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07-24-2007, 05:30 PM
| #1 (permalink) |
| Seasoned Veteran  Join Date: Apr 2007 Location: Mount Vernon, NY
Posts: 7,296
Weight Statistics 4/1/07 Start Date:
4/19/07 Surgery Date:
5' 9" Height: 258 lb Start Weight:
146 lb Current Weight:
165 lb Goal Weight:
112 lb Weight Loss:
-19 lb Lb Left to Lose:
43.4108527132 % % Lost:
04/19/2008 Goal Date:
Body Mass Index 38.0957781979 BMI Start:
21.5580760344 BMI Current:
24.36357908 BMI Goal:
Weight Loss Method Roux en Y Gastric Bypass    |  I'm a little confused.... ...which is nothing new LOL! I went to the dr today to follow up on my bloodwork from last month and to get my 2nd b12 shot. (this was with my PCP my surgeon does not do bloodwork or administer shots) He said my labs are good and that he doesnt want to give me the shot anymore.....? He says I am nowhere near depleated (my level is 910 whatever that means) and that he doesnt want to see me again for 2 months. UM...are we supposed to wait until our vitamins depleat to get more? also, isnt the shot standard? can you overdose from this? what would be the reason for NOT wanting to give this? DOC???????
__________________ Anything worth having is worth working for Kenya R.  Lap RNY 4/19/07     Last edited by Kenyar : 07-25-2007 at 06:39 AM. Reason: clarification |
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07-24-2007, 05:50 PM
| #2 (permalink) |
| WLS Master Guru  Join Date: Mar 2007 Location: Louisiana
Posts: 899
Weight Statistics 4/23/07 Surgery Date:
Height: 385 lb Start Weight:
257 lb Current Weight:
190 lb Goal Weight:
128 lb Weight Loss:
67 lb Lb Left to Lose:
33.2467532468 % % Lost:
Body Mass Index 62 BMI Start:
41 BMI Current:
Weight Loss Method Roux en Y Gastric Bypass |  I don't know the answer but I am anxiously awaiting Doc's response. Roz
__________________ Too Blessed to be Stressed  |
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07-24-2007, 05:54 PM
| #3 (permalink) |
| Seasoned Veteran Join Date: Apr 2007 Location: Mount Vernon, NY
Posts: 7,296
Weight Statistics 4/1/07 Start Date:
4/19/07 Surgery Date:
5' 9" Height: 258 lb Start Weight:
146 lb Current Weight:
165 lb Goal Weight:
112 lb Weight Loss:
-19 lb Lb Left to Lose:
43.4108527132 % % Lost:
04/19/2008 Goal Date:
Body Mass Index 38.0957781979 BMI Start:
21.5580760344 BMI Current:
24.36357908 BMI Goal:
Weight Loss Method Roux en Y Gastric Bypass | yes i am getting a little frustrated with my PCP. i know he is a dr and he has done right by me up until WLS. i think our difference in opinions here might make me switch to someone who primarily cares for WLS patients because this is one risk i dont want to take. him stopping my shots could result in catastrophe 6 months down the road.....i just dont want to wait to find out later on i am sick because of this, ya know?
__________________ Anything worth having is worth working for Kenya R. Lap RNY 4/19/07 |
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07-24-2007, 08:24 PM
| #4 (permalink) |
| WLS Master Guru  Join Date: Jan 2007 Location: Cuero, South Texas
Posts: 524
Weight Statistics May 1, 2007 Start Date:
June 25, 2007 Surgery Date:
Height: 270 lb Start Weight:
200 lb Current Weight:
130 lb Goal Weight:
70 lb Weight Loss:
70 lb Lb Left to Lose:
25.9259259259 % % Lost:
June 25, 2008 Goal Date:
Body Mass Index 45.83 BMI Start:
35.2 BMI Current:
22.31 BMI Goal:
Weight Loss Method Roux en Y Gastric Bypass | My Dr. also seems to think for anything besides the surgery and healing I should see my PCP. Like for my diabetes and high blood pressure etc. Anyway that is what I do. He told me today I do not need to come back for 2 months also. BUT I am taking B-12 sublingual tablets that I get at Walgreens. He never mentioned having to take shots but when I have labs if it is too low they may give me one. My nutritionist also told me to use these tablets. Hope this helps. Mattie
__________________ Grandiose16 Don't let today's disappointments cast a shadow on tomorrow's dreams.   |
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07-24-2007, 08:31 PM
| #5 (permalink) |
| Seasoned Veteran Join Date: Apr 2007 Location: Mount Vernon, NY
Posts: 7,296
Weight Statistics 4/1/07 Start Date:
4/19/07 Surgery Date:
5' 9" Height: 258 lb Start Weight:
146 lb Current Weight:
165 lb Goal Weight:
112 lb Weight Loss:
-19 lb Lb Left to Lose:
43.4108527132 % % Lost:
04/19/2008 Goal Date:
Body Mass Index 38.0957781979 BMI Start:
21.5580760344 BMI Current:
24.36357908 BMI Goal:
Weight Loss Method Roux en Y Gastric Bypass | yep. i was using the tablets ever since my first day home and they werent cutting it. after about 2 months post op i had a BAD bout of tiredness. so i went to my pcp on the advice of my surgeon, and my PCP started me on the shots stating i wasnt absorping the tablets properly. and now he's the one who is denying me LOL! go figure.
