Foxbins

I'm so sorry he treated you like that, he's about thirty years behind the times and the obesity research, to say nothing of surgical interventions. Time for a new doc!

I had a sleeve with GERD too, and my surgeon in the first appointment had LINX as an option. Having read about the trouble lapbanders have, with esophageal erosion and slippage and other nasty complications I was not enthusiastic about a foreign body being placed around my esophagus. It turned out I was not a LINX candidate due to other conditions so I revised to bypass.

I had an esophageal stricture, and yes, sometimes stuff went down and sometimes it didn't. It would be frustrating to eat solids one day and be unable to swallow soup the next. My stricture was due to GERD and so when I converted from sleeve to bypass I had a myotomy to cut the stricture because the EGD dilation didn't work all that well.

I did a little research on it; it sounded interesting. However, it looks like leaving the sleeve in longer than a year causes a number of serious adverse events--pancreatitis, liver abscess, upper GI bleeds, and cholangitis. So my question would be, what happens to your weight loss after the sleeve is removed? Yes, apparently you'll lose weight while it's there, but it has to be removed sometime and then I think you may find yourself, after some time, right back where you started. This is the same problem I see with Lapbands and gastric balloons--they have to come out at some point. The study I read was done in Chile, by a Doctor Quezada. He's published quite a bit about it.

Have you seen a gastroenterologist? If I were you, that would be my next step. If you have, and your diet, medication, and behavioral interventions are not working, I think the next step would be a surgeon. There is a surgery for GERD called Nissen fundoplication, where the stomach is folded around the esophagus to keep the acid from moving up.

I'm so happy for you. Finally!

I drink regular coffee every morning. My doctor didn't have any prohibition against it.

I had my sleeve done in 2011, reached my goal weight of 138, and have maintained it since. I developed GERD about two years after the sleeve surgery. I've been on omeprazole since, the max dosage the past two years. GERD gave me an esophageal stricture which causes food and liquids to regurgitate back into my mouth after swallowing. It's truly gross to have to repeatedly reswallow the same mouthful of food. Sometimes things get stuck and I have to vomit them up. I've had a couple of endoscopies, a BRAVO study, and esophageal manometry. The manometry shows I have achalasia (impaired swallowing) too, not surprising when you only have a 12.5 mm wide esophagus. It was dilated during an endoscopy, but shrank back down fairly quickly. My surgeon wants to do a Heller myotomy to fix the stricture but a common side effect of myotomy is GERD. So he has to do something about the GERD, too, and that has to be some kind of bypass. Since I'm at goal weight with a BMI of 21, I don't have much spare poundage to lose. Plus I'm 65 and don't want to end up one of those "frail elderly" people who can't carry groceries or walk very far. I am hoping that my surgeon will make the very shortest bypass limb he can. Approval came a week after submission so I'm scheduled for June 29. No preop diet required. It's all happening a little fast and I'm a little freaked out. I think I've forgotten all the food stages :-). Support would be appreciated.

Okay, weight is 137.6, BMI 21. "Gentle" iron gives me diarrhea every morning. I think it's kind of funny that most everyone else has constipation with an RNY, and I have had to buy a new bottle of Spray N Wash because of liquid farts. My GP suggested taking iron every other day and I may try that next week. I take it at lunch, sandwiched between bites--eat about half my lunch, take the iron and my vitamin, and eat the rest of my lunch--so the irritation isn't in the pouch but in the intestines. Reflux is still happening, about three times at night this past week. Sriracha, even in small quantities, is a definite food for producing reflux at night. Vinegar also seems to be a culprit. However, reflux seems to be improving with the cog/beh interventions and dietary management.

Your sleeve can't be reversed, the excess portion of your stomach was removed and discarded after your sleeve surgery, but there are other revision surgeries that can work with the stomach that remains. RNY, Mini-Bypass, and DS or SIPS are all possible with a sleeved stomach. Look in the Revision forum for people's stories.

There are a number of threads, including mine, about having RNY for GERD in the Revision forum.

It would be unethical for her to retaliate. You could sue her. Of course, that would take money and time...if you have called her supervisor it sounds like you have done all you are comfortable doing. However, I strongly encourage you to leave her poor reviews on social media and implore your surgeon's office not to refer patients to her. If they want a psych eval so badly, they should find a clinician who can get them done in a timely manner. Are you in a small town where there is only one psychologist? I'm wondering why the surgeon's office only refers to one person.

Call her office and tell her you will report her to the state Board of Psychology if she doesn't send in the report within 72 hours. I'd also flag her on Yelp, Facebook, Twitter, etc. 30 days is ample time to write this type of report.

137.8 today. I am happy that I seem to have stabilized around 136-138. My BMI is 21, so I'm thin but not scrawny. Only one episode of reflux this week at night, but I was sick too, with a splitting headache that wasn't relieved by Tylenol. I rooted through the medicine cabinet and found some Vicodin from a long-ago dental procedure and took one of those. I finally went to sleep but woke up feeling pretty crummy, no appetite and still a bit of a headache, so I rested most of the day. I got the gentle iron yesterday, I will start next Sunday because I just reduced my omeprazole dose again and I don't want to change too many variables at once.

