Re: My labs

[Guest guest]

Kym,

Didn't you get a ferritin? Usually the ferritin drops, then the TIBC

goes up, then the last thing you would see would be anemia.

Anyway, if I were you I would eat some cow. lol But look who is

speaking.

Also, you got an MMA test without a B12 level? It is not a specific

test and you could be under-excreting it from your kidneys, for

example.

Marta

[Guest guest]

This is a new doctor. She's not too bright. Seriously. I wont be

going back. The only thing I liked about her was that I was able to

talk her into a monthly ambian script

Anyway... they were SUPPOSED to order Ferratin, and the other Ferritin

sounding things DR K asks for. but they didn't. So I'll have to do

that. I feel REALLY REALLY fatigued though. So I am just sure my

iron is off.

B12 is also one they skipped. So I need to go get that too

right? I am convinced she ordered that test because she thinks I had

the RNY. I could see her eyes glazed over when I was explaining the

difference. And when I talked about that I have my stomach and

therefor the intrinsic factors for the B vitamins..... she just dumbly

nodded and then still commented that it could be a B deficiency that

is making me feel tired. And who knows.... maybe it is.

Since I can go to any doctor... Im thinking about trying to find a

hematologist to be my PCP. All I need is someone who will write me a

script for hormones, ambian and Vit. D (and perhaps Iron infusions

and B12 shots!)

Are iron infusions dangerous? I mean... why don't we just get iron

infusions once a year? I'd rather do it now before my stores are

too low....

[Guest guest]

Kym,

First of all, anyone who can complete med school and residency

is " bright " . Unfortunately, she probably doesn't have time during

an office visit to get into a detailed discussion with you about

WLS. We all know about general surgical procedures such as the roux-

en-Y. What she needs to know is where your intestines were sliced

and spliced and she will understand the physiology.

You say *she* ordered B12? Isn't she ordering the labs Dr.K

recommends? Anyway, the gastric bypass surgery is not the only

cause of B12 deficiency, so it is worth checking out.

It sounds as though you are not anemic and you MAY or may NOT be low

in your storage iron.

Yes, Iron infusions are dangerous. If you need one, then you need

one and I wouldn't worry about the danger, it is minimal, but I

prefer to avoid an infusion for myself, that is why I started taking

Vitron-C. I realize that my diet is inadequate in iron and I do not

feel able to change my eating habits enough to increase my iron

stores through food intake alone.

Monthly Ambien is not necessarily a good idea. Many people become

dependent on sophorics when used chronically. If a patient is

having chronic problems with sleep then the cause of the insomnia

should be investigated. I feel it is unfortunate that physicians

are put under economic pressure to give patients what they " want "

instead of what they " need " and that is why I work in Correctional

Medicine. Sorry, editorial comment!

As for your desire to have a hematologist for a PCP, well, I

disagree. For an adult, an internist is the primary care

specialist. You could also have a Family Practioner as a PCP.

Unless you have a serious blood disorder, I do not see any reason

for you to regularly see a hematologist. You say that you only want

someone to write you your prescriptions? Well, there are plenty of

providers out there who are willing to do that, but you would be

cheating yourself to settle for that.

Marta

Internist with integrity.

>

> This is a new doctor. She's not too bright. Seriously. I wont

be

> going back. The only thing I liked about her was that I was able

to

> talk her into a monthly ambian script

>

> Anyway... they were SUPPOSED to order Ferratin, and the other

Ferritin

> sounding things DR K asks for. but they didn't. So I'll have to

do

> that. I feel REALLY REALLY fatigued though. So I am just sure

my

> iron is off.

>

> B12 is also one they skipped. So I need to go get that too

> right? I am convinced she ordered that test because she thinks I

had

> the RNY. I could see her eyes glazed over when I was explaining

the

> difference. And when I talked about that I have my stomach and

> therefor the intrinsic factors for the B vitamins..... she just

dumbly

> nodded and then still commented that it could be a B deficiency

that

> is making me feel tired. And who knows.... maybe it is.

>

> Since I can go to any doctor... Im thinking about trying to find a

> hematologist to be my PCP. All I need is someone who will write

me a

> script for hormones, ambian and Vit. D (and perhaps Iron

infusions

> and B12 shots!)

>

> Are iron infusions dangerous? I mean... why don't we just get

iron

> infusions once a year? I'd rather do it now before my stores

are

> too low....

>

[Guest guest]

Thanks for your comments marta. Please understand that I haven't

shared the " backstory " of everything that has happened. I realize

you don't really know me... but I am a pretty compliant and educated

patient. I listen. I am proactive. I do have my own opinions

and do not just blindly follow doctors advice if I dont understand

the " why " behind what they are doing. I ask questions.

wrote:

> First of all, anyone who can complete med school and residency

> is " bright " . Unfortunately, she probably doesn't have time during

> an office visit to get into a detailed discussion with you about

> WLS. We all know about general surgical procedures such as the

roux-

> en-Y. What she needs to know is where your intestines were sliced

> and spliced and she will understand the physiology.

I actually did explain the physiology and offered even a picture.

But she kept going back to the RNY because that is what she knows.

