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Old 12-02-2007, 10:18 PM   #1
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Exclamation When is too much weight loss too much?

I finally have an appointment with a gastroenterologist (think that's the word) on January 3rd. I finally managed to get in to see this doctor because I went to the emergency room about 2 weeks ago and they got me a quick referral. Here is the history of my problems:

Severe loss of appetite
Bloating after eating
Stomach aches after eating sometimes
Nausea while and after eating
Loss of weight from 158 down to 105 lbs. in a year
Anemia

That's a pretty condensed story of it all. My big problems began about a year ago, after my 2nd daughter was born. I'd had similar problems prior but not to this extent. Previously I'd been able to deal with it, although I was losing weight then too. I went to the ER because I felt really ill, dizzy, cold, heart racing, thought for sure I was dehydrated or something and all this was finally catching up to me. They basically sat me in a room, hardly checked me over and ran a thyroid test (normal results) and a CBC which only said I was anemic. I could have probably told them that! The doctor was considering doing a CT scan of my stomach but I am not sure why and I decided ultimatetly to just see the gastro doctor instead of sitting in the ER for hours on end waiting on this stuff. Figured I must have been fine that night despite feeling like I was about to fall over. My weight is continuing to drop and my appetite is basically nonexistent. One thing that worries me a lot is how there are times when my weight actually stabilizes but my body changes, like I'm losing muscle or something.

So I have about a month to go till my appointment but I'm continually worrying about how to deal with all this until something is figured out. I just keep thinking that with my weight dropping like this I can't believe I'm not totally sick right now. I would like to know why that is and how in the world am I supposed to know when too much is too much if my body doesn't give signs? Everytime I think I'm getting worse it turns out that it's just fine. I'm not hoping to get worse, not trying to make it sound like that but I'm really worried that I won't have any signs of anything and one day I'll just drop dead from a heart attack. Hope that makes sense. I can't get enough food into my body to keep my weight up or even stable so it's really hard to know how to handle that. Ensure can only help so much.

P.S. From reading others' stories here I do suspect it might be gastroparesis, especially based on the fact I can tolerate liquids just fine.

Added: I'm a 23 year old female, am 5'3" tall and am a small build. Which gives me a BMI at this time of 18.6

Last edited by momtobaby1; 12-02-2007 at 10:22 PM. Reason: To add information that might be helpful

 
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Old 12-03-2007, 06:21 AM   #2
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Re: When is too much weight loss too much?

I'm in a situation now where I cannot eat any fat. It sends me into horrid stomach pains. My weight and build are just like yours, and I'm 28. I weigh just a few pounds more than you. At this weight, I'd say we're still not underweight, but we're close. I think for 5'2" which is what I am, 95 was considered unhealthy according to the govt. charts? I could be wrong though. So I'd say you're borderline. You're small, and you're on the edge of being too small.

What I'm having to do is eat really small quantities. I'm not hungry either most of the time. I have to force myself to eat small amounts. This will keep your stomach from shrinking more than it has. Keep food in it all the time if you can. Drink liquids that are caloric. Can you tolerate something like Ensure? For a liquid that would at least give you a bit of sustanance. Try to eat high on the carb side if you can. Things like starches, pastas, breads, crackers, etc. This will help combat the weight loss a little bit at least. Also, be sure to try to get fruits and veggies, because if you don't have enough fiber you'll have all sorts of other problems.

Can you see your primary care physician in the meantime? I saw mine before I saw the GI. She ordered bloodwork and an ultrasound while I was waiting to see the specialist. It will at least get the ball rolling a little faster.

What are your pain symptoms? Pay very, very close attention to what you eat and how it affects you. It took me a solid month to pinpoint exactly what kinds of foods were bad for me, and which were ok. I started to write down things I ate and how I felt afterward.

Hang in there hon. I'm sorry you're feeling so terrible.

 
Old 12-03-2007, 06:27 AM   #3
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Re: When is too much weight loss too much?

