Lipase Concerns After Surgery
Greetings, medical professionals. I’m a 31-year-old woman, measuring 5 feet 7 inches tall and weighing 250 pounds. I quit smoking six years ago. I recently underwent a sleeve gastrectomy and am now one week post-operation. My current medications include Topamax for intracranial hypertension, along with bariatric multivitamins and calcium supplements. The surgery itself went smoothly, though I have been experiencing some more significant overall discomfort and difficulty swallowing than I had anticipated, which led to an additional day of hospitalization before being discharged on Sunday. Since then, I’ve been striving to stay hydrated by consuming roughly 88 ounces of water daily—split into two 44-ounce cups—as well as two protein shakes that each contain 30 grams of protein. However, on Monday, I found myself in the emergency room due to an abrupt onset of a strange sensation in my body, which was determined to be a result of dehydration. During my ER visit, my lipase levels were found to be elevated at 105, alongside high blood pressure of 145 over 100 and an accelerated pulse rate. After receiving intravenous fluids, I began to feel much improved, and the medical staff suggested that the elevated lipase levels might be attributed to postoperative irritation. Today, I had a follow-up appointment with my primary care physician. On my way in, I noticed that even walking short distances was causing me to feel breathless and my heart rate soared to 150 beats per minute while standing still (my resting heart rate typically hovers around 100). My primary physician ordered a D-dimer test, which returned positive, and subsequently, I was sent to the ER for a CT scan. Thankfully, the results showed no signs of blood clots, so I was discharged shortly thereafter. I also experienced a dip in my blood sugar during this time, but after consuming some juice, I felt better. My primary doctor reran the lipase test, though the ER did not conduct one. By the end of the day, the results revealed a concerning rise to 213. My doctor indicated that ideally, these levels should stabilize or decrease, yet mine have doubled. Additionally, I am experiencing pain beneath my left ribcage, which may correlate with the location of my stomach. As I await further communication from the office, I understand it’s now the weekend, so I am uncertain about how long it might take for the on-call physician to respond to this matter.
Answers (1)
9/13/2025, 12:31:04 AM
OpenHealth AI
It's understandable to feel concerned about your elevated lipase levels and overall symptoms following your sleeve gastrectomy. Elevated lipase can indicate several situations, especially post-surgery. Given your recent experiences, let’s break down what you’re facing and what you can do next.
Overview
You’re one week post-surgery with elevated lipase levels increasing from 105 to 213, alongside discomfort, excessive thirst, and a concerning dip in your blood sugar. The pain under your left ribcage and feeling breathless during activity adds to your worries.
Explanation
-
Lipase Levels: Elevated lipase levels can suggest issues related to the pancreas or irritation due to surgery. In your case, your doctor suspects this may be postoperative irritation, particularly given that you had surgery very recently.
-
Dehydration: Your previous episode of dehydration highlights the need for consistent hydration, especially post-surgery, when your body has increased needs.
-
Breathlessness and Elevated Heart Rate: These symptoms, along with your D-dimer test being positive, raised concerns about possible clots, but the absence of blood clots on your CT scan is a relief. Breathlessness can also arise from factors like anxiety, dehydration, or increased effort with physical activities due to your recent surgery.
Next Steps
-
Continue Hydration: Keep focusing on hydration. Aim for at least 88 ounces of water daily, as you have been doing. You might also include electrolyte solutions if suggested by your healthcare team, especially since you’re recovering from surgery.
-
Monitor Symptoms: Track your symptoms closely, particularly your heart rate, breathlessness, and any abdominal pain. Write down when symptoms occur and their intensity to provide clear information to your healthcare provider.
-
Rest and Activity: Prioritize rest but also try light movement as tolerated. It's important not to strain yourself; short walks (as comfortable) can help in recovery without inducing breathlessness.
-
Dietary Adjustments: Ensure you’re consuming small, frequent meals post-surgery to help manage blood sugar levels. Keeping a balance of protein and carbohydrates can be especially beneficial.
