Need your help (long)

Hi Grads... I need your help. 5 months after my surgery, I passed out at work. I was living on 750 calories or less a day at that time, I was also severely dehydrated. In addition, I had a stricture. Everything I ate was thrown up - nothing got past the stricture. My heart rate was consistently low, in the 40s-50s. My BP was low. I was dizzy all the time, had blackouts. After the episode at work I was hospitalized for a week while to they did tons of cardiac tests -they thought it was my heart, I thought it was the malnutrition. My doctors didn't understand gastric bypass - they didn't listen to me when I tried to talk to them. They eventually released me with the recommendation to see the cardiologist outside of the hospital. After I left the hospital, I had the stricture repaired by my surgeon, so I was eating. My water drinking habits resumed, as did my exercise. My strange heart rate problems continued, so I kept my appointment and went to the cardiologist. He had me put on a holter monitor, 30 day event monitor, and he ran other tests. He found nothing. The only thing that was showed was my low BP and heart rate. But I was still feeling dizzy, lightheaded and I was getting crankier by the day. I also passed out on two more occasions. However, I was eating and drinking more, the only fact that allowed me to believe I was improving. Dehydration, as you all know, can cause horrific problems. I went about with my life convinced that the issues I was experiencing was related to malnutrition, fast weight loss, or was just in my head. (Actually, I was thinking that A LOT). I started doing a lot of the tricks - shaking, doing little dances, bouncing from one foot to the other, to stop the dizziness, to prevent a black out. I pretty much convinced myself that I was going to be ok. Then my husband's company Christmas party came. I was out on the patio, a beautiful Florida evening, talking to my husband's boss (who I just met, considering my husband just started his new job). You all know where this is going don't you! Down I went, face first onto concrete, onto the glass I was holding. For the first time in my life, I got stitches in my face. I also hurt my knee, broke three of my teeth, and cut open my hand and chin. I went through my history with the doctors at the ER - they were convinced that I was beaten by my husband. I left in a huff because they just weren't listening to me - and the following Monday I went to my PCP. My PCP, knowing what happened last Spring, gave me an EKG, noted the abnormal results, and sent me off to the hospital to be admitted. Another week in the hospital - same tests - and I was convinced I was crazy. Until, that is, I had a tilt table test. I passed out cold. For the first time I thought, maybe I am not crazy - maybe there is something wrong. It isn't malnutrition anymore - I eat normally, although in small portions, and I drink water religiously. It is Neurocardiogenic Syncope- they tell me. They give me a prescription for Toprol (beta blocker) and send me on my way with instructions to not drive and not be alone for a week. Now I am waiting for my second test to see if the dosage they have me on is correct or not. Whew - did I promise this would be long?? I apologize. My deepest fear right now is that I somehow did this to myself - by having the gastric bypass. I keep wondering - did I trade one set of problems for another? Did I do this to myself? So my question is - could forced malnutrition cause NCS? Could someone with massive weight loss suddenly develop neurological problems or lead to a diagnosis of NCS? Or is it all a coincidence? Was it malnutrition? Vitamin deficiency? Or is all in my head? I am sorry for talking your ears off - I just am so confused. I never had these problems before. I am going for my follow up tomorrow - I have to "get clear" in my head about this before I go. Thanks all Laura -145

Sorry to hear you have had this experience! Sounds like your current treatment plan may be helpful...from what I know about NCS there is a bit of a trial and error period, and sometimes it takes a combination of drugs to combat the spells of fainting. Just out of curiosity...have you had insulin resistance or metabolism issues in the past? I am not sure if the current thinking links metabolism with NCS, but I do remember theories of relationship. Also, does it come on suddenly or can you begin to recognize the signs of an episode (feeling warm, flushed, claminess, shakes, etc.)? Except for possibly the dehydration issue, I very much doubt this sudden onset has anything to do with WLS. Keep hydrated...always!!! Karen

Hi karen - thanks for your reply. I have not had metabolism problems - in fact I really have been relatively healthy - for a MO individual anyway. I have started to learn how to recognize the symptoms. I have started to learn how stop an event from happening too. I do think it really is closely related to dehydration. Laura

Hi Laura, I am so sorry for all you have gone through. I very much doubt that what you have experienced has anything to do with the WLS. My "non-medical" advice is this: SEE A PHYSICIAN WHO SPECIALIZES IN WEIGHT LOSS SURGERY PATIENTS "ONLY". You need to talk to someone who understands us. Seeing specialist after specialist after specialist who does not know how your internal system works is like having your teeth drilled by a blind doctor. I would either return to the original doctor who performed the WLS or seek an opinion from another surgeon who devotes his life to weight loss surgery. He/she will be the only person who can give you advice in that area. Once the WLS surgeon has ruled out that it is NOT caused by your WLS, he can direct you to the proper physician. Please remember, emergency doctors are just that, "emergency". They deal only with life or death situations and are not always knowledgeable about other fields (I say that from experience). We have a tendency to blame a lot of conditions on the WLS, but usually it is something else, masked as being due to the WLS. I hope this helps you. I hope you speak to your surgeon before the "specialists" send you all over the city running up tests and scaring you so much. Hugs to you, Missy.

I so agree with this. Emergency treats the immediate - follow up on your own. Medical personnel, unless they have dealth with someone who has had WLS, may not know how to deal with one who has had it. I had one staff member ask me how much they cut off when I told him I had WLS. I need to find specialists. But, when I do, they tell me they don't want to deal with someone else's patient (my doc is out of state). Ugh! Thanks for the reply.

