Ache or pain months AFTER surgery and...

[BlondePatriotInCDA 407]

I had my one year check up with my bariatric surgeon yesterday, labs were all perfect, I was told I'm 20 percentage points down in my BMI and the surgeon said I'm exactly what the program hopes for in outcomes...etc. Etc...

My questions to the doctor were the following:

1. When do I quit aching / feeling pain in my hips, shoulders and elbows I've heard so much about after losing weight?! He asked if I had this pain beforehand, I told him no its all since surgery.

2. I also asked about occasional pain that feels like gallbladder pain now (its been removed) asking if it could be a stone in my biliary tract? He said not likely its probably just "phantom pain." All fine and good but there's nothing phantom about it - it hurts like my old gallbladder attacks!

3. Lastly, I wanted to know when I get the magical much talked about energy after losing weight? He said everyone is different, and "you do seem to have an odd bunch of symptoms that should go away after surgery - not start up"!

He went on to say that I might not meet my goal, saying it might be "unrealistic" yet I asked at my first meeting with him when he asked about my goal if it was unreasonable to which he said no! If I'm doing "exceptionally well" on the program then why is it now possibly "unreasonable"? He said I've got maybe 6 months more in which the surgery will continue to help me lose weight, but since its slowing down...I probably won't hit the goal (40 lbs to go). He knew the average weight lost in the 18 months following surgery, why say my goal was reasonable then? Sorry, I'm finding myself annoyed and discouraged now.

So, my questions are: anyone else around a year out that is or has experienced the above issues? If so, do you still deal with it? If not, when did it go away (any of the above)? Did you after being told your goal is unreasonable and probably won't hit it, continue to lose and hit your goal or did you adjust your goal?

Edited August 23 by BlondePatriotInCDA

[ShoppGirl 4,335]

27 minutes ago, BlondePatriotInCDA said:

I had my one year check up with my bariatric surgeon yesterday, labs were all perfect, I was told I'm 20 percentage points down in my BMI and the surgeon said I'm exactly what the program hopes for in outcomes...etc. Etc...

My questions to the doctor were the following:

1. When do I quit aching / feeling pain in my hips, shoulders and elbows I've heard so much about after losing weight?! He asked if I had this pain beforehand, I told him no its all since surgery.

2. I also asked about occasional pain that feels like gallbladder pain now (its been removed) asking if it could be a stone in my biliary tract? He said not likely its probably just "phantom pain." All fine and good but there's nothing phantom about it - it hurts like my old gallbladder attacks!

3. Lastly, I wanted to know when I get the magical much talked about energy after losing weight? He said everyone is different, and "you do seem to have an odd bunch of symptoms that should go away after surgery - not start up"!

He went on to say that I might not meet my goal, saying it might be "unrealistic" yet I asked at my first meeting with him when he asked about my goal if it was unreasonable to which he said no! If I'm doing "exceptionally well" on the program then why is it now possibly "unreasonable"? He said I've got maybe 6 months more in which the surgery will continue to help me lose weight, but since its slowing down...I probably won't hit the goal (40 lbs to go). He knew the average weight lost in the 18 months following surgery, why say my goal was reasonable then? Sorry, I'm finding myself annoyed and discouraged now.

So, my questions are: anyone else around a year out that is or has experienced the above issues? If so, do you still deal with it? If not, when did it go away (any of the above)? Did you after being told your goal is unreasonable and probably won't hit it, continue to lose and hit your goal or did you adjust your goal?

Idk about the pain and I can’t speak personally about the goal but I have been on here for almost four years and seen several people surpass their surgeons goal for them. Do not let that discourage you. Keep doing what you are doing and let your body settle in where it is happy. They honestly shouldn’t even try to predict because every single body is different and we all respond to the surgery in different ways. On the gallbladder pain note, I would trust your gut and ask another Doctor if he just dismissed it. Only you know what your pain is. And in terms of the joint pain, maybe see what a chiropractor says. Maybe your body is off balance now because our posture is so bad to compensate for the weight and it may not have gone back on its own. Just a thought.

[BlondePatriotInCDA 407]

1 minute ago, ShoppGirl said:

Idk about the pain and I can’t speak personally about the goal but I have been on here for almost four years and seen several people surpass their surgeons goal for them. Do not let that discourage you. Keep doing what you are doing and let your body settle in where it is happy. They honestly shouldn’t even try to predict because every single body is different and we all respond to the surgery in different ways. On the gallbladder pain note, I would trust your gut and ask another Doctor if he just dismissed it. Only you know what your pain is. And in terms of the joint pain, maybe see what a chiropractor says. Maybe your body is off balance now because our posture is so bad to compensate for the weight and it may not have gone back on its own. Just a thought.

