Metabloic/Enzyme Disorder Post-DS w/ neuropathy?

Went to my neuro yesterday. I "failed" my 2 hour glucose test- I was abnormally low. I started at 75 and after taking the glucose drink and waiting 2 hours it was at a 52. I am having pretty serious neuropathy and migraines and a plethora of other symptoms. She mentioned in researching what could be going on with me she found some research saying that post-DSers are at risk of developing metabolic/enzyme disorders due to the severe malabsorption issues and she feels that I may be experiencing this. She mentioned that this is a rare side effect but apparently does happen. Has anyone heard anything about this or experienced any blood sugar issues, metabolic issues, neuropathy issues, or problems with enzymes post DS? I am 2 years post and FINALLY have NO deficiencies. Everything is well above a normal level now. I am also on Gabapentin (400 mg am and noon and 600 mg evening) so that SHOULD be controlling the neuropathy (I'm on it for my fibromyalsia) but it isn't. Neuropathy is in my hands and feet mostly and is worse at night. Any thoughts/suggestions or anything at all would be most helpful!

I have heard of metabolic/enzyme disorder, however, I don't know much about it. Only what I have read online regarding it.

I'm wondering if you had your common channel lengthened would it make a difference and help this disorder?  I have also heard that glucose tests are inconclusive for RNY and DSers due to the way the intestines are configured.

I'm sorry you are having such issues and will keep you in my thoughts and hope for a full recovery.

Maddie

I would worry about weight gain if I lengthened my common channel (which is 90 cm).  *sigh*  I just keep telling everyone 1) I wish they would have listened to my complaints more seriously when I was fat instead of telling me I was fat and needed to just lose weight 2) now I have lost a significant amount of weight and the symptoms I was dealing with before (mostly fibromyalsia related in nature) don't hold a candle to what I am dealing with now.  Now I just want them to find out what is wrong with me and treat it.  I go back on chemo this week (methotrexate) for my rheumatoid arthritis which makes me very tired, weak and nauseated.  I just keep telling the doctors I just want to know whats wrong with me and stop feeling pain all the time and be some what normal.  I am only 30!  I have 2 kids with autism.  Now I have the beginning stages of cervical cancer to top everything else off.  My migraine disorder is so bad it causes seizures.  *sigh*  I hope they find a solution soon and can fix the neuropathy.  I fell and sprained my ankle not once but twice in the past week.  My symptoms are progressing rapidly.  The only good thing is they have ruled out MS with my MRI.

You have all these issues and you are worried that lengthening your common channel will cause you to gain weight?  I'm thinking you need to rethink your position. Gaining weight would and is the LEAST of your worries. And truthfully from what I understand those who have 100 - 125 cm common channels maintain and have lost weight have lost to goal and kept it off. You need some clarity and I'm not being mean, but perhaps some counselling as well. These issues that you are currently dealing with are serious and if lengthening your common channel will help to resolve or reverse many of your issues and gaining some weight is a side effect, well then you know what you have to do. 

Honestly I have no idea who I would even have do it.  I don't trust my surgeon as far as I can throw him (which isn't far).  My after care with Marshall has been terrible.  Gaining weight, even 5 pounds, would but more stress on my joints which would majorly affect my rheumatoid arthritis.  I have arthritis in my hands, hips, and knees and  I have degeneration issues in my SI joints.  I'm not going to say I don't have body image issues ****rtainly do- though my body dysmorphia is much much better than it was a year ago and I am at a more comfortable level with my body and body image due to medication and therapy) but I am much more concerned with weight impacting my medical conditions vs a body image thing.  If gaining some weight because of lengthening my common channel would fix many of my issues I would do it but my rheumatoid arthritis is something that is going to end up crippling me eventually in life and the more I weigh the more complications I will have from that.

I make no claims that I am a "typical" or simple case at all heh.  It is definitely a case of weighing options.  If it comes down to having to have my common channel lengthened 1) I am not even sure my insurance would cover it (I have Medicaid) 2) I would not allow the surgeon who did my DS and gall bladder surgeries to touch me so I would need to find another surgeon to do it which would also prove difficult.

You could start here:

John C. Alverdy, MD *
Email: [email protected]
Vivek N. Prachand, MD, FACS *
Email: [email protected]
 

Center for the Surgical Treatment of Obesity
University of Chicago Medical Center
5758 S. Maryland Ave.
Chicago, IL 60637
Phone: 773-834-8900
Fax: 773-834-0201

Office Mailing Address:
John C. Alverdy, MD
University of Chicago Medical Center
5841 S. Maryland Avenue, MC 6090
Chicago, IL 60637

Office Mailing Address:
Vivek N. Prachand, MD
University of Chicago Medical Center
5841 S. Maryland Avenue, MC5036
Chicago, IL 60637

I have RA so I get the stress on the joints thing, but truthfully 10-20 pounds is not going to make that much of a stress on your joints.  Especially in non weight bearing areas like hands, wrists, fingers, etc.

The thing to do is to call one of these doctors. I'm pretty certain that if you are suffereing from a syndrome due to the length of your CC a properly worded letter or two to Medicaid would likely get you an approval.

The wait list, last I heard, to get in to see either of those doctors on Medicaid was 7 years.  Which is NUTS!  I will give them a call tomorrow and see if that is still the case.

I assume that is to get a ds, you don't need a DS you need a revision of your common channel length.

I owe you an apology and so I shall set it forth now. I apologize. I have been informed that my suggestion to have your common channel lengthened may not fix the issues you are currently facing. It has been pointed out to me that though the DS may not have been the reason for your complications that perhaps having the DS set them in motion. Something akin to the perfect storm.

I have done a lot of reading of abstracts this morning regarding metabolic disorders and while they all say basically the same thing (they occur), they do not address how to resolve it and if any resolution is even possible nor do they seem to address many autoimmune dieseases. I may not have delved deep enough into the subject to find it, but nothing I read unfortunately suggested any sort of resolution. 

There were repeated suggestions that micronutrient dificiences may be the cause of some problems. I don't know how extensive your blood work has been, but perhaps checking for Thaimine, copper, and zinc deficiencies may be in order. Again, I don't know if adding any of these items to your daily vitamin regime would help, but if you are deficient in any of them they can cause other metabolic problems. 

Is there a metobolic disorder doctor in your network of doctors that you can go see? Perhaps someone who has seen wls related metobolic disorders. At the very least contact one of the wls surgeons and see if they can see you or have any input or suggestions to whom you could contact for help.

In the end I do hope you get some answers and help for your issues. Being in chronic pain is very wearing on a person psychologically. 

Maddie

I have RA and for a while I tried to figure out what would set it off, but came up empty handed. For several years I got gold shots which helped some. I have been in remission for many years now, but again, I don't know why or if I did or have done anything to do so.

 I am sorry for all your issues. If I were you I would also contact Dr Rabkin. I understand he is in Chicago about once a month, or every other month and see what he has to say.  I sure have no answers for you but hope you find some answers soon.

John M. Rabkin, MD, FACS *

Pacific Laparoscopy
2250 Hayes Street, 3rd Floor
San Francisco, CA 94117
Phone: 415-668-3200 or 1-888-848-8446 toll free
Fax: 415-668-2010
Email: [email protected]