-
Know When to Seek Help: If your pain worsens, you experience new symptoms (like significant shortness of breath, confusion, or severe abdominal pain), or if your elevated lipase levels increase further, don’t hesitate to seek emergency medical attention.
-
Follow-Up: Maintain communication with your primary care physician regarding the rising lipase levels and any other concerns. If you don’t hear back soon, consider reaching out to their office early next week to follow up.
Your current situation is understandably unsettling, but you are taking the right steps. Please feel reassured that with good management and monitoring, you will continue to recover. Let me know if you have more questions or need additional guidance!
Related Questions
Discrepancy Between CT and MRI Findings of Liver Size
Subject: 35-year-old female, height 5'3", weight 110 lbs; not on any medications besides a calcium supplement, and previously took 1g of salt tablets from June through July. Backstory: In April, I began experiencing a worsening of chronic symptoms alongside some new issues. This culminated in a visit to the emergency room due to near-fainting spells and low blood pressure. I also noticed a significant decrease in my appetite, which made eating quite uncomfortable, leading to a weight loss of approximately 10-15 lbs. Upon consulting a new primary care physician, I underwent extensive blood tests. The results largely appeared normal, including liver function tests, although my serum iron and transferrin saturation levels were elevated. Consequently, I was referred to a hematologist, who diagnosed me with hemochromatosis and recommended a liver MRI to check for potential iron deposits. Simultaneously, my PCP ordered an abdominal CT scan to investigate my early satiety issues. The abdominal CT scan conducted in late June returned normal results, specifically noting that my liver was “within normal parameters.” Due to scheduling conflicts, I only managed to get the liver MRI this past week (September). The findings indicated a mildly enlarged liver, measuring 19 cm. Reflecting on my alcohol consumption, I used to drink heavily in my twenties—averaging 4-8 beverages on most nights. Though I moderated my drinking in my thirties, prior to the ER visit in April, I was still consuming about 2-4 beers on an evening, sometimes reaching 5 drinks. Since then, I’ve significantly cut down to 0-1 beer most nights, and a maximum of 2-3 drinks once or twice a week. Despite some ongoing appetite loss, I maintain a well-rounded omnivorous diet, primarily composed of homemade meals rich in fruits and vegetables. I avoid excessive consumption of fried foods and saturated fats, opting for a balanced approach instead. I have consulted with a cardiologist who performed an echocardiogram and a continuous EKG monitor, finding nothing alarming. He added me to salt tablets temporarily for low blood pressure, which I discontinued in July as my readings stabilized. Furthermore, my hematologist confirmed that my bloodwork did not suggest any cancer risk. In summary, I'm puzzled by how my liver could appear normal on the June CT scan while the MRI in September indicated a size of 19 cm, especially in light of my reduced alcohol intake. Could the enlargement simply have not been detectable on the CT? Also, how concerning is a liver measuring 19 cm for someone who is 35 years old and weighs 110 lbs? Any insights would be greatly appreciated as I await communication from my healthcare providers, hopefully by Monday.
Concerns Over Ear Symptoms and Dizziness
I am a 14-year-old weighing 120 pounds, and for several years, I've been experiencing some unusual health issues. Occasionally, it feels as though fluid is leaking from my ear, and I often feel quite dizzy, especially when swinging on playground equipment or flying in an airplane, where I notice significant pressure in my head. I am seeking advice as I am worried these symptoms could indicate something serious, like a brain tumor.
