Trouble with malnutrition

[Amanda-Cleckner 6]

I had the sleeve surgery 9/26/16 and did well with it till I had my gallbladder removed in 2018 then I developed severe gastric reflux. My surgeon found that my bile duct got stuck open after they removed my gallbladder. With the bile constantly running in my sleeve it eroded it causing some precancerous changes. Once my insurance approved for a second surgery we went with changing over to a bypass in June of 2020 to fix the problem. I was very happy that we ended up doing the revision because I no longer had to sleep sitting up and my stalled weight loss finally started back up again and I was able to continue my weight loss journey. Fast forward to the present of this year I have been holding a good weight of between 137 to 145 lbs and no health issues really I just still struggled with dumping a lot cause my new pouch didn't always like food but I maintain weight with the help of shakes. Then in August of this year for some reason I just started getting where I didn't feel well and I dropped like 17 lb like it was nothing. I contacted my surgeon because I was concerned because of how weak and tired I had felt and I've noticed like vision changes my muscles or shrinking rapidly I was becoming dehydrated and all kinds of new things that I wasn't prepared for. My surgeon ordered a upper scope and a lower which come back very good. My lab showed that I did have a couple Vitamin deficiencies so I increased my Vitamins I actually have to go redo my labs here because I also ended up getting sick and went in the ER in my liver counts were high and they never been high before so we're checking those this week. But now I'm having a harder time eating and getting my body to absorb my nutrition even the Protein Shakes aren't helping maintain my body weight I am dropping weight still pretty rapidly I'm down to 124 lb now and my immune system seems to have been weakened because I get sick super easy and I try to stay away from other people otherwise that makes it harder on me and I guess get wiped out. I am currently waiting for my surgeon to call me back because I'm getting more concerned about how we come getting it's getting harder to do every daily things such as washing my hair folding my clothes and putting them away my muscles hurt and they're tired and weak and they get all cramped up. I'm blessed to have this surgery but I was never expecting that I would get this new very weird complication of just not being able to eat very well and to maintain weight. I trust my surgery team he's wonderful I'm hoping they can figure this out I'd really do not want a feeding tube or a PICC line I work with the public and that's even getting hard to do and I've almost thought about applying for disability until I get this figured out so I can quit losing weight by exertion. I'm just wondering is anybody else going through something like this or they just out of nowhere started losing weight again and they just can't seem to get it to stop. I'm worried not only for myself but for my family because my kids are still pretty young and I'm not ready to leave this world yet I still have a lot to live for.

Hw: 268

SW 221lbs

LW 124lns

Height 5'2

[Hope4NewMe 167]

I have no experience but just wanted to say that I hope that they figure things out for you soon. It sounds like a horrible situation to be in. Hugs!

[Amanda-Cleckner 6]

Thank you I hope they figure it out too I am just trying to stay positive.

[ms.sss 14,679]

im assuming they checked when they did ur labs, but putting it out there just in case: thyroid issues?

[Amanda-Cleckner 6]

Ya they said everything looked good other than Vitamin A and B12 deficiency and my Protein levels where low. But I'm doing a repeat this week to check them and my liver counts since they were elevated.

[Jdymitc 43]

I had issues similar to yours where I started with a sleeve in 7/2020 my body started going through severe issues that I couldn’t even hold down a sip of Water causing me to vomit uncontrollably in the end of 8/2020 I went to use my restroom and I collapsed. My surgical team had me enter a rehab to try and help me build up my strength and put in a PICC line. I was in the rehab for 6 weeks and the team started to work with my insurance and got permission for a revision to a bypass.(my brain started to have issues with retaining short term memories due to lack of nutrition) Had the revision to bypass done in 3/2021 My body took forever to start to regulate and start to work the way it is supposed to. I pushed myself to do as much work with my brain to get back to “normal “ as much as possible and I’d say I am about 90% recovered. Physically I’m back to “normal” most days occasionally I’ll still have a nauseous day or some dumping but I was just at my dr last week and I am down just shy of 200lbs

stay strong you will get through this

Family members ask me if I could rewind time if I’d still go through with the surgery and I say I may have opted for the bypass instead of the sleeve but absolutely because if I didn’t get that weight off I know without a doubt I’d be dead within a few years so even with all these issues the surgery was worth it.

[Amanda-Cleckner 6]

Thank you for sharing your story with me it gives me hope that I can get better.

