! :D

Really Great post Will, I really like your style and your posts and am happy to see you posting more! Eric, congratulations, at least you know what the labs are now. I hate the fear of the not knowing, that's my greatest nemesis. And, you couldn't be in a better place to get the tools you need to turn this around LONG TERM! My best thoughts and wishes for success to you! Rob
 
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Really Great post Will, I really like your style and your posts and am happy to see you posting more! Eric, congratulations, at least you know what the labs are now. I hate the fear of the not knowing, that's my greatest nemesis. And, you couldn't be in a better place to get the tools you need to turn this around LONG TERM! My best thoughts and wishes for success to you! Rob

Thanks Brutha Rob! :ngbbs450d0391e9c80:
 

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