Thank you! Great suggestions.

[Arabesque 6,986]

I wonder if the joint pain could be from your muscles, tendons & skeleton readjusting to a your new posture & other odd twinges and spasms. They had changed to support your larger body before & then they have to adjust again. I remember upper back pain about 2/3 to my goal and it took a while to stop slouching (had to consciously sit or stand straighter if I noticed I was slouching) & my body learnt how to stand upright again.

As for the ‘phantom’ gall like pain, I don’t know. Maybe request an ultra sound to check your kidneys, liver & bile ducts just to be sure.

My energy isn’t great. Always better in the morning than the afternoon. I seem to go, go, go then stop now, can’t do anything g more. Though that is pretty much how Gilbert’s is so I put it down to that & my low blood pressure more than my sleeve and I was a lot like that before my sleeve. Would push through then - didn’t want anyone to think I was lazy because I was fat! No I listen to my body. Apparently Gilbert’s is more common than people realise. What’s your bilirubin levels like. High levels are a sign of it. It is genetic so does any one in your family have it?

Congratulations on your weight loss. Yay! Don’t worry about what weight you end up at. (I know easier said than done.) Remember that weight will be the weight your body is happiest at & is easier to maintain.

[BlondePatriotInCDA 407]

14 hours ago, Arabesque said:

I wonder if the joint pain could be from your muscles, tendons & skeleton readjusting to a your new posture & other odd twinges and spasms. They had changed to support your larger body before & then they have to adjust again. I remember upper back pain about 2/3 to my goal and it took a while to stop slouching (had to consciously sit or stand straighter if I noticed I was slouching) & my body learnt how to stand upright again.

As for the ‘phantom’ gall like pain, I don’t know. Maybe request an ultra sound to check your kidneys, liver & bile ducts just to be sure.

My energy isn’t great. Always better in the morning than the afternoon. I seem to go, go, go then stop now, can’t do anything g more. Though that is pretty much how Gilbert’s is so I put it down to that & my low blood pressure more than my sleeve and I was a lot like that before my sleeve. Would push through then - didn’t want anyone to think I was lazy because I was fat! No I listen to my body. Apparently Gilbert’s is more common than people realise. What’s your bilirubin levels like. High levels are a sign of it. It is genetic so does any one in your family have it?

Congratulations on your weight loss. Yay! Don’t worry about what weight you end up at. (I know easier said than done.) Remember that weight will be the weight your body is happiest at & is easier to maintain.

Thank you for responding! I've never heard of Gilbert's before and I need to do some research. My labs all came back great (although 2pts high in ferrous Iron and iron transport or something?) Doctor said a few points high or low he considers lab errors and nothing to be concerned about. Although, my bilirubin wasn't checked this time since it was nutrient nourishment based labs. In the past I don't recall ever having bilirubin issues, nor my family ...but as I've said I've never heard of Gilbert's before.

I'm hoping the aches and pains are as you suggested and just my body readjusting, but I would have thought my doctor would have agreed when I suggested it. He said its usually the other way around; pain before surgery that goes away, who knows!

Again, thank you for responding and giving me possible reasons! Its appreciated!

[MrsFitz 377]

Purely my experience - when I lost a lot of weight previously, I had a lot of pains in my hands and feet. Had the usual blood tests and everything was fine. My GP wasn’t convinced and booked me in for a different blood test and an ultrasound scan on my hands. Both confirmed that I had seronegative rheumatoid arthritis.

I’ve cut & paste the following from the RA website, just in case it may ring a couple of bells with you:

Some of the most important symptoms in diagnosing seronegative rheumatoid arthritis include:

• Joint pain, stiffness specifically in the hands but also in knees, elbows, hips, feet and ankles
• Joint swelling and redness
• Joint tenderness
• Symmetrical symptoms and in multiple joints
• Ongoing inflammation
• Morning stiffness lasting longer than 30 minutes
• Fatigue
• Eye redness

I may be way off but this was my experience. I was 43 when I was diagnosed and just entering perimenopause (which also has an effect on having the symptoms and being diagnosed RA too)

I hope you find some answers and some relief.

[BlondePatriotInCDA 407]

7 hours ago, MrsFitz said:

Purely my experience - when I lost a lot of weight previously, I had a lot of pains in my hands and feet. Had the usual blood tests and everything was fine. My GP wasn’t convinced and booked me in for a different blood test and an ultrasound scan on my hands. Both confirmed that I had seronegative rheumatoid arthritis.

