Chimera

Hope everyone had a nice turkey day Surgery went well - almost 10 hours, and a lot was accomplished! The hiatal hernia was repaired, anchored in place with mesh - hopefully that wont be an issue in the coming years. My sleeve was repaired - Doc said it was like a curled up shrimp, with a significant stricture in one area - he was able to fix it up and get things equalized. When I had the sleeve done in 2012, that surgeon used a 40 bougee, Dr. Srikanth used a 34. He removed an inflamed gallbladder full of stones, and worked on my small intestine to convert the vsg to the DS. So far so good. The first three days I didn't feel so great but energy has been getting better every day. Struggling with fluids a bit and trying to get in the supplements - I'll get there I know it takes time. The supplement requirements are pretty intense - My old surgeon had DS lumped in with RNY with supplement needs (he does not do the DS). I take Vitamins and minerals pretty much all day long, and Protein supplementation is to be 150g a day due to the malabsorption. Worse thing is the constipation - a nightmare, but it will get better I hear. Hope you guys are all doing well.

I'm so sorry that you are in pain Denise - I can relate, though the knee is much more stable, it better be since it is made out of metal lol! It still hurts quite a bit, and as does everything else it seems. I was at my final pre-op appt with the new surgeon whom I really like (Dr. Srikanth in Federal Way, WA) and I was pretty stunned at the results of labs that were done on Hallowen...normal Iron level should be at least 100 - mine is 11, I am peri-monopausal, so some months I will have a normal cycle, some times it will be light, then I will miss one and then its like those elevator doors opening in The Shining. I also have frequent nosebleeds. So I have a few more hoops added - doc wants a colonoscopy, that took a bit to get on short notice, and have that Thursday afternoon and I see an ear, nose, and throat doc on Friday morning, then more iron infusion after that. So after I get a call from the hospital to clear everything in ab out an hour, I drop off my post surgery scrips and pick up the fun stuff so I get to sit on the toilet for the next two days haha! I guess my gallbladder is packed full of stones - I will be very happy to get that out. The stricture and hernia are pretty serious - doc says some mesh may be involved to anchor my esophagus in place and keep that stomach where it should be. A dear friend found out he was showing signs of Barrett's esophagus in June - she lived until mid September - that one gets you fast. This doc is super comprehensive and it is cool to find out all the things inside that I did not know about - my husband and I have matching cysts on our livers lol. The last bone scan revealed arthritis just about everywhere - my hands have been bothering me and sure enough it showed up between the carpals and metacarpals. I'm an inch shorter than I used to be too - so that mea I need to lose even more weight haha. I am hoping that the surgery will help with the reflux so I can get off of PPI's - I worry that my bones are just going to turn to dust. You guys don't even what to know what the Vitamin req's are with the surgery - its pretty intense - 4500 mg of Calcium a day, 150g of Protein (2 scoops of Optimum Nutrition chocolate mixed with 4 oz. of Water three times a day gets me to 144g with only 12 oz. of liquid) this is good since I am also to drink an ocean of liquid a day I wont go into the other supplements the list is long. I honestly cant quite believe that insurance approved a revision - I got denied round one and was ok with the decision either way. Round two they said yes. I will keep you guys posted with how it all goes. I am sorry I have been so bad at keeping in touch with the board. I have only recently started reading other forums again - I hate drama and get upset when everyone else seems upset. I asked how long the procedure will take - this one is going to be a humdinger - 6-9 hours of surgery. Wish me luck! If for some reason I don't make it - its been a good ride

Its been a long time since I have checked in - as usual Looks like there havent been a lot of folks responding lately on this thread but thought I would give you guys an update. As it turns out I have been having some ongoing problems that will require som more surgery. I have always had terrible gerd prior to and it seemed to get worse after the sugery. My lucky husband had his resolve completely after his vsg and hernia repair. I started seeing another bariatric doc last year, as my doc had moved to another practice and we moved as well. To make a very long story shorter - and the number of tests I've had done dwarf the first surgery - I will be having revision surgery on 11/22/16 - 11 days from now. I have a significant hiatal hernia, a stricture, and various other sundry things that will be repaired - gallbladder out and removal of stray sutures (which is goofy but that's what the photos after the last egd) My new surgeon is going to revise my sleeve a traditional Duodenal Switch. I had gained back about 30 lbs from my lowest weight. And it took just about a year to recover from the total knee replacement - what a nightmare that is, but at least I can walk again. Hopefully the hips and back wont hurt as much soon. Wishing everyone well and hope everyone is happy and healthy