When I would point out the difference, she was irritated. Im sure

it's because she doesn't usually have to listen to technical info

from patients. She wrote me off. She saw herself as having more

education and knowledge then me and therefore didn't listen to the

patient at all.

All that aside -- it wasn't a good fit. And I don't think she's

particularly bright. She didn't take a thourough medical history

and she didn't ask good questions. She's not the doctor for me.

>

> You say *she* ordered B12? Isn't she ordering the labs Dr.K

> recommends? Anyway, the gastric bypass surgery is not the only

> cause of B12 deficiency, so it is worth checking out.

She ordered that MMA test. I gave her the lab slip from Dr. K.

They missed at least half a dozen things. I don't know if she

picked and chose not to do certain things or it was an oversight.

Again... not too impressed. They also didn't collect the vitamin

A correctly (it was exposed to light for more then half hour) - but

Im not going worry about that.

>

> It sounds as though you are not anemic and you MAY or may NOT be

low

> in your storage iron.

This is the part I am trying to better understand. I guess I

can't really have a good picture about what stage Im in utnil we get

the Ferritin numbers right? What does just the IRon Binding

Capacity number mean if that is out of range? What I don't

understand is if its a " pre " indicator. Was your iron binding

numbers high too? Anyone else have ok total iron but the binding

number was high?

> Yes, Iron infusions are dangerous. If you need one, then you need

> one and I wouldn't worry about the danger, it is minimal, but I

> prefer to avoid an infusion for myself, that is why I started

taking

> Vitron-C. I realize that my diet is inadequate in iron and I do

not

> feel able to change my eating habits enough to increase my iron

> stores through food intake alone.

I will read up on iron infusions and look into Vitron-C. My problem

is that I have chronic hemmroids and iron binds me up and makes them

worse. So... Im wondering if infusions would skip that issue and

simply be worth it for me.

>

> Monthly Ambien is not necessarily a good idea. Many people become

> dependent on sophorics when used chronically. If a patient is

> having chronic problems with sleep then the cause of the insomnia

> should be investigated. I feel it is unfortunate that physicians

> are put under economic pressure to give patients what they " want "

> instead of what they " need " and that is why I work in Correctional

> Medicine. Sorry, editorial comment!

There are reasons for the ambian. I think my sleep isses are

complex (iron? vit B? estrogen?) And I agree...if a doctor could

help me address those reasons (she kept saying that she felt maybe

the B12 could be my sleep issue problem) then I wouldn't need the

ambian.

When you say " correctional medicine " you mean correcting others

mistakes or working with prisioners? (My sister is a dentist in a

prision and loves it!)

> As for your desire to have a hematologist for a PCP, well, I

> disagree. For an adult, an internist is the primary care

> specialist. You could also have a Family Practioner as a PCP.

> Unless you have a serious blood disorder, I do not see any reason

> for you to regularly see a hematologist. You say that you only

want

> someone to write you your prescriptions? Well, there are plenty

of

> providers out there who are willing to do that, but you would be

> cheating yourself to settle for that.

I want someone who will listen and be proactive. I go to the

doctor once a year. I have found that truthfully marta, I diagnose

myself and then a doctor confirms my dx. I RARELY have found

anyone who has taken the time or interest to figure out what is

really wrong. Internist, GP, ARNP, or otherwise. Since I had

the DS, I can't even get one of these professionals to follow DR.

K's blood sucking instructions.... not once have they gotten it

right. And they dont double CHECK to see if it was done right...

if they got everything then need to see the whole picture. I do

it.

So yes Marta... my confidence level is low in my healthcare

providers. My whole family works in the healthcare field. I'm

aware of the conditions that healthcare workers work under. It

sucks. And so I constantly struggle with asking for help from

people who seem to not give a shit versus just trying to figure it

all out myself. I realize there is probably a great balance to

work towards there...but like everything else in my life sometimes

balance is ellusive.

Thanks for your comments. I am willing to take all education on

iron you have to offer

Thanks

--Kym

[Guest guest]

Kym,

I have a great idea! Why not come for a follow-up visit with Dr.K and

then we can go out to dinner and visit in person. The local yokels

like to do that when out-of-staters come to visit!

You should come every year and then you will know you are getting the

best of care.

I am going to be offline for a day or so because I am taking my board

exam tomorrow and have to leave soon to drive to the city where I am

taking the exam. I will be back late tomorrow or Saturday.

Marta

[Guest guest]

Kym,

There are some good sites out there for patients. One is

labtestsonline.com and some others that I have posted links to in the

links section. Another site, not linked, is emedicine.com. They have

encyclopedia-type of information on health subjects.

I have to run, talk to you all later!

Marta

[Guest guest]

I'm actually considering that. However it's a very expensive

doctor's appointment

Good luck with your exams!

--me

>

> Kym,

>

> I have a great idea! Why not come for a follow-up visit with Dr.K

and

> then we can go out to dinner and visit in person. The local

yokels

> like to do that when out-of-staters come to visit!

>

> You should come every year and then you will know you are getting

the

> best of care.

>

> I am going to be offline for a day or so because I am taking my

board

> exam tomorrow and have to leave soon to drive to the city where I

am

> taking the exam. I will be back late tomorrow or Saturday.

>

> Marta

>