Anyone else's stomach too small to eat solids 9 months out from surgery?

ajalew
on 3/27/11 9:03 am - Sanford, MI
I am hoping someone has had a similar experience to mine and might be able to help me or give some suggestions.  I had wanted a gastric sleeve in 2009 and because of MAJOR complications from that surgery had to have an RNY done a year later (July 2010).  Its been 9 months since the RNY surgery and I cannot eat solid foods without tremendous and horrible pain stomach/back pain.  I don't vomit or get bad nausea, just intense pain.  The pain is worse than the pain I had with LABOR for my daughter.  It is completely unbearable so I am on a liquid/baby food puree diet.  Even then, if I eat (well, drink?) too fast I still have pain, just not to the same degree.  

I take chewable gas-x with every meal, a digestive aid before/after each eating, and even Reglan to try to get my teeny stomach to process foods faster so that I can eat more.  The problem is that I simply cannot get ENOUGH total nutrition on a liquid pureed diet so I feel really hungry all the time even though I am getting more than enough calories each day.   I have searched high and low for the right combination of poweders/liquids/purees to get as much whole food nutrition as I can.  But there is only so much one can do with such limitations.  

I have a protein powder with added nutrition and a lot of other veggie stuff (spinach, spirulina, etc) that I use in daily smoothies, a daily protein drink with vitamins (organic version of Boost basically), baby food dinners (pureed chicken with veggies, etc). Sometimes I can eat a little bit of cheese and egg beaters.  And I can eat all the chocolate I could dream of.  :/   I do take a quality vitamin supplement and have even tried working with two different nutritionist.   They don't know what to tell me other than drink more nutrition.  I AM drinking more.  If I drink ANY MORE than I already am I will start putting on pounds like crazy.  

I am so sick of living on liquids.  I cannot do this for the rest of my life.  Its so hard to enjoy going out to parties or to dinner with friends and family because I can't eat anything at all.  I smell the food and my mouth literally starts to water, its embarassing.  

My doctor's seem to have no clue what to do with me.  They just tell me I am eating too much. But I can't eat anything solid.  I chew and chew and chew and still if I eat something solid (not to the point of pain, just a few small bites) I will feel STUFFED for hours and then I get so incredibly run down from lack of enough calories that I can barely function.   

Is there literally NOTHING that can be done?  Am I just screwed at the young age of 31 years to being on a gross liquid diet the REST of my life???  I didn't even need the sleeve surgery all that badly.  I weighed 180 pounds, not so huge that I couldn't function.  I just wanted to be healthy and had a band for a while and loved it.  But I had too much scar tissue so it had to be removed and I gained a bunch of weight and panicked.  So opted for the sleeve.  BAD IDEA.  I don't enjoy life like I used too because no matter how many nutrition shakes or smoothies or jars of baby food veggies I eat I don't have any energy!   All my "labs" are fine.  I had an endoscopy and it said my stomach is "fine."  Well, I don't feel fine.  I feel horrible all the time and I'm so sick of it.   I wouldn't hate being on liquids so much if I felt good, but I don't.  

Many of the powders and supplements I take are organic so I know it's not because of lots of processing and chemicals that is the reason I don't have energy.  Its the lack of REAL food.  Powders are a SUPPLEMENT to a healthy diet.  NOT a healthy diet.  

Has anyone had this problem and found a "cure" for a stomach that can't seem to handle solid foods?  Is there a surgery that makes a stomach LARGER?  I can't even eat solids to "stretch" my stomach out in an effort to make it bigger because the pain is too incredible.  

Any help at all would be most appreciated. 
Lady Lithia
on 3/27/11 9:11 am
An interesting problem you have.

What were the complications? You had a sleeve and were revised (if I am reading your story right)

Tell us about the complications...what actually happened.

Have they checked to see if it is your esophagus that is spasming? Sometimes folks have issues with esophageal spasms and those can be excruciating (I underwent a special test and was in teh 5% who couldn't tolerate the 72 hour test, having horrendous spasms any time I  consumed anything.... this was pre-WLS)

If it is spasms, then you at least know your source of problem.