Morning everyone - 6 weeks today since my last post - 6 weeks to the day on my TKR surgery. I have a pretty decent pain tolerance, but this ride has been excrutiating, and makes my VSG with complications feel like a stroll among the daisies. The first two weeks passed in a blur of agony and extremely limited mobility - doing much better now, drove for the first time last Friday to pay a visit to a new doctor, visiting my old doc is just too far a drive since our move south. Working hard on getting better every day. If anyone ever needs joint replacement I found a good forum called Bonesmart.org - lots of folks from the UK, sounds like the procedures post surgery are a bit different than the US - good reading! My weight is up right now - I've have been pretty much immobile for the last month and a half, but I don't really care right now I will focus on that later. As always sorry to be such a stranger and wishing everyone a happy Monday

Leaving for the hospital in just a bit for my total knee replacement on the left side - I haven't really been on the computer much the last few weeks. See you guys on the other side

Hi ladies, Lots of news lately - had started a great new job and had to leave it one week because I could hardly walk - long story short - I will be having a total knee replacement on my left knee in about 3 weeks. Not looking forward to how long I know this one is going to take to heal from, but lookingforward to hopefully walking and exercizinf pain free for the first time in a long time.

/comforts Florinda I have finally gotten into the habit of using My Fitness Pal on my phone to log my food - after switching from little paper journals from my surgeons office ( I have no idea why I was so attched to those things). I've been pretty good food wise but the scale doesnt want to budge. I put an imaginary day in - right around 1000 calories (its usually at 1250) and its says in 5 weeks I will weigh 11 lbs less than I do today...I want to tell the app - oh no I wont lol. I feel like I can eat next to nothing and the reading on the scale just wants to stay the same - I was reading old journal entries this morning and came across a quote mentioning that to maintain a loss one needs to get pretty vigorous exercise 5-6 hours per week - which is what I had been doing, and Im not now - go figure lol. Bah!

Very interesting Florinda - and chin up darlin, keep fighting the good fight - you are doing what you need to do to take good care of yourself. The SWANK plan sounds like anything but - it sounds terrible. Makes me think of one of my clients when I lived in NYC who went on a raw macrobiotic diet to help combat Lyme disease and she just started looking like death warmed over - like she had been drained of blood - then another client came waltzing in how had been doing Atkins for the first time looking fit as a fiddle, rosy cheeked - and quite slim. I found a doc closer to us who looks like he has significant experience with revision - I think I might see if I can attend one of his seminars to ask about the gerd issues and a RNY - I am scared of having to get a manometry (hubby had to have it and said it was the worst experience of his life - its where they thread sensors through your nose down your esophagus to place sensors for overnight study, his desciption of it is terrifying and hubby is no puss by a long shot lol) though I am more scared of Barretts esophagus!

wondering if revision surgery is an option because of the acid? anyone know if a RNY or a DS makes the acid stop? Back to the research.

Aw shucks - Thanks Kim and I guess I am a bit worried about what that acid can do after reading up on it all a bit. Even one of the pharmacists give me the hairy eyeball when I pick up my omeprazole scrip - every time she tells me you aren't supposed to take that long term - and I tell her that my nutritionists and surgeon tells me I will probably be on it for the rest of my life. One of the reasons I am getting more worried is that I am much more frequently finding acid regurgitating up into my mouth, in all body positions, not just lying down - often times it happens when I am asleep and I have aspirated acid - it is not a pleasant way to wake up - choking and sputtering having sprayed stomach acid out through the nose. Very hard to fall back asleep. Hmm - back to the research.

Our power was out for a bit as well - that was some crazy wind wasnt it. Glad we are getting a bit of rain for once. Do you guys have issues with acid? I had terrible gerd prior to surgery - as did my husband, he had a hiatal hernia that they repaired at the same time as surgery and has never had to take a ppi or other form of acid reducer. My gerd has always been bad, but it is so bad now that if I miss one omeprazole within a couple of hours I am in agony - and often times I can still feel the acid even with the medicine - it seems like it is getting worse. I did a bit of reading and it looks like sleeves can make the acid issue much worse - how did I not know this? The funny thing is when posed the silly hypothetical question of what would you do in the event of a zombie apocalypse - my first thought is Oh damn I need to go rob the pharmacy for every proton pump inhibitor and every antacid they stock! And make sure I have all my eyeglasses haha!

