Expert: Karla K. - 10/7/2011

Question
I am given infusions approximately every 6 months.  I experience debilitating fatigue before each one and yet my hemoglobin, etc. levels are not low at that time.  It seems that by the time my blood results show that I need an infusion, I am half-dead!!  It effects my life so drastically (sleeping in, tired all the time, brain fog).  I was wondering if there is anything I can do before the infusion to improve my fatigue; instead of just waiting until the blood tests show "it's time."

Answer
Hi Cindy:

It's tough for me to tell what's going on as I'm not sure which surgery you had (RNY, DS, VSG, Lap-Band), what your bloodwork is like, etc., but I'll try. I'm assuming you had either a DS or RNY.  Honestly,  I really think that you need to talk with your surgeon, nutritionist, and hematologist to figure out the best way to address this. They should be working to figure out the problem, rather than just waiting to see you every six months.

I'm going to assume that you're taking your vitamins--and getting comprehensive bloodwork done at least once per year.  You mention your hemoglobin levels, but I wonder what else they're checking. How's your B12? Folate? What about your vitamin D and parathyroid hormone? Etc.  Have they done a reticulocyte count?  These are all things that the hematologist can address.

What does your diet look like? Are you getting enough protein in? Water? Exercise? Honestly, none of those factors would explain the extreme fatigue to the degree you're describing.  They can contribute, but my guess is something else is going on.  I'm sorry that I can't be of more help, but I really think you just need to be the "squeaky" wheel with your hematologist and surgeon until they figure out the problem.

Good luck,
Karla