Severe Muscle Loss. Any Suggestions?

[pdallariva 57]

I was scheduled for the middle of September for my 4th scope. I am still unable to tolerate Proteins or foods. My doctor called me today and moved my scope up to tomorrow. I guess some of my blood work came back and I am losing a lot of muscle. He says he is very stumped as to why I can tolerate Water but nothing else. I pray that tomorrow's scope shows him something that will be able to fix my eating problems. I wake up everyday as if I was up all night and my body hurts so badly. He promised me that this is not how I will live the rest of my life. Any suggestions out there?

Sent from my iPhone using the BariatricPal App

[gina171 626]

I will be watching here to see what you learn tomorrow. This is such an awful experience for you, I am so sorry.

Have you thought about getting another surgeon to look at you? Is there a major Bariatric center in your geographical area? Like mayo, Cleveland Clinic, Duke? I believe Duke "fixes" problematic surgeries for many people in the mid-Atlantic and Southeast states. I bet other big centers would, too? Maybe look for ones that have major Bariatric Fellowships (usually linked to a university).

Thinking of you, hoping you get relief soon.

Sent from my iPhone using the BariatricPal App

Edited August 30, 2016 by gina171

[James Marusek 5,244]

@@pdallariva, to recap, this is what you have told us.

You had RNY gastric bypass surgery on June 7, 2016.

You cannot tolerate Protein shakes, other Protein supplements, or even milk. And you cannot eat food.

You had blood work done and it came back all good. (except you are losing muscle from lack of protein intake). Also you are losing your hair. Another sign of a lack of protein.

You were admitted 4 times for dehydration and low potassium.

You had a stricture and underwent dilation three times.

You have been unable to take your Vitamins.

You have a lack of energy and an inability to get a restful sleep.

On the plus side you can tolerate Water.

The three most important elements after RNY gastric bypass surgery is to meet your daily protein, Fluid and Vitamin requirements. And this is just not happening. So something is seriously wrong and your surgery team needs to solve this problem or at least explain what the root problem is.

You say that you cannot tolerate Vitamins. What have you tried? What are you taking? B12 is a very important Vitamin after surgery. It can be taken sublingual. You just place a small tablet under your tongue for a minute or two and it dissolves away. Are you taking this. There is another option. Give yourself a B12 injection once per month. I did it for a year. B12 deficiency will definitely drain away your energy levels. So what are you doing to get your B12 in?

The focus is protein, fluids and vitamins.

[James Marusek 5,244]

Perhaps you have an ulcer. This could explain some of your conditions. Or you might have a pre-existing condition called H pylori infection.

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.

So the general advice from above if I am interpreting it properly is to avoid NSAIDs (such as Aspirin, Ibuprofen, Diclofenac, Naproxen, Meloxicam, Celecoxib, Indomethacin, Ketorolac, Ketoprofen, Nimesulide, Piroxicam, Etoricoxib, Mefenamic acid, Carprofen, Aspirin/paracetamol/caffeine, Etodolac, Loxoprofen, Nabumetone, Flurbiprofen, Salicylic acid, Aceclofenac, Sulindac, Phenylbutazone, Dexketoprofen, Lornoxicam, Tenoxicam, Diflunisal, Diclofenac/Misoprostol, Flunixin, Benzydamine, Valdecoxib, Oxaprozin, Nepafenac, Etofenamate, Ethenzamide, Naproxen sodium, Dexibuprofen, Diclofenac sodium, Bromfenac, Diclofenac potassium, Fenoprofen, Tolfenamic acid, Tolmetin, Tiaprofenic acid, Lumiracoxib, Phenazone, Salsalate, Felbinac, Hydrocodone/ibuprofen, Fenbufen] and but use proton pump inhibitors [Omeprazole, Pantoprazole, Esomeprazole, Lansoprazole, Rabeprazole, Dexlansoprazole, Rabeprazole sodium, Pantoprazole sodium, Esomeprazole magnesium, Omeprazole magnesium, Naproxen/Esomeprazole, Esomeprazole sodium, Omeprazole/Bicarbonate ion] and/or sucralfate [Carafate] antacid.

After RNY gastric bypass surgery, my surgeon put me on Omeprazole [Prilosec] for a year to lessen the affects of surgery on my stomach. So if you are suffering from an ulcer, this approach may be beneficial.

[pdallariva 57]

I have asked about B12 injections but he did not prescribe. Also I am currently going to cleveland clinic. As far as NSAIDS I'm allergic to them so I'm not taking them. I will try and post an update tomorrow. Thank you all!!

Sent from my iPhone using the BariatricPal App

Also I take nexium 40mg 2x a day

Sent from my iPhone using the BariatricPal App

[pdallariva 57]

Also my creatine and BUN levels were extremely low.

Sent from my iPhone using the BariatricPal App

[gina171 626]

I have asked about B12 injections but he did not prescribe. Also I am currently going to cleveland clinic. As far as NSAIDS I'm allergic to them so I'm not taking them. I will try and post an update tomorrow. Thank you all!!

Sent from my iPhone using the BariatricPal App

Also I take nexium 40mg 2x a day

Sent from my iPhone using the BariatricPal App

I am shocked and disappointed that the surgeons at the Cleveland Clinic have not been more aggressive about getting to the root of your issues. Ugh.

Sent from my iPhone using the BariatricPal App

[James Marusek 5,244]

Having a low BUN level may not be a problem but having a high one is.

The kidneys are two bean-shaped organs located on each side of the spine. They’re responsible for filtering out of the blood waste products, excess Water, and other impurities. These important organs also control the pH, salt levels, and potassium levels in the body. The kidneys even produce hormones that manage red blood cell production and regulate blood pressure.

A blood urea nitrogen (BUN) test is used to determine how well your kidneys are working. It does this by measuring the amount of urea nitrogen in the blood. Urea nitrogen is a waste product that’s created in the liver when the body breaks down Proteins. Normally, the kidneys filter out this waste, and urinating removes it from the body.

BUN levels tend to increase when the kidneys or liver are damaged. Having too much urea nitrogen in the blood or having high BUN levels can be a sign of kidney or liver problems.

[James Marusek 5,244]

Creatine is a nitrogenous organic acid that occurs naturally in vertebrates and helps to supply energy to all cells in the body, primarily muscle. So low creatine levels might be one of the reasons why you have a lack of energy.

[pdallariva 57]

Back home from getting my scope done. The dr told me everything is open fine and to go home and drink Water. I took some sips of Water and threw up immediately. So basically worse than what I was. Waiting on dr to call me back.

Sent from my iPhone using the BariatricPal App

[shelbys mom 70]

Back home from getting my scope done. The dr told me everything is open fine and to go home and drink Water. I took some sips of Water and threw up immediately. So basically worse than what I was. Waiting on dr to call me back.

Sent from my iPhone using the BariatricPal App

Could you possible taking too big pf sips?

Sent from my SM-N920P using the BariatricPal App

[Mudgy6 88]

I prayerfully wish you a speedy recovery

Sent from my SM-G550T1 using the BariatricPal App

[Shrinkinqtpi 202]

How did everything turn our?

Sent from my iPhone using the BariatricPal App

[pdallariva 57]

Sorry for the late response. I had the scope and he said everything looked good. All my Vitamin levels came back good except still losing muscle. They basically told me to eat whatever I can at this point. I started with small crackers like 1 every 4 hours. Today I am able to tolerate about 15 total in a day. I have started walking a lot!!!! My body dose not ache near as much. I am taking it one day at a time.

Sent from my iPhone using the BariatricPal App