I’ve cut & paste the following from the RA website, just in case it may ring a couple of bells with you:

Some of the most important symptoms in diagnosing seronegative rheumatoid arthritis include:

• Joint pain, stiffness specifically in the hands but also in knees, elbows, hips, feet and ankles
• Joint swelling and redness
• Joint tenderness
• Symmetrical symptoms and in multiple joints
• Ongoing inflammation
• Morning stiffness lasting longer than 30 minutes
• Fatigue
• Eye redness

I may be way off but this was my experience. I was 43 when I was diagnosed and just entering perimenopause (which also has an effect on having the symptoms and being diagnosed RA too)

I hope you find some answers and some relief.

Thank you! I have an appointment with my GP Monday Ill ask...I forgot about my hands being achy! What did they recommend to treat? Has it gotten better?

[NickelChip 1,121]

I'm curious if you've ever gone in for a DEXA scan to determine your body composition. I ask because I know that if you've been obese for a long time, your body architecture has changed to support that weight, and that isn't something that just goes away as you lose fat. BMI, which is problematic at best, can be skewed by formerly obese people weighing more because of extra bone and organ mass that a never obese person of similar height and build would not have. If you have a DEXA scan, you can get a much more reliable idea of how much body fat, bone mass, etc., you have and may feel a lot better about your progress.

I would also take a step back and ask yourself why that number you've set is important to you. If you "only" lost 25 more lbs, you would have lost half your body weight. That's kinda crazy! You would be half the person you were before (in a good way, of course). Or if you "only" lost 10 more pounds, would it really be so bad? Would 40 lbs really make a massive difference in how you look and feel compared to where you are now? Are you putting so much pressure on yourself to reach an arbitrary number that you don't fully appreciate just how amazing your progress is? You're down 110 pounds! That's like having an entire Olympic gymnast you are no longer dragging around on your back every day.

Regarding your energy levels, are you getting enough fruit and veg? If you're still really low carb and really low calorie, as I seem to remember your dietician was having you do, that might account for the lack of energy. It could be your body is needing more fuel than you're giving it and is lacking the phytonutrients that don't come in a Multivitamin.

[BlondePatriotInCDA 407]

31 minutes ago, NickelChip said:

I'm curious if you've ever gone in for a DEXA scan to determine your body composition. I ask because I know that if you've been obese for a long time, your body architecture has changed to support that weight, and that isn't something that just goes away as you lose fat. BMI, which is problematic at best, can be skewed by formerly obese people weighing more because of extra bone and organ mass that a never obese person of similar height and build would not have. If you have a DEXA scan, you can get a much more reliable idea of how much body fat, bone mass, etc., you have and may feel a lot better about your progress.

I would also take a step back and ask yourself why that number you've set is important to you. If you "only" lost 25 more lbs, you would have lost half your body weight. That's kinda crazy! You would be half the person you were before (in a good way, of course). Or if you "only" lost 10 more pounds, would it really be so bad? Would 40 lbs really make a massive difference in how you look and feel compared to where you are now? Are you putting so much pressure on yourself to reach an arbitrary number that you don't fully appreciate just how amazing your progress is? You're down 110 pounds! That's like having an entire Olympic gymnast you are no longer dragging around on your back every day.

Regarding your energy levels, are you getting enough fruit and veg? If you're still really low carb and really low calorie, as I seem to remember your dietician was having you do, that might account for the lack of energy. It could be your body is needing more fuel than you're giving it and is lacking the phytonutrients that don't come in a Multivitamin.

🤔 Definitely food for thought. You brought up some very good points. I just am leery of adding fruit and or veggies since I am extremely carb sensitive. Perhaps I'll slowly introduce a few more. Its just difficult to add something without removing Protein since I'm restricted to 800 calories and fruit adds a lot more calories.

Tbh, I don't know why I'm hung up on reaching my goal, perhaps its because I'm very goal-centric, if I don't reach my goal to me I'll feel as if I've failed, even when I haven't. I've always up until the last ten years weighed 105-108, so I felt 120 was reasonable for my small frame and height. Plus, I'm still classified as over weight! I am still heavy for my height.

Lastly, I still have quite a bit of fat on my small frame (its not All just skin) so, if I'm being honest I do need to lose the rolls on my stomach and arms. I know the difference between skin excess and skin with fat. Perhaps 140 would be a better goal..I don't know. I do understand I'll never be what I was, but I feel perhaps it was the doctors and dietician's jobs to tell me 120 wouldn't work based on my starting BMI, my age etc, and explain reasonable surgical expectations - they didn't which is why I assumed it was obtainable.