The Ontario Psychological Association website has a "find a psychologist" feature. You can enter a number of parameters to narrow down the options. Good luck to you!

I had little red bumps on my stomach, I figured out they were from whatever they scrubbed my stomach with before surgery. For stomach pain, talk to the doc. I'd personally call your doctor's office, as often the staff know the answer to your questions and if they don't, they will make sure your surgeon answers you.

I think each surgeon becomes comfortable with their procedure. It also appears from what I've read that some surgeons staple close to the bougie, some a little looser, and some do an overstitch over the staple line that tightens things. Research has shown that generally bougie sizes smaller than 32F have higher incidences of complications, and sizes larger than 42 have poorer weight loss outcomes, but really if your surgeon is experienced I would not really focus on bougie size. You can ask, but it's not the only factor contributing to success.

I tried after surgery but my ferritin levels fell to almost nothing. My doctor said there was almost no way I could donate regularly without becoming anemic. When I did donate, I didn't have any nausea or dizziness.

Psychologist here--I just thought I would chime in with a few thoughts. Competence is a legal issue and everyone is assumed to be competent to consent to whatever unless someone (lawyer, doctor, family member, etc.) raises the issue of whether or not someone is competent. Competence is specific to the task, so someone might be competent to make a will but not competent to consent to treatment. Not likely, but never say never. The purpose of the psych eval is to try to determine if there are psychological factors that would be a contraindication to surgery. Undiagnosed and untreated eating disorders, or Munchausen Syndrome, or using food as an antidepressant or antianxiety agent. The MMPI is widely used for a variety of purposes. I personally would not use it when evaluating someone for a bariatric procedure, but I have a sneaking suspicion that some insurance won't pay the clinician unless they use tests specified by the insurance company. There are consistency measures built into it in case someone decides to answer randomly or without reading the questions carefully.

I've been taking carbonyl iron since January and it didn't bother me until after the bypass. Switching now to iron bisglycinate chelate.

Okay, things are still better. Iron definitely irritates my stomach and makes it produce more fluid. My doctor suggested "gentle iron" and I will give that a try, if it doesn't work I'm pretty sure heme iron will, but it is so expensive and not covered by my insurance. I have also started using cognitive/behavioral interventions before I go to sleep to help me. Only woke up one night last week with the crawly esophagus feeling and that is an improvement. Doing a taper on the PPI because why should I take it? My staple line is healed and my reflux is not acid. It will also help with iron absorption if I can get some acid back into the common channel. I'm decreasing 10 mg a week over 8 weeks.

First trip since the pandemic started. Strangely, reflux was better, I am wondering if it's because I forgot to pack the iron supplement. I know the iron irritates my intestines but I didn't know it could influence reflux. I will have to experiment with taking it/not taking it to see if that's the cause. Also, I found out I'm sensitive to some kind of sugar alcohol--I had pancakes for breakfast one day and the syrup in a little pitcher on the tray was thicksomething er and not sugary-sweet like pancake syrup. I used a few tablespoons and was treated to the most amazing amounts of bloating, gas, and liquid poop. I spent the afternoon in the bathroom. I think the waiter just grabbed whatever pitcher was nearest in the kitchen and either it was "diet" syrup or they buy something augmented with sugar alcohols because it's cheap. I won't make that mistake again.

I had daily regurgitation, everything I swallowed came back up, and needed to be swallowed again, sometimes 3 or 4 more times. I had heartburn a few times a week, and learned to have antacids in the car, in my purse, next to my bed, etc. I had acid reflux mostly at night, it would wake me up with acid in my throat and sometimes in my mouth, and then I couldn't get back to sleep because I was afraid it would happen again. Being vertical helps move the acid down into your intestines, so I encourage you to stand up and walk as much as you can. So does drinking lots of liquid--it dilutes the acid that's there and moves it downward. I drink loads of Crystal Light each day. I saw my surgeon today, he did an endoscopy, everything looks good, no gastritis, no esophagitis. He offered to put me on tricyclic antidepressants because they can help esophageal hypersensitivity. I said no thanks. I'll try what I'm doing now, keeping a food diary, walking 3 miles daily, raising the head of the bed, and using melatonin at night to help whatever residual lower esophageal sphincter function I have left. I really don't want to take any pills and especially not tricyclics. Too many side effects.

Yes, my GERD started about 2 years after my sleeve, and was pretty well controlled with a PPI up until about 3 years ago. It got worse over the past two years. Are you taking a PPI, using antacids, making dietary changes, elevating the head of your bed?

No, I didn't have any nausea with my GERD. I vomited acid a few times but I wasn't nauseated beforehand. I don't know if gastric juice minus acid can still cause Barrett's. I think I am an exception in that because I had a myotomy, where my esophagus was widened, the gastric juice can more easily flow up. Many, many people on this board have had revisions to RNY for GERD and I can think of only one other person who still had reflux after surgery, so that makes 2 out of many. The vast majority of people are cured. I know you are worried but Barrett's is no joke. If conventional treatment is not improving your GERD, if I were in your shoes I'd have the RNY. Like I said, I am way better than I was with the sleeve and statistically you would most likely fall in the group of people who are cured.