longterm nutritional problems

Question
QUESTION: RNY, 6/03. Leaks, infections and ulcers, multiple hospitalizations in the 90 days postop. NOW, Vit D is 8 on 50,000 units 1x weekly. Serum calcium 9.4, BUT bone densityis bad. Spine T is -4.7 PTH is 74.9 so I can't take Forteo. Ive had multiple fractures and now am having pain in my upper LEFT quadrant.  I thought I probably had adhesions or maybe a hernia-- it's the same place all the longterm postop pain was.  It's getting to be a constant persistant ache with a big increase in the pain level after I try to eat and even drink and it radiates around my waist to my back now. It's getting worse. I no longer accept the adhesions or hernia theory.  I think I'm sick and because I'm uninsured, good help is impossible to find. My vit A is abnormal as is Vit D, B12 is elevated for a change and I haven't had a shot since March 2008. I'm having labs tomorrow and added lipase and amylase to the list...any suggestions. Thank you very much for your time.  I really need help.

ANSWER: Terry,

Do you have a bariatric surgeon who is helping with your care?  Even if you are uninsured, your surgeon should want to try to find a way to help you.

Bone loss can be very serious.  I would also look at an albumen/prealbumen level, and perhaps at zinc.

But mostly, I want to encourage you to call the person who did your surgery, explain your situation and ask for their help in your care.  Even if you have not followed up with your surgeon in many years, he/she has a strong interest in making sure that your are successful long-term.

If your surgeon has retired or is not near you, let me know where you are and I can try to get you a local name.

In Health,

Dr. Jacques

---------- FOLLOW-UP ----------

QUESTION: Thank you so much for your response!! My surgeon and I ended our relationship after 90 days of back and forth to the hospital with no end in site in the immediate post op phase of this mess.  I know I need an endocrinologist but have been unable to find one that takes cash paying pts. I'm located in Ocean County NJ.  I did find an internist named Michael Rothkopf who specializes in 'metabolic nutrition" and have an appt on 6/22, but I have to cancel as it's 50+ miles from me and I have no way to get there. If there is anyone who you feel could and is willing to help me, I'd appreciate it. My home number is .  THANK YOU SO MUCH!  Terry

Answer
Terry,

This is the list of surgeons who are closest to you.  Anyone who has Centers of Excellence by their name is at a location that takes Medicare, which might be a better place for you to start.

I don't know this area of the country well enough to know who would be closest to you - but this is where I would start.  

I think it is important to see a bariatric surgeon because you may have a surgical issue and a good program will have all the other health professionals who can assist in your care.

Please let me know if I can provide additional information.

In Health.

Dr. Jacques

# Morris J. Washington MD
Regular Member
Surgeries Performed:
LGBPLBREV
Freehold NJ USA
(732) 761-1740
About: 25 miles

# Ragui W. Sadek MD
Regular Member
Surgeries Performed:
LGBPOGBPLBPEDREVFOLLGBP
Freehold NJ USA
(732) 761-1740
About: 25 miles

# Christopher J. Boynton MD
Regular Member
Surgeries Performed:
LGBPGBP
Mt. Holly NJ USA
(609) 267-7050
About: 29 miles

# Earl L. Noyan MD
Regular Member
Surgeries Performed:
LGBPLBGBPDGBPREVFOLL
Trenton NJ USA
(609) 585-2447
About: 32 miles

# David F. Greenbaum MD (Centers of Excellence)
Regular Member
Surgeries Performed:
LGBPDGBPOGBPBPD/DSOGRLBPD/DSREVFOLLVBGSRG
Willingboro NJ USA
(609) 877-1737
About: 34 miles

# Frank J. Borao MD
Regular Member
Surgeries Performed:
LGBPLBOGBPGBBGBREV
Shrewsbury NJ USA
(732) 389-1331
About: 34 miles

# Samuel H. Wasser MD (Centers of Excellence)
Regular Member
Surgeries Performed:
LGBPLBGBPOGR
Willingboro NJ USA
(609) 877-1737
About: 34 miles

# Richard D. Ing MD (Centers of Excellence)
Regular Member
Surgeries Performed:
LGBPDGBPOGBPLBOGRGBREVFOLLGBP
Willingboro NJ USA
(609) 877-1737
About: 34 miles

# Louis G. Fares II MD
Regular Member
Surgeries Performed:
LGBPLBREVFOLLGBP
Hamilton NJ USA
(609) 585-1400
About: 34 miles

# Adam S. Goldstein DO
Regular Member
Surgeries Performed:
LB
Voorhees NJ USA
(856) 596-7440
About: 35 miles

# Robert E. Brolin MD (Centers of Excellence)
Regular Member
Surgeries Performed:
LGBPGBPDGBPOGBPREVFOLLPED
Plainsboro NJ USA
(609) 785-5870
About: 36 miles

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