6 weeks and some troubles

Stitch83
on 4/11/18 7:08 pm
RNY on 02/26/18

Hi all...I am six weeks out and in general have been surprised at how smoothly things have gone, not too many complications and haven't had any food not going down well or bad reactions to. However, the one trouble I have is my blood pressure. It is quite low and is causing me lots of dizziness and lightheadedness. I almost passed out in the shower the other day and then my heart was racing after getting dressed. Heart was also racing today after a short 25 min walk with the dog and I felt really low energy after. At my one month follow up the doctor said my heart races due to the low blood pressure. I have an appointment booked Monday with my pcp to review it. In the mean time does any one have any suggestions? I was told to add salt which I have been doing and keep my water intake up, also have been doing that wth at least 2 litres but usually 2.5. I can't seem to find any sugar free Gatorade so that's not an option...at least until I can get to the States to look.

Second question is I am being asked by family/friends if my lightheadedness could be related to lack of food. I am getting an average of 450 calories daily and eat three meals so I thought no. My Center recommends three meals and two snacks though so wondered if maybe they do have a point? Should I be increasing calories/food intake?

HW: 285 SW: 260 CW: 226 Dr. Grantcharov, St. Michael's

Referral: May 2017 Orientation: June 5/17 Nurse: Aug. 17/17 Doctor/Dietician/SW finished by Dec. 11/17 Surgical Ed. Class: Dec. 18/17 Surgeon: Jan. 9/18 Surgery: February 26, 2018!!

ScottAndrews
on 4/11/18 9:32 pm
RNY on 03/20/17

Orthostatic hypotension is quite common in the first few months post surgery especially in the AM after fasting all night. If there's a time of day when we're at our most dehydrated it's usually in the morning. That might be your culprit but it sounds like your being vigilant with your liquids. If it was happening after you're eating something sugary or carby I'd say you could be having an insulin spike.

I have no idea if adding calories will help but 450 sounds a little low.

Stitch83
on 4/11/18 10:19 pm
RNY on 02/26/18

Thanks for the reply. Yeah it doesn't have any correlation to eating. I suspect it is the orthostatic type but I have it all day. For sure it is worse after I wake from napping too I'm the afternoon though so that fits.

Thanks for the feedback about calories, it's hard to know at this stage what's right or off still.

HW: 285 SW: 260 CW: 226 Dr. Grantcharov, St. Michael's

Referral: May 2017 Orientation: June 5/17 Nurse: Aug. 17/17 Doctor/Dietician/SW finished by Dec. 11/17 Surgical Ed. Class: Dec. 18/17 Surgeon: Jan. 9/18 Surgery: February 26, 2018!!

Grim Traveller
on 4/12/18 4:19 am
RNY on 08/21/12

Orthostatic hypotension. It's really common after WLS, but most docs aren't familiar with it in that context.

It is NOT lack of food.

We built miles and miles of extra blood vessels to run our obese bodies. As you lose weight, you don't need them all. That helps lead to blood pressure drops. Imagine opening all the taps in your house at once, running the showers, flushing the toilets, and running the outside taps. Water pressure will be crap.

It gets better over time. Your body will make adaptations to being thinner, just as it did when we got fatter. But the first year could see many issues with orthostatic hypotension.

Drink more. If you think you are drinking enough, drink even more. Add salt. Don't go low sodium on anything. If you are on BP meds, talk to docs about going off of them, soon. When you get up from lying down or sitting, do it slowly, in stages. Stand for a moment before walking. I actually passed out a few times from the dizziness. It's no joke.

I never saw a zero calorie gatorade. I think the lowest cal version had 80 calories, which is way too much. I did drink a mountain of Powerade Zero that first year.

It's easy to test for orthostatic hypotension. They teach it to most nursing students. Check your BP while lying down and resting. Then check it right after standing up. If there is a drop, which comes back up, its OH.

6'3" tall, male. Maintaining a loss of 280 pounds.

Highest weight was 475. Consult weight 04/12 was 411. RNY on 08/21/12 at 359 lbs. Current weight 195.

