Mal Absorption of Protein Causing Sub-Dermal Edema ... Anyone Else ???

on 10/10/22 11:27 am
RNY on 12/14/18

Mal Absorption of Protein Causing Sub-Dermal Edema ... Anyone Else ???

On Sept. 1, 2021, after returning to CA after being away in GA (living out my mother's life journey) ... I noticed my legs and feet swelling up; first I thought, oh it's cause I've been on the road for 2 weeks, then I blamed the climate change, but then it started getting worse. I had immediately gone to my primary doctor, she ordered bloodwork, but the words that came out of her mouth were unheard of ... "Marcia, your proteins are low." ... No way, I said, that is all I practically eat. Well, increase your proteins, and lets see what the labs show and sure enough they were low. Had appointment with my Bariatric doctor and he was, very unusual; lets increase your intake, do more blood in a few weeks and see where we are at.

Trying not to make this story long ... in addition to bloodwork, my Primary also ordered a CT Scan of Abdomen, to make sure there were no signs of leakage, obstructions, etc. ... well, fortunately there were not, but unfortunately it was discovered I had (2) Large Kidney Stones in my Left, "Marcia, why are you not keeled over in pain?" Doc, I don't have any pain ... MRI, Ultrasound, etc. ... well, 1 is lodged in the upper pole and the other lodge in the lower pole ... didn't know I even had them ... The only reason I bring these finding up are because my Bariatric doc needed for me to be cleared from Urology before what he knew needed to be done ... REVISION Surgery (I really didn't want, but if I had to have, I had to have.

Then, I played the waiting game, insurance authorization, referrals, appointments ... it was painful as each day passed ... the EDEMA was taking over my body ... I couldn't walk, stand, sit, lay ... I could not get in and out of bed, up or down on toilet, wear any of my clothes nor shoes ... tears on a daily ... in the meantime, my protein levels (albumin) continue to drop ... it is explained to me that I am malnourished and too unhealthy for surgery/recovery until my protein levels are restored to healthy range ... well, doc, what do we do ... we need to put a feeding tube in your 3 year (then) resting stomach ... I jumped some details ... I couldn't take the wait for a urology appointment no matter the urgency I expressed and I decided to take myself into the ER and made sure they admitted me (doc thought it also was a good plan) on Dec. 13, 2021 (1 Day BEFORE my 3 year Post Op Anniversary) ...

... it took another 2 1/2 weeks before anything was done ... finally, get Urology clearance that the kidney stones, etc. can wait ... Dec. 30th finally have procedure and get a G-Tube installed ... Jan. 2nd we start the Feeding process, and also finally give me some Lasix (why did I have to wait SO LONG) ... Released from Hospital on Jan 9th to go to Rehab, as Muscle Atrophy had now occurred and I could not take care of myself, walk, stand, balance, etc. ... Finally, released from Rehab on Feb. 2nd, and to continue feeding the tube (as well as , eating orally****il March 13th ... Edema finally going away, life starting to come back to normal ...

... had a conversation with my doc, so, how will we know, if I need the surgery or not ... he, was a smarta$$ at first "well, if the Edema returns" ... Doc, seriously, how long will it take before the Edema return if it does ... 6-8 months. We continue checking blood levels regularly, and why did/does he have to be so smart ... almost 6 months to the day, and my legs and feet are starting up again :'( ... it's inevitable, it would seem, surgery being scheduled.

Anyone else ???

on 10/11/22 12:29 pm

No experience with this other than my ankles swelling up ( a bit) when I drive for days from South Florida to New York.

Just wanted to say I feel so much sympathy for you and pray you and your docs will figure out the cause .

Getting those big kidney stones out sooner rather than later is probably a good idea too.

hugs and best wishes

on 10/11/22 2:36 pm
RNY on 12/14/18


on 10/13/22 9:37 pm

I had a problem with kidney stones during the first 3 years post wls (hospital emergency room stuff). I also had kidney stones prior to wls but not in many years, and it became worse after the surgery. The doctor told me this is not uncommon for wls patients do to an anomaly in processing protein. After a few years it became a non issue. I'm pretty sure I still get them regularly but they don't grow large enough to be a serious problem anymore.

on 10/15/22 7:51 pm
RNY on 12/14/18

Thanks for your reply and I'm glad your situation with stones isn't serious anymore, however, my post is 'really' about the malabsorption of protein and it causing sub-dermal edema and now needing a revision surgery because my by-pass section is not absorbing properly.

on 10/17/22 3:23 am

Hey MOAKEN, sorry to hear about your struggles.

Wishing you the best and hope you are ok.

Fingers crossed the docs can get to the bottom of it for you.

on 10/17/22 6:21 am
RNY on 12/14/18

Thank you very much and I am praying for that end result as well.

on 11/22/22 10:16 am

Maybe see if hydrolyzed protein (there may be some shakes or powder for that) or adding protein digestive enzymes during meals helps.

I wonder if getting more of your protein from vegetable sources might help. Do you like tofu? It can be seasoned numerous ways.

Consulting with a registered dietitian with bariatric experience could be helpful.

on 11/22/22 10:38 am
RNY on 12/14/18

Thank you for your suggestions and yes, I like Tofu, have tried adding all types of proteins and have consulted a specialist, and my bariatric surgeon ... we are hopefully on a road to recovery and solution as he was performing the procedure to give me a G-tube into my resting stomach; he observed a Fibrine obstructing (wrapped around) a good portion of gut/intestines; and in positive hopeful theory; causing the mal-absorption/malnutrition ... we shall see and I will keep all posted.

on 11/22/22 4:49 pm

Looked up fibrin obstruction. Didn't know it could happen.

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