Help! I am desperate to find answers...
Has anyone had a similar experience to this? Do please read through to the end (I know it is long but I am desperate).
Before I tell my story, just let me say that I do not ever regret having an MGB after trying the Lapband first. I lost the weight, it has stayed off, and the MGB is Sooooooo much easier to live with than the lapband. I do not want to discourage anyone from the MGB, I think it is one of the best options available, and I fully believe the problems I am about to describe are not at all typical.
And yet I am hoping someone else may recognise what has been happening, and possibly even have some information or advice that could help me.
My story:
I had the Lapband put on in 2004, when I weighed 138kg (304 pounds) and had given up hope of losing weight ever. I lost about 30 kgs in the first year and then started having major reflux problems which I battled for another year, but loosening of the band was letting me put on weight. My surgeon (in Australia), was closely associated with Dr Rutledge at CLOS, and was at the time introducing the MGB in my city where no one else was performing it. He is very highly respected in bariatric surgery and has an impeccable track record.
In 2006 he suggested the MGB but cautioned me to think very carefully about it as it was new-ish, and he had only done 4 of them before. He had been trained by Dr Rutledge, made me read all of Dr R's patient materials, and he told me that 2 of the four he had done had developed extremely unusual complications that he and Dr Rutledge had been unable to attribute to the surgery itself.
I decided to do it, had the surgery with an open wound (laparoscopy was not possible because of adhesions) and then something leaked and had to be fixed 2 days later. I suffered other complications because of this leak, and a long stay in hospital because the surgery wound was compromised by the leak and dehiscence occurred which took two months to heal.
Nevertheless, I settled in to life with the MGB and never ever had problems with eating different foods and pretty quickly worked out which foods caused dumping and so avoid them. I lost another 30kg and am still very happy with the MGB.
Here is the problem. 2 years later I had major loose skin issues and chose to have a breast lift and a full body lift. One minor area of the suture line over my sacrum broke down with dehiscence, but eventually healed. Then a full 12 months after that surgery, I started to form ulcers on the scar line around my hips/waist that wept fluid continually, were connected to small hollow pockets in the tissue deeper down, and never healed. Surgery was performed to debride them, and they were left as open wounds to ensure those pockets closed up. These ulcers never formed any where else - my breast scars were perfectly fine.
SO, it has been 2 years since the first ulcer came up, and to this day they continue to form, or old ones break down again; I have had periods of diahorrea that last 3 months; I have had joint pain; a dry mouth for 6 months; nasal sores; red eyes; and the list goes on. I have been seen by dermatologists, gastroenterologists, surgeons, infectious disease specialists and immunologists. The verdict is I must have some non-typical, unnameable overactive immune disorder, that no one knows how to confirm or treat. I have to live with the symptoms.
My deep down belief is that this is related to malabsorption issues from my MGB. I have ongoing problems with deficiencies in iron, B12 and vitamin D. I have adjusted my diet and take supplements but they never seem to improve. Now I am developing osteoarthritis in my fingers and toes and I am only 43. I am taking supplements for those but can't be sure I am absorbing them well enough. I just don't know who to turn to for help or answers. I have even thought of trying to email or write to Dr Rutledge but can't be sure he would see my message or care to reply.
Maybe someone has experienced something similar? I am at the end of my tether.
:(
Before I tell my story, just let me say that I do not ever regret having an MGB after trying the Lapband first. I lost the weight, it has stayed off, and the MGB is Sooooooo much easier to live with than the lapband. I do not want to discourage anyone from the MGB, I think it is one of the best options available, and I fully believe the problems I am about to describe are not at all typical.
And yet I am hoping someone else may recognise what has been happening, and possibly even have some information or advice that could help me.
My story:
I had the Lapband put on in 2004, when I weighed 138kg (304 pounds) and had given up hope of losing weight ever. I lost about 30 kgs in the first year and then started having major reflux problems which I battled for another year, but loosening of the band was letting me put on weight. My surgeon (in Australia), was closely associated with Dr Rutledge at CLOS, and was at the time introducing the MGB in my city where no one else was performing it. He is very highly respected in bariatric surgery and has an impeccable track record.
