Feeling out of sorts

Things have been hectic for me lately, and by no means okay or stable. But today when I went for my walk I felt so...weak and tired. It wasn't as bad as when I went to the ER a few days ago, but it was a little similar. I felt ok on the drive to the waterfront, but as soon as I got out and started walking it felt---difficult. I've had gastric bypass and I'm struggling to get my liquids in aeach day, but I am getting at leas 48-50 ounces in. Anyway, my upper body and arms felt weak and tired and I felt like I wasn't getting enough air when I breathed, like I couldn't inhale deep enough. Again, it wasn't as bad as when I went into the ER for dehydration, but it was very hard to maintain walking as opposed to not even being able to stand. Lastly, I was sweating more than I thought I should, especially for there being such a cool breeze, and it felt like my heart was beating extra hard. Not beating fast like palpatations, just beating hard. I don't know. I have been and am extremely stressed lately, but my weekend walks are usually long but managable. I can usually do it without having to stop once (its a 2 1/2~ mile walk). It really tires me out and makes me sweat, but I can do it. This tikme however I had to stop frequently. Even 8 hours later and a short 1 and a 1/2 hour nap I still feel run down and weak. Has anyone experienced this? I tried checking WebMD with my symptoms and it ranged from blood clots (which only shared a few symptoms) to dehydration (which shared a few more, but not the majority). I've been walking, and getting my fluids so I don't know whats wrong with me. I refuse to spend another night in the hospital, I dont think my sanity could take it.

Alexx,
I am sorry you are not feeling well.  I have found that when I am not getting enough protein I feel very sluggish.  How's your vitamin intake??  I enjoy Sugar free ice pops and they give me  additional fluids.  Also broth is a great way to get in extra fluids and my Surgeons office actually sells broth which contains 15 grams of protein...so I not only get in a cup of fluids, I also get some extra protein  Perhaps you should call your Dr. or Nutritionist and go over your daily intake (including vitamins)  and symptoms.  I hope you feel better soon.....and call your doc!!!   

Hugs
Jane

Hi Alexx, i am also sorry that you don't feel well, i know it's hard to get down all those protiens and tha****er but maybe that was the problem...you should call your surgeon today maybe they have some anwsers...i also suffer from alot of mental anguish and i do see a psychiatrist and take prozac, i guess things have not been so great for me as well but do feel better...

fellow brooklynite (lol)  p.s. if you ever want to email me my addy is [email protected], being we both live in brooklyn and looking for support...

frankie

How are your labs?? many electrolyte abnormalities come to mind....Anemia comes to mind, http://en.wikipedia.org/wiki/Anemia  (Anemia diminishes the capability of individuals who are affected to perform physical activities. ) as well dehydration not bearing a trip to Er may be the least of concerns please consider it...dehydration can be fatal, I am guessing less than 64 oz is not enough before exercise after that would ned to increase? Malnutrition as well at this point has a factor in fatigue. Stress can also cause anxiety/panick feelings to have these symptoms as well may be combo of all things.... only seeing a health care provider can assist u in correct diagnosis and swift t, do not delay!!!!!!!!!!!!!!!!!If it is a blood clot even more reason to run to them.... http://en.wikipedia.org/wiki/Dehydration Symptoms and prognosis

Symptoms may include headaches similar to what is experienced during a hangover, a sudden episode of visual snow, decreased blood pressure (hypotension), and dizziness or fainting when standing up due to orthostatic hypotension. Untreated dehydration generally results in delirium, unconsciousness, and in extreme cases death.

Dehydration symptoms generally become noticeable after 2% of one's normal water volume has been lost. Initially, one experiences thirst and discomfort, possibly along with loss of appetite and dry skin. This can be followed by constipation. Athletes may suffer a loss of performance of up to 30%^[2], and experience flushing, low endurance, rapid heart rates, elevated body temperatures, and rapid onset of fatigue.