Best of luck Denise - I hope things are going well and you are on the mend already! I dont mind sharing what meds I take - not at all. I currently take Wellbutrin SR - the Sr stands for slow release I believe, I am supposed to take one in the am and another later in the day but oneseems just fine. I was prescribed this medicine when I wanted to stop smoking (which I did on November 1, 2010 after 28 years of a pack and a half a day habit.) My doc prescribed Wellbutrin because I have anxiety issues - mentioning that the other popular smoking cessation drug Chantix, could send folks with anxiety into a tail spin ( meaning it can really ramp you up). I asked my GP how it works and she said with a chuckle that they really aren't sure why it works so well to help quit smoking. It is not an SSRI, I have a long and diverse history with those as well. The nice thing about the Wellbutrin is that it does not have the heinous side effect of killing the libido or making it so that one cannot reach climax - which I hear is common. My docs at the WL surgery office have kept me on the Wellbutrin, as it also has a positive effect for folks trying to lose and maintain their weight, I don't notice a huge difference in how I feel with it - I do know that I seem to be on a much more even keel than in the past. I'll take it. I also take a lot of anti-histamines for allergy and dermatological issues - I worked with accelerated solvents and oxidizing chemicals for decades and I am hyper sensitive to my environment. My skin, eyes, and mucous membranes are super easy to irritate - so it is a continual battle to keep inflammation at bay. Interestingly enough - anti-histamines are also considered useful in the treatment of generalized anxiety symptoms - which I have along with PTSD/acute anxiety (i.e. panic disorder) in a nutshell, a brutally abusive childhood spent with a raging alcoholic stepdad and a horrifying car crash in my early 20's that put me out of commission for a year are big elements of where this all came from - 'hi, nothing, nowhere is a safe place to be.' and welcome to using food as a substance to soothe and disappear. I take Klonopin when life is just too edgy, and when I know I will be in the passenger seat of the car for a long trip. I used to take this one daily just to get through the day in the late 90's when I finally found my way to the therapists couch. The potent cocktail of drugs I used to take daily were Zoloft, Trazadone at bedtime, and Ativan and then Klonopin(Clonazepam) on a daily basis. I was in rough shape back then, confronting issues for the first time. I went to therapy 3 times a week and then was in an eating disorder group as well - which was challenging as most of the other members were anorectics and bulimics, which while very similar to bingers/compulsive overeaters (meaning that one can turn into the other pretty easily they say.) those folks can be very hard on those they few as inferior. So now I just use Wellbutrin and the clonazepam as needed, and a lot of anti-histamines - hubby and I take the Safeway brand sleepy medicine - which is just Benadryl but a whole lot cheaper - if you look at the price on Zeequil, its the same stuff and they just charge an arm and a leg. Diphenhydramine is the anti-histamine. I have heard good things about L-methyfolate and ​Sam-e. I recently went off of melatonin because once its built up to a therapeutic level in my system I get serious nosebleeds - which seems to have happened to a lot of folks. Sheryl I have also taken the 5HTTP, seemed like good stuff but I was using my other regular meds so I am not sure if it makes a lot of difference. What is interesting - when I was in bad shape all that medication make me feel normal, My normal from waking until sleep was like being on fire without meds - I wanted to die - just dart out into traffic and have the pain just stop. Now - one Clonopin knocks me on my ass - I really feel it - whereas before I was in such a state that it just made the day tolerable enough to get through - so I could do the work needed in therapy to get a little better. I know that I am permanently imprinted by the bad things that happened in my life, that I will always be afraid of things - but it is better than it used to be. I have considered trying that flashing light therapy to help with the PTSD - I have heard good things about it.

