Ask Dr. K: Problems over the years
2012
2011
2010
2009
Stontium
Biphosphonates 9/21
Hair loss after weight loss surgery! 5/18
Drug interactions with herbal remedies 5/4
Exercise habit
Pregnancy after duodenal switch 4/27
Calorie calculation 4/13
Cells found in bones 3/11
Calorie predictive relations in energy regulation by rats3/9
2/2
Am I going Bald
Trans Fatty Acids 1/7
2008
Olive oil 12/30
Bariatric surgery before pregnancy 12/5
Antioxidant effects of almonds 10/20
Moderate Exercise Yields Big Benefits 6/1
There are numerous sources available on the internet for patients to search for information. The information that one can find ranges from scientific to anecdotal. Patients individually have asked me a number of questions and I will peridically address them in an "Ask Dr. K" newsletter. I would also like for my opatients to submit their questions by emailing it to me.
“Problems Over The Years”
Question:
“What are the main things we should be looking for
"symptom wise" at 3, 5, 7, or 10, etc. years out. I'd
like to know how the duodenal switch effects teeth? On hydration as I think my body
pulls water from my stool when I'm not drinking enough.
Actually - it's not "enough" it's that my body passes it out my
kidneys if I am not sipping constantly throughout the day. Is
that normal? Omega Fatty Acids - are we screwed? What do
those deficiencies look like?”
Answer:
I do not know of any particular study that looks at the health of the
teeth specifically, however, I would assume that if a patient is not
complaint with their Calcium, or even complaint, and they are deficient
in minerals such as Calcium, Vitamin D, Magnesium, and others, then
one can develop poor teeth.
Hydration is a very important issue. Surgery or not, most of us tend to
run around a little “dry”. Constipation may be a side effect of inadequate
water intake.
For the Omega fatty acids, see the next newsletter dated 9/22.
Question:
I would love to know what types of problems are seen in
post operative patients and what the distributions are by years
post-op.
Answer:
In very broad terms, I can classify them in both time frame, and in
term of causes of complication (mechanical vs. nutritional). See table 1.
Please note that this is by-no-means a complete list, only a brief, very brief, overview of some of the potential problems that may surface. This list is not meant to be all inclusive or complete.
| Post operative Time Frame |
Nutritional | Mechanical |
| Days | Dehydration | Leaks, abscesses, infection (urinary, pulmonary) DVT, PE, Wound dehiscence, Bowel Obstruction |
| Weeks | Dehydration, protein calorie malnutrition-acute |
Wound infections, DVT, PE, Bowel Obstruction |
| Months | Protein Calorie Malnutrition, mineral deficiency, Kidney stones | Bowel obstruction, Cholecystitis (if your gallbladder not removed) |
| Years 1-3 | Protein Calorie Malnutrition, mineral deficiency, Kidney stones | Bowel obstruction, Cholecystitis (if your gallbladder not removed) |
| Years 3-5 | Occasional mineral deficiency, Kidney stones |
Bowel obstruction, Skin Rashes (if applicable) |
| Years over 5 | Occasional mineral deficiency, Kidney stones |
Bowel obstruction, Skin Rashes (if applicable) |
Deep Vain Thrombosis (DVT) Where a blood clot is formed in the deep venous system of
the lower legs and can travel and block the flow of the blood to the lungs. If large enough in it
a common cause of death in post operative patients. DVT’s are not the same as varicose
veins.
Pulmonary Embolism (PE) A clot or a tumor that is dislodged from one part of the venous
circulatory system and blocks the flow of the blood to the lungs. The most common source for
the PE is a DVT.
Wound Dehiscence Complete or partial breakdown of the suture line at the deep layers where the bowel may become unprotected. In some cases this needs re-operation on an urgent fashion.