Labs 3 years out

[FishingNurse 1,210]

Hello all! I posted in the Vets Forum but nobody had any input so I am trying in this area where there seems to be more traffic.

All my labs were normal pre-op, at 1 year and at 2 years, and now at nearly 3 years I am very low on multiple labs. Has this happened to anyone else? My nutrtion is much better now that it was at year 1 and 2.

I am going to see a hematologist and possible get Iron transfusions. I am scheduled for a endoscopy as well. My primary doesn't seem to think this is related to my surgery. I am a RN and my thought is the prilosec I take for my horrid reflux could contribute to the lack of Iron absorbtion.

Thanks for reading! My results are listed with the normals after. Any thoughts or comments appreciated.

WBC: 3.3 (3.8-11.0)

RBC: 4.47 (3.7-5.2

Hemoglobin: 10.1 (11.8-15.5)

Hematocrit: 33.8 (35.0-46.0)

Iron: 20 (50-165)

Iron binding capacity 427 (250-450)

Iron Saturation 5 (20-55)

Prealbumin 17.3 (20.0-40.0)

Ferritin 2 (10-291)

everything else was normal.....

[Beach Lover 1,084]

Just one question...............Are you still taking all of your Vitamin supplements? I am just over 1 year post op and I noticed I was feeling a little tired so I upped the Iron. Keep us posted on your outcome.

[par1959 470]

I attended my monthly support group meeting today. And suppliments were part of the conversation. Statistic suggest that most of us will quit taking supplimants within 2 years after surgery. Examples, were given for why this is not a good idea and the damage can be hard to fix. My Doc stated one must take a mutivitamin/multimineral, B12, Calcium and Iron daily for life. He does not care what brand you perfer (aka costco is fine).

[Miss Mac 6,262]

I have not yet had this issue post op, but I was an anorexic / anemic teeneager. The cause was that I simply did not eat enough food to sustain proper nutrition. I was terrified of getting obese like the 95% of the rest of my extended family. Needless to say, I am concerned about this rearing its ugly head again since my food volume, though quite healthy, is not much. In my teen years, the cure was to have B12 shots once a month, and I had to eat liver twice a week. My mom only knew how to fry shoe leather liver, so a Mexican neighbor had mercy on me and put minced liver in tostadas or tacos for me twice a week. That made the liver unnoticeable and quite palatable. Well, if it happens again, I will know what to do. Also, I am making sure this time around that I am getting Vitamin C by putting lemon in my Water, eating tomatoes (and an occasional grapefruit), and I take a Vitamin C supplement to help with absorption. Also, I am eating my fair share of steak and eggs.....just hoping for the best with it all. I hope that you are able to find an answer to you problem without too much difficulty or aggavation.

[FishingNurse 1,210]

Thank you all for your input. I did not keep taking my supplements after 1.5 years probably cause I always ate 1500+ cals a day and focused on Protein, and all my labs post op were all normal at 6 months and a year, and at 2 years, I guess I was wrong! (silly I know I am a healthcare worker in an inatient facility for eating disorders) I am on ferrous gluconate 325mg twice daily with 1000mg of Vitamin C. And I am going for 100g of Protein a day now instead of 70. Its not easy!! All my B Vitamins are normal. I take a good Multivitamin now too.

I will keep everyone posted on the endoscopy results/ and labs in 6 weeks.

[Kindle 8,667]

I did a lot of research before surgery on long term side effects of cancer and ulcer gastrectomy patients. The nutritional deficits they were seeing manifested themselves 10, 20, even 30 years out. Iron was the first one to show up, then B12, and Vitamin D. Between 10 and 20 years after a partial or total gastrectomy, up to 90% of patients had deficiencies with women being more affected than men. This really raised the red flag for me on just his important it is to continue supplements and get annual bloodwork.

[onlybroomegirl 250]

My PCP said part of what we had to develop Calcium & Iron was removed with surgery, so supplements were mandatory. Best of luck to you.

[Beach Lover 1,084]

Thank you all for your input. I did not keep taking my supplements after 1.5 years probably cause I always ate 1500+ cals a day and focused on Protein, and all my labs post op were all normal at 6 months and a year, and at 2 years, I guess I was wrong! (silly I know I am a healthcare worker in an inatient facility for eating disorders) I am on ferrous gluconate 325mg twice daily with 1000mg of Vitamin C. And I am going for 100g of Protein a day now instead of 70. Its not easy!! All my B Vitamins are normal. I take a good Multivitamin now too.

