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Blog 559

A blog by LAN2k

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One Year VSG Anniversary

In about 8 hours it will be one year since I had my sleeve. I have reached my goal in fact I'm about a half pound below at 134.5lbs. I still can't eat some foods very well, like chicken (white meat especially). I've got multiple issues to work on that reach beyond the body. Today the size 10 shorts I picked up in June are too big, (I am able to pull them up and down without unzipping...so I went and purchased 2 pair in size 6-8 for what's left of the warm season here in NY and for then, next summer. I have yet much body work to do. My muscles need to be strengthened. I haven't any butt! It went flat and so did my breasts. My arms need a bit of sculpting as do my legs..so I am resigned to weight train best I am able. I can't believe how quickly the year went by. The weight came off. I want to thank every one here who has helped me along the way...If it were not for this message board and the many of you who reached over to me, I might have had a nervous breakdown. You all know who you are and I thank you each one, so very very much. I wish everyone who goes this route to lose weight the best in good health in every way, along the journey:001_wub:.
LAN2k

LAN2k

13
 

Upper Endoscopy Report in relation to LPR diagnosis follow-up

I had my 2nd upper endoscopy since my VSG surgery 9-15-2009, yesterday and over-all "FINDINGS" for Oropharynx, Esophagus, EG-Junction, Cardia, Fundus, body, all "Normal". The report continues : Antrum "Mild gastritis Biopsy taken "Duodenum Bulb- Normal 2nd portion- Normal 3rd portion-Biopsy taken.   I suppose I will hear from the doctor or one of his personal sometime next week for further findings...   Although I was groggy when the doctor spoke with me after I awoke,while still on the table, he told me everything looked good, or fine...He also told me I did NOT need to take any PPI, and could just end taking the Protonix, (generic form)...no need to wean off.   My next move will be to meet with yet ANOTHER ENT, since the last one I saw diagnosed me, (according to this reputable gastroenterologist), incorrectly. Meaning my throat, nasal, problem, (feeling as if I've a glob or web of sorts just hanging, and/or with pools of mucus or saliva).. is not symptomatic of any sort of acid reflux, LPR,(silent), as was my diagnosis, or GERD. This doctor feels the problem is literally in my head, and needs to be closely scrutinized by an ENT. He has referred me to one and will send THAT doctor a full report of his findings and speculation. In the meanwhile I'm still very uncomfortable with this throat irritation, (yes my throat does get irritated, from constant 24/7 secretions...and naturally, I've anxiety over this yet undiagnosed, unresolved condition.
LAN2k

LAN2k

3
 

Finally got up the courage to see an Otolaryngologist

Hey gals and guys I just thought to report what the ENT said during my appointment with him yesterday-(I finally broke down and got scoped)! It's called LPR or Laryngopharyngeal Reflux: "This occurs when reflux material extends above the upper sphincter into the throat. The structures and tissues of the larynx, (voice box), throat, trachea, bronchi, and lungs are more sensitive to stomach acid and digestive enzymes than the esophagus. Most patients with LPR never experience any chest pain or other typical heartburn symptoms." Any or several of the following may be seen: Thickening of the posterior commissure, (back part of the larynx). sometimes called "pachydermia" or "cobble-stoning", Redness of the arytenoids (cartilages that move the vocal cords), Edema (swelling) of the vocal cords, Small ulcers in the posterior part of the larynx, Granulomas, (scar tissue) of the posterior part of the larynx..   Any of those symptoms indicate acid reflux and can manifest itself through an over production of mucus which collects in a part of the throat up through the esophagus...exactly as I have described. There are other tests that may be requested such as Barium espphagram, or an x-ray taken while swallowing barium, 24-hour pH monitoring w/placement of pH sensitive probes. For now he told me that I must stay on the PPI and that Aciphex is an excellent drug BUT it only lasts 17 hours and so I can take an OTC Prilosec, or any other OTC, like Pepcid ac before bed. I do also have some other stuff going on like typical seasonal allergies and probably my cat's dander doesn't help but I intuitively felt that since my surgery this non-stop mucus thing in my throat just like a lump or glob was related to my stomach...and it apparently was/is! A form of acid reflux called Laryngopharyngeal Reflux! He wants to see me again in 6 weeks...Yay Well at least I know now what's going on.
LAN2k

