The Bachelor

Bachelor Scurvy, Bariatric Surgery, and Social Support

The newest case history in the New England Journal of Medicine offers a vivid picture of some important pitfalls after bariatric surgery. We learned a new diagnosis – bachelor scurvy. But most of all, it gives a vivid reminder of the importance of social support after surgery.

Leg Weakness, Falling, and Anemia

Susan Bennett and colleagues present the case of a 64-year-old man, six years after gastric bypass surgery. He was developing weakness in his legs, falling, and had lost some teeth. He was also drinking more alcohol (6-7 glasses/day) recently.

Certainly, the alcohol consumption is a cause concern for a patient after bariatric surgery. But ultimately, the diagnosis was scurvy – vitamin C deficiency. It can explain the loss of teeth, progressive weakness, and falling. Other micronutrient deficiencies were contributing to the problem, causing neuropathy and anemia. This case ended badly. The patient recovered initially, but six months later he suffered a relapse of alcohol use. He fell while under the influence and died of a brain hemorrhage.

It’s a complicated case, but the diagnosis of bachelor scurvy stood out. It earned that name from an association with men living alone. These men are at risk because they eat alone, prepare their own meals or eat out, drink excessively, and eat virtually no fruits and vegetables. It’s a vivid picture of unhealthy social isolation.

Social Support and Bariatric Surgery

This case provides a good reminder of the importance of social support after bariatric surgery. Patients face daunting changes and nutrition can be critical. Alcohol dependence is a very real risk. A strong social network is essential.

People find that support in many different ways. It might be family. A surgery support group can be helpful. A circle of friends, a church community, or the OAC might provide it. But without doubt, social support is essential for a good outcome.

Click here for the case study. For more on social support after bariatric surgery, click here, here, and here.

The Bachelor, photograph © Maritè Toledo / flickr

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July 25, 2018