Evenkeel

Almost 9 months post-op and I'm well below goal weight. I continue to lose 1-2 pounds a week and am right on the edge of underweight. I saw my surgeon on Friday and he said that as long as I feel okay and he doesn't think I'm anorexic then I just need to "stop losing weight" and everything will be okay. See you in July. *sigh* I'm tired of being told I'm too skinny, that I need to eat, that I need to stop losing weight. Believe me, I'm trying. At this point, if I gained 10 pounds I would be happy. My capacity is okay but dumping is an issue with fats and sugars. Insurance won't pay for acarbose. I pack in as much Protein and good fats as I can every day but I can still only hit 750-ish calories daily on average. If I eat more animal protein then I can't take in as many calories that day because I just don't digest fast enough, even with drinking lots of fluids between meals to "coax" it through. Protein shakes are an absolute no-go. I have to take in some carbs or I have issues with hypoglycemia. If it were possible to eat nothing but bacon and ice cream to just maintain then I'd do it. I also just got a job on my feet and am supposed to exercise to help protect my muscle but that means even more calories burned to compensate for. Help!

Did anyone reach a "normal" weight around six months, or at least during the "honeymoon" period after surgery? How much more did you lose, and how long did it take for your weight to stabilize? I hit my goal weight last Friday, which is also a "normal" weight for my height, and due to ongoing issues I'm concerned about becoming underweight before stabilizing. My surgeon just told me "we've never had anyone lose too much weight even though we rarely have people lose all of their excess weight, you're still in the honeymoon phase, your body will stabilize eventually." Okay, fine. Then I step on the scale this morning and find I've lost 3 pounds since Friday. I lost 3 pounds last week, too. Argh.

I'm a few days shy of five months post-op and down 87 pounds. I'm 18 pounds from the top end of a "normal" BMI at 150. I'm still losing at a rate of 2-4 pounds a week, so if I keep following my current average trend I'll be there in six weeks. I met with a nutritionist who is quite alarmed at the amount of the loss and the potential for my food tolerance issues to not only keep it going but potentially cause damage to my heart muscle if it hasn't all ready. She readily admitted that she doesn't have much experience with gastric bypass patients but still thought it seems abnormal. She also said that 130 pounds would be the point at which action would absolutely need to be taken if I keep going at the rate I'm going but she'd really rather see something hapoen sooner than later. So, any thoughts? Is she being overly cautious? Should I be proactive or would I be wasting my time?

One stall at three weeks for one week. I should call my surgeon but through all of my issues all he's said is "You're doing great! I think you're going to be one of the lucky ones to lose all of your excess weight." and shrug his shoulders otherwise. Let's say I'm not optimistic he'll be helpful.

That's part of my problem. Due to food intolerances and other as-yet-undiagnosed gut issues not related to surgery it's nearly impossible to get 70 grams of protein or anywhere near a decent number of calories a day. I also can't tolerate shakes of any kind. My digestive system, especially my stomach and first part of my intestines, just doesn't cooperate. Exercise is therefore an issue because I burn calories I can ill afford to lose. I do it, but then I lose even more weight that week. Vitamins are fine and I try my hardest to get my fluids but pushing those then interferes with eating. Getting to somewhere between 130 and 150 and leveling off would be perfect. Plateauing at 7 months would still be okay for me. Thanks for your reply!

