Why Am I So Cold After Gastric Bypass

Nagging cough after bypass surgery

The coughing is normal, so is the soreness in the center of your chest. My mother had the dry coughing and soreness for about a year after her first bypasses and also after her second bypasses. Irritating, YES, but not life threatening.

Recovery time differs from one person to another.

Keep exercising. This could cause more soreness, so if it’s too bothersome, ease up a bit for a while, but don’t stop completely.

My mother had bypass heart surgery 11 years ago. She is 86 Years of age. She continues to have a cough. Anytime she eats or drinks water or any drink she starts to cough and sometimes seems to choke and cannot get her breath. What can she do to correct this. This concerns me deeply and I do not know what to do for her.

Gastric bypass surgery

Gastric bypass is surgery that helps you lose weight by changing how your stomach and small intestine handle the food you eat.

After the surgery, your stomach will be smaller. You will feel full with less food.

The food you eat will no longer go into some parts of your stomach and small intestine that absorb food. Because of this, your body will not get all of the calories from the food you eat.

Description

You will have general anesthesia before this surgery. You will be asleep and pain-free.

There are 2 steps during gastric bypass surgery:

  • The first step makes your stomach smaller. Your surgeon uses staples to divide your stomach into a small upper section and a larger bottom section. The top section of your stomach (called the pouch) is where the food you eat will go. The pouch is about the size of a walnut. It holds only about 1 ounce (oz) or 28 grams (g) of food. Because of this you will eat less and lose weight.
  • The second step is the bypass. Your surgeon connects a small part of your small intestine (the jejunum) to a small hole in your pouch. The food you eat will now travel from the pouch into this new opening and into your small intestine. As a result, your body will absorb fewer calories.

Gastric bypass can be done in two ways. With open surgery, your surgeon makes a large surgical cut to open your belly. The bypass is done by working on your stomach, small intestine, and other organs.

Another way to do this surgery is to use a tiny camera, called a laparoscope. This camera is placed in your belly. The surgery is called laparoscopy. The scope allows the surgeon to see inside your belly.

In this surgery:

  • The surgeon makes 4 to 6 small cuts in your belly.
  • The scope and instruments needed to perform the surgery are inserted through these cuts.
  • The camera is connected to a video monitor in the operating room. This allows the surgeon to view inside your belly while doing the operation.

Advantages of laparoscopy over open surgery include:

  • Shorter hospital stay and quicker recovery.
  • Less pain.
  • Smaller scars and a lower risk of getting a hernia or infection.

This surgery takes about 2 to 4 hours.

Why the Procedure is Performed

Weight-loss surgery may be an option if you are very obese and have not been able to lose weight through diet and exercise.

Doctors often use the body mass index (BMI) and health conditions such as type 2 diabetes (diabetes that started in adulthood) and high blood pressure to determine which people are most likely to benefit from weight-loss surgery.

Gastric bypass surgery is not a quick fix for obesity. It will greatly change your lifestyle. After this surgery, you must eat healthy foods, control portion sizes of what you eat, and exercise. If you do not follow these measures, you may have complications from the surgery and poor weight loss.

Be sure to discuss the benefits and risks with your surgeon.

This procedure may be recommended if you have:

  • A BMI of 40 or more. Someone with a BMI of 40 or more is at least 100 pounds (45 kilograms) over their recommended weight. A normal BMI is between 18.5 and 25.
  • A BMI of 35 or more and a serious medical condition that might improve with weight loss. Some of these conditions are obstructive sleep apnea, type 2 diabetes, and heart disease.

Gastric bypass is major surgery and it has many risks. Some of these risks are very serious. You should discuss these risks with your surgeon.

