Gaining and keeping weight on

Question
I had gastric bypass Apr 8th of 2008. Approx. three weeks after surgery my uncle was dying in florida. I took the trip and it cost me dearly. I ended up nearly bleeding out. Just before my plane left to go back to alaska I was sweating uncontrollably. I ask the stewardess if she had any way to take my blood pressure and I was feeling very sick and faint. 22 minutes later I woke up in the jet way with paramedics putting me on a stretcher. Long story short I had 5+ units of blood put in me and a gastro doc had to cauderize me in two places. I went home to heal and kept losing weight. Aug 14th I was on a trip with my wife and had a gallbladder attack and nearly died. It took three days to figure out what was wrong with me and they took out my bladder. All the while since the surgery I had allot of trouble eating solids. I finally started doing protein shakes and such with lots of supplements. Dec 17th I had a total right hip replacement. I am a 52 yr old white male. My weight fell to 143 lbs and I'm 5'9". I finally called my gastric doc and he told me to get in there. I thought it was loss of appetite due to narcotics and my body healing. He immediately did a scope on me and found my 6 mm ring not right. He straightened it out, expanded it a little and put me on nexium and pancreatic enzymes. Even now I eat as much as I can but sometimes I just can't eat much. There are days when I can eat solids fine but never in much quantity. My weight has come up some but only to around 154 lbs. If I don't eat plenty or take my supplements(and I'm learning allot more on that too) I go down to 148 or so in no time. I want to be around 165 but just can't get there. My hip seems to be healing fine and I'm nearly off narcotics. I take 3 to 4 ms contin 30 mg a day. Sometimes I take a norco 10/325 for break through pain but not often. Need help gaining weight. I've even resorted to cookies or ice cream sometimes and I just can't seem to gain. Do you have any ideas. Ask me any question and I'll be totally up front. This will not be private. Post it for anyone to read. Thanks.

Answer
Ron,
Sounds like you have been through a really rough time and I'm sorry to hear that.  In working your way through this, you definitely need to stay in close contact with your bariatric surgeon - he is going to be in the best position to advise you on how to achieve your best nutrition.

My input is for you to drink 4-6 bottles each day of a protein drink such as Ensure or Boost, over and above your food intake.  To bring your weight up after your hip surgery and your challenges related to the gastric bypass, you are probably going to need to take in more than 1,800 calories per day for a while, and liquid calories are probably the only practical way to do that.

Best of luck!
Dr JP

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