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Hi all! I am currently trying to get more involved in reviewing the

post-operative vitamin labs in our practice and was wondering what other

practices were doing. In practices where dietitians review the labs is a PA/MD

also reviewing the labs? When additional supplementation is warranted do you

recommend over-the-counter vitamins? If prescriptions are needed how do you

handle it?

Thanks for your help!

, MS, RD, CDN

Montefiore Medical Center

Bronx, NY

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I actually complete the lab result letter we send to patients. We

developed protocols (primarily developed by myself with input from

surgeons and then team/Medial Director/surgeon approval) that I follow

to comment on to the patients. If something is out of the scope of

those protocols I consult or forward the letter to the NP in our

practice and she adds comments. I usually try to direct the patient to

OTC supplements to address the lab. If they are Vitamin D deficient the

NP sends a prescription for the pt. If it is B12 or thiamin requiring

IM repletion I call the PCP and advise them about our program

recommendations and ask them to carry them out. Occasionally a PCP

wants an order from us and then the NP calls. Most PCPs are very

willing to act on the advise of the RD and program protocols. If it is

iron we have criteria we use to create a referral to hematology for

consideration of iron infusions when appropriate or when oral repletion

has not made improvements.

I find this process works well because I ask the most detailed questions

about what the patients is taking and can direct them specifically as to

what changes are likely beneficial. It is also an opportunity to

reinforce the importance of long term supplementation and lab results.

The patients usually look to me as the one to help them be sure they do

not have deficiencies.

Hope that helps

Diane Olson MS RD CDE

UW Health Bariatric Surgery Program

University of Wisconsin Hospital and Clinics

(608) 265-1718

dolson3@...

Post-operative Labs

Hi all! I am currently trying to get more involved in reviewing the

post-operative vitamin labs in our practice and was wondering what other

practices were doing. In practices where dietitians review the labs is

a PA/MD also reviewing the labs? When additional supplementation is

warranted do you recommend over-the-counter vitamins? If prescriptions

are needed how do you handle it?

Thanks for your help!

, MS, RD, CDN

Montefiore Medical Center

Bronx, NY

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