skin and bones

I need help I was a member right after surgery and for the first couple of years  I  did fine held my weight and then gained some now I am   going into my 6 year after rny RNY bypass surgery have gone back to work as a nurses aide  and now dropped another 40lbs and I am still losing don't want to lose any more all I see are skin and bones and thats literally all that is left of me  I work 3rd shift so I usually only get ime to eat one or twice a day I try to make sure its always a protein based meal but that dosen't always work. I have gotten away from taking my vitamins in the last year ,I'm either going to bed or going to work or trying to have a life and it  seems like take my vitamins is to easy to forget  Half the time I forget to take my daily meds so  vitamins  don't seem like a prioity  . I am sorry this is long and rambling but  I am literally wasting away I have no muscle tone  no body fat  can't hardly set in a chir because I am setting on my butt bones now . My Dr. quit  doing the surgery right after I had it I went thru Cori Center  but I have.t had any contact with them since the first year check up. My family Dr knows nothing about baratric paients or surgery and  although I have regular blood tests he does't question it when my protein is way to low it wa really low this last test and I need help quick before I end up dead.   I feel sick all the time now  I know my body is cannibalizeing its self but don't know where to get help or from who . This is not a farce or a joke its real and I am scared please help me if you can, Thanks Sandy Pitt

Hi Sandy, I'm so sorry to hear about your situation but you've come to a great place of support.  In all honesty, it sounds like you need to tap into your nurses around you to find out who to go to for help.  You not only need a physician who knows how to help bariatric patients but you also need a nutritionist that will put you on a plan to help you with energy levels, muscle tone and such. THIS is SUPER important!!!!   You definitely DO not want to get further into a health crisis at all, your organs can start shutting down if you don't jump on this right away. 

Make a goal for yourself to pick up the phone or ask one of the nurses you work with for help.  It's a tough step, but you took a HUGE step by reaching out to us. :)

We definitely want to see you get well and be healthy, that is the most important part of our journeys is to be healthy. 

There are some great resources on here also with some tips about what to ask your doctor for when you get your blood work done and things.  I would tap into those too.

Please pick up the phone and take that important step for your health. 

Keep us posted.

~Shannon

Hi Sandy,
I am at that place where most people think I am too thin, and I want to stay right where I am. I always take all my vitamins, some in the morning and some at bedtime, but the THING that has saved me is bananas and peanut butter. Every night I count up the calories I ate during the day. I take a frozen banana out of my freezer and put on lots of peanut butter, especially if I am short of calories for the day. I buy bananas at Costco or Trader Joes, put them in a paper bag until they are ripe and then freeze them in a freezer bag. It is the perfect high-protein, good vitamin late night snack and I have one almost evey night. The potassium keeps my legs from cramping too.

Good luck,nancy

Hi Sandy -

Here are my suggestions:

1 -- EAT.  Yes... I mean it. Seriously.  Eat something dang it!  At this point you need to be taking in about 1400 --1600 calories per day (possibily more!).  Figure out a schedule for meals and snacks (3 meals 2-3 snacks) and set times for each of those meals/snacks.  Then stick to it.  Get a note from  your doctor if you have to have 10 minutes breaks at work every 3 hours so you can eat.  This is essential.  You are literally starving your body and you will die if you don't feed it.  This is serious.  If there's some type of mental issues going on that is preventing you from eating, then see a counselor and get it fixed.  There's a thread on the RNY Forum called "What are you eating/doing today?" -- it's a place for you to plan out your day's meals and come up with a plan to get all the nutrients you need during the day.  It's a good way to see your whole day at once and know what you have to do for your body to keep it healthy. (Also a great place to learn new recipes and get ideas of what others are eating.)

2 -- VITAMINS -- you KNOW you need to be taking them.  Why  aren't you?  Don't let some lame excuse get in the way of your health.  When you signed on for this surgery  you also made the commitment to take vitamins for the rest of your life.  Figure out a schedule and start being a fanatic about this.  Your life literally depends on it.   I use www.mymedschedule.com to enter in all my vitamins and meds and set dose times for each thing... then they send me a text message on my cell phone (or an email) to remind me to take my meds.  Since signing up for this free service I am almost 100% compliant with my vitamins.  

3 -- DEXA SCAN --- my mom is 5.5 years out from RNY and wasn't faithful in taking her calcium and when she did, it was carbonate, not citrate.  Last year she was diagnosed with osteoporosis with an 18.1% bone density loss in her spine.  It sounds like you haven't been faithful with your supplements, so I'd suggest getting a DEXA scan schedule to see how you're fairing in this department.  We should all be getting a bone density scan done in the first year after surgery anyway... so if you haven't had one, you're overdue anyway.  

4 -- LABS -- Here's a list of the labs your PCP needs to order for you.  If you haven't been having 10-13 vials of blood being drawn during your labs, you haven't had the right stuff tested.  And remember that the ideal levels of some tests are higher than the normal person.  For instance we want our Vitamin D to be up around 80-100 whereas the normal scale starts way down at 30.  And our B12 needs to hover around the 1000 mark but the normal scale says it can be as low as 300, I think.  There's also a spreadsheet at that link that you can download and keep track of all your own labs... that way you can spot any downward trends that can be fixed before they become deficiencies.  Nobody cares about your labs as much as YOU do -- so be your own best advocate for getting things done right.

5 -- YOUR DOCTOR -- If your PCP is not being proactive and aggressive with your lab results, find a new PCP.  If he's not willing to be educated about bariatric surgery and how you need to be treated with a different set of rules and guidelines.. then find someone who is already familiar with it or is willing to learn.  Everytime I go see my PCP I take him some new research to read or information about WLS that he needs to know about.  When I was there a couple weeks ago he brought in a file folder that contained all the stuff I'd ever given him and the reports were all dog-eared and highlighted and marked up... that made me feel so much more secure in my treatment from him.  He's also got 13 other WLS patients, so I know he's got a vested interest in learning all he can.  Here's the ASMBS guidelines that show the basic bariatric nutrition - its a great resource to start with for your doctor (and you).

6 - A BARIATRIC SURGEON -- if you really feel that you need to see a surgeon or visit a WLS clinic for a follow up, start making some calls and find one.  A nutritionist might be helpful in getting you back on track with your eating too. 

7 -- EXERCISE -- if you don't use your lean muscle mass your body will think you don't want it... so when you don't feed your body and it need nutrients, it will turn on itself and feed off it's own muscle for the nourishment it needs.  That's why you are weak and have no muscles left.  Your body is canabalizing itself.  Remember that your heart is a muscle.  So start using that muscle.  Start with some cariod (just walking is a good start) to build up your lung and heart strength.  Then add some weight training so you can start to regain some of your muscle back.  It takes a LONG time to build muscle once it's been eaten by  your body... so you have to stick with it for the long haul. 

I know you're scared... I can sense it in your message.  And maybe some of my words have been harsh or to the point.  Right now I don't think you need to be coddled or hugged or patted on the head.  You need to get TOUGH with your life and stop making excuses for your behavior.  Yes... I honestly believe you have let this happen to yourself because you haven't taken the time or engery to care enough about your health.  Don't let life get in the way of living.  Eat.  Take some vitamins.  Get in to the doctor and insist he take care of you.  Exercise.  It's all the basic stuff that you already know.  You've come a long way and done a lot of work to get this far... don't let it all go to hell because you aren't making yourself  priority in  your life. 

You're a strong woman.  Take baby steps to get to the life you want.  You can do it!

Pam