- Transient Hair-Loss
Hair-loss and -thinning are common side-effects which occurs in almost
everyone during the first 6 months. It is very alarming, however it
will not lead to baldness and it is reversible. Once your weight stabilizes
and you take in more protein, the hair will grow back. Hair treatments
and permanents should be avoided. Be sure to take in an adequate amount of protein.
- Nausea
Since the new stomach pouch is smaller, it will not be able to hold
as much food as it did. Therefore, if you get full but continue to
eat more, or eat quickly without chewing thoroughly, chances are an episode
of vomiting will result. These habits will change after several episodes
of vomiting. Therefore, you will have to "re-learn"
your way of eating by eating slower, chewing food well, and stopping
when you feel full.
If you have had no problems with eating during the first month after surgery and then
suddenly experience vomiting after eating or drinking, you may have
developed a "stricture", or narrowing, at the point where the
stomach pouch connects with the small intestine. You should call your
surgeon for further evaluation.
- Lactose Intolerance
The enzyme needed to digest milk and other dairy products (lactase)
does not reach food in the usual fashion and may not be able to fully
digest milk. Undigested milk can lead to gas, cramping, and diarrhea.
You may need to avoid dairy products and eat foods which do not contain
lactose (e.g.. soy milk, lactaid).
- Changed Bowel Habits
Not only is the amount of food and liquid taken-in less, but the
digestion of it is changed. Therefore, you will experience a change
in your bowel habits. After a gastric bypass, patients may experience
constipation which can be treated with a mild natural stool softener,
or by simply increasing the amount of fluid taken. After a BPD/DS, patients
may experience diarrhea which is usually associated with fat in the
diet. If however this is not the case, a small amount of pancreatic
enzymes may be required, which would be prescribed by your surgeon.
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- Loss of Muscle Mass
Since the amount of calories eaten is drastically reduced after
surgery, the body will look to burn other energy stores to maintain
itself. Surprisingly, the body prefers to use-up muscle for energy before
using-up fat. Therefore, most of the weight you lose will be muscle
and then fat. However, this can be avoided. The way to prevent muscle-loss is
to exercise everyday. It is extremely important to perform
both aerobic activity and weightlifting regularly after surgery. These
activities can be alternated, but should be done at least
3 times a weekt for 20-30 minutes. Exercising everyday, however, is ideal and should be
the goal. Increased fat burning, muscle building and toning, and increased
feeling of energy are the results which lead to a more fulfilling life.
- Gallstones
With any rapid weight-loss, there is an increased risk of developing
gallstones. About 1 in 10 people will experience problems from gallstones
and will need their gallbladders removed. We do not routinely remove
gallbladders at the time of weight-loss surgery, because that would
mean 9 of 10 people would have their gallbladders removed unnecessarily.
Instead, anyone who has a gallbladder is placed on a medication called
Actigall® (ursodeoxycholine) that prevents the formation of gallstones,
for 6 months. If the gallbladder for some reason still needs to be removed,
it can be done laparoscopically at a later date.
- Excess Skin
After a large amount of weight-lost, you may find yourself with
excess skin in places you never knew existed. The logical question is
"What happens to the excess skin?" Weight-loss after surgery
continues for about 18-24 months. After that, your body is equilibrated
and ready for surgery for excess skin removal. This is typically
performed by a plastic surgeon
experienced in this field. The plastic surgeon will evaluate you and
decide with you what areas need "tightening-up". Unfortunately,
this is cosmetic surgery and is not covered by insurance. However, there
are many plastic surgeons who are flexible and may be able to work out
a payment schedule with you.
- Pregnancy Problems
We recommend that a woman delay pregnancy for 18 months after weight-loss surgery because
of the nutritional changes occurring in the body.
Although there have been women who successfully carried pregnancies
to term as early as 6 months after surgery, their babies were overall
below normal in weight, and some women had miscarriages. Because we do not
fully understand the implications of weight-loss surgery on successful
pregnancies, we suggest that you wait for at least 18 months after surgery
to have a child. And even after that, you must make sure that your obstetrician
is aware of your weight-loss surgery and that you and your baby should
be followed closely.
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