Symptoms of mild dehydration include thirst, decreased urine volume, abnormally dark urine, unexplained tiredness, lack of tears when crying, headache, dry mouth, and dizziness when standing due to orthostatic hypotension.

In moderate to severe dehydration, there may be no urine output at all. Other symptoms in these states include lethargy or extreme sleepiness, seizures, sunken fontanel (soft spot) in infants, fainting, and sunken eyes.

The symptoms become increasingly severe with greater water loss. One's heart and respiration rates begin to increase to compensate for decreased plasma volume and blood pressure, while body temperature may rise because of decreased sweating. Around 5% to 6% water loss, one may become groggy or sleepy, experience headaches or nausea, and may feel tingling in one's limbs (paresthesia). With 10% to 15% fluid loss, muscles may become spastic, skin may shrivel and wrinkle, vision may dim, urination will be greatly reduced and may become painful, and delirium may begin. Losses greater than 15% are usually fatal. ^[3] Water Calculator Are you drinking enough? http://nutrition.about.com/library/blwatercalculator.htm  http://www.mcvitamins.com/water.htm

HIBERNATION

 

Summarized from:

 

Weight Loss surgery: Finding the thin person hiding inside of you second edition by Barbra Thompson P. 198

 

"Hibernation syndrome can be experienced within 2-4 weeks after surgery, when the body realizes that it will not be getting the nourishment that it is used to receiving and reacts to that. Your body just wants to stay immobile until the old food supply returns, you will feel extremely tired, lethargic and often depressed. This comes at a time when you are beginning to recover from the traumatic effects of the surgery. The pain is usually gone and the energy was just starting to return....The best way to deal with this if it affects you (not everyone gets it) is to recognize the symptoms and know it is normal. Then start exercise so that the body "figures out" it has ample energy/fuel stored and does not have to be fed constantly. This will pass within a few weeks." ~~~~~~~~~~~~~~ Hibernation Syndrome   After WLS, you may be feeling tired and become depressed. When you are several weeks post op, and are either on a liquid diet or you are eating many fewer calories than you were pre op, this depression and inactivity can become more pronounced. All you want to do is sleep, you may have crying spells, you may begin to believe that the surgery was a mistake, or you may think 'what in the world have I done to myself?'   All these feelings are completely normal and, to a certain extent, are to be expected. The low number of calories you are eating produces what many of us call the 'hibernation syndrome' and your depression and feelings of despair, are a direct result.   During the weeks immediately following surgery, our body starts to notice that we are not taking in enough calories. It doesn't know we've had WLS, or that it's the year 2003. Our body is missing food, thinks this is a famine, and struggles to conserve our energy. The human body reacts like it always has in a famine; it makes us depressed--so we don't have the motivation to do anything, and it makes us tired--so we don't have the energy to do anything. In this way, we will conserve as many calories as possible and remain alive. You can see the practical value of this as our bodies have been living through famines, snowstorms, and other periods of unstable food supply for centuries.   This stage can last several weeks. Our discomfort is compounded as we are, at this same time, trying to recover from major surgery, adopt new eating habits, and deal with a liquid or soft diet. To get out of this stage, our body has to say to itself 'gee, this famine is lasting a bit too long. If I keep conserving my energy with inactivity, I will starve to death. I'd better use my last store of energy (the remaining fat and muscles in our body) to hunt up some food'. At this point, our body will switch from getting energy from food, to getting energy from our fat (and muscle too if we don't eat enough protein) and that is what we want.   In order to deal with this difficult transition period, tell yourself that you're right on track; this is exactly what is normal and to be expected. Tell yourself that, in a few weeks, this will pass, and you will feel like a completely new person. We all seem to turn the corner about 4-6 weeks post op. Then, your mood will lighten and, with your weight loss starting to add up, you'll feel more positive and have a better outlook on life. Just keep telling yourself that you will not always feel this way! You WILL be back to feeling like your old self. Just give it time! ~~~~~~~~~~~~~ Reactive hypoglycemia also comes to mind did u eat prior?? Symptoms of, and Foods to Relieve, Hypoglycemia Symptoms of hypoglycemia Sweating, drowsiness, feeling warm, difficulty speaking, inability to concentrate, hunger, anxiety, confusion, nausea, trembling, headaches, dizziness. These symptoms may also be triggered by stress or anxiety. The only way to know if the symptoms are due to hypoglycemia is to test a small sample of blood.  Here are some links regarding Reactive Hypoglycemia: http://www.medpagetoday.com/Gastroenterology/PancreaticDisea ses/tb1/1399 http://www.opinions3.com/reactive_hypoglycemia.htm http://www.hypoglycemia-treatment-info.com/ http://www.fred.net/slowup/hypo.html http://www.sover.net/~devstar/hypogly.pdf

