Throwing up...

I'm about 5 weeks out, and I'm on "soft cooked" foods.  Mostly it's been fine, but the last several days I've thrown up almost immediately after eating and it's wigging me out. It's all high protein food, nothing I'm not supposed to eat.  And it's food I've eaten before without problems (fish, lean turkey, etc) but I've been throwing up and I am worried there is something wrong.  I'm going to call my surgeon today, but I'm wondering if other people have sudden intolerances like that and if that ever goes away?

HW: 283 CW: 255 GW: 160

RNY on 03/9/2015

Some people get strictures not to long after surgery it could be that.  Very smart to call your surgeon.  Make sure you keep up with your fluids and if you have to go back to liquid protein for a couple of days I don't see that being a problem. 

Hopefully your surgeon can get to the bottom of it. 

You're, what, five weeks post-op? Perfect time to develop a stricture. They're usually easy to fix---just call your surgeon.

That happened to me just after my 4-week point, and my doc said he hears that a lot at 4-5 weeks out.  I hadn't vomited once in the first 4 weeks, then all of the sudden wham!  My surgeon explained that at the 4-5 week point the healing that going on causes some shrinking (like when you scrape your knee, the scab will shrink a bit as it's getting better).  I had to slow down even more during this point and go back to using the 1 oz medicine cups to make sure I wasn't overdoing it.  I'm at 9 weeks now, and it's getting much better.  Hope that helps. 

PS:  What's stricture?

For new RNYers you need to know these...Brian

What is a stricture?  This question comes up weekly, if not daily on OH.  Below is a copy and paste from Wikipedia.  If you are a few weeks out post op from RNY and have problems keeping well chewed food (even water) down, you might have a stricture.  Very common and very treatable (about 10% of RNY patients get them).  Also do not freak out if you have to go back a second or third time to get treated for one.  The Gastroenterologist will go just below the pouch and air up the "balloon" .  It is an outpatient procedure and you will be sedated.
  
As the anastomosis heals, it forms scar tissue, which naturally tends to shrink ("contract") over time, making the opening smaller. This is called a "stricture". Usually, the passage of food through an anastomosis will keep it stretched open, but if the inflammation and healing process outpaces the stretching process, scarring may make the opening so small that even liquids can no longer pass through it. The solution is a procedure called gastroendoscopy, and stretching of the connection by inflating a balloon inside it. Sometimes this manipulation may have to be performed more than once to achieve lasting correction.
 

Dehydration...#1 reason RNY patients reenter the hospital!!
[edit] Symptoms and prognosis

Symptoms may include headaches similar to what is experienced during a hangover, muscle cramps, 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, swelling of the tongue 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%^[6], 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, irritability, lack of tears when crying, headache, dry mouth, dizziness when standing due to orthostatic hypotension, and in some cases can cause insomnia.

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 (decreased skin turgor), vision may dim, urination will be greatly reduced and may become painful, and delirium may begin. Losses greater than 15% are usually fatal.

In people over age 50, the body’s thirst sensation diminishes and continues diminishing with age. Many senior citizens suffer symptoms of dehydration. Dehydration along with hyperthermia results in seniors dying during extreme hot weather.

Dehydration is the excessive loss of water from the body. Diseases of the gastrointestinal tract can lead to dehydration in various ways. Often, dehydration becomes the major problem in an otherwise self-limited illness. Fluid loss may even be severe enough to become life-threatening.

The best treatment for minor dehydration is drinking water and stopping fluid loss. Sports drinks and other rehydration fluids are preferable to water; plain water restores only the volume of the blood plasma, inhibiting the thirst mechanism before solute levels can be replenished.^[13] To stop fluid loss from vomiting and diarrhea, avoid solid foods and drink only clear liquids. In some cases, eating of salted foods may have a positive impact on the person. However, eating salted foods should come with more intake of a clear liquid. It is wise to slowly drink liquids when dehydrated. ^[14]

In more severe cases, correction of a dehydrated state is accomplished by the replenishment of necessary water and electrolytes (rehydration, through oral rehydration therapy or intravenous therapy).

Thank you, Brian... I guess this is what my doc was explaining to me, but he never used the term Stricture.  Good to know.  (I LOVE this place!