Thank you for giving me lots to think about, either way I still have 6 months before I am put on maintenance or my weight loss is set as I was told by the doctor. I appreciate your insights.

Oh and no, I've never had a DEXA scan. I've never heard of it. Also, its about time that gymnast got off my back - no more freeloading!

Edited August 24 by BlondePatriotInCDA

[MrsFitz 377]

5 hours ago, BlondePatriotInCDA said:

Thank you! I have an appointment with my GP Monday Ill ask...I forgot about my hands being achy! What did they recommend to treat? Has it gotten better?

RA is a degenerative autoimmune disease so no cure but it can be slowed down with medication. I was really lucky that my GP didn’t delay with the tests and referral to Rheumatology so I don’t have too much damage to my joints. Fatigue can wipe me out though!

[BlondePatriotInCDA 407]

I've been researching (its part of what I do for a living anyway soo) this topic and have found several papers regarding pain after bariatric surgery:

"Results: Nineteen of the respondents fulfilled the criteria for hypermobility. There were no significant differences between the groups with and without hypermobility regarding pain in weight-bearing joints before or after surgery. There was a significant difference between the groups with increased or novel pain in the ankles, shoulders, hands, and feet (P<.05) after the weight loss. Furthermore, the patients with hypermobility had increased or novel pain in a significantly higher number of weight-bearing joints, other joints, and joints in total (P< .05).

Conclusion: Even with a small sample size, a tendency can be seen for people with hypermobility to experience increased joint pain after weight loss compared with those without hypermobility."

https://pubmed.ncbi.nlm.nih.gov/28274706/

I do have some hypermobility. Its a very small sampling for a research medical study, but its in line with what I'm experiencing. Also, I'm only experiencing pain in one hip (weight bearing) and my back, the rest; hands, shoulders and elbows aren't. It could just be wear and tear from 14 years of gymnastics and later on physical alterations with much larger combatants for 15 years.. So life stressing my body rearing its ugly head as I age. 😥

Either way, perhaps if someone else experiences this after surgery it will help knowing they're not the only one and give them a stepping stone to some answers.

[SleeveToBypass2023 2,482]

On 8/23/2024 at 9:08 PM, BlondePatriotInCDA said:

🤔 Definitely food for thought. You brought up some very good points. I just am leery of adding fruit and or veggies since I am extremely carb sensitive. Perhaps I'll slowly introduce a few more. Its just difficult to add something without removing Protein since I'm restricted to 800 calories and fruit adds a lot more calories.

Tbh, I don't know why I'm hung up on reaching my goal, perhaps its because I'm very goal-centric, if I don't reach my goal to me I'll feel as if I've failed, even when I haven't. I've always up until the last ten years weighed 105-108, so I felt 120 was reasonable for my small frame and height. Plus, I'm still classified as over weight! I am still heavy for my height.

Lastly, I still have quite a bit of fat on my small frame (its not All just skin) so, if I'm being honest I do need to lose the rolls on my stomach and arms. I know the difference between skin excess and skin with fat. Perhaps 140 would be a better goal..I don't know. I do understand I'll never be what I was, but I feel perhaps it was the doctors and dietician's jobs to tell me 120 wouldn't work based on my starting BMI, my age etc, and explain reasonable surgical expectations - they didn't which is why I assumed it was obtainable.

Thank you for giving me lots to think about, either way I still have 6 months before I am put on maintenance or my weight loss is set as I was told by the doctor. I appreciate your insights.

Oh and no, I've never had a DEXA scan. I've never heard of it. Also, its about time that gymnast got off my back - no more freeloading!

I'm noticing more aches and pains since I've dropped so much weight. I thought it was weird, too, so I asked my doctor and he said it can be normal with bariatric patients. Particularly those who lose a substantial amount of weight. I may go back and ask for additional testing, just to be sure. But being hyper focused on hitting or not hitting the goal number on the scale you set can really do a number on you mentally and emotionally. I'm very goal oriented when it comes to work and school, but I had to learn to let some of that go when it came to my personal life. Specifically weight loss. It took a while, but I realized that the NSVs were way more important than the number on the scale. Once I figured that out and took some of the pressure off myself, the scale actually started to move more in the direction I wanted it to lol

[BlondePatriotInCDA 407]

5 hours ago, SleeveToBypass2023 said:

I'm noticing more aches and pains since I've dropped so much weight. I thought it was weird, too, so I asked my doctor and he said it can be normal with bariatric patients. Particularly those who lose a substantial amount of weight. I may go back and ask for additional testing, just to be sure. But being hyper focused on hitting or not hitting the goal number on the scale you set can really do a number on you mentally and emotionally. I'm very goal oriented when it comes to work and school, but I had to learn to let some of that go when it came to my personal life. Specifically weight loss. It took a while, but I realized that the NSVs were way more important than the number on the scale. Once I figured that out and took some of the pressure off myself, the scale actually started to move more in the direction I wanted it to lol

Its good (and bad) that I'm not the only one experiencing the aches and pains! Thank you for sharing, it helps knowing this.

I understand about the doing "A number" on myself with my goal and trying to over achieve. That being said, the goal I chose is in the middle of a healthy BMI, I still have quite a bit of fat on my frame and I'm still classified as "over weight." If not my weight goal, I'd like to at least get to a healthy BMI where I'm not overweight. Overweight IS unhealthy. I don't feel I'm being unreasonable to at least try for healthy, not just healthier than I was..that make sense? I wouldn't say I'm "hyper focused" on my weight goal, no more than anyone else is who's on this forum and gone through wls.

Lastly, we've all set goals regarding our weight and health, its something to shoot for. I know I may not achieve it, but its a goal nonetheless. Just as walking 5 miles a day, or finally being able to do my yoga Vrischikasana, Astavakrasana and Eka Haste Vrksasanav poses again! Which, with all my new aches and pains who knows if I will ever be able to do them again, but I still want to strive to do them since I once enjoyed them - its a goal!

[ShoppGirl 4,335]

8 minutes ago, BlondePatriotInCDA said:

Its good (and bad) that I'm not the only one experiencing the aches and pains! Thank you for sharing, it helps knowing this.

I understand about the doing "A number" on myself with my goal and trying to over achieve. That being said, the goal I chose is in the middle of a healthy BMI, I still have quite a bit of fat on my frame and I'm still classified as "over weight." If not my weight goal, I'd like to at least get to a healthy BMI where I'm not overweight. Overweight IS unhealthy. I don't feel I'm being unreasonable to at least try for healthy, not just healthier than I was..that make sense? I wouldn't say I'm "hyper focused" on my weight goal, no more than anyone else is who's on this forum and gone through wls.

Lastly, we've all set goals regarding our weight and health, its something to shoot for. I know I may not achieve it, but its a goal nonetheless. Just as walking 5 miles a day, or finally being able to do my yoga Vrischikasana, Astavakrasana and Eka Haste Vrksasanav poses again! Which, with all my new aches and pains who knows if I will ever be able to do them again, but I still want to strive to do them since I once enjoyed them - its a goal!

If it’s inflammation causing the pain mayne tumeric will help. Ask a Dr of course since we are all on a Combo of stuff and even these Vitamins can interact or reduce absorbtion and all of that but I was told to use it since we can’t have NSAIDS. May help some

[catwoman7 11,161]

In reference to a comment above, I had a DEXA scan and found it very helpful. I thought I had more weight I could lose since I was near the top of my normal BMI range - but the technician said "no - you're done. You're at 21% fat, which is on the low end for a woman". I was shocked. But like the commenter said, you're always going to have more bone and muscle than someone who's never been obese. And I remember being told at one point by someone in my clinic that that is why we often look 10 lbs lighter than the scale would suggest (you do lose bone and muscle while losing weight - but that's fine because we don't need it anymore - we had all that infrastructure to hold up all that weight we once had. We do lose some of it, but not all).

some pain isn't uncommon because of shifting architecture, as someone else said. You're carrying your body differently now, and your bones and joints aren't used to it. I'm not sure if that happened to me, but I'd get major butt pain if I sat for too long. I had to buy coccyx pillows for my car and office chair. I don't really get that any more (although I keep a coccyx pillow in my car for long drives) - not sure if I just figured out how to sit on it so it doesn't produce pain, or what..

re: unrealistic goals - after successfully getting down to around 170 lbs, I told one of the staff members at my clinic that I was going to shoot for 150 (which is a normal BMI for someone my height). I was told that wasn't realistic, that only about 10-15% of their patients make it that far. Most end up in the "overweight" or "class 1 obese" category (which isn't very obese). The research I read back that up (I did end up making it - actually got quite a bit lower than that - but years later, I'm now technically "overweight"). Anyway, that's what your surgeon might have been referring to. Not many of us make it all the way down to normal BMI.