__________________ Anything worth having is worth working for Kenya R. Lap RNY 4/19/07 |
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07-24-2007, 11:07 PM
| #6 (permalink) |
| WLS Master Guru  Join Date: Jan 2006 Location: Oklahoma City, Okla USA
Posts: 762
Blog Entries: 46 Weight Statistics 05/17/02 Start Date:
05/17/02 Surgery Date:
5' 5" Height: 355 lb Start Weight:
192 lb Current Weight:
175 lb Goal Weight:
163 lb Weight Loss:
17 lb Lb Left to Lose:
45.9154929577 % % Lost:
may 2008 Goal Date:
Body Mass Index 59.0686390533 BMI Start:
31.9469822485 BMI Current:
29.1183431953 BMI Goal:
Weight Loss Method Roux en Y Gastric Bypass  | there are many places you can go out patient that will give you the b-12 shots and you just pay them for it. PCP's seem to be a lot better about the whole shot issue than the surgeons. Most surgeons seem to do their job,ie:the surgery ...then you are on your own after the 1st year for most of 'em. good luck see ya! on your way..hope you do well! I still remember meeting a friend's surgeon and him saying with disbelief on his face "YOU had this surgery?" I point blank asked him if he saw his patients beyond a year out? of course not...I suggested he might want to begin seeing his patients longer follow up time as they DO continue losing up to and beyond 2 yrs out.. *rolls eyes* good grief! I personally believe in PREVENTION not waiting until your labs are down or you're sick but that is MY way of thinking..I ain't gonna wait until I'm that bad off to then take what? 6-9 mos to get 'well' again? no way Jose.. --bree I
__________________ --BREE open RNY 5/17/2002 -166 lbs(-200 at lowest)  Everything & Anything is possible with Belief in place....WLS changes LIVES  |
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07-25-2007, 03:34 AM
| #7 (permalink) |
| Super Moderator  | VB12 is water soluble, so no, you can't get an overdose, the extra will be excreted out of you. 910 means (if the analysis is done the standard way--there are different ways to analyze, for which the normal ranges will be different) that your VB12 blood level is on the very upper end of the normal range. That's why your PCP said you don't need it for now. Also, you may need to keep in mind that insurance might not cover the VB12 shots if your level is high, so that may be why your PCP refused your shot. Now, one thing that could be tried is, how much will it fall in a month without the shot. That will give you and your PCP a fair idea of how often to go for the shots. For instance, if you are still taking sublingual VB12s, then how high will the level stay without the shots. If the fall is slow, then it may be that one shot every 2 or 3 months is enough. Of course, once the depletion is severe it will take time to bring it up to speed (the same with anything else) so it's important to start supplementing while the level is within normal limits and keep it there. That said. I am thinking that maybe there should be a WLS expertise certified PCP. ASBS (the society of bariatric surgeons) could set up a course of study for PCPs and give them comprehensive info on the various types of WLS surgery, how they work, the differences, the similarities, complications that can happen post op, and what signs to watch for, what things need to be followed up regularly, blood labs etc, the psycholgical, physical, and social issues post ops may encounter and how the PCP should deal with them, medication, referral to specialists, send the post op back to the surgeon, etc. This needn't be something on the level of training in residencies. It can be a study course of a day or two given at a neaby bariatric center. Then the bariatric centers and surgeons can have these PCPs registered with them so if the post op's regular PCP seems uncooperative, the surgeons can refer the patients to such PCPs. This way, with the exploding number of surgeries and the limited number of surgeons resulting in the surgeons haveing their hands full with just the surgery and not much time for long term followup, they still can keep track through these PCPs, and save time all around, for the patients, surgeons and PCPs. Whaddayathink? Off my soap box. 