I found a cached version - here it is below. Though I think that how one views the glass - as half empty or half full in terms of stats 5 years+ out...I have read stats that have EWL at 50-60% at 5 years and they feel that is still a great success. Benefits of Sleeve Gastrectomy Wane at 5 years The weight loss and diabetes remission achieved with laparoscopic sleeve gastrectomy (LSG) appear to wane by 5 years, a new cohort study suggests. Sleeve gastrectomy has been growing in popularity as a bariatric technique, but data on its long-term effect on obesity-related comorbidities are scarce, with most findings reported so far limited to 2-year outcomes, explain Inbal Golomb, from Rabin Medical Center, Beilinson Hospital, Petah Tikva, Israel, and colleagues, in their paper published online August 5, 2015 in JAMA Surgery. In their retrospective analysis of a prospective cohort study of 443 patients who underwent bariatric surgery at the university hospital between 2006 and 2013, the percentage of excess body weight lost had dropped from 77% in 241 patients with available data at 1 year to 56% among 39 at 5 years. And of the 82 diagnosed with type 2 diabetes prior to surgery, the proportions achieving complete remission — defined as a fasting glucose level of less than 100 mg/dL and HbA1c below 6% — were 51% of 71 with available data at 1 year and 20% of 10 at the 5-year mark. Total cholesterol didn't change significantly at all, and decreases in LDL cholesterol were significant at 1 year but not at 5 years. "Undergoing LSG induced a reduction in [percent of excess weight loss] and a major improvement in obesity-related comorbidities in the short term," Mr Golomb and colleagues note. But the longer follow-up data "revealed weight regain and a decrease in remission rates for [type 2 diabetes] and other obesity-related comorbidities. These data should be taken into consideration in the decision-making process for the most appropriate operation for a given obese patient," they conclude. In an accompanying editorial, Anita P Courcoulas, MD, of the University of Pittsburgh department of surgery, Pennsylvania, observes that there are "critical gaps in knowledge in this area," resulting from the "paucity of comparative trials, incomplete follow-up, a lack of standardized definitions for changes in health status (eg, diabetes mellitus remission), and the tendency to a rush to judgment in favor of surgical-treatment options." Gastric Bypass Appears Better for Diabetes and Heavier Patients Asked to comment, Philip Schauer, MD, director of the Bariatric & Metabolic Institute at Cleveland Clinic, Ohio, told Medscape Medical News, "This is a 5-year study that adds to our understanding of the durability of the sleeve gastrectomy. These authors show, like the others do, that some of that weight loss and improvement in comorbidities does retard over time." However, added Dr Schauer, who was one of the first surgeons to perform LSG over a decade ago, "Even at 5 years, there is still significant weight loss, and even though the remission rate of diabetes drops from 50% to 20%, that's still remarkable. That's not achievable with medical treatment." He noted that LSG typically works better — and with more durable results — for patients with a shorter duration of diabetes and for those with lower levels of obesity (ie, 50–100 pounds overweight, as opposed >100 pounds). And it has some advantages over gastric bypass: it's a shorter procedure, with less short-term comorbidity. But, he said, there is growing evidence from his data and those of others that "when we look at longer-term and more important outcomes, we're now seeing pretty consistent reporting in favor of the gastric bypass over the sleeve, at least for diabetes and the higher-weight people, too." Large Randomized Trial Comparing Surgical Procedures Impractical In her editorial, Dr Courcoulas says that cost and feasibility issues will make a large randomized comparative trial among surgical procedures relatively impractical. Therefore, she said, data on long-term outcomes will need to come from sources such as large electronic databases and "also by thoughtful inference that will be made through pooled analyses of data like that from Golomb and colleagues and from many other disparate randomized and nonrandomized studies of bariatric surgery. "It will take time, patience, and a willingness to avoid a rush to judgment," she adds. Dr Schauer said, "I agree with her; we have to dampen our enthusiasm a little bit until we see the longer-term results." In the meantime, Dr Courcoulas writes, "clinicians and prospective patients will need to discuss and weigh the evidence in a dynamic exchange driven not always by final conclusions but by the most current available data." The study authors have no relevant financial relationships. Dr Courcoulas reports receiving grants from Nutrisystem, Ethicon, and Covidien and serving as a project consultant for Ethicon and Apollo Endosurgery. D. Schauer has received grants from Ethicon, Covidien, Novo Nordisk, the National Institutes of Health, and a travel grant from Nestle and is on advisory board for Surgiquest. JAMA Surg.Published online August 5, 2015. Abstract, Editorial ​

I have terrible anxiety and have powerful medicine for the worst bouts - but I cant take that all the time (used to, just to get through the day) - will talk about it more later - little privacy atm. I did not realize that you need to sign up for that article - I was able to just read it earlier.

Okay finding an article on Facebook from a day ago on a very busy group is impossible - Googled it and found it right away - http://www.medscape.com/viewarticle/849141 ​