Risks for anesthesia and surgery in general include:

  • Allergic reactions to medicines
  • Breathing problems
  • Bleeding, blood clots, infection
  • Heart problems

Risks for gastric bypass include:

  • Gastritis (inflamed stomach lining), heartburn, or stomach ulcers
  • Injury to the stomach, intestines, or other organs during surgery
  • Leaking from the line where parts of the stomach have been stapled together
  • Poor nutrition
  • Scarring inside your belly that could lead to a blockage in your bowel in the future
  • Vomiting from eating more than your stomach pouch can hold

Before the Procedure

Your surgeon will ask you to have tests and visits with other health care providers before you have this surgery. Some of these are:

  • A complete physical exam.
  • Blood tests, ultrasound of your gallbladder, and other tests to make sure you are healthy enough to have surgery.
  • Visits with your doctor to make sure other medical problems you may have, such as diabetes, high blood pressure, and heart or lung problems, are under control.
  • Nutritional counseling.
  • Classes to help you learn what happens during the surgery, what you should expect afterward, and what risks or problems may occur afterward.
  • You may want to visit with a counselor to make sure you are emotionally ready for this surgery. You must be able to make major changes in your lifestyle after surgery.

If you smoke, you should stop several weeks before surgery and not start smoking again after surgery. Smoking slows recovery and increases the risks for problems. Tell your doctor or nurse if you need help quitting.

Tell your surgeon or nurse:

  • If you are or might be pregnant
  • What medicines, vitamins, herbs, and other supplements you are taking, even ones you bought without a prescription

During the week before your surgery:

  • You may be asked to stop taking medicines that make it hard for your blood to clot. These include aspirin, ibuprofen (Advil, Motrin), warfarin (Coumadin), and others.
  • Ask your doctor which drugs you should still take on the day of your surgery.
  • Prepare your home for after the surgery.

On the day of surgery:

  • Follow instructions about when to stop eating and drinking.
  • Take the drugs your doctor told you to take with a small sip of water.
  • Arrive at the hospital on time.

After the Procedure

Most people stay in the hospital for 1 to 4 days after surgery.

In the hospital:

  • You will be asked to sit on the side of the bed and walk a little on the same day you have surgery.
  • You may have a (tube) catheter that goes through your nose into your stomach for 1 or 2 days. This tube helps drain fluids from your intestine.
  • You may have a catheter in your bladder to remove urine.
  • You will not be able to eat for the first 1 to 3 days. After that, you can have liquids and then pureed or soft foods.
  • You may have a tube connected to the larger part of your stomach that was bypassed. The catheter will come out of your side and will drain fluids.
  • You will wear special stockings on your legs to help prevent blood clots from forming.
  • You will receive shots of medicine to prevent blood clots.
  • You will receive pain medicine. You will take pills for pain or receive pain medicine through an IV, a catheter that goes into your vein.

You will be able to go home when:

  • You can eat liquid or pureed food without vomiting.
  • You can move around without a lot of pain.
  • You do not need pain medicine through an IV or given by shot.

Be sure to follow instructions for how to care for yourself at home.

Outlook (Prognosis)

Most people lose about 10 to 20 pounds (4.5 to 9 kilograms) a month in the first year after surgery. Weight loss will decrease over time. By sticking to your diet and exercise from the beginning, you lose more weight.

You may lose one half or more of your extra weight in the first 2 years. You will lose weight quickly after surgery if you are still on a liquid or pureed diet.

Losing enough weight after surgery can improve many medical conditions, including:

Weighing less should also make it much easier for you to move around and do your everyday activities.

To lose weight and avoid complications from the procedure, you will need to follow the exercise and eating guidelines that your doctor and dietitian have given you.

Alternative Names

Bariatric surgery – gastric bypass; Roux-en-Y gastric bypass; Gastric bypass – Roux-en-Y; Weight-loss surgery – gastric bypass; Obesity surgery – gastric bypass

Home » Reasons for Not Losing Weight After Bariatric Surgery

Bariatric surgeryВ includes a series of surgicalВ weight loss procedures designed to help obese or morbidly obese patients who have failed to lose weight usingВ other methods. Despite the fact that there are proven non-surgical, medically supervised weight loss programs, for some patients, losing weight is an almost impossible task.В However, there are specific reasons for not losing weight after bariatric surgery, and understanding these reasons can help patients avoid them.