Focus on Fluids

 

 

 

One of the main challenges for a gastric bypass patient over time is to maintain hydration. Your body needs just as much fluid after the surgery as it did before surgery, yet the new stomach pouch limits you to 1-2 ounces at a time.  (NO MORE GUZZLING!) Maintenance of fluid intake may also be difficult because of the necessity to take in food or fluids, and not both at once. You must compensate for this by taking small amounts of fluid on a near-constant basis. Usually this means that you should carry your fluid source with you at all times.

 

 

 

*** We cannot overemphasize that the liquid must be a caffeine, carbonation & calorie-free. Patients who use fruit juice or other calorie-containing liquids for hydration may experience inadequate weight loss because of the calories in these fluids, and can experience dumping syndrome from the sugar. Caffeine is a possible appetite-stimulant, diuretic and irritant and can potentially cause ulcers in the new pouch and add to dehydration and low-iron blood (which we already poorly absorb iron post-op). Carbonation can possibly cause gastric irritation, if carbonated beverage also contains phosphorus it may act to leach calcium out of bones, and some feel it may stretch pouch/stoma.

 

 

 

Drinking at least 64 ounces of fluids post-op is a necessity. Water is the body’s best source, and serves the purpose to aid digestion and absorption of food; it regulates temperature and circulation, carries nutrients and O2 to the cells of the body and removes toxins and waste.

 

 

 

Dehydration can cause/aggravate constipation, kidney stones, urinary infections, high or low blood pressure, difficulty controlling diabetes and migraines. Dizziness, clumsiness, muscle cramps in arms and legs, dark yellow urine, fatigue, irritability, are sunken eyes, low blood pressure and fainting, bloating, and a fast, weak pulse -- are signs that dehydration is setting in.

 

 

 

Fluids should be consumed on a near-constant basis, but not during meals and not soon following food. If you drink during your meal, you will tend to wash the food out of the stomach pouch, and consume more food than is desirable. It may seem strange at first to eat without drinking but it works fine. A good tip here is to actually not have any fluid on the table while you are eating. In addition to reducing your overall food intake, this new habit will encourage you to chew more thoroughly before swallowing, because you will not count on the fluid to wash down half-chewed food. Also note that soup is kind of like drinking liquids with food – soup is not an absolute "no-no" but recognize that it should not be a regular part of your diet.

 

 

 

Liquids should not be consumed for about 30-60 minutes after eating. This is because the food actually forms a plug that blocks the outlet from the pouch until it has all passed through. If you drink liquids on top of this plug it will create a very uncomfortable sensation and may also force food downstream more quickly than it should go.

 

 

 

A brief review on coordinating liquids and food:

 

ü       Sip liquids constantly, even just before eating. Don’t drink liquids while eating.

 

ü       Don’t drink liquids until about one hour after completing your meal.

 

ü       When the stomach pouch is mature (six months or more after surgery) it is useful to wait two or three hours after eating before consuming liquid.

 

 

 

 If you must choose between liquids and food (frequently true in the first months after gastric bypass) – choose liquids!