One other thing: my concern with the anemia would be internal bleeding. Where is your stomach pain located? At first they believed I had a peptic ulcer, or gastritis. Both can cause bleeding. Also, Is your pain in the center upper abdomen between sternum and belly button? Is it upper left? Upper right? Lower? Being able to tell the doctor where your pain is will help guide them. Where the pain is located is an indication of what the problem is (be it stomach, pancreas, gallbladder, etc.) I'm guessing with the anemia they'll want to check things out inside, either endoscopy or colonscopy, depending where the pain is.

Ugh. I feel for you. I'm so nervous about my weight loss but it's only been about 10 pounds in 3 to 4 weeks. However, I suspect it will be another 10 or so at the rate I'm going. I'm close to the 100 mark and I do worry about being below it. I've been below once in my adult life after a really bad break up of a 5 year relationship (just got sad and didn't eat much for a long while), and I recall how much my body hurt, and how bad I felt in general. Not looking forward to that.

 
Old 12-03-2007, 07:44 AM   #4
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Re: When is too much weight loss too much?

Hi April, thanks for your reply! I checked online to see what my healthy weight range is for a 23 year old female of 5'3" height and it came back as 104-127. That also took into account my activity level. As far as BMI it said normal is 18.5-24.9. Mine is 18.6 so I guess I am really on the edge then. It worries me knowing that I can't keep my weight stable. I have had lots of comments from people who don't understand like "I wish I had a body like yours" and "I wish I could eat like you". I get a bit mad when people say those things because if they only knew what it feels like to have this happen. Like you my body hurts when it gets lower than a certain weight. Muscle pain, bone type pain, makes it difficult to sit comfortably in a chair. Tired all the time, can't think clearly, am clumsy, etc. I'd give anything right now to be able to eat a normal meal and feel normal again.

I've tried to eat small amounts but because my appetite is so small it takes almost setting an alarm to go off to remind me to eat. It's frustrating that my stomach isn't telling me when it's time and I need to depend on something else like a clock. I do have some Boost Plus in the fridge and try and drink one or two when I remember that I need to. I can tolerate liquids for the most part just fine. First thing in the morning is difficult because I feel full even then and will get heartburn from milk even. I always thought milk helped heartburn. It seems to make my stomach churn in the morning though.

Pain symptoms... it tends to be either located in either my lower stomach almost around my pelvic area or up between my breast bones. Heartburn type area but sharp pains. The ER doctor mentioned that an endoscopy might be needed as he did mention an ulcer. I always just thought that the anemia was probably going on because of the lack of nutrients. Wouldn't I have more pain symptoms with an ulcer?

Thanks for the tip about writing down what I eat and feel after. I am going to start that today and hopefully that will help the gastro doctor figure things out more. I have noticed some foods do cause me pain, such as really greasy meats like from McDonalds. I always used to enjoy a hamburger every once in awhile but half the time now it causes me pain in my stomach.

Do you have a diagnosis (for you I mean)?

 
Old 12-03-2007, 02:22 PM   #5
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Re: When is too much weight loss too much?

No diagnosis yet for me. They think it's my gallbladder but the tests have come back normal. So, they're waiting and retesting later down the line and just monitoring me and keeping me medicated on various things that don't seem to make much of a difference.

They first thought ulcer with me. Or gastritis. Not so much GERD because my pain was lower than that. So I stopped eating anything acidic. If you look up diets for ulcers and gastritis you'll get some good ideas as to what kinds of foods to avoid and so forth. For me, it did not work. Then I started wondering about gb issues, and the doctor also mentioned the idea too. The endoscopy came back fine, so while waiting for the gb tests, I dropped the ulcer/gastritis diet and started eating gallbladder friendly foods. Basically, I stopped eating all fats. Talk about difficult. I notice that anything with fat really causes me distress. I've been to the ER twice--two Sundays in a row. It's painful and frustrating. But through trial and error I did learn that the gallbladder diet works best for me. It took me 2 weeks of frustration to figure out what I could eat though, and I had to try very hard to find friendly foods for me. It takes time and determination.

Typically gb pain is upper abdomen, esp. upper right abdomen. It doesn't sound like gallbladder is troubling you, only because of the location of your pain. But, everyone presents differently. Also, for me, it's so hard to pinpoint the pain when it gets to be terrible, because really my whole upper abdomen starts to hurt. So if an ulcer friendly diet doesn't work, you might try removing fats and seeing if that has an effect.