There are currently four types of bariatric surgery performed in the United States, which are adjustable gastric banding, Roux-en-Y gastric bypass,В sleeve gastrectomy, and biliopancreatic diversion with duodenal switch. All of them are performed and work differently, which isВ why physicians evaluate the patient prior to deciding which one is more appropriate. Despite the fact that bariatric surgical procedures have been meticulouslyВ studied and are proven to beboth safe and effective, patients can not always loseВ the amount of weight expected after weight loss surgery, due to several

Lack of Compliance That Avoids Weight Loss

None of the types of bariatric surgery cause weight loss directly, and the entireВ treatment process involvesВ a highВ level of commitment and compliance from the patient. Even before, but particularly after the surgery, patients need to follow a strict diet, which is designed by theirВ medical healthcare team to increase weight loss, help the stomach continue healing, and decrease the possibility of side-effects. ImmediatelyВ after the surgery, patients initiate a liquid diet, slowly transition to solid foods, and three or four months following the procedure may return to a normal diet.

In addition, best practicesВ can help keep a patient’s weight-loss goals on track, including eating and drinking slowly,В keeping meals small,В drinking plenty of liquids between meals,В chewing food thoroughly, favoringВ high-protein foods, avoidingВ foods that are high in fat and sugar, tryingВ each new food alone to evaluate tolerability,В and takingВ recommended vitamin and mineral supplements. When patients fail to follow physicians’ recommendations regarding diet and exercise, not only can weight loss be compromised, but they are also at higher risk of suffering side-effects.

Diabetes As Cause to Not Lose Weight After Bariatric Surgery

Obese and morbidly obese patients commonly develop comorbidities, which are other medical conditions associated with obesity. Bariatric surgery is expected to help them lose weight, which can also result in improvements in overall health, including these conditions. However, there areВ other problems related to the existence of comorbidities, which occur when patients need to take medication that can influence weight loss. Among these conditions is diabetes, one of the most common obesity comorbidities.

According to the study “ Factors associated with suboptimal weight loss after gastric bypass surgery ,” patients with diabetes may need to take insulin or other drugs thatВ stimulate the production of fat and cholesterol, making it more difficult for them to lose weight. “Other factors that may lead to weight gain in patients with diabetes include a ‘protective’ increase in caloric intake to treat episodes of hypoglycemia [low blood sugar], reduction of urinary glucose losses and sodium and water retention that are a direct effect of insulin on the distal tubule in the kidney,” explained the authors.

Bariatric Surgery Complications That InhibitВ Weight Loss

In addition to problems that already exist prior to surgery, patients can also be prevented from losing weight due to complications that occur after the surgery. The same study demonstrated thatВ diabetes and having a larger size stomach pouch were independently associated with poor weight loss. The size of the stomach pouch created during a bariatric surgery is determined using anatomical landmarks, but the researchersВ “believe it is critical to stress the importance of and to teach the creation of the small gastric pouch and to better standardize the technique used for pouch creation,” in order to improve outcomes.

Similarly, in the case of the use of the gastric band, surgeons place a rubber ring around the patients’ stomach, reducing its size. However, one of the complications that can occur is gastric band erosion, which consists ofВ the band growing into the stomach. Due to this malfunction, the band will stop restricting the organ and patients will not only feel hungry again, but also they will start gaining or regaining weight as well. Fistulas between the gastric pouch and remnant can also cause problems with weight loss, and both physicians and patients need to be attentive to signs of potential problems that may unable weight loss and compromise the patients’ health.

InabilityВ to Lose Weight inВ the Long-Term

Bariatric surgery, just like any type of medically supervised weight loss program, does not work miracles and won’t directly cause weight loss for the rest of patients’ lives. Even when patients are able to lose weight right after the surgery, continuing to visit a physician regularly and follow a healthy life-style is keyВ to ensuringВ long-term results. According to the study “ Long-term Management of Patients After Weight Loss Surgery ,” the main factors that contribute to successful weight loss after bariatric surgery are the patient’s ability to make lifestyle changes and maintain those changes years after the procedure.

“Maintenance of weight loss is obtained by following a healthy balanced diet with regular exercise every week. Weight regain is a warning sign. It is best for patients to return to the bariatric team at the earliest signs of weight regain. If weight regain is caught in its early stages, it is easier for patients to get back on track. Regain of weight can be due to changes in operative anatomy and requires workup, but the most common causes are changes in diet, lack of exercise, or psychological issues,” state the authors.

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