No real Weight Loss after Revision

[newyorkbitch]

Are you taking a PPI?

[illinids2]

Has your GI ordered a gastric emptying study to determine if your stomach is emptying properly and the pyloric valve is working properly? That is critical.

Shape could have some impact but I would be doubtful that it is causing gastroparesis. With the fact that you had multiple stomach surgeries it is possible that the vagus nerve was damaged (that is a risk of stomach surgery) and that could very well be causing your issues.

If it is actually narrowing/stricture you should be able to have an endoscope and get relief.

[goodkel]

Please let us know when you hear from Dr. Alverdy...

[abbysmom]

I definitely will let you know what Dr. Alverdy says....

[abbysmom]

Spoke with Dr. Alverdy's physician assistant today. All she would say is Dr. Alverdy cannot do anything as far as surgery for you.
I asked her to explain and all she would is repeat the same words. I asked to at least make an appointment with him to discuss
what he saw in my tests and she said "why?" Very sarcastic. So I guess that is that I cannot afford to go to see my surgeon. He is the one I wish I could have seen.

[abbysmom]

Illinids2...Have not had a gastric emptying tests but the UGI said there was no significant delay in emptying if that makes
any difference.

[illinids2]

Aug 26, 2014 18:17:03 GMT -5 abbysmom said:

Illinids2...Have not had a gastric emptying tests but the UGI said there was no significant delay in emptying if that makes
any difference.

Because gastroparesis is defined as:

Gastroparesis is a condition in which the muscles in your stomach don't function normally.



Ordinarily, strong muscular contractions propel food through your digestive tract. But in gastroparesis, the muscles in the wall of your stomach work poorly or not at all. This prevents your stomach from emptying properly. Gastroparesis can interfere with digestion, cause nausea and vomiting, and cause problems with blood sugar levels and nutrition.

If you have gastroparesis you would have a significant delay in gastric emptying, by definition.   

I really think you need to look closely at your diet and make some adjustments to see if this doesn't help you out.  This is what you listed on your food log earlier:

I had plain yogurt for breakfast and lunch. Had 1/3 of small pork chop for dinner. Coffee. water throughout the day. This is a typical day. I must say I am bloated all the time because of the gastroparesis. Gastro doc told me to eat beans, lentils for protein. No vegs that give me gas.or lettuce.or fruit. Also no meat but I do eat meat anyway small pieces and chew,chew,chew.



Read more: weightlosssurgery.proboards.com/thread/9292/real-weight-loss-after-revision?page=1#ixzz3BXusL9In

Couple of points:
A serving of greek yogurt is 11 grams of protein....so 2 in a day is 22 grams
A small pork chop has 16 g protein...1/3 of that = 6 grams

If this is really what you you eat in a day (this is not 6 small meals a day as you said earlier) you had a whopping 28 grams of protein.  If this is in fact what you eat, that is a big problem.   A DS patient can't sustain on that infinitesimal amount of protein. As a woman you need to be getting 120 grams of protein a day at a minimum.  Believe it or not the more protein you eat the more weight you will also lose.  If you are eating this small amount of protein then you are putting your body into starvation mode.   

and you GI doc is giving you bad advice if he is telling you to eat beans and lentils for protein.   Those are both notoriously hard on the GI tract. 

Eggs, cottage cheese, nuts (cashews, pistachios, almonds), sunflower seeds, light crispy bacon are all excellent sources of protein.  Try variations on these items and try some of the suggested protein drinks with water to see if you can't get some more protein that way, but the bottom line is you really need to significantly up your protein intake from what you had stated that you eat. 

Honestly, I think your stomach issues/pain could be coming from not eating enough. If I don't eat something every 1 to 1.5 hours I feel nauseous and I get bad GERD like symptoms.   

[goodkel]

Scott gave you excellent advice above.

You need to EAT a whole lot more and most assuredly the amount of protein you are eating now is dangerously insufficient. How long have you been starving yourself like this?

From the moment you wake up, eat something protein every 2-3 hours until you go sleep at night. Make sure you get in some fat, too.

A surgeons' job is to cut and to make sure that what he cut is healing properly. Most don't do anything beyond that competently, if at all. Alverdy saw nothing requiring his cutting skills.

Please get another complete set of labs and post them here. You can use this spreadsheet to know what labs you need and to track them. weightlosssurgery.proboards.com/thread/8800/lab-template

I suspect that you have received incorrect information about these, too, as you have so many other issues.

It worries me.

[abbysmom]

Thanks so much for the advice. I am going to follow what you told me to eat. I do feel like I am starving. and I do have gerd.
I am going to see another gastro doctor to see about the gastroparesis. You may get tired of me because I definitely need help with my diet. I have started the protein shakes that Goodkel told me about and I really like them. Will see how this goes.
I am so worried about going over on the carbs.

[newyorkbitch]

Are you taking a PPI?

[abbysmom]

yes I am....Nexium 40 mg

[newyorkbitch]

All at once?