I will keep everyone posted on the endoscopy results/ and labs in 6 weeks.

You may be a nurse but you are human and irregardless of being a nurse we all mess up to some extent even when we know better. I for one am grateful that you posted your dilemma as it will serve a purpose in my life to always take my Vitamin supplements for life. I am sure at some point I would have become weary of it and slacked. I now know that I must remain diligent. Thank you for that!! Keep us posted!

[gomekast 559]

So, at my last check up, my bariatric nurse told me that things change year to year for us post op. Even as far out as 4 or 5 years. She said that people dont realize that your body changes abd is still leveling off and settling in where it wants that far out.

My preal level was low like yours and my bariatric dr told me I needed to eat more whole food...that I was getting too much Protein supplements in my diet. But my brother in law doctor told me that many of the blood tests they use to measure nutrition are out of date and to take it all with a grain of salt. He said any recent antibiotics courses can affect it all and give false lows in those older tests.

Like you, I feel my nutrition now is better than ever. I eat 3 small meals, 2 shake Snacks and 1 food snack. No sugar and next to no processed carbs.

Good luck to getting some answers!

[Savedbygrace22 28]

Yes, PPIs do keep the body from absorbing Iron. Years before my sleeve ( I'm almost 7 wks out) I had to have an iron infusion at the oncology clinic. At the time I was on Nexium. I asked my Surgeon's office about this last wk. she said it was my decision wheather to take the bariatric iron or not.

Edited June 23, 2014 by Savedbygrace22

[gomekast 559]

Yes, PPIs do keep the body from absorbing Iron. Years before my sleeve ( I'm almost 7 wks out) I had to have an iron infusion at the oncology clinic. At the time I was on Nexium. I asked my Surgeon's office about this last wk. she said it was my decision wheather to take the bariatric iron or not.

I'm kinda worried about this now myself. I've been on prilosec since October last year. I had diagnosed reflux that they found once my surgery was done...what do the Dr's recommend long term that's safe? Anyone found anything safer long term for reflux post op?

[bikrchk 1,313]

I also take Omeprazole and just knocked it back to once per day as the reflux is managed and I was concerned with the side effects of too much medication long term. I'm only 9 months out but my labs have been perfect so far. Just a thought, but if you're taking an additional Iron supplement, you're not taking it with a Multivitamin or with Calcium are you? My team told me that can affect how much Iron we absorb. I was directed to take my iron supplement mid-day with no other supplements.

[Mrsmiller#4 5]

Good morning is not how I'm feeling. Today is 8 weeks post vsg. I feel like I'm going downhill. I'm down almost 40 lbs which is great but I can't seem to keep anything down. I did better 2 weeks ago. food stayed put and the variety was good. Slowly over the last ten days I've become so so weak. Over the weekend I started having trouble even keeping thick liquid down and I'm nauseous all the time. Even liquid is a fight. It feels like it gets stuck and then I throw it up. I feel like I'm losing to fast. I can't even handle getting my own food bcause I'm weak and the smell of any food causes nausea. Anyone else have this and what did u do.

[FishingNurse 1,210]

Thank you all so much !!

[gomekast 559]

Good morning is not how I'm feeling. Today is 8 weeks post vsg. I feel like I'm going downhill. I'm down almost 40 lbs which is great but I can't seem to keep anything down. I did better 2 weeks ago. food stayed put and the variety was good. Slowly over the last ten days I've become so so weak. Over the weekend I started having trouble even keeping thick liquid down and I'm nauseous all the time. Even liquid is a fight. It feels like it gets stuck and then I throw it up. I feel like I'm losing to fast. I can't even handle getting my own food bcause I'm weak and the smell of any food causes nausea. Anyone else have this and what did u do.

Hey honey. .sounds like a miserable time. Call your program asap. They may want to see you today to rule out anything serious.

Is there anything that is creating some unknown stress? I remember my nurse telling me that stress will cause the sleeve to swell more than usual greatly limiting eating and drinking capacity (it wss holiday season which is a high stress trigger for many).

But seriously, make a call to them asap!