Question:
How can I help my step-daughter adjust to gastric bypass surgery?
My step-daughter had surgery 11 months ago. She went from 275 to 125. She still continues to vomit. She also sweats, has difficulty breathing at times and cannot eat over one to two tiny meals per day. She suffers from the same depression she had before the surgery and extremely low self-esteem. Her immune system is shot. Her hair is beginning to fall out. She looks gaunt and pale. She had extremely poor eating habits pre-op and post-op. She continues to smoke. She also has diarhea at times looks as though she has difficulty walking. She has no energy and seems to drag herself through the day. — pamshan (posted on September 24, 2007)
September 23, 2007
it sounds like she's severely malnutritioned especially in the protein
dept...maybe she should go back to basics and start drinking the protein
shakes again...is she still taking the supplements? she couldn't be
anorexic could she? is she on medication for her depression? if she isn't
tell her to go see a doctor asap because i myself have suffered depression
for years which is why i got big in the first place...i'm on the right meds
now and i feel great! since youre stepdaughter has self esteem issues she
probably doesn't think enough of herself to take care of herself...start
with getting her on some good meds and then maybe some therapy too.....if
she doesn't love and respect herself, noone else will either....i'll be
thinking of her and feel her pain...i've been there...
— lizzie42
September 23, 2007
Your description makes it clear that weight was a symptom of deeper
problems, psychologically and nutritionally. A good therapist could help
her tackle self-esteem issues. A dietician can teach her how to eat if she
is willing to learn. Smoking is clearly self-destructive. You mention no
positives--does she enjoy looking better and wearing normal clothing? Is
she just plain depressed? If you can get her to sign up for FitDay on the
internet she will have a tracking device for food and feelings if she will
use it. She is not helping herself or using the tool of bariatric surgery
to give her a healthier life. She needs help caring about herself. I hope
you get some helpful suggestions. Good luck.
— [Deactivated Member]
September 23, 2007
Your description makes it clear that weight was a symptom of deeper
problems, psychologically and nutritionally. A good therapist could help
her tackle self-esteem issues. A dietician can teach her how to eat if she
is willing to learn. Smoking is clearly self-destructive. You mention no
positives--does she enjoy looking better and wearing normal clothing? Is
she just plain depressed? If you can get her to sign up for FitDay on the
internet she will have a tracking device for food and feelings if she will
use it. She is not helping herself or using the tool of bariatric surgery
to give her a healthier life. She needs help caring about herself. I hope
you get some helpful suggestions. Good luck.
— [Deactivated Member]
September 23, 2007
She must get as much protein in as possible. That can cause the heair to
fall out, and make her have no energy at all. She will be digging herself
out of a whole of bad nutrition for a while but she will do fine. Best
wishes.
— [Deactivated Member]
September 24, 2007
First off, get her back to the surgeon who performed the WLS. He needs to
take her blood work and other tests to look at her physical condition.
There may be something wrong with her surgery which may need to be
corrected. She may have a stricture, an intestinal blockage or adhesions
around her intestines. It will be up to the doctor to give her a CT scan
to test for these. She may have developed ulcers along where her pouch
staples were. That is common in people who smoke after gastric bypass (or
even for those exposed to second-hand smoke -- she must stop smoking. It is
extremely risky and dangerous for gastric bypass patients.) He may make a
number of recommedations, i.e., does she have asthma, what vitamines is she
taking (she should be taking beta-carotene, B-12, B complex, iron,
multivatimin, C, calcium citrate, magnesium + D, folic acid, zinc, fish
oil, B complex and MUST TAKE THESE FOR THE REST OF HER LIFE). At 11
months, she should be able to swallow pills but some of the above are
available in chewable, sublingual or liquid format. Her surgeon may
recommend that she get b-12 shots. For nausea, she should be on Prevacid
or something similar. Does her doctor have ties with a dietician and
psychologist? If so, they would be the ones she should be seeing as they
know all about the issues people face post op. She needs to see a
councelor pronto! Her depression, self-esteem issues and lethargy (which
could be exacerbated by vitamin deficincies) need to be addressed as soon
as possible as she has obviously not been using her "tool" (WLS)
to change her eating habits but only to lose weight. Sounds like she is
becoming anorexic which is just trading one addiction for another. If so,
this is very serious and you must step in and get her help immediately.