I have had exactly the same thing happen, right down to taking toprol (XL works better for me than the regular) It IS related to the weight loss but remains somewhat of a mystery. Pay particular attention to your B vitamins and calcium intake. I have/had intermittent cardiac arrythmias and still have some fainting spells. The Toprol takes a while to get used to. It needs time. My last episode was in June. My cardiologist was pretty useless when it came to knowledge of WLS so wasn't much help. Didn't seem entirely motivated to learn, either. I refused coumadin and lipitor in addition to the toprol as these are really serious drugs (I did a lot of research and these really are not appropriate for this, at least for me) Did this to yourself? Maybe. But, the fact that your heart and circulatory system is having some trouble now pales in comparison to what likely would have occurred if you had remained obese. One thing I was assured of: this is rarely fatal and is not a risk for stroke or heart failure. It is an electrical malfunction that may correct itself in time. tee

Oh, Tee, you do not know I thrilled I am to read your reply. Of course, not thrilled you have had to deal with this, but thrilled to know I may not be the only one. Rarely fatal, and is not a risk for stroke or heart failure - I have read this too and I am happy to know this. I do hope it corrects itself in time. My body has been through so much in the last year, I do hope that this might just be something that needs to work itself out. Thanks Tee.

Hi Laura ... wow, what an ordeal! I too am one who thinks a lot of things are just "in my head", so I just tend to "deal" with things. Your post, however, may actually put a perspective on something I have been going through, or then again, maybe not ... (I'll try to make it short) In July of this year I was bit by a neighbor's dog ... spent 5 days in the hospital (I was taken to this hosp by paramedics, so it wasn't my first hospital of choice, where my WLS had been done). Upon release, I still saw the doc every other day as he was packing the deep puncture wounds, and about a week after I had been released from the hospital, he was packing the wounds and asked if I felt ok, because I guess I didn't look too well (my coloring was off and I was clammy). I told him that earlier in the day my heart was racing, I was pretty lightheaded and dizzy and that I was having a hard time catching my breath. I thought it may have been my asthma (although I hadn't needed asthma meds for a few years, since before my WLS), so I brought in all my old meds, and he said "no, this isn't asthma related" and took me to the emergency room. I guess he needed to check for blood clots, since I was laid up for 5 days a week prior ... I was cleared of blood clots, but they wanted to keep me for monitoring, as my heart rate was 40 (and I guess I don't look like a well-conditioned athlete). Over the next 4 days I was subjected to several cardio and pulmonary tests ... which all came out fine, but the cardiologist said my EKG was a little abnormal, but not to worry about it unless I had chest pains. ... this particular hospital was not WLS friendly, they don't do the surgery and the docs I encountered seemed to be clueless about it. Even the dietician, who I spoke with twice, didn't completely get it ... but I actually ended up not really eating in the hospital (I blamed it on the pain meds?) I really haven't gotten my appetite back since then either. Anyway, I still have bouts of lightheadedness and dizziness, and at times my arms feel like noodles, but it usually just goes away, so I tend not to think too much about it. I've just now let my WLS doc convince me to have a CT Scan and an Endoscopy for the loss of appetite (I've dropped ~40 pounds since all this ... which is good though!) ... (he brought it up once before as a we "could" do a scope, yadda yadda yadda ... you can take a look at my profile to see how I feel about that) ... and I did have the CT Scan today, am scheduled for the endoscopy on the 23rd, but am feeling the urge to skip it ... once again, what if it is just all in my head? I really don't want to waste anyone's time (including my own)! Like you (and as I mentioned), I don't do well with NOT being well, or the thought of it ... I often feel a lot of this may just be in my head and really don't want to waste anyone's time. I also hate not having answers, and don't want to go "looking" for things to be wrong. WLS was the first surgery of my life (at the age of 41) ... and I've seen more docs in the past 6 months than I have in my life ... ENOUGH already!!! No more!! I'm a healthy person ... the only two times I ever want to see a hospital again are to give birth and for my plastics. whoa ... got a little rant out there!! sorry!! anyway ... Laura, thank you so much for sharing your story ... you don't really know how it may affect or make someone aware of something they didn't even know existed. So, thank you again ... and please, please I'd like to follow your progress (via email if you'd like) and any other answers you may come across. Thanks again, and good luck to you! Karyn (guess I didn't do too well keeping it short! ... sorry!)

Hi Laura, Very interesting post. I, too, was hospitalized last February with heart fibrillations, which I had had only twice before, but which regulated itself. This time I was hospitalized and they put me on a beta-pace, Sotilol, which I'm still on and wish I could get off of. I had an incident a few months ago where I came upstairs and fainted dead away at the top (luckily, I didn't fall back down the stairs). I didn't say anything to my husband until the next day. I hurt my head and spine and arm. I called the doctor, who then put me in on a 24 hour monitor. They couldn't find anything either. Did a sitting,standing test for pressure and that was ok. My pcp said maybe my heart rate slowed after taking a sleep med. So, my point is, I am printing out your post so that if it happens again, I can have them check it out. Funny, how we don't relate some very serious things to WLS (after all, our insides are drastically reduced), and it could have affects on the way the rest of our body works. Thanks for your post, again. Marilyn