In 2006 he suggested the MGB but cautioned me to think very carefully about it as it was new-ish, and he had only done 4 of them before. He had been trained by Dr Rutledge, made me read all of Dr R's patient materials, and he told me that 2 of the four he had done had developed extremely unusual complications that he and Dr Rutledge had been unable to attribute to the surgery itself.
I decided to do it, had the surgery with an open wound (laparoscopy was not possible because of adhesions) and then something leaked and had to be fixed 2 days later. I suffered other complications because of this leak, and a long stay in hospital because the surgery wound was compromised by the leak and dehiscence occurred which took two months to heal.
Nevertheless, I settled in to life with the MGB and never ever had problems with eating different foods and pretty quickly worked out which foods caused dumping and so avoid them. I lost another 30kg and am still very happy with the MGB.
Here is the problem. 2 years later I had major loose skin issues and chose to have a breast lift and a full body lift. One minor area of the suture line over my sacrum broke down with dehiscence, but eventually healed. Then a full 12 months after that surgery, I started to form ulcers on the scar line around my hips/waist that wept fluid continually, were connected to small hollow pockets in the tissue deeper down, and never healed. Surgery was performed to debride them, and they were left as open wounds to ensure those pockets closed up. These ulcers never formed any where else - my breast scars were perfectly fine.
SO, it has been 2 years since the first ulcer came up, and to this day they continue to form, or old ones break down again; I have had periods of diahorrea that last 3 months; I have had joint pain; a dry mouth for 6 months; nasal sores; red eyes; and the list goes on. I have been seen by dermatologists, gastroenterologists, surgeons, infectious disease specialists and immunologists. The verdict is I must have some non-typical, unnameable overactive immune disorder, that no one knows how to confirm or treat. I have to live with the symptoms.
My deep down belief is that this is related to malabsorption issues from my MGB. I have ongoing problems with deficiencies in iron, B12 and vitamin D. I have adjusted my diet and take supplements but they never seem to improve. Now I am developing osteoarthritis in my fingers and toes and I am only 43. I am taking supplements for those but can't be sure I am absorbing them well enough. I just don't know who to turn to for help or answers. I have even thought of trying to email or write to Dr Rutledge but can't be sure he would see my message or care to reply.
Maybe someone has experienced something similar? I am at the end of my tether.
:(
(deactivated member)
on 1/21/12 1:50 pm, edited 1/21/12 2:15 pm
on 1/21/12 1:50 pm, edited 1/21/12 2:15 pm
Im sorry youre having these problems and although I havent had the surgery, I have done some research about it so I will chime in until someone more experienced can give their input....
First of all, have you spoken to your surgeon? I see where you mentioned seing other specialists but having now more experience with this surgery, your own surgeon might have some data for you or at least be able to make some recommendations. If that doesnt work, I wouldnt hesitate to try to contact Dr Rutledges office and see if he can make any recommendations just based on your symptoms, All they can do is say no but its worth a try.
Secondly, I would recommend posting your most recent lab results and a list of the vitamins you take (including mg and brand etc) as there are many people here that can look at your results and tell you if theres something you might not be seeing. ALSO I noticed that the vitamins you seem to be deficient in (Iron B12 and D) are also the 3 big ones that you cant get from a run of the mill tablet so be certain to post what type of Iron, B12 and D you are taking so we can help you make sure youre taking the right kind you also need to post WHEN you are taking those vitamins because lets say youre taking your iron and your calcium at the same time, well that would be your first problem, even if youre taking your iron say in the morning with cottage cheese (which contains calcium), thats going to cause you to not absorb the iron so its not just about what youre taking but WHEN and WHAT WITH.