Have you gotten a second opinion? I would

Some folks have issues with solid foods in the beginning, with not chewing well enough, and/or eating too fast, and have to learn to chew better (chewing in front of a clock or reciting the alphabet for each bite of food).... and the thing is that if they really persevere, then the restriction and the issues do subside. You won't gain size in your pouch until you actively challenge it with solids.... so you might fnid that if you presevere with the solids that you chew to heck and back, you will have added capacity over time.

So.....

1. get another opinion
2. have them check for esophageal spasms
3. Work on chewing to death your meals and eating, and even if you are stuffed for hours afterwards, drink some calories, and try again.... over time this may very well improve your situation.

Good luck!

~Lady Lithia~ 200 lbs lost! 
March 9, 2011 - Coccygectomy!
I chased my dreams, and my dreams, they caught me!
giraffesmiley.gif picture by hardyharhar_bucket

Ladytazz
on 3/27/11 9:17 am
I don't know what to say. I suspect that your problem is linked to your sleeve problem. If you had to be revised from a band due to scar tissue and then had a problem with the sleeve maybe you have a lot of scar tissue there? Adhesions maybe? Why were you revised from the sleeve? Knowing that might explain more.
As far as your doctor goes, it sounds like you may need a new doctor. It doesn't sound like he is taking your problems seriously enough. Is the problem that it hurts to eat or that you can't eat a lot? That was a little confusing.
And then there is the possiblity that it is something emotionally that causes your problems. I really don't know without knowing your of course but there may be a fear of eating if it has caused you a great deal of pain in the past. I wouldn't let my doctor just blow this off. This is your health and quality of life you are talking about.
TamaraL
on 3/27/11 9:18 am
are you sure you don't have a ulcer.  I read that some people are not able to eat a lot of solids when the have a ulcer??  If you had problems with sleeve and then revised to bypass I would ask dr about ulcer



 

ceruleanme
on 3/27/11 9:28 am - CA
 During my pre-surgical psych consult, the therapist was telling me that her RNY was either done wrong, or something had gone wrong and she needed to have hers re-done.

I would strongly recommend consulting with a different bariatric surgeon. A second opinion couldn't hurt, and you really shouldn't be having so many problems still. 

I wish you lots of luck!
ajalew
on 3/27/11 9:47 am - Sanford, MI
Wow, I appreciate the quick replies.  

Let me expand on the original problem.  I had a lap-band for years and LOVED it.  I was VERY good at chewing really well and rarely had many of the side effects from not chewing well enough that many bandsters suffer from while trying to get used to their bands.  So I do believe I'm a pretty accomplished chewer.  :)  Bad acid reflux for years caused me to develop a lot of scar tissue at the base of my esophegus and upper portion of my stomach.  The problems started about five years back and I would end up in the ER a couple times a year because the scar tissue would swell up out of no where and I would not even be able to swallow my own spit.  It would usually take steriods to get the swelling to go back down.  

It swelling shut episodes started to get much worse when I moved from the desert in California back to my home state of Michigan.  I realized I couldn't just keep hoping it would go away and had all the fill removed from my band but that wasn't really enough.  While the fill was removed I had gained about 20 pounds over two years (most of it in the first six months and then maintained with no problem).  Then I got pregnant!   I could only tolerate carbs for most of the pregnancy and gained 55 pounds!   That's when I decided to take things further and have the band removed completely (since it was STILL causing problems even without the fill in it) and have my stomach converted to a "permanent" band - the Sleeve.  

My surgeon was aware of the extensive scar tissue and was going to remove some of it and then create the sleeve around it.  However, when he tried to suture up the part where the stomach and the esophegus come together (that curved area) it would not hold stitches.  This mean I had a huge hole right there - it was about 1" long which is huge.  He tried two more times (two more surgeries) in the following ten days to get sutures to hold and when it was obvious that it would only cause more damage to go back in it was decided to let it heal on it own.  