I was floating along just fine until last Thursday, which was three weeks post-op. That day I had horrible upper and lower abdominal pain all day. I had terrible gas and six bowel movements, which got looser as the day went along, ending in yellow diarrhea. Friday it was better but by day's end it was back to horrible pain and yellow diarrhea again. Middle of the night I woke up in pain so bad I thought I was going to pass out, had another bowel movement, and it eventually passed. Saturday morning I called my surgeon, was told to just do fluids that day, and if it didn't get better to go to the ER. The pain was better all day but still had a BM that evening, same thing. This morning I woke up nauseous and in pain, took my morning meds and felt gaggy just swallowing Water. A half hour later I had a similar BM and decided it was time to go the ER. They did blood work and a contrast CT and said everything was normal. I'm supposed to be having an upper endoscopy tomorrow to check for a stricture but my surgeon (who did see me in the ER) isn't sure that's the issue with all of the symptoms that I'm having. The upper pain is on the left below my ribs, center under my sternum, and right below my ribs straight through to my back. The lower abdominal pain is crampy and all over. The upper pain comes and goes and is worse when I eat or drink, though it does happen even when I'm not. It's sharp/stabby and crampy/dull/burning. No fever or vomiting. The only pain when pressing on my abdomen is on the left side. Does this sound familiar to anyone? I'm at my wit's end. I can't eat or drink anything at this point without massive pain and nausea. The thought of anything besides water turns my stomach. I don't know what will happen if they don't find a stricture. I hadn't even progressed much as far as diet. The day before the symptoms started I tried scrambled eggs, which sat fine in my stomach. I've been off of surgical pain meds since five days post op, was walking miles every day, had loads of energy and was doing fine. My incisions are totally healed. I'm totally stumped.

It's still early in the process for you. Any protein is better than nothing so don't beat yourself up too much. Try a different kind of shake, maybe. I really liked Isopure because they are thin like milk and taste great. If you make them with milk of some type then that packs in the protein even more when you can only get little bits down at a time. They also make an unflavored powder you can add to stuff, but it's not completely tasteless (at least to me) so it's better when added to applesauce or things like that. Maybe that would open up some possibilites for you.

It will get better. Don't push too hard with food. Protein shakes are okay, too, while you're healing. Vitamins are very important, too, since deficiencies can cause more pain and many fibro people are all ready borderline or deficient in one or more micronutrient anyway. Do you take muscle relaxers? I found those were also very helpful for stomach cramping and pain in my topmost incision, and my surgeon had said ahead of time that it probably would.

No HIDA scan, but ultrasounds and a CT scan at different times have showed a normal gallbladder. This is more of a dull/crampy and deep pain that is either just in in the middle or all the way across under my ribcage.

He suggested genetic testing for celiac even after asking if gluten-containing food caused me issues and me telling him no, and then said that even if the testing showed I carried the gene it didn't mean I had it. :/ I asked what the IgA result was, knowing that if it was normal then there was no point in doing genetic testing. When he saw it was normal he said there was no point in doing the genetic testing. *sigh* He said again he has no clue and that he could follow up again in three months if I wanted him to. I declined, and he said I could come back if needed. Basically, back to square one.

No resolution yet. I had a very frustrating visit with a gastro, who said "if it'/ not celiac then I don't know what it is." I was tested for celiac, which was negative. My follow-up is today. He did an IgA along with the celiac panel and I don't know that result. That might give an additional clue. I think the rheumatologist is my next stop, though.

I'm about 3 1/2 months out from RNY. I lost 7 lbs last week. My pattern seems to be 2-3 lbs down one week and 3-5 lbs the next, but last week is a new record for me since the first month after surgery. I'm 13.5 from my goal and 33.5 from a "healthy" BMI just under 25% so I can certainly afford to lose a bunch more. I'm just wondering when the rapid loss generally starts to taper off because I'm concerned about the RNY weight loss masking some other health issue that also causes weight loss. Yes, I and my doctors do have reason to suspect something else, and I was symptomatic last week. Thanks for any input!

I'm not sure who your comment was directed at, Inner Surfer Girl? I'm not having an issue with a stall, have not in fact had one since week three.

I'm just wondering if anyone else took topamax before surgery for reasons other than weight loss and what your experience was continuing it after surgery. I was taking topamax before surgery (75mg daily) for weight loss, depression, and fibro pain. I've been having GI issues with a lot of nausea and extreme anorexia for the last few weeks, to the point where the idea of almost all foods turns my stomach. My surgeon thinks it might be a good idea to see about reducing the topamax because I've lost 70 pounds since it was originally prescribed. He's hoping that that would reduce any appetite suppression it might be doing. I agree but I'm afraid of a reduction in control of my depression and pain. I have an appointment with my doctor but wanted to see what others might have experienced.

