Dehydration at 5 weeks out...

[Daydra 345]

Another update: Followup appointment today. Swallow test fine, no remaining kink, unsure of torsion at this point. My sleeve appears to have a bend in it, but it doesn't appear to be restricting flow. Still probably have some swelling. Capacity is only about 1 oz. Nausea seems to be mostly resolved. It's still a full time job to get in a meager amount of calories and fluids. I am constantly eating and drinking and still not making my nutrition goals. I have a lot of fatigue. I'm finding that some of my worst eating habits pre-surgery are not what or how much I was eating, but the times I was prone not to eat, like Breakfast, particularly if I'm so fatigued that I sleep way in on the weekends. I got up way late on Saturday and then nearly passed out in the shower. Not a good time. Fortunately something I can fix simply by not being an idiot... That also meant that I had a severely reduced caloric total on Saturday, that set Sunday up as difficult as well. Also having some upper abdominal aching... discomfort/almost pain when taking a deep breath, yawning, sneezing, really any abdominal contraction/stretch. Doc thinks it might be scar tissue causing the sensation, but I'm starting to think it's the pain from being in bed too much due to fatigue. Feeling a bit like I'm in a less than desirable cycle... Lack of calories causing fatigue, fatigue making it feel impossible to get any activity in (even shopping completely wears me out right now, causes me to sleep/nap too much, making less time to consume the calories I need.

Anyway, doc says I may have up to 6 more weeks of swelling, and then I should see a vast improvement. At this point, she doesn't see anything to be worried about, so I have my next followup in a month, but have a standby appointment in 10 days just in case anything gets worse.

Thanks all!

[lazerider 78]

Hey

I have almost the same thing, surgery 8/19/2013. I have been unable to keep anything down. It comes out either end. Had two hospital visits due to dehydration the feeling is my body telling me to slow down and re group. I am not keeping fluids down had a second swallow test to check for anything that was wrong. My doctor told me my stomach is still not at its normal size. I am slowly resting and trying to get fluids in my blood work is all over the place.

[Daydra 345]

Hey

I have almost the same thing, surgery 8/19/2013. I have been unable to keep anything down. It comes out either end. Had two hospital visits due to dehydration the feeling is my body telling me to slow down and re group. I am not keeping fluids down had a second swallow test to check for anything that was wrong. My doctor told me my stomach is still not at its normal size. I am slowly resting and trying to get fluids in my blood work is all over the place.

I'm sorry you are having such a hard time! Good luck! It's a struggle to find any kind of balance when it feels like things aren't going as they should. Definitely keep on top of it, and always call the doc if anything gets worse, or doesn't feel right. It never hurts to at least ask the question. If you've discontinued your anti-nausea med, you might consider taking that again for awhile. I found that it really did help for me. The feeling that I was getting in my stomach before we stretched out the kink was making me avoid drinking and eating. And of course, all that did was make the whole problem worse...

[ctsleeve 20]

I'm at nearly 5 weeks (tomorrow) and have this onset of nausea that is making me not at all interested in eating and worried that this is some sort of twist.

How did they realize you had a twist?

Which anti-nausea medicine did you take that helped? I have some zofran and reglan, and the prilosec/prevacid I take in the mornings.

I'm feeling so discouraged by this nausea. I was feeling so good and being so careful to follow the rules and do everything I can for a smooth recovery. I am incredibly anxious that this is going to turn out to be a big problem.

[Daydra 345]

I'm at nearly 5 weeks (tomorrow) and have this onset of nausea that is making me not at all interested in eating and worried that this is some sort of twist.

How did they realize you had a twist?

Which anti-nausea medicine did you take that helped? I have some zofran and reglan, and the prilosec/prevacid I take in the mornings.

I'm feeling so discouraged by this nausea. I was feeling so good and being so careful to follow the rules and do everything I can for a smooth recovery. I am incredibly anxious that this is going to turn out to be a big problem.

So here's the good news... far more likely than not, it will be a minor problem. I didn't recognize that I really had a problem until I started feeling really dehydrated. At that point, I called my clinic and they talked me into coming in to do a swallow test (just like the morning after surgery). The doc can get a pretty good picture of what is happening as you swallow, so can usually determine a stricture or kink. It might be able to be solved by an endoscopy exactly like we do before surgery, so it's really a minor procedure (just passing the scope through can often resolve the kink, creating immediate relief for the patient). If more is needed, like a balloon dilation, we have to wait until about week 12 to make sure that the staple line is strong enough to handle the pressure. There are other options if that doesn't work.

The only anti nausea med I have is Zofran. I am starting to realize that I don't really need it much unless I am becoming more dehydrated. I find that if it doesn't seem to be that effective on any particular day, and I look back at my Fluid intake for the day or two previous, usually my fluids are low. Also, my urine output on the days it doesn't seem effective is lower than on the days it does. If I'm feeling less dehydrated, it doesn't seem like I even have any significant nausea and might only take it in the morning to get past taking my daily meds and brushing my teeth (which would frequently send me into a major gag and possible vomit reaction even before surgery...) I'm taking otc prilosec right now because when I finished my prescription at 30 days, my body wasn't really ready to come off and I woke up the next morning at 3am with a mouth full of acid (a less than pleasant experience...)

I totally understand feeling discouraged, but this issue is usually temporary and fixable. I have to admit to feeling a bit miserable myself, waiting for the nausea, dehydration, Constipation (that's a really fun one... I even got to experience fecal impaction. So don't recommend that one...), abdominal discomfort, fatigue, lightheadedness, weakness.... The list feels like it goes on forever right now. However, like I said... temporary and fixable. By week 12, pretty much all the swelling will have gone down and we'll have a little more capacity to get food/fluids in, and likely less nausea due to that alone.

