I need some help/advice for my mom!

My mom had gastric bypass a few months ago. Her doctor wanted her to have it because she was Type 2 diabetic and in danger of a lot of other health issues that would be solved by losing weight. She is 69 years old. Things were going well at first - she felt well, she was able to eat as needed, and was losing the weight. She is about 5'5" and I'm not sure about her current weight, but she's lost quite a bit and can now fit into like size large in women's (she was at a 2XL or 3XL before).

But recently she has become very weak and has fallen several times (which is dangerous at her age). She went in to the doctor and they were initially convinced based on scans and blood work that she she had fatty liver that had advanced to cirrhosis, and they said it was Stage 3 cirrhosis (and that her only hope for survival would be a liver transplant). The doctor also told her that she was severely malnourished, comparing her to starving kids in other countries. He said that was the cause of her weakness, along with the liver issues.

A biopsy was done on her liver and she's Stage 1 of fatty liver, which means she can turn it around with diet and exercise, and we're all very happy about that. However, she is still extremely malnourished. The doctor's solution was that she eat more protein. She has been focused on doing so ever since her surgery; now she is trying to up her intake even further. And despite trying to get as much protein as she can, her last blood work showed that her protein is at a 2, which is apparently really bad.

So a couple of questions for you - Have you heard of anyone going through something similar to this? What did they do to improve their nutrition and overall health? (Because at this point the doctor is now recommending undoing the surgery so that she can absorb protein better, but I don't want my elderly mother to undergo surgery again.)

How can she up her protein? She is already eating large amounts of protein at every meal and snacking on it throughout the day. She is also eating plenty of vegetables. I know you're not supposed to get your protein from drinking, but would that be helpful here? Just to make sure that she's getting enough? And how many grams of protein should she be eating a day?

What kind of vitamins should she be taking, and at what dosage? She is very low on like Vitamin D and B, and assures me that she's taking OTC vitamins that her doctor recommended. I know that's not good enough if you have absorption issues and gastric bypass, and I also know that doctors' recommendations (especially those who don't focus on bariatrics) often recommend way below what is needed. (Her vitamin levels are bad enough that the doctor wrote her a prescription for vitamins to take once a week.)

Any and all advice/help/suggestions would be most welcome. Thank you!

Adding on - she told me she takes the Fusion brand Multivitamin every day (designed for bariatric patients) and a calcium/Vitamin D that is 1000iu twice a day. Looking at the label for the multivitamin, it seems low to me.

She should be consulting with her Bariateic team as well as her other doctors for sure. Every program Has different requirements but there does seem to be some consistency in the requirement of 2x the daily multi vitamin, plus the calcium and other minerals. You could google the American Bariateic society and they have a list of vitamin and mineral requirements.

my program had a protein requirement and didn?t care if you used protein shakes to get it. The protein was the important part. There are people here who still use them and people that have never used them. I would think her getting the protein right now would be more important than the how. Hope you get the support she needs!

The liver is nothing to worry about. Those readings are common with rapid weight loss and improve when the weight loss stops. The protein you are referring to is albumin and that is serious. She would need a lot of protein supplements to bring it up from a 2. It is not possible to do it with food, especially with reduced appetite and malabsorption. She would have to be willing to work with a skilled nutritionist and be willing to take the supplements which do not taste very good.