I've had other GI issues since surgery and maybe that's to blame but I thought I'd ask here first. This morning I sat down to eat something I've eaten successfully many times before and as soon as I went to swallow the first bite my body immediately "nope!"-ed with nausea and burning in my esophagus/throat. I waited a minute for it to settle, attempted another bite, and it happened again, only worse. I fought the urge to vomit and had to throw the rest out. Taking a bite of something and getting nauseous happens once in a while but today is a new extreme. Is this common to be happening still at 8 weeks out?

I've seen rheumatologists before for other chronic pain issues but not for this. It would take forever to get into one, the last time took over six months, and I know for a fact that the ones here in town wouldn't entertain an EDS diagnosis. They'd want to send me to a geneticist and the wait list is two years long. My concern with the celiac thing is if I haven't been exposed to it for a few months, why would I be showing symptoms now? I've read many studies now where it does happen that celiac "activates" after major surgery and mimics gallbladder symptoms but the gluten component is missing. He also didn't say whether the villi were flattened. I tried cheese this weekend and confirmed that milk is an absolute no-go but it didn't cause as much of the gallbladder-y pain, just stomach and gas pain. I wonder if the GI doc will do some allergy and gluten testing anyway. Gluten seems to be in everything, so it's possible I was exposed without knowing it. I've had a chronically elevated SED rate for a few years now, slightly so, that the last rheumy blamed on being overweight after testing for inflammatory processes came back negative (his words.) Looking at autoimmune possibilities, lupus and spondylosis seem to fit the bill looking at the big picture, with Sjogren's a distant third. I've been tested for ankylosing spondylitis in the past based on chronic pain symptoms and was negative but now I see only 30-some% of people actually carry the marker for it. All of that really doesn't matter because the first-line treatments all seem to be the same: prednisone, which I can't have because of the gastric bypass. I asked my surgeon about it when I was in the hospital since he thought it was IBS and he said no because it's a steroidal anti-inflammatory. So yeah, now it's just seeing what the GI doc has to say.

The results of my biopsies came back. The stomach ones were normal. The intestinal ones showed "acute lymphocytic infiltrates consistent with celiac disease." My surgeon said there are a few other markers to look for to be celiac and I don't believe I've ingested any gluten in a few months. It could also indicate something else autoimmune. Now I have to see the gastroenterologist. My surgeon said to keep doing what I'm doing if it works for me. *sigh*

I tried to simplify for the sake of brevity and failed. I forgot to add that I also take escitalopram with the topamax for my depression and fibro pain. My doctor said that in some patients the two work together to control fibro pain and depression, which it apparently does for me. I also get migraines, which we found the topamax controls pretty well at 50 mg. I'm one of the lucky ones that gets several different types, too. I never had much of an appetite before surgery and the topamax killed most of the little I had left. Most of my obesity issues lay in genetics, medications, chronic pain issues leading to little or no exercise, and making really poor food choices when I actually did eat.

Thank you. Sludge is exactly what I'm suspecting and what I'm hoping would show up on a HIDA scan, along with reduced function. I'm just so sick of all this.

I do have my gb. They checked both in the CT and said they were fine. My gb was also fine at my pre-op gb ultrasound. I'm not convinced, though. I have a long history of a set of the same specific reoccurring but long-lasting (four weeks plus) gb-type symptoms with varying vague diagnoses from different doctors. I've never had a HIDA scan, though. My family history is incomplete because I know nothing about my dad's side. My mom's side has no history of gallbladder issues so they look at that, the fact that I have no vomiting, and rule out gallbladder issues with normal CT scans. I also have severe GERD that is controlled by omeprazole. Complicating that, I have fibromyalgia, which several rheumatologists have said is probably secondary to another autoimmune disorder but they haven't found enough information in bloodwork to figure out what it is. I was recently told by another specialist that I likely have Ehlers-Danlos Hypermobility, something that was all ready suspected by my family doctor (who follows me for my fibro and laundry list of other issues) and myself. That can cross-type with other variants of EDS, some of which can cause issues with the digestive system, and that would also explain issues I have with my heart that my mother's side also does not have a history of. My mom's side actually has no history of any of my issues besides obesity. Sooooooooo...yeah. I woke up Thursday feeling a million times better but continue to have issues. The bowel issues are gone but the upper pain is still there. I'm struggling to eat but can stay hydrated. I follow up with my surgeon on Wednesday. If I'm still having issues I'm going to ask for a HIDA scan if he doesn't have his own plan of action. If he has no plan of his own and refuses a scan I will be presenting myself at a higher-level medical system. I can't afford to not be able to take in enough Protein for so long.

