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.

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'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?

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 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 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'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*