M1 -24; M2 -21; M3 -19; M4 -21; M5 -13; M6 -21; M7 -10; M8 -16; M9 -10; M10 -8; M11 -6; M12 -5.

Stitch83
on 4/12/18 8:46 am
RNY on 02/26/18

Thanks for the explanation...that makes total sense, all the extra blood vessels! Not on any blood pressure meds but I am trying to increase my salt for sure. I cannot find Powerade zero here yet but will definitely pick up a bunch when I next head over the border. They did check my blood pressure from lying to sitting to standing and it went lower each time. After about ten minutes it was up to 80/50 so I guess it must have gone up to that lol. Makes sense with that info that it's OH. Did you find that it affected your energy level at all? It feels really draining for me for awhile after an incident. Thanks for all the tips on managing it.

HW: 285 SW: 260 CW: 226 Dr. Grantcharov, St. Michael's

Referral: May 2017 Orientation: June 5/17 Nurse: Aug. 17/17 Doctor/Dietician/SW finished by Dec. 11/17 Surgical Ed. Class: Dec. 18/17 Surgeon: Jan. 9/18 Surgery: February 26, 2018!!

kitmouse
on 4/14/18 8:16 am
RNY on 07/27/17

When you are in a "down"position and you know you want to get up, squeeze all the muscles in your legs. Squeeze, relax, squeeze, relax. About 10 times (test it out, you may need more or less). What you're doing is squeezing the blood back out of where it's pooled in your legs, back up into your heart for circulation to your brain. If you are standing and you feel dizzy or lightheaded (I see stars) do the same thing. Blood up to your brain. Pump, pump, pump.

Stitch83
on 4/15/18 7:41 pm
RNY on 02/26/18

Thanks for the tip! Love these forums for all the great tips and ideas.

HW: 285 SW: 260 CW: 226 Dr. Grantcharov, St. Michael's

Referral: May 2017 Orientation: June 5/17 Nurse: Aug. 17/17 Doctor/Dietician/SW finished by Dec. 11/17 Surgical Ed. Class: Dec. 18/17 Surgeon: Jan. 9/18 Surgery: February 26, 2018!!

H.A.L.A B.
on 4/12/18 6:27 am

We eat very little at the beginning and a lot of us drink protein shakes that has close to no salt. I used salt capsules since I could not put enough salt in my food.

You may try to get some salt pils- capsules. They can be find on line or in sport stores.

I had to do that a few times. If we don't eat carbs or enough salt - there is nothing in our body to keep the water in. In situation like that ,- the more plain water you drink - the worse you may feel.

Hala. RNY 5/14/2008; Happy At Goal =HAG

"I can eat or do anything I want to - as long as I am willing to deal with the consequences"

"Failure is not falling down, It is not getting up once you fell... So pick yourself up, dust yourself off, and start all over again...."

Stitch83
on 4/12/18 8:47 am
RNY on 02/26/18

Ohh I didn't even think about salt capsules...that's a great idea!! I will check out some stores today because even adding salt to things is not enough I think.

HW: 285 SW: 260 CW: 226 Dr. Grantcharov, St. Michael's

Referral: May 2017 Orientation: June 5/17 Nurse: Aug. 17/17 Doctor/Dietician/SW finished by Dec. 11/17 Surgical Ed. Class: Dec. 18/17 Surgeon: Jan. 9/18 Surgery: February 26, 2018!!

countrysweetheart
on 4/12/18 7:29 am
RNY on 03/26/17

I also had these issues, I fainted at a friends birthday party and the concrete floor wasn't so soft lol. The doctor said it was due to standing in one spot for too long also my blood work came back with low sodium. I take 1/2cup of the G2 Gatorade in the morning with my meds, it has seemed to have helped. I hope you get it figured out, take care.

Starting weight:280lbs-Referral: July 11/16-Orientation: September 29/16-Pre-surgery-weight 249lbs Surgery date: March 26/17-M1-16lbs-M2-10lbs-M3-10lbs-M4-9lbs-M5-9lbs-M6-8lbs-M7-5lbs-M8-6-M9-4-M10-7-M11-Maintained-M12-Maintained-M13-
Goal Reached January 8/18

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