[twin43]

Hi, I am a nurse and a friend of mine had a gastric bypass about 1 year ago. She is having extreme neuro issues including pain and burning of feet and hands as well as sensitivity to light. She is exhausted and has tremors. She is forgetful and depressed. She was in a wheelchair at one point and now after physical therapy can walk sometimes with a walker. I believe she has substituted alcohol for food as her means of comfort. I had not seen her in 5 months and was devastated by what I saw. Her gastric bypass MD says it is not related to her surgery. I think she has a vitamin deficiency, ie. b12 or thiamine. Any input or any advice on a nutritionist or specialist in CT on post-op complications?

[MsVickie]

Honey,

I have no advice for you on this. I have never heard of this before. I would think she needs to see a Neurologist. Its seems her Surgeon has noted this and don't think it comes from the surgery. If she has substituted alcohol this may be the reason? I honestly don't have any idea but a Neurologist is where i would think she would need to be right now considering the burning sensations she is experiencing. Has she lost to much weight? Is that what you meant by shocked when you seen her ? Im sure DOC will be of great help with this.

[Kenyar]

Ive heard of something similar but i dont think its proven to be directly related to the surgery. sometimes when people lose the weight too quickly other things arise. add in the factor of not taking the vitamins or staying on top of the protein and you may really hurt yourself. sounds like something similar to a friends ailment. beri beri? though this is common in other areas nder other conditions, she was actually diagnosed with this. again may not be direclty linked to the surgery. wish i had more info for you.

check out the symptoms here: Beri-Beri - LoveToKnow 1911

[twin43]

She has seen a neurologist and I must say he is wonderful. He does not know what is wrong with her. He sent her to another neurologist to see if he might have missed something and he too is confused. In all honesty, they may not know about the alcohol. (Alcohol can increase the nutrition deficiency). I must say I do not have much faith in most docs as they write prescriptions to cover symptoms and have almost no knowledge on nutrition. I have downloaded several articles on neuro complications after surgery mostly related to deficiency in B vitamins. I know it is not common but it can happen. She has many of these symptoms. Thanks for your input. When I saw her she was reclined in the front seat of a car. She was stammering to talk and she had generalized tremors. She barely could walk with a walker from the intense pain and she was definitely sober at the time. She only leaves the house for doctor appts. This was a fun loving vivacious nurse who worked full time less than six months ago.

[Kenyar]

Oh yeah alcohol may play a HUGE roll in this. We are re-routed so to speak. I am sure post op alcohol does way more harm than pre-op. I am sure doc sanae will be in shortly. She always saves the day!

[DocSanae]

Hi twin43, welcome to the board, thank you for joining us.

Your friend really seems to be in a spot.
Any and every possibility should be considered.
Do you know if she's been taking all the supplements she should?
What are her lab results for all her vit levels, iron level, minor minerals like zinc, copper, magnesium, etc, as well as the rest, blood count, liver functions, blood sugar, etc etc?
Her back condition? Anything there, like degenerative bone disease that probably was caused originally by her obesity, then aggravated temporarily durin the rapid weightloss phase.
Did she have any comorbidities such as diabetes? Diabetes in itself can cause nerual complications, which maybe wasn't obvious when obese, but the emergence of the sypmtoms may have coincided with the surgery.
And, of course, if alcohol has gotten into the mix, that is going to through a huge kink in there.

Along with her complete present physical assessment, the order of things is also an indicator in uncovering what exactly is going on. Did her depression come on first (which is a great possibility, as almost everyone gets depressive to some extent during the rapid weightloss) which led to stuff like not taking her supplements, and turning to alcohol. In which case, the depression is going to have to be treated along with whatever deficiency. Also, since you are a nurse, I'm sure you're aware that depression will exacebrate physical symptoms, so, that may be the reason there's a gap in her subjective complaints and her physical symptoms, and the findings of the various drs.

Is your friend the patient of a large and reliable bariatric center with multiple drs and specialists, and have affiliation to a larger medical center that can be accessed easily? If not, switching to this type of facility is one option. If she's already the patient of such a center, maybe having her seen by a reliable general internist who has extensive knowledge of neurology, nutrition, metabolic and endocrine diseases and bariatric surgery; and who can coordinate and work with any required number of specialists would be the best way. From the sounds of what you have posted, it's pretty much obvious that she needs to be seen by different specialists, so finding a dr who is a good coordinator might be the best choice for her.

(((((((HUGS)))))) to you and your friend.

[BreeChick]

Thiamine thiamine thiamine....this is,in MY own opinion one of THE most important supplements besides the b-12 SHOTS to be getting in..

research thiamine deficiency regarding WLS on MEDLINE/MEDSEARCH..you'll be very much on board with taking this particular supplement!

My ex EMT partner's sister had the surgery and had the exact symptoms that you are describing. I'll have to call and ask him what it was they diagnosed her with. One of the thiamine issues if I remember right is the Wernicke's Encephalopathy..you'll have too look it up & I'm sure the Doc can explain what that is!

--bree

[DocSanae]

Wernicke's is a type of alcoholic encephalopathy.

[fr1endly2]

JUST wanted to welcome you to the board twin43. POST op i have had some minor issues with numbness in my hands and feet that a nerologist
hasnt figured out why. HE looin in depth in my vitamin levels, more so then my surgeon and all was fine as well as a few other tests. I have passed all with flying colors. OF course i am not as bad off as your friend and i hope she gets to doctors that can help her.

GETTING hooked on alcohol can happen post op. We loose our friend food and can start subing in alchol in its place. MANY surgeons suggest no drinking the first 12 months at all in hopes this addiction switch doesnt happen.
I will keep your friend in my thoughts......
and welcome again!

[not quite Barbie]

Nerve damage may occur after weight-loss surgery - Yahoo! News

Interesting article about this exact problem at the above link.

Nerve damage may occur after weight-loss surgery
"Some are permanently disabled," she said. Among patients who develop symptoms years down the road, the spinal cord typically is affected, resulting in falling, extreme coordination and gait problems, and severe spasticity, and some individuals need to use wheelchairs.
Juhasz-Pocsine and her team describe 26 cases of neurological problems that occurred in gastric bypass patients in the medical journal Neurology. Symptoms typically involved more than one portion of the neurological system.
While restoring nutritional deficiencies, which included lack of vitamin B12, thiamine, or copper, helped patients, many continued to have symptoms for months, while symptoms remained permanent in some patients, Juhasz-Pocsine and her team report. The patient who fared best was a woman who underwent surgery to reverse her gastric bypass after developing rapidly progressing symptoms that didn't respond to other treatment."