[Arabesque 6,480]

Have to admit I wondered thyroid too. Gall removal can cause malabsorption issues which would add to those associated with your bypass. I struggle absorbing Protein & one med since my gall was removed. And my energy is lower than it was before the gall surgery 2.5yrs ago. My labs come back really well too (except the protein which vacillates between 58-61 so barely ok & that’s with meds to help).

Also going through a hungry not hungry phase at the moment. Usually this last for a meal or a day or two except this time it’s been 6 or more weeks. Dropped a meal & a snack (now 3 meals & 2 snacks) cause don’t want to eat them. I am concerned as my protein intake is lower as a result. Have lost about a kilogram (2lbs) which puts me back at my lowest weight (48.4kg/about 106lbs yesterday). Not as much as you but … Hoping Christmas will sort it out as I might be tempted to eat a little more again. If it continues I’ll be calling the doctor who does my post sleeve surgery checks. She wasn’t happy 18 days ago at my last appointment when I was 49kg. (She prefers me in the 49/50kg range.)

Wonder if it a combination of things with not one single thing being really out of sync or not functioning correctly is what’s happening?? Our bodies are complex & maybe yours needs some fine tuning. I hope they find some answers for you soon.

All the best.

[Amanda-Cleckner 6]

Thank you. I hope your able to eat more and maintain a healthy weight as well. I never thought I would have a problem gaining weight, but it's a real thing now and kinda scary.

[learn2cook 492]

I’m stumped but wish you the best and an easy solution!

[Amanda-Cleckner 6]

Thank you.

[ms.sss 14,679]

22 hours ago, Amanda-Cleckner said:

Then in August of this year for some reason I just started getting where I didn't feel well and I dropped like 17 lb like it was nothing.

i re-read your initial post, and picked up on this line that i missed the first time...

are you saying you lost 17 lbs (from a weight of 137-145) in one month?

i.e., you ended up weighing 120-128 at the end of said month?

[Amanda-Cleckner 6]

Yes without even trying it just fell off and I became weak and I am still struggling with extreme fatigue and weakness my muscles have wasted away I will have to post a picture of when I was 145 and weight training last year to me dropping that weight now looks like my muscle just vanished.

[ChunkCat 674]

I don't know how common this is with Bypass, but it sometimes happens with patients who have the Duodenal Switch because the level of malabsorption from the surgery is significantly more than with the Bypass. It usually happens a few years out because that's how long it takes to deplete the body of its stores. That's why we have to have lab work done frequently to monitor our Vitamin levels and Protein levels. Some patients end up malnourished when their vitamin levels drop too low or their protein levels drop too low.

There are medications they can prescribe to help you better absorb protein but I can't remember what it is called, it is a digestive enzyme of some sort. A GI doctor would know what it is, your surgeon might know too. The liver is very sensitive and things getting out of whack can definitely cause it to be angry. I hope they do more testing and figure out what is going on...

You have probably lost muscle mass as your body takes protein from your muscles to compensate from the depleted protein levels. Try Protein Shakes and protein waters that are made with whey protein isolate. It is the easiest form to absorb and it will help your protein levels go up. This is what DS patients are advised to consume, most premade shakes will be made with inferior types of whey that may not help your protein levels. Unjury makes some good ones, Syntrax is another brand that makes medical grade whey protein isolate. There are a number of them around!

[ms.sss 14,679]

On 12/8/2023 at 11:39 AM, Amanda-Cleckner said:

Yes without even trying it just fell off and I became weak and I am still struggling with extreme fatigue and weakness my muscles have wasted away I will have to post a picture of when I was 145 and weight training last year to me dropping that weight now looks like my muscle just vanished.

17 lbs in one month at your weight this far out i think is not the norm. have you lost further weight since august? i.e., what do u weigh now?

aside: we are roughly the same stats (tho im 5+ yrs out) and while i have been known to drop 5 lbs unwittingly in a month, i've never experienced a 17 lbs drop in a single month since way back in my 1st or 2nd month post op...but i weighed over 200 lbs back then)

hopefully your doc/team has some answers for u now?

❤️

also: are you eating enough calories to maintain your weight, do u know? i have found that i need to eat alot of low volume, high calorie stuff to meet my caloric maintenance needs (and yes, often times this includes items not necessarily on a "healthy" food diet)

Edited December 17, 2023 by ms.sss