At the risk of repeating myself..

If you go to the doctor and you have hypertension, he evaluates your case, he looks at your history of your blood pressure, and then he decides (based on a number of factors – drug reps not to be excluded!) which form of medication to prescribe to you. You typically stay on it for two to four weeks, record your B/P at home and then when you return, show what your levels have been. The doctor will then evaluate how the medication is – or isn’t – working, and may keep you on the same dose, may cut your dose in potency, may increase it, or may try another drug altogether. It’s a trial and error kinda thing.


[Frankly, there a lot of normies running around with some majorly screwed up vitamin levels, too, only they don’t pay attention to it until it becomes life altering.]

Who your surgeon is (because each surgeon has his/her own personal set of surgical protocols and philosophy of surgery), what your particular surgical specs are, your health history, your level of compliance with taking your vitamins, any other RX’s you might be on, as well as the trends of your post-op labs from your pre-ops to NOW all come into play.

This is why I believe WHOLEHEARTEDLY that every post-op ought to:

  1. Have a spreadsheet of their labs – from pre-op forevermore. If you don’t have a template, there are some in the files, or you can borrow mine -it’s at:
  2. Have the list of their vitamins/supplements written out somewhere -including manufacturer name, strength, dosage, and any notes as to when/wherefores pertaining to tweaking of supplements – and on hand -always.
  3. DEMAND (if necessary) a hard copy on ALL labs drawn – no matter what. My doctor’s MA knows that it doesn’t matter if it’s a post-op related lab, I want a hard copy of it – so she takes a photo copy of whatever comes in and I get it as soon as possible. I’ve learned more stuff from some of those “auxiliary” lab runs that had nothing to do with my DS, but helped me to have a better understanding of what’s going on with my body. It’s *my* responsibility to know what’s going on with my body – I am, after all, the one who has to live in it!
  4. Have a copy of their op report from their DS (and nowadays more and more surgeons are providing a video of your surgery as well – important stuff to have on hand) and know their surgical specs.

Sorry – a little warning here – a rant is about to ensue: people, we go into DS knowing we’re asking for intestinal malabsorption. The DS isAMAZING – phenomenal, wild, wonderful, and honestly one of the best gifts I’ve ever been given. However, it’s a very powerful surgery – and if you don’t take it seriously, there is potential that you can give yourself a slow fairly tortuous death. And it’s not just us – we have a whole heck of a lot more in common with some of your RNY peers than a lot of us are willing to accept – at least on the malabsorption front. WLS is a big deal.

Duh – so is morbid obesity – and for those of us who were at super, supermorbid obesity and on death’s door, we were willing to accept the big deal!

Getting the DS and chalking “but I feel fine” up as sufficient for how you’re doing as a post-op and an excuse for not being vigilant about supplementing, labs, and knowing what’s going on with your own is willful NEGLIGENCE.

Okay – sorry – I couldn’t hold that in.

So yes, there are some fairly universal truths for malabsorbers. We need more B-12 than the average bear, our low lipid numbers are not a bad thing, we do need to supplement B’s no matter what the community (and some of our surgeons) were saying five, six, seven years ago. Some folks need more of one thing than another. That’s why it’s so important to take ownership for your labs and being consistent with having them done and yes, even knowing what your numbers are.

Okay – I’ll shut up now.


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