I had the surgery May 2009 and the hole did not heal completely until Jan/Feb 2010.  Unfortunately, during or after this time (we're not sure when exactly) my stomach went into major overdrive and started producing scar tissue lower down all along the scar line.  Eventually all but sealing up my stomach.  From what I understand (from the doctors) this stricture was about half way down the sleeve of the stomach.  Up until March 2010 I had been on a feeding tube and didn't really take much of anything at all by mouth which is why it is unknown when the other scar tissue formed.  

My surgeon at this point was afraid to touch me again and found only ONE doctor here in Michigan willing to do anything.  Dr Birkmeyer is a gastric surgeon at the University of Michigan Health System.  The only alternative I had was to have my intestines re-routed above the stricture in the stomach.  That happened July 2010.  I was on liquids for another month and then started eating solids.  I complained about the pain but was told it would go away with time.  So I tried to eat smaller amounts and chew better.  

I was on Ultram for six months starting September 2010 because the pain was actually getting WORSE not better.   I left this next part out of the original post simply because it was getting so long and I was afraid no one would want to read a 20 page long post.  But, this next part does complicate matters slightly (and it is mentioned in my blog from last week I posted on here).  However, I do suspect that the problem will simply continue as it was before hand and I need to have some hope on my horizon.

It was discovered the end of October that I was pregnant again (not intended, our birth control failed us) and that made all of this so much more complicated.  Luckily during the RNY the doctor did not remove hardly any of my intestines since it wasn't needed for weight loss (I was down to 150 at that point).  So I stayed on the Ultram until several weeks ago because it was the only way I could get in solid food.  But I do not want my baby being born with an addiction to Ultram and if you do not go off pain meds by the end of the 2nd trimested you cannot go off them during the 3rd trimester (I can explain this is someone wants to know why).  

In order to limit the amount of pain medication I was taking I supplemented many of my meals with liquids/pureed foods.  But I was still able to eat at least one or two REAL meals a day.  My energy levels where great and the pregnancy progressed well.   However, these last few weeks have been awful.  I cannot feel like I am ever getting enough to eat.  

And I appreciate the mention of it being an emotional problem with food.  I have seen a therapist just to confirm that is it NOT emotional because the doctor accused me of only wanting pain medicine for "emotional" reasons, not real pain.  Sigh.  I can only eat a couple of bites of really, really well chewed food and I feel stuffed for SO LONG afterwards.

About the esophegeal spasms... Dr Birkmeyer thinks that my stomach is spasm when I put solid food in it and that causes the pain.  I guess I should have put that in the original post.  Sorry.  I was trying to keep it short and guess I left out critical information.  I just didn't think anyone would want to read much more than what I had already posted there.  

I did have an endoscopy (safe for baby) two months ago to rule out an ulcer and a new stricture.  Because of the pregnancy it limits the tests they can run.  I am wondering if my vagus nerve was damaged during one of the surgeries and maybe I now have gastroparesis (paralyzed stomach) because I don't have problems with liquids, only solids.  The stomach processes liquids differently.  BUT, most people with gastroparasis have severe nausea and I do not have that symptom.  So its still up in the air and can't be confirmed or denied one way or another for 10 more weeks at least.  

I just feel desperate for energy.  I don't even care how I get it anymore.  If someone knows a "miracle cure" liquid I'll take that.  I just can't handle trying to take care of my 2.5 year old and do my job (which I've had to cut back to 10 to 14 hours per week because I am too tired to do anything more) and do all the other things that life requires of us.  

I need to express that I am NOT depressed.  I am frustrated.  Very frustrated!  But I hold out hope that there is something that will help or work or make it possible for me to feel at least somewhat healthy again. 

Anyway, thank you for responding so quickly.  I didn't expect hardly anyone to even take the time to read such a long post.  :)  
ajalew
on 3/27/11 9:49 am, edited 3/27/11 9:50 am - Sanford, MI
Oh, I forgot to add that no other grastric surgeons will see me for at least three months.  I'm kind of hoping to find something that I can do now to make it more tolerable and to have more energy.

However, I think I will need to push harder (in three months) to get that second opinion.  I didn't realize that they could do a revision on an RNY that was done wrong (which is why I'm asking here!).