I have fibro, DJD in my lower spine, osteoarthritis, lax joints, plus a laundry list of other issues, and am 4 weeks post-op. I mostly had the surgery as a last resort to get whatever relief I could from those issues. I haven't had much time to see any improvement post-surgery. I've lost 70 pounds total since starting the process toward surgery, though, and I've seen some improvement since then so there mit be something to it. I wish you luck!

For anyone interested, my endoscopy was normal. Esophagus, stomach, and upper intestine looked fine. My staple line is still healing. They took biopsies and the results should be available today or tomorrow. I called my surgeon right afterward who said to just stay with Clear liquids, that it's probably a bug and it'll pass. I asked how long I should put up with it since even drinking Water makes me gaggy and puts me in horrible pain. I was told if the pain is too much I should go to the ER. I feel like what they're telling me is that as long as I'm not actually vomiting that I'm meeting their description of "tolerating" fluids and they won't look any further. I now haven't had anything by mouth since midnight Sunday night. I had six BMs yesterday, all brown diarrhea, and two so far today. I'm in more pain today than yesterday and am going back to the ER when my wife gets home from work in a few hours. I will be a very squeaky wheel who won't be ignored. If anything, at this point in healing I cannot afford to not be taking in fluids or Protein.

I'm 10 days post op and my surgeon isn't very helpful as to what my diet should look like. At my follow-up on day 8 he said I could move to a "transitional diet" and gave me a sheet of paper that says I can now eat things like eggs, refried Beans, tuna, chili, reduced fat cheese, anything that can be easily be broken up with a fork. His nurse said I don't have to "do" purees, per se, just to take my time getting to the soft stuff. 60g of Protein, no or low carb, less than 10g of fat per day, 64+ ounces of Water per day, okay. So what could I do here? I've had zero issues getting my fluids in since day one. I've tried unsweetened applesauce, thinned out refried beans, and refried beans with taco sauce (YUM!) with no issues. Are soy products okay, like tofu or meat substitutes? What about barley? As far as chili, I was under the impression that meats were pretty much verboten until the solid or "full" food phase, or am I mistaken? I thought I was prepared but he's really thrown me for a loop. My next follow-up appointment is a month from now.

20160711_123334.jpg20160711_123258.jpgSent from my SM-G935T using the BariatricPal App Thank you! That helps a lot!

Vitamins are sorted. I take a chewable Multivitamin and various supplements, all of which were approved by my surgeon's nurse. For Protein, I have Isopure protein powders I liked before surgery. He started me on Bariatric Advantage shakes post-surgery. I physically couldn't tolerate those at all no matter what I tried because of the texture and developed an aversion to shakes in general. I was able to tolerate an Isopure shake this morning so I'll do that for the foreseeable future. I also have the unflavored that I can add to whatever. Three meals a day? Good to know. I wasn't sure how often we're allowed to eat puree/mushy stuff. I definitely want to avoid dumping, which is part of the reason I chose RNY over sleeve. As long as I have the 3x/day guideline I think I'm comfortable going with a puree/soft hybrid diet. I don't like seafood so that pretty much takes out a lot of the hardest-to-digest bits of the soft stage, if I avoid all other meats until later in the month. I'll give my doc a call about soy stuff and barley. I'll do a shake in the morning and evening, which will give me 50g of protein all on its own. Thanks so much for your help!