How to treat post-op complications of duodenal switch surgery?

Question

Hello doctor,

I am 2 months post-op from duodenal switch surgery and have serious nutrient deficiency problems. My hair is falling out in chunks, I am constantly feeling dizzy, and my laboratory tests show critically low potassium and protein levels. I am following all the post-op instructions, but am still losing weight way too fast, down 68 pounds in eight weeks. The bariatric team said to expect some side effects, but this seems extreme. I am taking all the vitamins they prescribed, but I still feel like I am dying. My husband is freaking out because I passed out in the shower yesterday. The dumping syndrome is so severe that I cannot even go to work some days. Nobody warned me about the constant diarrhea and stomach cramps. My BMI went from 44 to 32. Is this normal, or did something go wrong with my surgery? Should I go to the ER or see a different specialist? What tests should I ask for? Will these problems be permanent, or will they eventually resolve?

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I understand your concern.

I so wish that your bariatric surgery team had made you sit down and explained to you what to expect, the most commonly faced challenges by almost 98 percent of the individuals who undergo this procedure.

As I have mentioned above, your hair fall, nutritional deficiencies and the rest are common side effects of the procedure you have gone through. Just the intensity of it differs in different individuals.

Yes, this needs to be addressed as you are two months post op. If a severe electrolyte imbalance is present, they will fix it by intravenous fluid infusion.

It is always a wise thing to consult another specialist for a parallel second opinion. If any post-surgical complications are being missed, another surgeon specialist might be able to catch hold of it.

Mainly:

Serum electrolytes (to check for imbalances in sodium, potassium, calcium, and other electrolytes).
Vitamin B12 levels (to assess for deficiencies that could cause fatigue and neurological symptoms).
Vitamin D levels (important for bone health and immune function).
Kidney function test (KFT) (to evaluate kidney function, especially if you are experiencing dehydration or imbalances).
Liver function test (LFT) (to check the health of your liver).
Complete blood count (CBC) (to detect anemia or other blood-related issues).
Iron profile (to assess iron levels and detect potential deficiencies).
Urine routine (to check for dehydration or any kidney or urinary tract issues).
Thyroid profile (to assess thyroid function, which could be impacting your energy levels).

If there is an underlying complication, by addressing it, it should eventually resolve.

And now I do feel a visit to the emergency room will be beneficial.

I hope this helps.

Kindly follow up if you have more concerns.

Thank you.