Also, are you getting enough salt? I remember from watching some youtube videos about the mini gastric bypass and salt that some people were having some of the symptoms you describe dry mouth, dizzyness, joint pain with a low salt intake. I would at least look at those videos and see if that might be a simple thing to try. The salt issue isnt just for newly post ops....Invest 8 min watching this (there are plenty of salt videos in dr rutledges files on youtube but this one mentions how its a long term concern and at least it might resolve a small part of the problem.
http://www.youtube.com/user/DrRRutledge#p/search/0/52X_mYk1r V0
Im sure if you post your most recent labs, vitamin regimen (what, how much and when) and a sample of what youre eating in a given day (what, how much and which meals you are taking with which vitamins) and a list of any other meds youre taking and when, you will get lots of direction from this group. At least it will be a good place to start and might even solve your issues.
Best of luck to you!
First of all, have you spoken to your surgeon? I see where you mentioned seing other specialists but having now more experience with this surgery, your own surgeon might have some data for you or at least be able to make some recommendations. If that doesnt work, I wouldnt hesitate to try to contact Dr Rutledges office and see if he can make any recommendations just based on your symptoms, All they can do is say no but its worth a try.
Secondly, I would recommend posting your most recent lab results and a list of the vitamins you take (including mg and brand etc) as there are many people here that can look at your results and tell you if theres something you might not be seeing. ALSO I noticed that the vitamins you seem to be deficient in (Iron B12 and D) are also the 3 big ones that you cant get from a run of the mill tablet so be certain to post what type of Iron, B12 and D you are taking so we can help you make sure youre taking the right kind you also need to post WHEN you are taking those vitamins because lets say youre taking your iron and your calcium at the same time, well that would be your first problem, even if youre taking your iron say in the morning with cottage cheese (which contains calcium), thats going to cause you to not absorb the iron so its not just about what youre taking but WHEN and WHAT WITH.
Also, are you getting enough salt? I remember from watching some youtube videos about the mini gastric bypass and salt that some people were having some of the symptoms you describe dry mouth, dizzyness, joint pain with a low salt intake. I would at least look at those videos and see if that might be a simple thing to try. The salt issue isnt just for newly post ops....Invest 8 min watching this (there are plenty of salt videos in dr rutledges files on youtube but this one mentions how its a long term concern and at least it might resolve a small part of the problem.
http://www.youtube.com/user/DrRRutledge#p/search/0/52X_mYk1r V0
Im sure if you post your most recent labs, vitamin regimen (what, how much and when) and a sample of what youre eating in a given day (what, how much and which meals you are taking with which vitamins) and a list of any other meds youre taking and when, you will get lots of direction from this group. At least it will be a good place to start and might even solve your issues.
Best of luck to you!
Hi,
I agree, get your labs checked by Dr. Rutledge and see what he suggests. Also I agree with the salt. You need the salt to help with hydration. Are you drinking enough water? You didn't mention it and you need a lot of that also.
Osteoarthritis is something that can be handed down through the family. Do any of your family members have it? I have a little myself but not like my mom. Her hands were terrible.
Keep us posted on what he says. Sometimes, however, Dr. R can be hard to get. My advice is to call him and keep calling until he answers.
I agree, get your labs checked by Dr. Rutledge and see what he suggests. Also I agree with the salt. You need the salt to help with hydration. Are you drinking enough water? You didn't mention it and you need a lot of that also.
Osteoarthritis is something that can be handed down through the family. Do any of your family members have it? I have a little myself but not like my mom. Her hands were terrible.
Keep us posted on what he says. Sometimes, however, Dr. R can be hard to get. My advice is to call him and keep calling until he answers.
Clueless about weight loss and weight loss surgery of any kind.
Low protein may hinder healing.
However, I had an open wound for 2 years. It never healed, then I had surgery to fix a hernia, a TT, and to cut away the tissue that wouldn't heal.
My TT scar opened in a couple of places. Then I had some skin die, and 2 more opened places months later, around on the sides.
I had surgery again to remove the tissue that would not heal, and restitch. The ones that opened months later were opened more, cleaned, and packed with saline gauze twice a day.
I never had an infection show up on any cultures, and I had many cultures. No pus, no infection.
