Liver woes and other exciting adventures

[Guest guest]

In a message dated 2/1/2003 8:03:43 AM Eastern Standard Time,

kdirving@... writes:

> See? No one in the Grad group has ever

> experienced anything like this, so it's likely not the fault of the

> surgery that my liver went wonky on me " ,

As far as I know, which is very little, obesity has a similar effect on the

liver as alcohol. It is no surprise that many people with the surgery also

have liver problems. I believe that it is not the surgery, but the previous

obesity that is the cause. A lot of surgery detractors forget what shape we

are in when we have the surgery and then put the cart before the horse.

I do hope you continue to get better.

Fay Bayuk

300/175

10/23/01

Dr

[Guest guest]

In a message dated 2/1/2003 5:03:44 AM Pacific Standard Time,

kdirving@... writes:

> So...my question to the group would be -- any of you ever have any nasty

> liver sequelae to your surgeries?

I am 2 1/2 years out - no liver issues, ever, and normal enzymes

Hubby is 18 months out - no liver issues, ever, and normal enzymes

Best friend is 13 months out - no liver issues, ever, and normal enzymes

We are all Duodenal Switch surgeries, and all had elevated enzymes prior to

surgery.

Kate

[Guest guest]

Well, it feels like I haven't posted here in ages...though I've been

keeping up, sporadically -- mainly because I've spent the past month

and a half being one sick puppy. Some of you might remember that I was

complaining about gastric pain after eating a while back? (Okay, I know

you don't remember, I never remember who's been doing what until I'm

reminded either, but that's okay. I don't take it personally.

*Sniff*....)

Anyway, back in December I started to develop a swollen lymph gland on

my neck. The darn thing started out like any other gland, the kind

you'd get for a cold or sore throat, say...but then it kept getting

bigger...and bigger...and BIGGER. Thing was the size of half a tennis

ball, and believe me, I'm not exaggerating.

I was back and forth to my GP's office a lot that week, and by two days

after New Year's he just took one look at me and got me in to see an

ear, nose and throat specialist within the hour, because he was afraid

the lymph node might be cancerous, it was growing that quickly. The ENT

guy pronounced the gland " not just extraordinary -- this one's

spectacular! " as if it were some kind of prize pumpkin I was growing on

the side of my neck, and sent me home with some Tylenol #3s to ease the

pain. He didn't think it was cancerous, as it was quite tender, but we

scheduled a biopsy just to be on the safe side.

So I went home, took two Tylenols, and within 15 minutes I was doubled

over in agony. Gastric pain like you wouldn't believe. I was sweating,

couldn't talk, wanted to throw up but couldn't (one of the side effects

of this surgery, for me, is that I cannot barf to save my soul. Dry

heaves only. Not that I mind, since I hate barfing more than almost

anything, but it's inconvenient sometimes). My husband was so scared,

he called an ambulance, and I got my first ambulance ride. Yay. I

wasn't in much condition to appreciate it, however. They gave me IV

morphine at the ER, along with Gravol, and I felt much more

comfortable; then they took about a zillion blood samples, in an effort

to figure out what was going on.

Well, it turns out that my liver enzymes were seriously elevated, to

the tune of about 100 times what they were supposed to be. According to

the tests, my liver was extremely unhappy, but we couldn't figure out

why. I had an ultrasound, and they found ascites, a collection of fluid

around the liver. Now, I remember ascites. That's what my mother had

before she died of liver, heart and lung failure. Granted, she was a

career alcoholic who essentially died of cirrhosis, but by the time

your liver gets around to secreting fluid in that volume, it's not a

happy camper at all. The ER doctor quizzed me extensively about my

drinking habits, and seemed surprised when I told her I rarely drink

alcohol -- maybe a glass of wine a month, if that.

I spent the next three weeks being sick, on and off. When it was bad, I

couldn't eat without experiencing pain afterward, sometimes for hours

at a time. The pain was slightly south of my breastbone and slightly to

the right, which corresponds roughly to the location of the liver, and

it was a cramping, boring kind of pain that often seemed to refer to

the right shoulderblade. When it was bad, I would be doubled over,

nauseated, miserable. Then I'd go for several days feeling more or less

okay, just tired out.

The ultrasound I had in the ER didn't detect any sign of blockage in

the common bile duct, and I don't have a gall bladder, so it wasn't

that; I had a CT scan a couple of weeks ago, so it's possible that this

will shed a bit more light on what's happening on my insides, but I'm

not optimistic that it'll solve the riddle. So far, our best guess is

that I have cytomegalovirus, or CMV, which can mimic mono (hence the

Monster Gland from Hell), and infect the liver. My liver enzymes were

almost back to normal last week, for which I am profoundly thankful; so

at this point we're assuming that I had a virus and it's gone now. I'm

going for more enzyme tests in a couple of weeks, just to make sure I'm

on the mend.

