Need help for my mom!

[Fire_Ice 1]

My mom had gastric bypass a few months ago. Her doctor wanted her to have it because she was Type 2 diabetic and in danger of a lot of other health issues that would be solved by losing weight. She is 69 years old. Things were going well at first - she felt well, she was able to eat as needed, and was losing the weight. She is about 5'5" and I'm not sure about her current weight, but she's lost quite a bit and can now fit into like size large in women's (she was at a 2XL or 3XL before).

But recently she has become very weak and has fallen several times (which is dangerous at her age). She went in to the doctor and they were initially convinced based on scans and blood work that she she had fatty liver that had advanced to cirrhosis, and they said it was Stage 3 cirrhosis (and that her only hope for survival would be a liver transplant). The doctor also told her that she was severely malnourished, comparing her to starving kids in other countries. He said that was the cause of her weakness, along with the liver issues.

A biopsy was done on her liver and she's Stage 1 of fatty liver, which means she can turn it around with diet and exercise, and we're all very happy about that. However, she is still extremely malnourished. The doctor's solution was that she eat more Protein. She has been focused on doing so ever since her surgery; now she is trying to up her intake even further. And despite trying to get as much protein as she can, her last blood work showed that her protein is at a 2, which is apparently really bad.

So a couple of questions for you - Have you heard of anyone going through something similar to this? What did they do to improve their nutrition and overall health? (Because at this point the doctor is now recommending undoing the surgery so that she can absorb protein better, but I don't want my elderly mother to undergo surgery again.)

How can she up her protein? She is already eating large amounts of protein at every meal and snacking on it throughout the day. She is also eating plenty of vegetables. I know you're not supposed to get your protein from drinking, but would that be helpful here? Just to make sure that she's getting enough? And how many grams of protein should she be eating a day?

What kind of Vitamins should she be taking, and at what dosage? She is very low on like Vitamin D and B, and assures me that she's taking OTC vitamins that her doctor recommended. I know that's not good enough if you have absorption issues and gastric bypass, and I also know that doctors' recommendations (especially those who don't focus on bariatrics) often recommend way below what is needed. (Her Vitamin levels are bad enough that the doctor wrote her a prescription for vitamins to take once a week.) She told me she takes the fusion brand Multivitamin every day (designed for bariatric patients) and a calcium/Vitamin D that is 1000iu twice a day. Looking at the label for the multivitamin, it seems low to me.

Any and all advice/help/suggestions would be most welcome. Thank you!

[janet dekker 5]

Hi I don't know of many people with the Protein problem but my daughter is in the same position as your mother her blood level for protein is almost non exciting her bariatric surgeon has told it is because she hS malabsorption but at the same time she is allergic to protein where as I hD the bypass and have fat malabsorption I am also 69yrs lost 70kg my daughter had the sleeve

In Australia we have a group on Facebook for the over 50 people maybe she should look at and even join it hope this helps abit

[catwoman7 10,864]

this is the first time I've heard of a case like this, and I've been on this site for nine years.

I malabsorb Protein so from the get-go I've had to be sure to get at least 100 grams in every day, but it sounds like your mother's case is more extreme. I still have a Protein Shake every morning so I can be sure my intake ends up at least 100 grams by the end of the day, but it sounds like your mother may need even more than. that. Maybe her liver issues are a factor in this, too.

I've taken OTC Vitamins all along and have never had deficiencies - and that's true of many of us. Usually, OTC versions are fine (although you usually have to take two regular multis a day, rather than one (which is true of many of the bariatric-specific multis). She may have to get prescription-strength vitamins (I know they have prescription-strength Vitamin D, for example - not sure about other vitamins).

hmmm...not sure what to tell you. This sounds like a pretty rare condition, so I hope someone can help her!

[Arabesque 6,478]

I have a Protein malabsorption issue too (mine began after my gall was removed). I was prescribed Creons. They’re pancreatic enzymes which help with absorption. Maybe ask her doctor about those.

Does she have a dietician? (Way more qualified than a nutritionalist.) They could help review your mum’s diet & make suggestions on what she could be adding or pick up if she is missing something. They may be able to offer suggestions on the Vitamins she is taking too (quality, quantity, other brand suggestions, etc.) Does she track all her food? If not maybe do it for a few weeks so she has it for the dietician to review. Tracking may be a lifetime behaviour so she can keep on top of the nutrients she is consuming & ensure she’s not accidentally missing something. Many continue to track in the long term to keep themselves honest & help them maintain.

Wishing your mother all the best & hope you get some advice & guidance on a definitive path forward.