I had poor blood flow in the abdominal area, probably due to obesity all those years.
I would guess the problems on the suture line are due to poor circulation, and the skin healing without the tissue beneath being healed first.
You need to take massive doses of dry D, like 50,000 IU per day for a while, and lots of calcium, taken twice a day to allow max absorption. B12 can be given in an injection once a week by you or a nurse or doctor.
Have you tried probiotics for the bowel troubles? May help. Also you might should take flagyl for a couple of weeks, in case you have a bacteria overgrowth in your bowel causing the diarrhea.
Best wishes.
However, I had an open wound for 2 years. It never healed, then I had surgery to fix a hernia, a TT, and to cut away the tissue that wouldn't heal.
My TT scar opened in a couple of places. Then I had some skin die, and 2 more opened places months later, around on the sides.
I had surgery again to remove the tissue that would not heal, and restitch. The ones that opened months later were opened more, cleaned, and packed with saline gauze twice a day.
I never had an infection show up on any cultures, and I had many cultures. No pus, no infection.
I had poor blood flow in the abdominal area, probably due to obesity all those years.
I would guess the problems on the suture line are due to poor circulation, and the skin healing without the tissue beneath being healed first.
You need to take massive doses of dry D, like 50,000 IU per day for a while, and lots of calcium, taken twice a day to allow max absorption. B12 can be given in an injection once a week by you or a nurse or doctor.
Have you tried probiotics for the bowel troubles? May help. Also you might should take flagyl for a couple of weeks, in case you have a bacteria overgrowth in your bowel causing the diarrhea.
Best wishes.
Thanks for your reply to my post. Like you I have also had many swabs and cultures and have never shown any infections or even pus. Every new "opening" starts as a pocket of serous fluid deep down in my tissue that slowly works its way to the surface. Once the fluid releases and empties, the wound continues to weep, and if it heals over at all, it usually doesn't last long because, as you mention, the hole in the tissue underneath hasn't healed so it eventually opens up again.
When you say "dry D" do you mean vitamin D? I am taking two 1000IU capsules of vitamin D a day at present but they are little fluid filled capsules. I'm not sure what dry D is but am keen to look at any solution. Is the calcium important in combination with the vitamin D?
I have been having B12 injections and at present seem to be maintaining normal levels.
Thanks again.
When you say "dry D" do you mean vitamin D? I am taking two 1000IU capsules of vitamin D a day at present but they are little fluid filled capsules. I'm not sure what dry D is but am keen to look at any solution. Is the calcium important in combination with the vitamin D?
I have been having B12 injections and at present seem to be maintaining normal levels.
Thanks again.
Vit D also comes in a dry formula. Sometimes the oil filled capsules are passed without absorption. So look for Dry Vitamin D. Calcium needs the D to be absorbed. Otherwise, you end with low calcium levels, which also show up as high PTH, parathryroid harmone.
So you need to take dry D with calcium, and have both checked along with PTH levels.
If you have any opening, you must pack it with gauze or something called plain packing strip, by Curity. You would saturate this strip with saline solution and push into the hole with a Q-tip if neccessary. Don't overfill, and do this twice a day for a couple of days. Then once a day, so you don't disturb the granulation too much, which is healing tissue. Don't wash out the wound, it's probably pretty clean.
I am very supprised your doctor hasn't had you use this method of healing from the inside out, because otherwise you will never heal.
Best wishes, and let me know how it's going!
So you need to take dry D with calcium, and have both checked along with PTH levels.
If you have any opening, you must pack it with gauze or something called plain packing strip, by Curity. You would saturate this strip with saline solution and push into the hole with a Q-tip if neccessary. Don't overfill, and do this twice a day for a couple of days. Then once a day, so you don't disturb the granulation too much, which is healing tissue. Don't wash out the wound, it's probably pretty clean.
I am very supprised your doctor hasn't had you use this method of healing from the inside out, because otherwise you will never heal.
Best wishes, and let me know how it's going!
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