Swelling from protein deficiency?

[Jshereetaylor]

Hey guys!
It has been a while since I have been on here. I have been suffering quite a bit and wanted some opinions from all of you. I had my VSG to Ds revision the end of April. For the most part I have done well with it. However since about July I started to have lower extremity swelling. It has kept on and become worse. I saw my pcp. She put me on Lasix and potassium. It still continued, I went back and they doubled that. They drew labs and told me my protein was just a point low so they thought it was due to malnutrition and protein deficiency. I have been taking in probably around 100 grams of protein every day. I am pretty much sick of protein shakes and chicken breasts. But, I am persistent. They told me the next step would be cardiology. She also said that some women who are relatively healthy get "idiopathic edema" and if that is the case there is nothing that can be done about it. It is now causing a rash on my lower legs (this is new and started yesterday) and I am concerned it may be stasis dermatitis. I am gonna ask for the cardiacconsult. But, my question is has anyone else encountered this? I am 36 years old. It stinks that I feel like I can not do almost anything with my family. And I have a very busy family.. cheer, dance, volleyball, softball, football, band,baseball, basketball, track, theater, etc. I want to be able to enjoy all of these things and I still do but I always pay for it..
On another side note I was in such pain in my abdomen and finally started vomiting that I went back to my pcp and am being treated for H pylori. Could this swelling be related to this?
Any help at all would be greatly appreciated.

 

[Larra]

There are lots of possible causes of edema, but I've never heard of H pylori as one of them. Of course you still need to be treated for that, but I doubt the treatment will solve the edema problem. I would look more towards the protein issue.
I don't understand why you are focused on just protein shakes and chicken breasts. With the DS one of the huge advantages we have is that we don't have to worry about fat intake, because we absorb only about 20% of the fat we consume. That means you can eat both lean and fatty forms of protein, which gives you lots of options. Have some beef! Much more concentrated form of protein than chicken. Try dark meat chicken, pork, ham bacon, iguana...ok maybe not the iguana, but you get the idea. And keep supplementing with the protein shakes til you get your levels back up. I can't promise you this will work but it's worth a try, and you want good levels of protein anyway.

 

[Jshereetaylor]

I am taking in plenty of everything! I had steak, and ham and eggs with cheese today, plus a shake. But I guess when I am trying to "count" my intake i usually think of one chicken breast is 25 grams, one shake is 20. I am definitely not skipping out on anything. And I hope it truly is just a protein deficiency, I know my body definitely shows signs of protein deficiency. I am losing hair like crazy. So, it very well may be. I was just very curious if this has happened to anyone else.

 

[DianaCox]

Who did your revision and what are your limb lengths?

 

[Jshereetaylor]

Dr Wilhelmy.
Alimentary limb 300 cm, bp 600 cm and cc 100 cm.

 

[DianaCox]

That's a long gut! 900 cm.

According to Dr. Hess, the limb lengths should be 10% common channel, 40% alimentary limb:

Volume of stomach100 ml (+ or - 15 ml)
Common Channel 10% of total small bowel length, 50, 75, 100 cm
Alimentary limb 40% of total (SBL) 250, 275, 300, 325, 350 cm
http://www.dshess.com/Parameters.htm

By that measure, your alimentary limb is only 33%. That's not far off, but you may need to consider using pancreatic enzymes to help increase your protein absorption if it is not adequate. Protein malnutrition can be very very serious. Keep a very keen eye on your levels and don't be afraid to sacrifice some percent weight loss for staying healthy. You can lose weight more slowly and over a longer period of time if necessary. The risk is that if you need a revision to lengthen the absorptive portion of your small intestine, you have to be healthy enough for surgery.

 

[Munchkin]

Post your protein labs. 1 point low on what??? And doesn't seem likely to me that it's protein related. Edema, rash, pain, hair loss, and vomiting. Any other symptoms?

BTW did you know a very real side effect of Lasix is hearing loss? There are lots of other diuretics out there.

 

[Charris]

THAT'S exactly what happened to me when I was malnourished IT got so bad that water started leaking out my skin. The rash becomes so unbearable. You more than likely need TPN..

 

[Larra]

Whoa there! There are other things that can be tried before going on TPN, such as the digestive enzymes @DianaCox mentioned. And we don't even know her labs, and whether they are going up, down, or sideways. Revision is last resort, TPN is next to last.

BTW have you tried the Pure Protein shakes? More expensive than the powders, but tasty (if you add just a little milk) and 35 gm of protein each. I get them at Trader Joe's, but I believe they can also be ordered on Amazon. Just read the labels carefully as there is also a variety with less protein.

 

[KathrynK]

So sorry you are going through this! You are about 6 months out. Have you had your full labs (vitamins, minerals, etc) with your surgeon yet? Or just the PCP? Does your surgeon know this is happening? Maybe call and discuss?
My feet used to swell pre-DS so much that I needed a bigger shoe size in the afternoon than in the morning. Have they suggested compression stockings? I hated them, but they helped.
Hope they find out the cause and cure soon!

 

[writegirl]

I had a raging h-pylori infection pre-op and did have terrible edema. Whether h-pylori impacted that issue, I can't say. I can say that the treatment was horrible and made me feel like hell and that feeling lasted for like 3 months while I built my gut back up. One thing, please be sure to get on a high quality probiotic. I use one that must be refrigerated. Also, be sure to NOT fall into the trap of self-diagnosing because internet searches can make you believe you've got all kinds of things going on. Go through the diagnosis process and try to ease your mind that it will get better. It will.

 

[Charris]

I guess I'm just special. I was told by the time I started the swelling and water oozing out my skin from malnutrition i couldn't get myself out if trouble. Fyi*** when my skin got the rashes that turned into HORRIBLE sores that kept giving me Mersa it was because of LOW niacin and magnesium. So have they checked all that stuff? Honestly, being sick from malnutrition i think has been the worse sickness I have suffered. i have had horrible medical problems pre and post DS. I'm so sorry you are going through this. I hope they figure it out soon! Good luck.

 

[BigGeekGirl]

I'm sorry you're going through this.

Would you mind posting your lab values for protein, albumin and prealbumin?

I'm curious how low you are and those results might help figure out if it's protein vs. something else causing the swelling.