The diarrhea sounds like she may be "dumping," that is, either
drinking with her meals, eating too fast, eating sweets, eating too large
portions. Some people, with "wrong thinking" use
"dumping" as a way to eat what they want, knowing that diarrhea
will just remove that from their system. Does she get at least 64 oz of
fluid each day? If not, she may be dehydrated which could also cause the
lethargy. How did she get approved for WLS if she has such depression, I
wonder. Did she attend any seminars, pre op, to discuss the pro's and
con's of WLS? If she is not aware of the complications, there are many
sites that will explain them. Her doctor, dietician and counselor will
know them, as well. WLS is not the end all and be all of weight loss. She
must develop good eating patterns, either three 4 oz meals a day with
little snacks between or 6 small meals. She should be eating at the same
time each day, as well. Get her a notebook, if she can't be bothered to
keep track online, of what she eats, how much protein and calories she is
ingesting. She needs to be journaling her thoughts about food, why she
doesn't/does eat -- what feelings she has before she does either. It is a
fact that those who write daily heal better. She must eat what the
dietician or nutritionist tell her to. Is she attending any support
meetings? Look online or ask her dietician, surgeon or use OH to locate a
session near where she lives. They are invaluable for giving support,
answering questions and making friends with people who've had the surgery
and who understand what she is going through. I wish her and you the very
best. -@li
— cherub13
September 24, 2007
this will be short and sweet.......get her to a therapist immediately
— bderuiter
September 24, 2007
Either back to the surgeon, or to the ER room asap and tell her to STOP
SMOKING!!!! Also after she gets out of the hospital, take her to the
nearest therapist! Those problems should have been found and fixed PRIOR
to her having the surgery. Good luck and God Bless!
— crystalsno
September 24, 2007
It sounds like she has serious malnutririon. Sounds like she isn't taking
her vitamins. Gettting enough protein. Etc. Etc. Etc. She needs to get into
a DOC and a THERAPIST - ASAP. This is not healthy. She needs help and fast.
Tranfusions for deficiencies are not fun, nor pleasant and it sounds to me
that she's beyond repair in some areas. You need to get her help and help
fast.
— jammerz
September 24, 2007
I agree that she needs help. Some people will not obey the rules of the
surgery.... One main rule is to stop smoking--it is dangerous and causes
many issues, including ulcers in the pouch which make it hard to eat. Also
when people eat the wrong foods with too much sugar or carbohydrates they
get diarhea & vomiting. The sweating and difficulting breathing are
symptoms I suffer when I eat something bad (my blood sugar spikes, then it
drops and causes a bad reaction when my insulin is out of whack). If she
never changed her eating habits after surgery she will never be healthy.
They always told me protein first, then vegetables, then carbs (usually by
the time you get to the carbs you are full). PLEASE talk to her and tell
her to get help. And you know, I don't even know her, so I don't know her
eating habits or anything else (she may be eating right, I am not trying to
judge, just going by what makes me sick and not feel good)---plus you said
she smoked, so that is a bad sign of someone who isn't taking this surgery
seriously, cause it can hurt your body, BAD!!
— GAYLE CARMACK-LYONS
September 25, 2007
I agree with everyone else...DOCTOR! Besides the other obvious issues the
short of breath thing could be indicative of severe anemia. Red blood cells
carry oxygen on them and if she is really short of red blood cells that
could be causing her shortness of breath. No offense but besides the
surgeon a mental health professional needs to be on board I would think.
Could it possibly be her emotional self is greatly effecting her physical
self? Fixing only one maybe a bandaid approach. Best wishes and prayers.
Please get her help whether she thinks she wants it or not.
— tazthewiz23
September 26, 2007
I agree with the previous posters...she needs lab work to really to see if
it's malnutrition or something more serious (such as a problem with the
actual surgery). I also agree with Heather T - since the symptoms you
describe sound like a classic case of anemia. As far as meds for depression
go, one option might be Bupropion (probably not the long-acting version).
It's also called Zyban (to help smokers quit) and Wellbutrin as brand
names...so it could help her with the depression and kicking the death
sticks at the same time. One added advantage is that Bupropion does not
tend to cause a decrease in sexual libido that most SSRIs (Prozac etc.)
cause. This is just my opinion - I'm a pharmacist, not a doctor. Good luck!
— NMlakerFan
September 26, 2007
If your step daughter is under 18, then you need to contact her doctors,
make sure she is seen, make sure that someone is supervising her medically.
If she is over 18, you can't really do anything other than offer your
support and hope she takes it.
WLS is not a treatment for depression or self esteem. It sounds like your
step daughter might need an evaluation for depression.
Good luck.
— mrsidknee
September 28, 2007
I personally think she is lacking VITAMINS for number 1. And number 2 she
is probably having more sugar than she she should if she has diarrhea. I
would start with the simplist cures first. If taking vits and slacking off
sugar don't help then I would worry. Vitamin difficiency can CAUSE ALOT of
problems all the ones you mentioned.
Jenniffer
— Jonesin
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