Post-Operative Experience and Ongoing Concerns
I am a 24-year-old woman who recently underwent a cholecystectomy, a procedure I definitely needed. Since then, I've successfully lost 45 kilograms, with an additional 10 kilograms shed post-surgery. However, my weight loss has plateaued. Before the operation, I often faced challenges in maintaining proper nutrition due to persistent vomiting and discomfort, and I've continued to have difficulties with nutrition in the aftermath of the procedure, possibly linked to psychological factors. I consulted with my general practitioner who conducted comprehensive blood tests; I found that I have a slight deficiency in folate, but all other results came back normal. Both my stool sample and urinalysis showed no abnormalities. For the past few days, I have been experiencing lower blood pressure, fluctuating between 90/50 and 108/69. Additionally, I've been suffering from dizziness when standing, moments of dimmed vision, and I have had two falls, though I did not lose consciousness. There has been no evidence of postural hypotension so far. When standing, the dizziness is accompanied by noticeable heart palpitations, particularly intense enough that I can feel them in my neck. My resting heart rate is generally around 70 beats per minute, but it can escalate to between 100 and 130 beats per minute upon standing. I am beginning to wonder if these symptoms are solely related to my nutrition and fluid intake, as I've been trying to be proactive about my health and can't shake the feeling of exhaustion. I requested a referral to a dietitian, but I felt dismissed since my current weight is considered healthy for my height.
Answers (1)
7/19/2025, 3:01:40 PM
OpenHealth AI
It sounds like you have been through a lot recently, with significant weight loss and ongoing health concerns after your cholecystectomy. Your symptoms of dizziness, palpitations, and lower blood pressure can understandably be worrying, especially since you also have a history of vomiting and nutritional challenges. Let’s break down your situation so we can address your concerns effectively.
Key Concerns:
- Nutrition and Deficiencies: You have a slight folate deficiency, which is important for overall health and can contribute to fatigue.
- Symptoms of Dizziness and Palpitations: These could be related to your blood pressure fluctuations and possibly linked to your nutrition and hydration status.
- Weight Plateau: This can occur after significant weight loss, even if you are making positive dietary changes.
Explanation:
Given your recent surgery and the quick weight loss, your body may still be adjusting. Nutritional issues can arise as your digestive system readjusts, and emotional factors can significantly impact eating habits and nutrient absorption. The symptoms you describe, including dizziness when standing and palpitations, may suggest that your body is not effectively managing blood volume or hydration, particularly if you've had difficulties maintaining proper nutrition.
Specific, Prioritized Steps:
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Hydration: Focus on drinking plenty of fluids, especially water, throughout the day. Electrolyte solutions (like sports drinks or rehydration solutions) can help if you're feeling dizzy due to low blood pressure or dehydration.
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Small, Frequent Meals: Since you struggle with nutrition, try eating smaller meals more frequently rather than three large ones. Incorporate nutrient-dense foods like lean proteins, whole grains, fruits, and vegetables that can help you meet your nutritional needs without overwhelming your digestive system.
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Monitoring Symptoms: Keep a symptom diary to track your blood pressure readings, heart rate, and any symptoms related to dizziness or palpitations. Note when these symptoms occur to identify any patterns or triggers.
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Focus on Folate-Rich Foods: Since you have a folate deficiency, include foods like leafy greens, legumes, and fortified cereals in your diet. If you find it difficult to achieve adequate intake through diet alone, consider discussing folate supplements with a healthcare provider.
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Gentle Physical Activity: Engage in light physical activities that can improve circulation, such as short walks or stretching exercises, particularly when your dizziness is mild. Avoid sudden movements that can exacerbate your symptoms.
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Refer back to Healthcare Providers: Since you felt dismissed by the dietitian referral, consider discussing your ongoing symptoms with your general practitioner again, emphasizing the impact they have on your daily life. Sometimes, patients need to advocate for themselves to be taken seriously, so clearly expressing your experience can lead to better support.
It’s important to take these symptoms seriously, especially since they impact your daily functioning. Progressing toward better nutrition and hydration can significantly help; don’t hesitate to seek further support from healthcare professionals if needed. You're not alone in this, and with some adjustments, you can work towards feeling better. Please let me know if you need more specific guidance or help!
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Are there concerns regarding the shunt size (9.9 mm)?** 7. **The measurement of the portal vein has shown improvement from 6.1 mm to 3.9 mm; should this be perceived as a positive sign or a reason for concern?** 8. **Are there special directives (diet modifications, medications) we should consider while awaiting the procedure?** 9. **Post-procedure, how long should we expect it might take for:** - Normalization of bilirubin levels? - Return of stool color to normal? - Resolution of jaundice? - Regression of hemangiomas? 10. **Can you recommend any specialized centers for pediatric Abernethy malformation treatments? We are located in Uzbekistan but are prepared to travel (to Turkey, Russia, South Korea, etc.)** --- ## ADDITIONAL INFORMATION - No family history of hepatic diseases - Pregnancy and delivery were normal - No additional congenital defects identified - Immunizations up to date - No history of bleeding disorders - No signs indicative of encephalopathy - Child is alert and engaged --- **I can supply actual MSCT images and comprehensive lab reports if they would be of assistance.** We sincerely appreciate any insights you can provide. We are striving to make the most informed decision regarding our daughter’s care and highly value expert medical opinions. **TL;DR:** 7-month-old diagnosed with Abernethy Type 2 malformation (9.9 mm portocaval shunt, patent portal vein). Liver functionality is improving (normalized ALT) while bilirubin remains elevated (242). Evaluating options between endovascular coil embolization and open surgery. Seeking expert advice on optimal treatment strategy and timing.