[illinids2]

Aug 26, 2014 22:33:03 GMT -5 abbysmom said:

Thanks so much for the advice. I am going to follow what you told me to eat. I do feel like I am starving. and I do have gerd.
I am going to see another gastro doctor to see about the gastroparesis. You may get tired of me because I definitely need help with my diet. I have started the protein shakes that Goodkel told me about and I really like them. Will see how this goes.
I am so worried about going over on the carbs.

Good deal and we won't get tired. Helping others (we all get help from this place) is what this board is all about. I would have been lost without it as Kel points out, surgical offices in general give terrible nutritional/supplement advice for DS living.

[abbysmom]

Went shopping today and loaded up on protein foods and more shake powder. Ready

[newyorkbitch]

If you are taking 40mg of Nexium once a day, it's no wonder you are having breakthrough heartburn.

Take 20mg in the am and 20mg in the pm. That will help.

You can also buy Prilosec (omeprazole) otc, 20mg, and take that.

[abbysmom]

This is the way my doctor prescribed the Nexium, in one tab. I get it through the pharmacy not over the counter. At my next visit I will discuss it with her.

[newyorkbitch]

You can get omeprazole otc, it doesn't require a prescription.

I realize your doctor prescribed it 40mg once per day - lots of people start out that way and then when they switch to twice a day, it makes a big difference.

Omeprazole, for the vast majority of people, has the same effect as Nexium. But omeprazole is available generically, and Nexium isn't (yet).

You could just call your doctor and when she calls you back, just say you're having some breakthrough heartburn and would it be okay to take 20mg prilosec am and pm instead of 40mg nexium once daily?

[abbysmom]

Thank you,I will ask her

[Girlrocker]

Hi Abby, I've been away recovering and you've gotten a lot more good advice here. Never worry about asking too many questions, besides as noted, our surgeons are very often excellent cutters but the guidance from them, staff, PCPs re: DS eating usually is sub-par. And, this is how you'll learn! We don't get the way we are overnight so it takes time to learn a new way to eat. Also, don't fear carbs. And I say this as a recovering carb addict. It helps weight loss to keep them in the 50g range, and from good sources (as long as they agree with you). Cream cheese pancakes and mug muffins became my salvation for sweet and starchy 'bread' treats. I've also found gluten free bread that has 11g a slice (Glutino, Udi's). Toasted and topped with a big bunch of protein - whether cottage cheese or deli meats, peanubutter, nice burger, great mini meal or snack, so satisfying.

[goodkel]

Aug 26, 2014 22:33:03 GMT -5 abbysmom said:

Thanks so much for the advice. I am going to follow what you told me to eat. I do feel like I am starving. and I do have gerd.
I am going to see another gastro doctor to see about the gastroparesis. You may get tired of me because I definitely need help with my diet. I have started the protein shakes that Goodkel told me about and I really like them. Will see how this goes.
I am so worried about going over on the carbs.

We won't get tired of you, especially if you listen to what we have to say.

There is a list of protein foods on our Nutrition board. Use the items on this list to create your daily menu:

weightlosssurgery.proboards.com/thread/2062/foods-high-protein

Once I was past my initial healing stage, I didn't count carbs because I just didn't eat them. No flour, no rice, no potatoes, no fruit, no sugar, only leafy vegetables. Sure, there were some carbs in condiments, yogurt, and things but, without eating all the other stuff it was minimal enough to not worry about.

When your body thinks you are starving it will hold on to everything it has. What you need is to feed it AND take the complete list of vitamins you can find in a pdf file here:

weightlosssurgery.proboards.com/thread/8611/vitalady-basic-vitamin-mineral-schedule

If Alverdy saw your scans and found nothing he could resolve surgically, I suspect that you are highly deficient in vitamins. Your body reacts to that the same way it does to starving, it holds on to the weight.

Glad you like the protein powder. Until you are up to speed on your eating, aim for two 60 gram shakes a day.

This is not the first that we have seen someone with a problem being shuffled from one lazy/incompetent doctor to another causing dangerous risks to their health. Our dear Dee is still recuperating from one such ordeal:
weightlosssurgery.proboards.com/thread/9100/deedee484-update

[abbysmom]

Thanks for everything...Like I said before, I really like this forum.
I have lost 3 pounds in 2 days following the diet

[goodkel]

YAY!

Now get on the vitamins, too!

[abbysmom]

Promise

[abbysmom]

Lost another pound...YES!!!! Since I am 3 years out do you think I will still loose a significant amount of weight??

[goodkel]

I can't say. The rapid weight loss window generally lasts about 2 years.

But, your DS never stops working. Keep a tight rein on those carbs, get in all your fluids (minimum of 64 ounces a day), and stay on top of those vitamins and labs. Post your lab results here so we can help you with them.

With plenty of protein, minimal carbs, plenty of liquids, and no vitamin deficiencies I think you could lose a substantial amount of weight. You'll just have to work harder at it than a new post op would.