Wednesday, September 5, 2018

Pumping That Iron!

Let’s talk about heavy metal! And no, I don’t mean bands like Metallica!

We are officially well over the two year post total gastrectomy mark. When we first started planning to have our surgery in the spring of 2016 we asked numerous times about vitamins and minerals that we would or wouldn’t be able to absorb with our new anatomy. We were told by our medical team that B12 would be the only vitamin we’d never be able to fully absorb. No problem, we take a shot on a regular basis and bing, bang, boom, B12 levels stay up. One thing no one ever mentioned or prepared us for was that with a roux en y reconstruction comes an increase in the chance of iron deficient anemia.

If you have followed our story then you know we like to do things together, even subconsciously. Over the spring and summer we both started experiencing extreme fatigue. For the most part we passed it off as just a side effect of our busy lives working, chasing kids, and being involved in a million different things. Then we started having headaches, leg cramps, dizzy spells and a love for munching ice. Something was up, but we still didn’t worry much about it. Then within a few weeks of each other we had our 6 month labs to monitor certain markers. Both of our Ferritin levels (the measure of the bodies iron stores) had absolutely plummeted. The hematologist told us they like to see a number over 50, Nicole was 8 and I was 3. The nurse practitioner made the comment to me “I bet you feel like crap.” Why yes, now that you mention it, I do feel like crap. Thankfully the hematology team didn’t play around and we both did two infusions over the course of a week of an iron product called Injectafer and we’ve both felt much better since shortly after the second infusion. Now the plan is to check those iron levels every 6 weeks or so and when we see them start to fall we’ll do another round of iron infusions.

So the point of this blog post is really for our fellow “TG’ers” or those getting ready for a gastrectomy. Apparently iron deficient anemia is very common after a total gastrectomy with roux en y reconstruction. I’m not very anatomy savvy, but here’s my basic understanding: iron is primarily absorbed in the duodenum (the first part of the small intestine immediately past the stomach). With the roux en y reconstruction the duodenum is rerouted and food bypasses that area. There is secondary absorption of iron that takes place further down the small intestine, but it’s just that, secondary absorption, you’re not getting the same full effect as if it were being absorbed in the duodenum. Your body stores up iron and you usually have about a two year store, hence why ours crashed when it did. The way the hematologist explained it, we could pop all the supplements we wanted but our bodies would never absorb enough of the iron to maintain us.

So stay on top of those routine labs, listen to your body, if something feels off talk to your doctor. Luckily there is an easy fix for iron deficient anemia, iron infusions are quick, simple, and offer relief pretty fast.

So that’s our PSA for now on keeping a check on your iron. We will try to do better with our blogging as we do have some exciting things coming up! As always, thank you for all the love, support and prayers that have been poured out on us during this crazy journey. We are thriving in this stomachless life and we owe it all to God’s grace and the unending support of family and friends.

Much Love,
Jessica & Nicole

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