First and foremost, recognize the recovery for weight loss surgery is six months to one year, not two weeks. One of the biggest risks after weight loss surgery is that the patient will develop chronic malnutrition. This can be incredibly serious. In extreme cases, a patient deprived of thiamine can go on to develop something called Wernicke encephalopathy/Korsakoff syndrome – a very serious neurological disease which can be permanent if thiamine is not restored to the patient’s system on time.
We have two of these cases right now in which patients will spend the rest of their lives in wheelchairs because doctors and nurses taking care of them were too inattentive to make the diagnosis on time.
Weight loss surgery is intended to create a serious disruption to the way a patient absorbs and metabolizes food. That’s why it works. Most people will recover, in time, the ability to absorb all of their essential nutrients on their own with a regular or modified diet.
About 145,000 Americans are now getting weight loss surgery every year. The number continues to go up. That’s almost a thousand patients a day, every working day, in American hospitals.
The most common weight loss procedures are the gastric bypass, the gastric sleeve, the “Roux-en-Y”, and lap bland.
If you are having severe symptoms after your weight loss surgery, keep the following things in mind:
If you go to the emergency room, always tell the doctor there about your weight loss surgery. Make sure the doctor understands when you had your surgery. Ask him or her to call your surgeon. (You should also be sure to tell your surgeon that you’re in the emergency room yourself as soon as you can.)
The most common reason for having to go to the emergency room after weight loss surgery is extreme nausea and vomiting.
Some nausea and vomiting is normal. It’s part of the recovery process for many patients. A key thing to remember is this: If the nausea and vomiting continues for more than a few days, you could be developing a serious nutritional deficit and you probably need to seek special medical help.
If your surgeon blows you off, consider going to a gastroenterologist. Insist on blood work being done. It is especially important that you have your doctor test your vitamin levels. These are special lab tests which are not ordinarily covered with routine laboratory testing.
Another thing to watch out for is extreme weight loss. How much is extreme weight loss? After all, the whole purpose of weight loss surgery is to lose weight.
A general rule of thumb is this: Many 300 pound patients will lose as much as 25 pounds in the first month after surgery. That’s on the high end of what a patient is expected to lose, but that much weight loss can be considered normal. However, 10 to 15 pounds of loss in the second month is more common.
Make sure that whatever doctor you see for complications after weight loss surgery understands exactly how much weight you have lost.
How much nausea and vomiting is too much? If you’re throwing up so much that you can’t really keep any meaningful nutrition down, you should see your doctor as soon as possible. All weight loss surgery patients are supposed to take vitamins after surgery. If you’re throwing up several times a day, however, you may not be getting the benefit of these vitamins.
Let’s review: It’s important to remember that the window for having serious complications after weight loss surgery may be as long as six months or even a year in some patients. It isn’t like gallbladder surgery. The biggest long-term risk after weight loss surgery (once you’ve healed well enough to avoid infection and bleeding) is serious malnutrition.
What are the specific signs and symptoms of Wernicke encephalopathy/thiamine deficiency?
There are three cardinal signs:
First, something doctors call ataxia, which usually manifests in layman’s terms as dizziness, vertigo, or weakness.
Second, something called nystagmus or “ocular abnormalities.” Blurry vision. Sensitivity to bright lights. And, as the disease gets worse, a sensation that your eyes can’t hold still. Nystagmus is defined as rapid involunatary movements of the eyes.
Finally, mental confusion. Difficulty concentrating or remembering things. These are known as “cerebellar” changes. This is usually a late sign of a very serious problem.
Weight loss surgery can be a tremendous blessing to some people. It is usually a surgery of last resort. For people who need it, it can be a game changer. But the complications are real and the window of opportunity to have a complication after weight loss surgery is quite a bit longer than most people realize.