 

CLEAR LIQUIDS IDEAS:

 

***(VARIETY IS THE KEY TO GETTING THROUGH THE FIRST 2 WEEKS!)***

 

 

 

ü       Broth any flavor (canned or made from bullion cubes) or strained soups such as chicken noodle without the noodles! Cup of soup brands strained.

 

ü       ¼-½ strength apple or cranberry or grape juice (OJ may be too acidic at first).

 

ü       Full or ½ strength Ocean Spray lite cranberry juice varieties (white, cran-grape, cran-raspberry, ****tail) these have 40 cal a glass vs 120 cal a glass of regular juices and are made with splenda. Available at Wal-Mart and PC.

 

ü       Diet V8 Splash (Wal-Mart and PC) 10 calories a glass and made with splenda, full strength or watered in ½.

 

ü       Carb Countdown dairy beverage. *has lactose.

 

ü       Carb Countdown yogurt smoothies (black cherry, peach, strawberry & strawberry-kiwi) *has lactose.

 

ü       Carb Countdown fruit flavored beverages in OJ section. (OJ flavored, orange-pineapple, orange-pineapple banana, Ruby red grapefruit & lemonade flavors).

 

ü       Old Orchard Low carb juices (30-40 calories a serving with 6-10 G carbs/with different varieties) full or ½ strength. Cranberry, Cranberry Raspberry, Cranberry Grape, and White Cranberry flavors available.

 

ü       Diet Very Fine juices.

 

ü       Crystal lite (Wal-Mart) any variety (decaf tea, lemonade, fruit punch etc), diet Tang (Wal-Mart) diet Kool-Aid any variety (Wal-Mart). OR Carb options & Wyler’s Light powdered beverages. NEW Wal-Mart-brand called great value, 4-C’s and Crystal lite have to go sizes! To add to a 16 oz bottle water! NEAT!**NOTE MANY PEOPLE WATER DOWN EVEN MOR FINDING IT TOO SWEET***

 

ü       Decaf tea or herbal decaf teas or decaf coffee hot or iced.

 

ü       WATER, try it iced, warm or with a little lemon or lime to flavor, many like to add a little splenda to change the taste! Water may have a metallic taste initially this is normal and goes away.

 

ü       Fruit 2O (bottled or/& they make a frozen Fruit 2O in raspberry and lemon! YUMM).

 

ü       Propel Fitness water by Gatorade: Kiwi Strawberry, Peach, Orange, Berry, Black Cherry, and Lemon.

 

ü       Diet Jell-O (you make or premade varieties).

 

ü       Sugar-free Popsicles (Popsicle brand has original and tropical fruit flavors.

 

ü       NO-Sugar added Fudgesicles (popsicle brand).

 

ü       New Minute Maid light (Light Lemonade, Light Guava Citrus, Light Raspberry Passion & light mango tropical) It is a 5 cal/serving juice (2 servings in a bottle)...0 fat 80 mg sodium 2 g carbs (less than 1 g sugar) 0 protein...(It comes in 4 packs 16.9 oz plastic bottles or 12 pk 12 oz cans).

 

ü       Wal-mart has SAM’s brand (called First-Harvest) non-calorie non-carbonated flavored beverages: cherry-limeade, lemonade, strawberry Kiwi and MY FAV peach-grapefruit. (4 pks of 20 oz size)

 

ü       K-Mart has similar ones 1 L size.

 

ü       Many many flavored waters popping up.

 

ü       http://www.flavors2go.com/ Flavors2Go are designed to offer the delicate taste of real fruit, not the heavy, artificial fruit taste that people have come to accept.

 

***TIP Keep a journal of each hour in a day for the first week of fluids.  Write down what you drink in the hour and what activity you do! You should move every 1-2 hrs even if it is just walking around the house to avoid respiratory or circulation problems. This helps keep you mindful! Remember you cannot catch up on fluids later in the day OR take a 2 L soda bottle empty and fill it each time you sip some fluid with same amount this is a great visual as to how far to go and how much u have drank, set midday to have it 1/2 gone!!!!