My recommendation to you would be to call your surgeon and talk about your specific symptoms. You want to make sure that there isn't something you need to investigate further. Don't be like me and wait, thinking it's "normal" or "not that bad" or "will get better". It's far better to call and ask than it is to sit home and be miserable and possibly get worse. I probably only called my surgeon when I did because I work in public health, and was able to pop over to the clinic side and ask the nurses what they thought. If I didn't have that easy resource, I might have tried to tough it out longer, and would have been worse off.

At this point, what I am doing right now to combat my particular issues is:

taking zofran in the morning and then deciding whether I need additional doses later in the day based on how I feel. (seems to affected by recent Fluid intake)

Sipping all day long the best that I can (still, my best day on fluid intake is in the 40 or so oz range)

Eating higher calorie foods (dairy seems to be the thing I tolerate the best, so I frequently will have a couple oz of full fat cheese in the evening before I go to bed to bump up my calories) Fage 2% is my favorite plain yogurt (23g Protein in 8oz, though I can never eat 8oz, I'll add a few blueberries and a squeeze of sugar free pancake syrup.)

Ignoring the 30 minutes per meal rule (I let it take me however long it takes me to finish a reasonable portion of whatever I'm eating. Unfortunately, this literally means I am eating all day... sometimes 20 minutes between bites)

Ignoring the no drinking while eating rule. There are 2 reasons this is a rule: 1- so it doesn't wash food out of your sleeve and make you hungry too early (really not an issue if you cannot get enough calories to keep from nearly fainting...) and 2 - so you don't try to "wash down" something that seems to be "stuck". That'll just make you vomit. I would think that we would be able to identify that situation, in which case, we just need to stop and let it work through or regurgitate, or whatever needs to happen.

I've stopped looking for low fat anything, really. I simply need the calories at this point.

Take a colace each evening (just started this yesterday after my most recent horrifying, at least to me, episode with fecal impaction) Hoping that this can keep things evened out.

All of my strategies were discussed with my surgeon and she feels that they are appropriate actions to take. The hope is that each week, it will get just a little better, a little easier to get fluid, a little easier to get calories, a little less nausea. As that happens, all of my adjustments will be revised closer to what the standard rules entail.

Here's my last recommendation... If you start really struggling with fatigue, resist the urge to sleep late on the weekends, waiting to eat until whenever you get up. Keep something by your bed, get up and get something to eat then go back to bed, anything. Weekends are the worst for me. I very very nearly passed out in the shower because I did this. When we're already on a very low calorie diet because of the surgery, and then we struggle to get in enough calories, which reduces that low amount even further, and then sleep until noon or something, it is simply a recipe for disaster. It will also mean that you struggle that day to get in enough calories, so you'll feel awful the next day as well. Trust me on this one... Totally miserable experience.

Good luck! I'm confident that it will be minor and you will be fine, but it's going to take some patience and endurance to get through it. Just remember that it's not permanent!

[ctsleeve 20]

Daydra, thank you a million times over for your thorough response. It's more comforting than you could know - I was a wreck about this last night! I will take your suggestions, stay in close touch with my doctor and above all else stay on top of Fluid intake.

I also like your suggestion about staying away from low-cal foods on days when I'm struggling to get much in, and about the drinking rule.

I'm able to get 60+ ounces of fluids every day, right now at least. If that starts to slip, I will contact my doctor right away.

Thank you again for sharing your experience and what worked for you. And especially for your kind reassurance!

[lazerider 78]

Hello sleevers

I know we was told no straw, but this has been my prayer answered. I can get down fluids and keep them down without having to feel like a huge gorilla is on my chest

[Daydra 345]

Daydra, thank you a million times over for your thorough response. It's more comforting than you could know - I was a wreck about this last night! I will take your suggestions, stay in close touch with my doctor and above all else stay on top of Fluid intake.

I also like your suggestion about staying away from low-cal foods on days when I'm struggling to get much in, and about the drinking rule.

I'm able to get 60+ ounces of fluids every day, right now at least. If that starts to slip, I will contact my doctor right away.

Thank you again for sharing your experience and what worked for you. And especially for your kind reassurance!

You are more than welcome! I'm just really glad that any experience or advice I can provide can be helpful to others (even if it takes me a novel to get it all out...) I decided immediately in this process that I would be extremely open about my surgery and my experience with anyone that I deem appropriate (friends, coworkers, anyone that asks about it, people here, obviously). Really anyone that would benefit from the knowledge of my experiences, or just knowing why I might be a little "off". I feel like it's already paid off, and not only the support that I've been able to offer here, but one of our clerical staff at the office brought down one of our accounting clerks to talk to me about it because she is also thinking about having the surgery and I was so glad to be able to discuss it with her - tell her about my experiences so far, my thoughts on the different options, direct her to information, and really just provide someone to talk to so she doesn't have to feel like she's going through it alone.

Anyway, I wish you the best and I know you'll get it worked out. And just as a reassurance, you are doing far better on fluids than I am. I would be thrilled to consistently get 60oz in, so keep up the good work!

[Daydra 345]

Hello sleevers

I know we was told no straw, but this has been my prayer answered. I can get down fluids and keep them down without having to feel like a huge gorilla is on my chest

I agree. I know that we're told that the risk with straws is too big of drinks or too much air to swallow, but this really hasn't been my experience. I think we have to decide which "rules" are appropriate for us (individually) to follow, and cautiously asses which ones we can safely adjust or ignore.