Meanwhile, however, my GP has been doing a lot of pacing the floor and

wringing his hands over my condition. He seems to think that my

" fragile " health status lately has to do with my RNY and its aftermath;

I, on the other hand, attribute it to the past two years, during which

I've had far more than the usual allotment of emotional stressors in my

life, including two parental deaths and one brush with death myself,

during the surgery. In fact, aside from this liver stuff, I consider

myself *very* healthy, a lot more so than I was when I was MO. My doc,

while a sweetie pie in every respect and a great general practitioner,

worries. I appreciate it, believe me, but I am thinking (hoping) that

his concern is misplaced in this case.

So...my question to the group would be -- any of you ever have any

nasty liver sequelae to your surgeries? I would really like to be able

to go back to my GP and say, " See? No one in the Grad group has ever

experienced anything like this, so it's likely not the fault of the

surgery that my liver went wonky on me " , not just because I want to be

right, but because I don't want him to refuse to refer any of his other

patients for WLS, just because he's paranoid about what happened to me.

On the other hand, if liver problems *are* a side-effect, I should

probably know about that, too.

Any takers? Thank you in advance...

I.

--

<><><><><><><><><><><><><><><><><><>

RNY September 19, 2001

Dr. Freeman, Ottawa General Hospital

BMI then: 43.5

BMI now: 22

-152 lbs

<><><><><><><><><><><><><><><><><><>

[Guest guest]

B wrote:

> With the precautions against drinking and the relatively common

> reporting of

> elevated liver functions I've been taking Milk Thistle ever since

> surgery.

> It may not help but I figure it can't hurt.

Yes, I read about this a while ago and started taking it when I

realized that the problem was liver-related. Like you, I don't know if

it'll help, but my research seems to indicate that it won't hurt.

> Now that I've had this surgery I sure wish

> I knew

> more in a real in depth manner about the functions of the pancreas,

> liver,

> bile ducts, duodenum, jejunum and all that other stuff that's been

> affected.

YES! Me too! I am the type who, when confronted with any challenge or

obstacle in life, like to research it to death. I find I've been kind

of limited in this by my lack of grounding in biology and chemistry,

when it comes to my WLS.

Take care,

I.

--

<><><><><><><><><><><><><><><><><><>

RNY September 19, 2001

Dr. Freeman, Ottawa General Hospital

BMI then: 43.5

BMI now: 22

-152 lbs

<><><><><><><><><><><><><><><><><><>

[Guest guest]

Fay wrote:

> As far as I know, which is very little, obesity has a similar effect

> on the

> liver as alcohol. It is no surprise that many people with the surgery

> also

> have liver problems.

Yes -- in fact, the reason I nearly bled out during the surgery is that

while they were doing the routine liver biopsy, they nicked a rather

large vein there. Turned out that at the time of surgery I had

" moderate to severe " fatty liver. No huge surprise, given my weight at

that time.

> I believe that it is not the surgery, but the

> previous

> obesity that is the cause. A lot of surgery detractors forget what

> shape we

> are in when we have the surgery and then put the cart before the

> horse.

I agree, but as it happens, my liver enzyme profile was just fine, as

short a time ago as last September. So the general consensus is that we

really are looking at a virus in this case. However, my GP seems to

think that the virus affected me this badly because of my " delicate "

condition following surgery. I say, " Bosh and humbug, " but I'd like to

be able to say that with a bit more confidence, you know?

> I do hope you continue to get better.

Thanks, Fay.

Take care,

I.

--

<><><><><><><><><><><><><><><><><><>

RNY September 19, 2001

Dr. Freeman, Ottawa General Hospital

BMI then: 43.5

BMI now: 22

-152 lbs

<><><><><><><><><><><><><><><><><><>

[Guest guest]

Well ~

Sorry to burst your bubble, but I too had a terrible bout with CMV.

BUT....it was NEVER attributed to my surgery. It was just a happening. I

have chronic fatigue and fibromyalgia, and it sometimes is associated with

the CFS. My son also had the same thing...and never had the surgery. I'm

grateful that the docs didn't see it as a complication of the surgery.

Fortunately, it IS something that gets better. Makes you sicker than all get

out...but does get better. I have also had spikes in my EBV titers...and

that too, shows a problem with the immune system, just as the CMV does. I

had a liver biopsy at the time, and all they found was a fatty liver which I

had at the time of my surgery. It was felt that the surgery was a GOOD

thing..and my liver would be forever grateful I had it. My enzymes are

practically normal now...but I take a great deal of milk thistle and a liver

formula of herbs. Did you turn a ghastly shade of yellow while you were at

this? I did, and was sure I was dying, before I got my dx. I looked and fel

t like it! Anyway...IMHO your surgery isn't responsible for this episode.

In fact, it probably would have been a whole lot worse had you NOT had the

surgery. When we are MO...our livers take the brunt. By the way, my

mother's autopsy report showed the fatty liver as the second cause of her

death.

Take care~

Regards~

Jacque

Distal RNY

Drs. Fox and Oh

Beginning BMI 50.0

Current BMI 21.0

> So...my question to the group would be -- any of you ever have any

> nasty liver sequelae to your surgeries? I would really like to be able

> to go back to my GP and say, " See? No one in the Grad group has ever

> experienced anything like this, so it's likely not the fault of the

> surgery that my liver went wonky on me " , not just because I want to be

> right, but because I don't want him to refuse to refer any of his other

> patients for WLS, just because he's paranoid about what happened to me.