And one more thing... every time I call and complain about the massive pain they always ask about nasuea.  Because I don't have nausea they don't take me seriously.  I just wonder if there's anyone else who has pain without nausea because that's such a problem for me and maybe someone has something to offer that could clue me in to what to say/ask my doctor.
Lady Lithia
on 3/27/11 9:59 am
My first suggestion is to post EVERYTHING on one huge enormous post over on teh pregnancy after WLS group..... that is where you will get the best targeted help...... add it all

Second thing.... you did mention one thing that I found peculiar (not accusatory peculiar, just peculiar peculiar) .... you mentioned that they didn't remove any of your intestines because you didnt' need to lose weight. You do know, don't you, that there are no intestines removed at all during any gastric bypass.....the intestines are partially bypassed not removed. I just wanted to make sure you understood your surgery.

It does sound like you have spasms whether your esophagus, your pouch, your old stomach, or something else. You honestly need to see a specialist..... an obstetrician who specializes in high risk pregnancies, adn I suspect you will get more help through that route than through a weight loss surgeon at this point....at least more IMMEDIATE help

So please, go post over on the pregnancy after weight loss surgery forum, do it now, you'll get a LOT more specific and pointed help there. Your situation sounds unique and we can only speculate, but the folks over there can focus on the most important thing, which is that baby, and secondarily on helping with suggestions on what to do long term about your problems (not that you aren't every bit as important as the baby, but I hope you get what I mean)

Good luck.

~Lady Lithia~ 200 lbs lost! 
March 9, 2011 - Coccygectomy!
I chased my dreams, and my dreams, they caught me!
giraffesmiley.gif picture by hardyharhar_bucket

poet_kelly
on 3/27/11 9:58 am - OH
I suspect it is not a matter of your stomach being too small.  Have they done an upper GI or an endoscopy?  Did they say your pouch size was abnormally small?

I suspect it's something else.  Have you been tested for gastroparesis?

View more of my photos at ObesityHelp.com          Kelly

Please note: I AM NOT A DOCTOR.  If you want medical advice, talk to your doctor.  Whatever I post, there is probably some surgeon or other health care provider somewhere that disagrees with me.  If you want to know what your surgeon thinks, then ask him or her.    Check out my blog.

 

ajalew
on 3/27/11 10:09 am - Sanford, MI
I did not realize there was a pregnancy after WLS support group!  I will go try to find it right now.  I don't get on this website all that often and didn't know that existed.  And I'll post the ENTIRE think if you really think I should.  Haha.  Its just soooo long.

I am seeing a high risk specialist already, but last week he talked about sending me down to a higher risk specialist in Ann Arbor (same hospital as Dr Birkmeyer).  I've been hoping to avoid that because I am so sick of going to so many different doctors.  But I probably will have no choice. That's why I was on here, I thought maybe I could go to my current high risk OB with a couple more ideas to try before they send me down to Ann Arbor.  Ah well... 

And you're right, I misspoke about the "removal of the intestines."  I always think that but I know you're correct, they don't actually REMOVE them.  I meant bypass.  Sorry.  I need to read back over my post before clicking the submit button.  I just re-read it and some of it makes me sound kind of ignorant.  :/  

Thank you for all your quick replies though.  I will post this where it would make more sense.  

Most Active
What's on your Wednesday menu?
Mkess · 10 replies · 175 views
What's on your Monday menu?
ladygodiva1228 · 3 replies · 112 views
What's on your Friday Menu?
Mkess · 3 replies · 75 views
Weight Loss slowing down
HappyGirl1021 · 2 replies · 88 views
What?s on your Thursday menu?
Melody P. · 2 replies · 83 views
Recent Topics
What's on your Friday Menu?
Mkess · 3 replies · 75 views
What?s on your Thursday menu?
Melody P. · 2 replies · 83 views
What's on your Wednesday menu?
Mkess · 10 replies · 175 views
Weight Loss slowing down
HappyGirl1021 · 2 replies · 88 views
×