Chronic Shoulder Discomfort
I’m a 20-year-old male currently prescribed Depakin Chrono for my epilepsy. Recently, I've been experiencing ongoing issues with both of my shoulders. Each episode of pain typically lasts for about a month, then shifts from one shoulder to the other, and this cycle has been persistent for three years. I suspect it’s not a tear or serious injury because engaging in activities such as biking or rock climbing provides temporary relief, yet I wake up the next day with the discomfort returning or occasionally absent altogether. Pressing on the shoulders does not generally invoke pain. When one shoulder starts to ache, the opposite side tends to feel somewhat unusual as well; although it's not painful, it doesn’t feel quite right—just a milder sensation of the same discomfort. Lifting my shoulder and moving my arm doesn’t trigger any pain either. I’ve attempted various stretching routines, including wall angels and resistance band exercises, but these have not yielded any improvement. Over the past few months, I consulted three different doctors who all struggled to identify the underlying cause and provided no effective solutions. The last professional suggested that I increase my exercise routine, which I recently began doing; however, this has led to intensified shoulder pain.
Potassium Chloride Dose Raised Concerns After Lasix Discontinuation
An 86-year-old female, standing at 5 feet 3 inches and weighing 150 pounds, has a medical history that includes being a former smoker, congestive heart failure (CHF), hypertension (HTN), and Parkinson's disease. The most recent estimated glomerular filtration rate (eGFR) recorded on August 30 was 52. Her current medication regimen consists of atenolol, atorvastatin, dabigatran, and potassium chloride at a dosage of 20 mEq. It has been 11 days since the healthcare provider opted to discontinue her Lasix, yet they advised her to persist with the potassium chloride dose of 20 mEq, as indicated in the discharge instructions from the emergency room. Should this raise any concerns?
Ongoing Issues Following My Appendectomy
At 26 years old, I found myself in the emergency room on July 1st because of abdominal discomfort. The doctors diagnosed me with chronic appendicitis and prescribed antibiotics, sending me home. A week later, I underwent an appendectomy. However, shortly after the surgery, I experienced a significant spike in fever (ranging from 101 to 104 degrees) accompanied by nausea and vomiting. Upon returning to the emergency room, medical personnel discovered signs of a urinary infection through tests but were unable to determine the underlying cause via a CT scan. As a result, I was treated with intravenous antibiotics, specifically Rocephin. For the next couple of days, I struggled with constant vomiting and persistent diarrhea, though my fever subsided. This led to another visit to the ER due to dehydration, where I was given Promethazine for nausea and Sucralfate, which I have since stopped taking. Since that time, I’ve been dealing with sporadic health issues. Some days, I feel relatively fine, but then I experience a return of various symptoms including nausea, vomiting, bowel irregularities, abdominal discomfort (localized in several areas), acid reflux, fatigue, and even blood in my stool. A CT scan in August revealed proctitis, yet no other significant findings were noted. Most of the tests conducted (such as a celiac panel and an OVA and parasite test) returned with negative results. It has been two weeks since I took an H. Pylori test, and I’m still awaiting the results. My father had prostate cancer in his sixties, but I have no substantial family history of cancer or conditions that could shed light on my situation. I’ve previously dealt with mild stomach issues, such as occasional nausea and diarrhea, but nothing of this magnitude or persistence. My surgeon and primary care provider have both referred me to a gastroenterologist, who has been very helpful, yet I still feel lost without a clear diagnosis. I'm now seeking guidance on medical attention for this weekend. Over the last few days, I've been grappling with diarrhea, extreme fatigue, and increasing pain in the area where my appendix used to be. I reached out to my gastroenterologist but did not receive a reply before the weekend. Initially, I thought I could wait it out, but the pain intensified tonight. It has become painful to have a bowel movement, and the discomfort isn't limited to just my lower right abdomen; I occasionally feel it in other areas of my abdomen and lower back. Although the pain isn’t as severe as my appendicitis, it has a troubling resemblance that concerns me. I don’t have a fever at the moment, but I worry about the possibility of another infection. I am contemplating whether to go to urgent care or the emergency room—urgent care has been subpar and lacks imaging technology, but I'm unsure if my current state warrants a visit to the ER, since I doubt it could be appendicitis again. **In Summary**: I've been experiencing various gastrointestinal issues including proctitis, nausea, and vomiting for two months following my appendectomy, and I'm uncertain where to seek medical help for the increasing abdominal pain I've endured over the last few days.