I don't know much else about other conditions, so I can only point you in those two directions in terms of diet. Maybe others will have other clues?

Have you tried antacids? Do they help? For me, they never even made a difference. I could drink half a bottle of Mylanta or take 10 Tums/Rolaids and it would not help. Do you have any relief?

Ulcers and gastritis typically feel a little better immediately after you eat, before it starts to hurt again. Do you have any temporary relief after eating? Again, this isn't always the case, but often times it can be. People will feel bad on an empty stomach, and then eat and feel better for a short while before the pain comes back.

Have you tried Prilosec OTC? It might be worth it to take in the meantime before you see your doctor. It's about $23 or so at the store, but it might help. If it is gastritis or ulcer or GERD. Also, to be safe, don't take ibuprophen or aspirin until you see the doctor. Stick with Tylenol.

I wish I could help you. The only thing I will say is don't take the Boost as a meal replacement. Take it in between mealtimes as a supplement to your diet. You're going to have to start forcing yourself to eat. Bring food with you everywhere. Even if it's just a saltine. Eat 2 every 60 or 90 minutes when you're not hungry, just as a small snack. Force yourself, unless it makes you really sick. You need to try to get your stomach to not shrink anymore. The less you eat, the less you'll want to eat. If you can get food into you even in small quantities, eventually your hunger will come back. One thing I did since I can't tolerate fat, is to buy some fancy bakery bread. Just some French or Italian or something. Anything that I could tolerate without butter on it. I would keep a ziploc baggie in my purse and just munch on bread whenever I could. I had to force myself at first, but eventually I came to really feel hunger. Took a week or so, but the appetite did come back. Basically, if you stop eating, you're not going to start feeling hungry again. If you can just keep putting food in your mouth, a bite or two here and there when you're not hungry, your appetite should start to return over time. This is what you want, so you can try to not lose weight.

I laugh when people say they wish they had my body. Laugh so hard. I am very small. I've always been pretty petite anyway. But it's not by choice lately. And it doesn't feel good lately. And anyway, no matter how much weight I lose I bet you anything I'll still have that pouch of cellulite right below my bum on the backs of my thighs. I try to explain to people that small or not I still have a 'normal' female body with the same normal female trouble spots AND I have a lot of pain in my stomach in addition to it, so they shouldn't wish to be me by any means. But they don't believe it. Whatever. I give up trying to reason with people and basically just roll my eyes when they say stuff like that.

I think you should try different things. Try some Prilosec. Try some antacids. Try a GERD/ulcer/gastritis diet. If they don't work, it doesn't necessarily mean you don't have any of those things, but it would suggest that maybe you should try something else. Just don't give up, and force yourself to eat bland stuff to fill you up.

Oh and the anemia may not be from internal bleeding. I would think a doctor would check that out first and foremost but it really could just be from a poor diet lacking iron. Better safe than sorry, but I didn't mean to freak you out before.

Also, my GI told me that yes, milk can make you feel better at first by coating the stomach, but a few minutes after drinking milk, your stomach produces excess acid because of the fat and calcium. She said skim milk will not have as much as an effect like that as whole milk. But milk being good for heartburn is somewhat of a misconception she said.

One last thing before I end this long ramble! I have heard from people who just come down with GERD or gastritis that it can be so painful that they thought they were dying. And not to say that either one is not serious, but it's less serious than, say, cancer or what have you. I think people don't realize that a common thing such as GERD can be so terribly painful. My brother had accute gastritis that 2 months of prescription Nexium and a less acidic diet healed perfectly, but he said that first month before he got his diagnosis was just awful. So, don't freak yourself out with worst-case scenarios. It could be something highly treatable, that once you see the doctor and get some medication or treatment, you'll do fantastically and feel great relief. I really hope so at any rate. Try to not get so discouraged. And please force yourself to eat some food. Even when you're not hungry.

xx

 
Old 12-04-2007, 10:31 AM   #6
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Re: When is too much weight loss too much?

