Hi
Four and a half years after oesophagectomy I've now started having swollen legs which, having done blood tests, my GP says is due to low blood protein, presumably due to my inability to digest proteins properly since the op. She suggests eating more protein, which I've been doing, but with no improvement so far. Has anyone else had this problem? If you have, what sort of remedy have you found? I really don't want to spend the rest of my life wearing surgical stockings.
kind regards
Ian
Haven't got to that stage yet, ( not looking forward to it lol ) have you tried protein shakes likebody builders take ?
Ian sorry to hear this. Post op issues common with the procedure we have had and my experience is that this is a specialist area and maybe the GP is not the best placed to advise. Nor is this site!! See a specialist back at your hospital.
Linking swollen legs with low protein is interesting- have you tried mild exercise say on a rowing machine?
Best of luck
My brother takes digestive enzymes, which have helped a great deal, but he has not had the gastric pull-up. However, it might well be worth investigating this possibility with your doctor, especially as DIs are available on prescription.
My Granddaughter is suffering from this at the moment. She has a lot df endocrine problems and she became bloated all over as the doctors said her veins were leaking fluid due to lack of protein. She has been having high protein drinks and water tablets to get rid of the excess fluid. At one time fluid was leaking through her skin, fortunately that has now stopped and she is slowly losing the excess fluid. She also had a problem with very high sodium levels so I don't know if that had anything to do with it. I will let you know if I find out any more.
I'm sorry you're experiencing the edema. I haven't had that issue (I underwent surgery about 13 months ago), but have been unable to tolerate fatty foods or food with much sugar in it. My oncologist thought that my stomach (what's left of it) may be emptying too fast for the pancreatic enzymes to work, which is needed to digest food. I was prescribed Creon, which is pancreatic enzymes extracted from pigs, which I'm to take with meals/food. I think it's helping somewhat. I also take Dicyclomine, (Bentyl) which "is used to treat spasms in your stomach caused by functional bowel disorders such as irritable bowel syndrome." It was prescribed due to frequent bouts of dumping syndrome. I take this 3-4 times/day before meals/food.
I can't say whether either of the above meds would benefit you, as it's uncertain from your post whether you aren't eating enough protein or just not absorbing or digesting it. I'd suggest you discuss that with a gastroenterologist.
Wish I could say that the above meds worked miracles for me. They didn't, unfortunately, and I continue to struggle with being able to maintain my weight. I'd actually like to gain back 10-15 pounds!
If your blood has been tested, and there is a shortfall, then you do need to address things, and this may need to be done with the advice of a specialist Upper GI dietician and perhaps some supplements. You might also think about having your mineral and vitamin levels checked if that has not been done already. The absorption of nutrition can be a problem after this surgery but the specialists normally have the answer, so I would contact your specialist nurse as the next port of call.
Hi Ian,
Instead of focusing on protein, I would suggest that you increase the quantity of fruits and salads in your diet. Also make sure your last meal in the day is a salad. Do it for two weeks and let me know the result.
Hi
Thanks for all the helpful replies. We're on holiday at the moment but after we get back I'll follow your suggestions and get onto the upper GI nurses.
best wishes
ian
What is your sleeping position - your swollen legs could simply be a result of hydro-statics?
( Info on age/height/weight etc would be useful)
Hi gutlesswonder
Thanks for your reply. I'm 70, short and a little overweight. I sleep in various positions, with a wedge and rwo pillows. My legs are always much less swollen when I first get up, so I think it's probably down to low blood protein as the blood tests suggest. I eat a lot of fibre, veg & fruit, and I wonder if food is being sped though the system before I can get all the protein out of it. Am I right in thinking you manage without PPIs? How do you get on with this?
best wishes
Ian
Hello ian-james
I have my whole bed tilted (blocks under the head legs) as part of the anti-reflux defenses. After several years I found my ankles swelling with minor breakdown of the skin and incipient ulcers beginning to form. I raised the bottom one third of the mattress and now sleep with my lower legs one or two inches above the level of my heart. During the night excess lymph flows downhill (back towards the torso) where cardiac function restores the blood balance to normal against the day time gravity gradient.
That your legs are better in the morning is probably a contraindication to this theory.
Lack of Pepsin and Hcl to activate it might produce a protein deficiency.
My above procedure has completely done the trick, although there is still evidence in the lower leg of damage to the peripheral capillary (bruising) and nervous systems (neuropathy), which is almost certainly due to chemo.
Yes, I have never taken PPIs as my major problem is bile; having had a cholecystectomy (involuntary.....I was unconscious!!) during the Ivor Lewis. My reasoning is that I need acid to neutralise the base (alkali) - putting aside any consideration of the possible long term side effects of PPIs.
This strategy is successful ninety per cent of the time. When I do get caught out is when, during deep sleep, I assume the foetal position. Having had very serious pneumonia from reflux inhalation, I am trying to devise some sort of device to prevent this - perhaps an anchored wedge between the knees. My wife has helpfully suggested a strip of fakir's nails down each side of the mattress.
Have you thought about eating Salmon? The protein is more easily broken down into the constituent amino-acids and hence may be more easily absorbed. Great for your HDL Cholesterol levels as well.
What is your blood A/G ratio (Albumin/Globulin) ?
Diaphragm hernia surgery 
GERD and nightly heartburn 
Bad dumping incident?
advice please for Creon 