LAN2k

5
 

Dated Journal Entries-About My WL Journey

4/16/2010 I had my sleeve done on 9/15/09 and suffered with unrelenting anxiety post surgery. Prior to surgery I was never clinically depressed only took anxiety medication once for an acute bout w/anxiety during a doctor supervised WL regimen that required me to take handfuls of vitamins and phentermine. I lost 76 lbs but put it all back on and then some about 5 years later.   After having the sleeve surgery I was so full of anxiety that I needed to get help. I was on the phone and on these message boards crying out for help. My PCP was very supportive and met with me often. Straight away she convinced me that it was OK to take an anti-anxiety medication while healing and that it might help me to get in the much needed nutrition. I tried xanax for about 2 weeks and although it helped me to feel better-- relaxed enough to get in bits of nutrition...when it wore off my anxiety grew even higher. My medication was changed to Klonopin .5mg and with such a low dose it was long lasting and helpful. I started therapy with the psychologist who has a practice and also works with my surgeon. I still had trouble eating even drinking, I'd a aversion, even repulsion towards food. My PCP had recorded one of my symptoms after WLS as "anorexia". I went to 2 psychiatrists, tried 2 anti-depressants, Welbutrin and Zoloft--both trials didn't last more than 5 days--I literally couldn't eat anything, they only increased my repulsion and anxiety. The second psychiatrist was better-I started at a low dose of an SNRI Serotonin Norepinephrine Reuptake Inhibitor (since the SSRI"s increased my anxiety and aversion to food). The name of the drug is Remeron (generic version-Mirtazapine), 30mgs taken daily at night before bed...Bingo! It worked. I found out about Remeron through this message board...(if you go back and read through my early posts you may find it.) A couple of people on this message board mentioned Remeron but didn't like it because of the side effect of an increase in appetite. When I saw that I figured it could be helpful to me since I had no appetite and fear of eating. My psychiatrist confirmed this for me and started me at a low dose of 15 mg for the first week then upped the dose to 30...I had no weird side effects, just a little groggy at first in the morning. What did happen was that finally I wanted to eat. I desired foods, (not everything) but it was so much better. I was able to eat and had to remember to eat slowly and chew well. Fast forward to this week and I've stopped taking the Remeron, (I do not want to be dependant on any medication indefinately). I notice a minor decrease in my appetite but I am able to eat enough to keep myself healthy. It's been 8 days since I stopped and I am alright so far. I still take a .5 dose of Klonopin as needed for anxiety--that usually amounts to 1 a day whenever the anxiety gets too high.   During this whole process of adjustment, I've I gotten myself in a 12 step support group called Overeaters Anonymous. The imposed weight loss compelled me to see I had issues with food and eating that had to be addressed so like a tortoise without its shell, I'm ready to deal with some underlying issues that created my compulsive eating habits etc. For me, I need to fix the inside as well as the outside in order to function well with the dramatic changes from this surgery. I'm 7 months out, 5'7", 158 lbs (25 lbs to goal) and wearing a size 10-12. It honestly feels good to have so much weight off but I still am not at peace with the forced changes in my eating capacity. I pray that will soon come.       4/18/2010   A big part of my anxiety is generated from discomfort in eating. I have lost most of my excess weight and it does feel healthier to not feel that heaviness on my body, although I am just now noticing that in some places I still have pain (like my right hip), which I had thought might be due to all the belly,hip, and rear-end fat I was carrying. There is a definite improvement in my knees, feet, and general mobility.   On the down side, I feel I am more vulnerable and must guard myself against any outside illness/infection etc. I'm uncomfortably cautious of what I eat for fear of any food born illness-UGH. I just feel like I can't afford to be sick since my consumption for nutrition is now limited and stomach so small. I'm yet uneasy about the way food feels much of the time when eating. With the exception of soft stuff, I still have to stand often (helps the food move down) and/or stop and wait 10 minutes or so before resuming even a 3 or 4 oz portion of some denser protein like meats and sometimes even fish. This is something that causes me anxiety. I just get scared and wonder if there could be something wrong--Seven months out and I still don't drink plain (even the best filtered/alkaline), water. Water weighs too heavy on my sleeve so I drink Vitamin Water and dilute it with good water--I don't know why but it works.   To sum it up I think I am happy that I went ahead with this surgery. I hope that in the final analysis I will truly be healthier and feel peace in that. For now there is always that nagging doubt and "what if" feeling and with every unusual sensation I worry.:cursing:
LAN2k

LAN2k

2
 

No Improvement yet and I am concerned!

LPR affects the larynx, pharynx, bronchi, trachea, and possibly even one's lungs. Sort of like a "Silent reflux" ...lovely...   LPR occurs when the upper esophageal sphincter (UES) opens and allows reflux to enter the throat. You can read all about it here:   http://ezinearticles.com/?Acid-Reflux-Part-3---Laryngopharyngeal-Reflux-(LPR)&id=157576   The ENT told me that my one a day PPI wasn't enough and to take an additional OTC like pepcid ac in addition. So I have for 3 days now and it has not made a difference. I am still with several of the symptoms as listed in the article. He told me to see him in 6 weeks. I just can't take another 6 weeks of feeling like I have a glob in my throat and all the futile attempts of throat clearing only makes my throat sore. So now what? Do I wait 6 weeks? I've had this going on since before my surgery only then I hadn't focused on it but I did find out I had an hiatal hernia (which was repaired at the time of the sleeve surgery). Is there anyone who knows about this "silent reflux" or LPR? Anyone experiencing this? I can't believe that instead of coming off the PPI medication I'm looking at increasing acid blockers by taking more stuff! Why does this have to happen? I just want to be OK! I'm calling another gastroenterologist (the one who did my upper endoscopy pre surgery). I want to get his opinion and if another upper endo will help to really see what's going on then I want him to do it. I finally got the courage to be scoped by the ENT and now I've a hunch I'm gonna have to have probes attached to my esophagus that will transmit info about pH levels via radio frequency!
LAN2k

LAN2k

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