I called and managed to get my appointment moved up to the 26th of December. Not much but at least it knocked off 8 days of waiting time. Right now that feels like a lifetime. I'm really hoping someone will cancel before then and I could get in sooner. I think because it's my first time going I can't probably get a faster appt.

Thanks for the diet tips, I have noticed some foods do cause me discomfort, I'm going to pay closer attention now so I can let the doctor know. I don't have too much pain, more like discomfort most of the time. After really heavy foods I do notice pain for awhile but most of the time it's bloating and an uncomfortable fullness. Stomach stretched kind of fullness. The area that my pain does tend to come in often worries me because there have been a couple of times that it felt like a heart attack. The likelihood of that is very slim, I know, I just worry a lot. I've always been someone who felt comfort from control in my life, not to the extent that I need to control others but I do need to feel a good amount of control over my own life and body. To have this happen to me and know I don't have much control over it is scary.

I used to deal with gastric reflux when I was 16 - 18 and it went away after being on Prilosec (prescription) for that time period. I haven't had any difficulties with it since. I don't think that GERD is likely the problem because I remember the pain I had with that and it's not like that. I do wonder though if it's connected somehow to what I'm dealing with now.

I feel like a big idiot here but I didn't realize your stomach could shrink from not eating. That probably is happening, it seems that it's a self perpetuating thing then. If that makes sense... that if your stomach shrinks due to not eating and you don't feel hunger and then don't eat and your stomach shrinks more and you again don't feel hunger and don't eat, etc. etc. We have lots of small foods in the house right now such as crackers and such so I'll try and do that. See how that goes. It's so frustrating, I know I need to eat but when you don't feel hungry it's really hard to make yourself put something in your mouth. I try to use Boost or Ensure as a supplement but sometimes it ends up being the only real thing I get in a day. I'm trying to find something with more calories and nutrients in it but unfortunately it seems the ones I'm looking for are web exclusive. I'd really like to be able to just go in a store and pick up something.

I'm trying to stay up (mood wise) but I'm just getting scared about what is going on. There isn't hardly a second in a day that I'm not aware of it. These last 3 days have really been bad for me. I can count on one hand the things I've managed to eat. I'm off school right now thankfully (i'm a pre-pharmacy student) and I'm really hoping that by the time school starts again in late January I'll be feeling better.

I've been wondering and maybe you know this (or someone does) how it's determined how bad your nutritional status is. I struggle with not knowing because sometimes I feel really bad and other times I feel decent. Mornings are good and evenings are quite bad. Afternoon and mid-day is so-so. I just wonder at this point how long I can wait to see someone. I've waited too long as it is, this has been going on for a year now. I don't want to let things get worse while I sit around and wait for my appointment. I also don't want to end up being fed with a tube or something. Honestly though I almost feel like it would be a relief at this point. That probably sounds terrible but I'm feeling really worn down.

I hope they get your situation figured out! I remember the pain of when I had GERD and it sounds kind of like what might be going on with you. Not saying you have that but the level of pain I remember and it's awful. I used to get knawing burning pain in my throat and chest to where I couldn't eat as much.

 
Old 12-04-2007, 09:31 PM   #7
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Re: When is too much weight loss too much?

From reading this thread, obviously i cant diagnose but it sounds a LOT like how i felt with Gastroparesis. Make sure your doc does a gastric emptying scan (its really not that bad i promise, just boring haha) to check for it as a lot of docs dont.

Basically before i was diagnosed i'd have TWO bites of food and feel totally full... my stomache stopped cueing me to feel hungry, and of course it shrank and i lost a ton of weight.... when i did eat i felt EXTREMELY bloated and LOOKED pregnant after only a few bites.... then i'd feel extremely nauseous, not always RIGHT away... often in the middle of the night and early in the morning.

I tolerated liquids... okay, i still got bloated but it was better than nothing... UNtil you get diagnosed try having lots of supplement drinks like Boost Smoothies, it helps to keep the weight up, you should be having 4-5 a day if you can handle it that will stop the lbs from falling off.... or at least help a little.

Good Luck I hope you get an answer, often thats the hardest part!!! WAITING.

 
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