Weightloss after surgery

[UnXmas]

Hi,

I don't have an ostomy yet, but for a long time my doctor has been mentioning it as a last resort.

Now I really seem out of options and I have an appointment in June, where we'll probably discuss a stoma again, and I think I may decide to have it finally, if my doctor still thinks it's a good idea.

But my question for those of you who've had a similar surgery is how much weight did you lose while recovering? I am terribly underweight right now. I've always been a bit underweight, but now my bmi is only about 12 or 13. I have been trying to gain weight since last December, and I haven't managed it, but I haven't lost any either and it seems like I'm stuck at this weight.

I would assume that my doctor will not recommend surgery while I am this underweight, however I'd thought that before and he happily went ahead with the operation, a couple of months ago, and I had no problems with recovery from that one. However that was a minor, laproscopic procedure, I didn't even have to stay overnight in hospital.

A few years ago I had a much more major surgery, and while recovering I lost several kilos - I don't really know how much because I wasn't weighing myself very often. I was a normal weight when I had that surgery though, so I could afford to lose a little. The reason I lost weight was because of all the nausea, etc. resulting from the anaesthetic, and because of the pain in my stomach caused by the surgery. So I was not eating enough, there weren't any problems with malabsorption.

I'm expecting the ostomy surgery to also be quite major. It will be done laproscopically if possible, and obviously will be planned and so not an emergency surgery. If you've had a similar surgery, how much weight did you lose because of it? Did you have problems eating after the surgery? Did you have to have any supplements or a feeding tube?

I actually really want a feeding tube right now. I've never had one, and to be honest I don't know much about them, except that inserting the tube sounds horrible and I think I'd faint as I do when I have anything invasive. I'm so tired of eating when it makes me so ill, and of the mental stress of worrying if I'm getting enough calories in, and forcing food down because I know I need to gain weight. The idea of knowing that most of my calorie needs are taken care of by the tube sounds like a relief to me. I'd still continue to eat normally as well as I do enjoy eating when I'm feeling well enough to!

What's surprised me though is that my doctors don't seem that concerned by my weight now. The doctor who would be doing this surgery has never really commented on my weight, and he's been seeing me for years and has seen me at various stages of both low weights and healthy weights. I can't believe he'd agree to operate on me now though.

When I was a teenager I was misdiagnosed with anorexia because I was losing weight, and the doctors treating me then treated me as if being 1kg underweight put your life at risk. I became used to doctors telling me that being underweight was the most dangerous thing in the world.

But now, when I'm no longer being treated by eating disorder specialists, my doctors don't seem that bothered. I really want a doctor to take responsibility of my weight for me, as I just can't eat enough anymore and need a long term solution. I hate knowing how worried my parents are about me.

So I suppose in a way I want the consultation about the ostomy to bring my weight to doctors' attention so I can get some help with it. Did anyone else have the surgery while underweight? Was it a concern when you went through the pre-op assessments?

Sorry this is so long, I'm just not sure how I'll ever be able to go ahead with the surgery if I can't find a solution to my weight.

 

[Dukeis]

I had a laproscopic total proctocolectomy in March. I lost 8 kilos right after surgery. I'm a big guy so it wasn't a problem for me. A few weeks after surgery my appetite come back like I never had in over 20 years. My doctor told me it was because my diseased colon was gone. I have now gained 6 kilos since surgery and my doctor told me to be careful not to gain anymore weight then before surgery.

 

[steffers]

A few weeks after surgery my appetite come back like I never had in over 20 years. My doctor told me it was because my diseased colon was gone.

I'm no doctor but I recon any weight loss you experience post surgery will be purely temporary and just a side affect of your body's healing period. But the benefits of having the surgery are going to far outweigh the negatives. As Dukeis has just said, you are going to have an appetite again and healthy intestine to digest it. No point putting oil in the car if there's a leak in the tank now is there?

I was treated with a feeding tube in my teens but I think they do that but its too much responsibility to ask of a child to 'drink' enough volume of elemental. I'm seeing a dietitian at the moment and now I just have to drink the cartons.

Good luck whatever you decide...but there's a big world out there...don't become the world's leading expert in bathroom interiors!

 

[2thFairy]

I lost 14 pounds while in the hospital, partially from ileus and partially from dehydration. Similar to Dukeis, my appetite came back in about 2-3 weeks and I turned into a regular piggy...eating all the time, though very small portions because I got full very fast...but always hungry. I was slower to gain the weight back, though. It's been 1-1/2 years now and I'm still 4 pounds less than I was going into surgery, but I think most people gain back their weight or more somewhere around the 3- to 4-month mark (?).

Special diet (soft foods, no fiber) for me was only in the first 6 weeks while the stoma is still swollen and more prone to obstruction, but after that, I can eat anything I want.

My surgery was an open procedure with a 12-inch incision. I have had multiple abdominal surgeries and have a belly full of adhesions, so there was no point in attempting a laparoscopic surgery for me.

 

[UnXmas]

Thanks for all the replies. My situation is a little different as I have gastroparesis (slow stomach emptying) which means I feel full very easily, and this won't be affected by the surgery. It's separate from Crohn's, and none of the doctors I see have any idea why I have - they suspect some more systemic problem, as I also have rectal problems affecting bowel control.

But I should have improvements regarding my other symptoms, so hopefully you're all right and maybe I'll be able to gain weight more easily after the surgery even with the gastroparesis.

 

[mflaum]

I went through my proctocolectomy back in February. At the time I was loosing a lot of weight from chemo, radiation and one painful fistula. I would say I lost close to 30 lbs between Oct and Feb. After the surgery, my doctor gave me a TPN line. I had that for about 6 of the 10 days I was in. 2200 calories a day. It helped.

My anus was removed was removed 4 weeks later. During the time in between I was at least able to maintain my post surgery weight. Appetite was pretty good. After the 2nd operation, I was prescribed mega acetate.
Since then, I've gained 8 lbs.

Like 2th Fairy, I've had 3 too many surgeries before my ostomy. The doc went straight through the other incisions. Fortunately, my surgeon is an artist. He did a phenomenal job both times.

 

[annawato]

I was in hospital for 4 months prior to my latest stoma and resection surgery. Even though I was already overweight I was fed intravenously (TPN) for all this time to improve my protein levels which are essential for healing and recovery. They wouldn't operate until they were at a good level. Consequently I gained 10 kilos while in hospital and haven't lost it since unfortunately. The post op period I was still being fed by IV until I could eat an adequate diet.
If you are keen to put on weight and also to be in good condition for surgery I would suggest protein drinks such as ensure, sustagen and two cal. I was given these on top of the TPN. I think it is good that you are thinking about your weight issue now so that you can do something about it pre op. From what I've heard, nasal feeding is pretty horrendous so don't go that route unless you can avoid it. Try the protein drinks first - two or three a day should really help.
Keep us updated with it all,