> On the other hand, if liver problems *are* a side-effect, I should

> probably know about that, too.

>

> Any takers? Thank you in advance...

>

> I.

[Guest guest]

I guess misery does love company! LOL! It IS good to know though, that

someone else has been there, and survived it. I really didn't think I was

going to live, it's hard when you don't know what's wrong, and everything

starts to go haywire on you. Thank heavens viruses are pretty self limiting,

especially this one. But guess if we DO get something, our weakness is our

liver...obvious from what we've been through. BUT, NOT necessarily

associated with the bypass sx. I also know of one other woman that had this

happen, and she is MO, and going to have the sx soon. Wonder if our fatty

livers don't create a weakness there, and that's why the virus attacks it.

My son is also MO. That seems to be more a common denominator than does the

surgery.

When I had my gallbladder removed, my biliary duct was jam packed with

stones, and they didn't know why I wasn't that hideous bilious yellow. But

with the CMV, it was plain for everyone to see how yellow I was. People

would come up and ask me if I KNEW I was yellow. After awhile, it was

getting old. Especially when it was doctors asking me this...LOL!

Hope you can convince your doc that you now know of three other cases, two of

which never had the surgery, and the third never had it attributed to that!

You really need to be able to keep those lines of good communication open if

he is to remain your doc. A reversal...?? Eeeks! Pretty drastic thinking

on his part. BTW, how far out from Sx are you? I was only about 7 mos out

when it showed up. It started a bit earlier than that....but it reached its

crescendo at 7 mos. I know you are more than a year out...but don't know how

much more. Take care..and be well!

Regards~

Jacque

Distal RNY

Drs. Fox and Oh

Beginning BMI 50.0

Current BMI 21.0

> Thanks, Jacque -- I'm sorry to hear that you and your son have suffered

> through this, but it's good to hear that your CMV was not associated

> with your weight loss surgery. I suspect that my GP is getting confused

> between the " newer " WLS surgeries and the old JI bypass, which in fact

> was discontinued in part because of its link to liver and kidney

> failure. But when you're sick as a dog and your doc comes into the room

> and says, " So! Guess you'll have to have that gastric bypass reversed,

> right? " it really doesn't do anything to make you feel better! (Of

> course I know that he cannot *force* me to have any surgery against my

> will, but he and I have always had such a good working relationship, I

> hate to feel this kind of pressure from him. I know it's only his

> concern talking, but still....)

>

> BTW, I haven't had any jaundice, though at one point my enzymes looked

> as though I had a blocked common bile duct, one of the symptoms of

> which is usually jaundice. However, back in 1980 when I had my

> gall-bladder out, I was supposed to have been jaundiced and I wasn't,

> either. So I guess it's not a foregone conclusion. If there's any weird

> disease around, you can pretty much be certain I'll get it; and if

> there's any atypical symptom presentation, that'll be me, too! LOL (I'm

> the one who got amoebic dysentery a few years back, without ever having

> travelled to a tropical country or exchanged saliva with anyone who

> had....)

>

> Anyway, thanks for the post. I appreciate the info.

>

> I.

>

> --

> <><><><><><><><><><><><><><><><><><>

> RNY September 19, 2001

> Dr. Freeman, Ottawa General Hospital

> BMI then: 43.5

> BMI now: 22

> -152 lbs

> <><><><><><><><><><><><><><><><><><>

>

>

[Guest guest]

Thanks, Jacque -- I'm sorry to hear that you and your son have suffered

through this, but it's good to hear that your CMV was not associated

with your weight loss surgery. I suspect that my GP is getting confused

between the " newer " WLS surgeries and the old JI bypass, which in fact

was discontinued in part because of its link to liver and kidney

failure. But when you're sick as a dog and your doc comes into the room

and says, " So! Guess you'll have to have that gastric bypass reversed,

right? " it really doesn't do anything to make you feel better! (Of

course I know that he cannot *force* me to have any surgery against my

will, but he and I have always had such a good working relationship, I

hate to feel this kind of pressure from him. I know it's only his

concern talking, but still....)

BTW, I haven't had any jaundice, though at one point my enzymes looked

as though I had a blocked common bile duct, one of the symptoms of

which is usually jaundice. However, back in 1980 when I had my

gall-bladder out, I was supposed to have been jaundiced and I wasn't,

either. So I guess it's not a foregone conclusion. If there's any weird

disease around, you can pretty much be certain I'll get it; and if

there's any atypical symptom presentation, that'll be me, too! LOL (I'm

the one who got amoebic dysentery a few years back, without ever having

travelled to a tropical country or exchanged saliva with anyone who

had....)

Anyway, thanks for the post. I appreciate the info.

I.

--

<><><><><><><><><><><><><><><><><><>

RNY September 19, 2001

Dr. Freeman, Ottawa General Hospital

BMI then: 43.5

BMI now: 22

-152 lbs

<><><><><><><><><><><><><><><><><><>