Nephrology

[Guest]

I am a post-op gastric bypass patient, who prior to surgery had few health related problems, such as insulin resistance, bipolar, ADD, and insomnia. Prior to surgery I had an EKG that showed inverted T waves and that was followed by a Dobutamine Stress Test in which the cardiologist stated he did see some inverted T waves, but only on respiration and I was cleared for the surgery. Upon my 3 month blood test (CBC, CMP) I was found to have hypokalemia level of 2.4 and immediately taken to the ER for Potassium IV. I have never displayed any of the symptoms asssociated with hypokalemia, but was placed on 25meq effervescent potassium supplement 2x per day. Since then it's a weekly roller coaster ride as to where my potassium level will be. My nephrologist cannot provide an explanation as to what is causing this problem other than poor absorbtion and he would like to take a wait and see attitude for the next 6 months. This has already been going on for over 9 months. All blood work comes back showing normal kidney functions, but the potassium always remains low unless I increase it to 25meq 4x per day, then i reached 4.5. He advised to reduce back to 2x per day and I'm back under 3.3. My concern is was this a pre-existing condition as indicated by the inverted T waves on the EKG and echo and exacerbated by the bypass surgery or is something else causing the problems. I continue to get a CMP and Mag draw every week (I currently take 400mg Mag-Oxide 2x daily). The current medications I am on are Celexa (depression/bipolar), Ritalin SR (ADD), Mag-Oxide 400mgx2 (hypomagnesia- it's running 1.6 to 1.8), Klonopin (Anxiety), Depakote (bipolar), Serax (sleep) and a multi-vitamin with iron. I also drink a lot of Orange Juice and potassium rich foods.

I am very frustrated at the sense of urgency my Dr is displaying and have been advised that I should perhaps seek a second opinion from Mayo Clinic.

Thanks in advance for your guidance.
What would your recommendations/suggestions be for cause or proceeding forward.