I am so sorry for your loss.  She must have been like a sister to you.

I'm no doctor, but I have spent my time in the trenches with diabetes, with a husband and MIL with type 1, and I can tell you that diabetes is a vascular disease.  That's why almost all diabetics have high blood pressure, and the vascular component is the cause of diabetic retinopathy ... and stroke. 

That thing you can't put your finger on, is it survivor guilt? 

It is NO WONDER that your focus is shot.  Please consider seeing a grief counselor ... and accept my sympathy for the loss of your dear friend. 

.....passed away last week.  She had a massive stroke....she was 29 days out from Open Gastric Bypass surgery.   She was so excited that she had finally made the decision to have surgery.  Her co-morbidities were diabetes, high blood pressure, edema and sleep disturbances....her BMI was 54.  The neurologists stated that he felt that the stroke was unrelated to the surgery.  I cannot help but think otherwise...????  She was complaining of having no energy to do anything and that continued to the end.  I told her that the first couple weeks that feeling is normal.  My own surgery was almost 2 years ago and I've lost 146 lbs.  Her decision to have surgery was also based on my success...along with the urging of her doctor of course.  I now have a sense of guilt, not that I "talked" her into surgery, but something I can't really put my finger on....????  Not only is she my best friend, we have also worked at the same company for over 30 years....our offices are directly across from each other.  I struggle coming into work everyday....really not so much as coming in, but being able to focus on actually working.  My manager and co-workers all understand and also are feeling their own grief.  I feel such grief for her husband and 2 children, also!  I'm just sharing my thoughts and feelings with people I know might understand???

That is very interesting, I developed mine after having lap Nissan Fundoplication which is surgery to correct acid reflux - they take the top of the stomach and wrap it around the esophagus to make a tighter sphincter to stop the acid from coming back up. I never realized that the surgery caused it, I just knew it happened after the fact.

 I had a RNY Gastric Bypass done in November 2009.  About 3 weeks after surgery I started having pain in my upper abdomen and between my breasts and nausea.  I was started on Carafate and Nexium suspension for supposed marginal ulcers, which were later confirmed on Endoscopy in December.  Despite this treatment, the pain and nausea continued, with the pain moving somewhat to below the right ribs and in the center of my upper abdomen .  A second Endoscopy in February revealed that the ulcers were healed, but a small 7 mm round non-fixated nodule in my esophagus was an incidental finding.  

Additional workup of the cause of my pain and nausea included an Abdominal Ultrasound, which showed sludge in my gallbladder, and a HIDA scan, which revealed an ejection fraction of 8% meaning the gallbladder was not functioning adequately.  Therefore, I had a Laparoscopic Cholecystectomy in March 2010.  A week later, I again developed fluctuating epigastric abdominal pain (lower and gradually stronger than before, which worsened with exercise), nausea and abdominal distention.  An abdominal/pelvic CT  in April 2010 only showed copious amount of stool in the colon consistent with constipation. I used numerous laxatives to clear up the constipation, but it did not effect the pain, nausea or distention.  

My surgeon referred me to a Gastroenterologist, *****commended an Enteroscopy with Balloon assist past the Jejunojejunal anastomosis to look for problems lower than the pouch, as well as an Ultrasound and biopsy of the Esophageal nodule, which was done in June 2010.  A small, superficial jejunal ulcer was found there, but no specific treatment recommended as they apparently are not very responsive to medication.  A repeat abdominal CT again only showed constipation.  Again, the use of Miralax did not improve the symptoms, although it affected the constipation. These symptoms worsen with eating and drinking, and I have seriously reduced the consistency and types of food I eat - mainly soupy/very soft and mostly the same thing every day.  I struggle to take in 625-725 cals. a day (and I'm 9 months out!)

A Diagnostic Laparoscopy was done August 3, 2010 to determine if there was any anatomical reason not picked up on previous tests for my symptoms.  My surgeon found and repaired 2 small defects in the adhesions between the large and small intestines that "could" be places where the small intestines could get herniated and cause an intermittent partial obstruction, but he is not convinced this was the problem.  He also released excess air in the remnant stomach, which he believe was iatrogenic from too exuberant inhalation by the anesthesiologist.  There were very few adhesions present, and the area where the jejunal ulcer was looked fine from the outside.

If the pain and nausea continue despite the repair in the defects, Dr. Kligman is recommending addressing the issue as a pain management one and going for a Celiac Axis Block.  Given the lack of findings on these many procedures he does not think there is likely to be a significant yield looking further.  I am concerned that just blocking the pain ignores a possible treatable or serious condition.  I just talked to my Gastro, who stated that he did not have anything else to offer in his differential diagnosis at this time, but that I certainly could reconsult him should symptoms change or become more specific.  He recommends following my surgeon's recommendations for treatment via pain management should my pain and nausea continue after the healing period from  the Diagnostic Laparoscopy.  I'll see my surgeon in about 2 1/2 weeks for follow-up.  I would appreciate other opinions. 

I just had the Spinal Cord Stimulator implanted at Cleveland Clinic (CCF) on Monday, August 2nd by Dr. Kapural and his team.  I am very sore, way more than I was for the trial version, but I have taken into consideration that this time around the incision in my back is a little bigger, and there is an added incision right above my left hip for the hardware with a tunnel in between the two, under the skin, to connect.  It feels like the worst back muscle cramp ever, but as my aunt says, you can stand anything as long as it is temporary, words to live by, seriously.
Next step, I am in the works to see a doctor in Mississippi to see if I am a candidate for a gastric pacemaker.  I do not have full-on gastroparesis, but I do have a severe case of delayed gastric emptying, so we will see what happens.  According to my GI at CCF, the doc in Mississippi is THE guy for gastric pacemakers, and one of the few that actually has a test to see if it works for you.
My PICC failed, and I am secretly pleased for all the wrong reasons, I just hated living that way, made me feel like a freak, of course I don't feel that way about anyone else who has one, just me...why are we so hard on ourselves?  I am looking at a 1-2 day trial of an NG feeding tube that runs to my small intestine to make sure I can tolerate the J-tube feedings before the surgeon will schedule the surgery to put in a Roux En Y Jejunostomy feeding tube, it will take the place of the PICC, and it is more liveable than a PICC, less risk of systemic infection, I can swim, etc...  I really just wish I could live without all of this stuff, but after going to CCF I have come to the harsh reality that this is all permanent.  They have told me that at this point, we just need to try and control the symptoms, the damage to my vagus nerve is permanent, it cannot be repaired.
I'm trying to keep my spirits up, I have re-enrolled in paramedic class, I will only know if I try.
As always, I am here for anyone who is struggling like me, although I wish there weren't anyone else.  If it takes me a while to get back to your emails, I apologize, I am not on here as much as I used to because of all my trips back and forth to Cleveland.  I think I will be home for a while this time, I have to have my stitches removed in 10 days, but they said my local pain management doc can take them out, which is good, I am not up for an 8 hour one way car ride at this point.
Good health to all!
Jules