BigDrew

I'm a physician assistant who had orthostasis for the first two years or so (now 4 yrs out), now just occasional. I've looked into this as much as possible and never found a good answer. One issue is the studies that evaluated adverse effects of surgery didn't include this issue in their outcomes, so there is essentially no data. I have looked for case reports, etc. but found very little, certainly nothing that made sense. My surgeon had no idea. At one point, they thought I might have a pituitary tumor because one of the hormone levels was elevated, but it turned out to be elevated BECAUSE of the low blood pressure, which is what is supposed to happen. The last time I saw my internist my BP was 84/62, and I felt "a little" dizzy here and there that day. Generally it runs in the 90s.
The way I've come to think of it is that there is "something" that leads obese people to be more likely to have hypertension. But when I was obese, my BP was normal. Now that obesity is absent, whatever "factor" that pushed my BP into the normal range is gone, leading to low BP. I read food labels looking for the MOST salt in a given item rather than the least. That has been helpful for me. I wish I had a better answer. Good luck!

Make sure you guys are getting ferritin levels checked, and not just depending on your RBCs and hemoglobin to make sure your Iron is ok. Mine were on the edge, but still normal when my doctor ran ferritin levels and my iron was VERY low. This can cause fatigue and a host of other symptoms.
And yep, I take my iron like I'm supposed to.....but managed to get iron deficiency without anemia anyway... because I donate blood a lot, still menstruate, and eat a mostly vegan diet.
Anyone suffereing low BP, fatigue, lack of stamina....get the full iron panel. Since I've been taking more iron and watching my diet, quit donating so much blood....my stamina is off the chart...terrific energy...and my hair is amazing.

i'm at two years and have noticed a lack of energy. In my case, I think it's the fact that I'm still not physically fit, although I'm quite slim. I had hoped to join a gym and start a regular fitness routine when I reached maintenance, but COVID had other plans. That will be my next goal.

Though not quite as far out as you, I still have issues with energy & low blood pressure.
I seem to feel weary more quickly than I did before surgery. And no it’s not a lack of fitness weary. I’ll be out doing chores or something & than suddenly think, nope had enough. Can’t do anything else at the moment. It’s hard to describe how it feels. It’s certainly not debilitating. I’m not puffing. My heart’s not pounding. Just feel weak. Sometimes just sitting for 5/10 minutes is enough & I’m right to go again. Is this how you feel?
The postural low blood pressure is just something I live with though it’s probably not quite as bad as it was. Maybe a 25% improvement in the last couple of months. I’ve always had a tendency to low blood pressure & when I’ve been slim before (in the 60kg range) I would have the vision loss & slight light headedness on standing a few times a month versus the several times a day I have it now. My GP prescribed a medication for low blood pressure but it did not help at all. I do all the sit up & stand slowly & wait before walking but it doesn’t really help. I sometimes bend over so my head is below my heart. Friend the deep breathing thing too but they don’t really help either. I just make sure I have a wall or furniture I can grab when it hits so I can ground myself. I’ve also be known to grab onto friends - in a non sexual way of course lol!
Hope someone has some ideas too.

According to the internet:
Nausea and vomiting are the most common complaints after bariatric surgery, and they are typically associated with inappropriate diet and noncompliance with a gastroplasty diet (ie, eat undisturbed, chew meticulously, never drink with meals, and wait 2 hours before drinking after solid food is consumed). If these symptoms are associated with epigastric pain, significant dehydration, or not explained by dietary indiscretions, an alternative diagnosis must be explored. One of the most common complications causing nausea and vomiting in gastric bypass patients is anastomotic ulcers, with and without stomal stenosis. Ulceration or stenosis at the gastrojejunostomy of the gastric bypass has a reported incidence of 3% to 20%. Although no unifying explanation for the etiology of anastomotic ulcers exists, most experts agree that the pathogenesis is likely multifactorial. These ulcers are thought to be due to a combination of preserved acid secretion in the pouch, tension from the Roux limb, ischemia from the operation, nonsteroidal anti-inflammatory drug (NSAID) use, and perhaps Helicobacter pylori infection. Evidence suggests that little acid is secreted in the gastric bypass pouch; however, staple line dehiscence may lead to excessive acid bathing of the anastomosis. Treatment for both marginal ulcers and stomal ulcers should include avoidance of NSAIDs, antisecretory therapy with proton-pump inhibitors, and/or sucralfate. In addition, H pylori infection should be identified and treated, if present.
Since you are taking Prilosec, you are taking a proton-pump inhibitor. That leaves a couple more items to check.
Around 50% of the world's population have H pylori infection, so it is fairly a common bug and a hard one to kill.

Tincture of time. I'd give it a while before panicking that you Have Something New. (You do; you have a new tummy and all your innards are cranky.) You were probably intubated during your procedure, and your poor esophagus got yanked around. I'm a week out, and mine is getting much better. Teeny sips, and hang in there!

Take small sips if you still get spasm, ask your surgeon for a swallow test, I have achalasia type lll, same symptoms my surgeon had to cut several muscles in my esophagus to relieve the spasms best of luck!

Sent from my SM-G955U using BariatricPal mobile app

Try drinking your fluids a little warm, this can sooth a cranky esophagus. Avoid anything cold or iced...as this will sometimes cause spasms.

Sweats or pj pants.
Some comfy slippers!
Your own pillow (both for your overnights and for the ride home)
Cell phone, charger with extra long cable.
Lip Balm and Dry Mouth Spray (these were so freaking helpful, they made the start of my recovery so much more pleasant!)

I didn't use anything else. I brought a book and never touched it. Change of clothes stayed in the bag.

Just a tiny warning: too much sugar free candy has a laxative effect. And wouldn't help as much with your dry mouth as Biotene, or at least that's what almost everyone says.😝🙏Best Wishes for your surgery

My own pillow - hold against my stomach for the ride home, chapstick, biotene mouth swabs, loose workout pants, my sneakers (instead of slippers), decaf/herbal tea bags - tastes better than plain Water, cell phone and charger, underwear and Shampoo, deodorant, toothbrush/paste, hair ties/hairbrush.

Headphones!

Someone told me to bring sugar free mints or other hard candy. Wonder if that’s ok.

I purchased cetaphile face wash wipes & body wipes. Wasn’t allowed to take a shower while at hospital (some are, but I was only there overnight) and I HATE feeling dirty or unkempt so these were good for me until I got home. Didn’t wanna log around face wash, moisturizer etc.
packing light is key

oh! I also brought my own slippers from home because I hate the anti-slip socks. They always bunch up

Lounge pants! You want something to put on your butt under your hospital gown that you feel comfortable roaming the halls in. Lounge pants (pajama bottoms) with a loose waist...comfy and affords you a little modesty getting your walking in the halls done.

Chapstick! Your dry lips will thank you.