__________________ "In every job that must be done, there is an element of fun."   Just a li'l bit 'bout myself  Last edited by DocSanae : 07-25-2007 at 03:41 AM. |
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07-25-2007, 04:08 AM
| #8 (permalink) |
| Seasoned Veteran Join Date: Apr 2007 Location: Mount Vernon, NY
Posts: 7,296
Weight Statistics 4/1/07 Start Date:
4/19/07 Surgery Date:
5' 9" Height: 258 lb Start Weight:
146 lb Current Weight:
165 lb Goal Weight:
112 lb Weight Loss:
-19 lb Lb Left to Lose:
43.4108527132 % % Lost:
04/19/2008 Goal Date:
Body Mass Index 38.0957781979 BMI Start:
21.5580760344 BMI Current:
24.36357908 BMI Goal:
Weight Loss Method Roux en Y Gastric Bypass | YESSSSSSS! i agree. and intend to actualy contact my surgeon today to see if he knows someone off hand (PCP) with experience with WLS patients. I just dont want to risk this. Maybe i am being overly concerned NOW but i'd rather be now, than in a pickle later..... the thing about the levels and the insurance is totally understandable. i just thought MAYBE he was alittle less concerned than he should be, and i could be wrong about that. but....i have to look into maintaining the level i am at. I feel great and dont want to get to where i was a month or so ago . I was SOOOOOOOO tired. THANKS DOC
__________________ Anything worth having is worth working for Kenya R. Lap RNY 4/19/07 |
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07-25-2007, 06:06 AM
| #9 (permalink) |
| Seasoned Veteran  Join Date: Jan 2006 Location: SOMEPLACE LONG ISLAND, NY
Posts: 6,756
Weight Statistics June 1, 2005 Start Date:
Height: 310 lb Start Weight:
167 lb Current Weight:
159 lb Goal Weight:
143 lb Weight Loss:
8 lb Lb Left to Lose:
46.1290322581 % % Lost:
Body Mass Index 51 BMI Start:
27 BMI Current:
Weight Loss Method Roux en Y Gastric Bypass | ITS very tought situation. NOT every surgeon requires b12 and b supplements. AND the reason i know my surgeon does require his patients to be on them is all in his technique and the way he reroutes things. VERY tough call but if your surgeon requires it i would think your pcp would give it based on the script from the surgeon. OR have your surgeon prescribe the NASCOBAL and you wouldnt need the PCP to give you any shot. just some thoughts hugs
__________________ LISA  http://w5.photobucket.com/widgets/dy...164/fr1endly2/ LAP RNY Gastric Bypass  |
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07-25-2007, 06:39 AM
| #10 (permalink) |
| Seasoned Veteran Join Date: Apr 2007 Location: Mount Vernon, NY
Posts: 7,296
Weight Statistics 4/1/07 Start Date:
4/19/07 Surgery Date:
5' 9" Height: 258 lb Start Weight:
146 lb Current Weight:
165 lb Goal Weight:
112 lb Weight Loss:
-19 lb Lb Left to Lose:
43.4108527132 % % Lost:
04/19/2008 Goal Date:
Body Mass Index 38.0957781979 BMI Start:
21.5580760344 BMI Current:
24.36357908 BMI Goal:
Weight Loss Method Roux en Y Gastric Bypass | my surgeon doesnt require the shot specifically, but he does require b12 and iw asnt getting results with the sublinguals....as for the nasal spray i am a little hesitant to move forward with that only because i have/had asthma and i dont like to inhale things. it might be a viable alternative though... and DOC i was thinking on the drive in to work: even if my PCP is concerned that insurance wont cover it because my levels are "normal", shouldnt it STILL be offered to me to pay for out of pocket? im just a little uncomfortable about this. if he is going to be giving me resistance this early on i cant imagine him cooperating further out....just a thought.
__________________ Anything worth having is worth working for Kenya R. Lap RNY 4/19/07 |
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