SqueakyWheel&Ethyl

Today is my Day 10 post-op. I went back to work yesterday, prematurely. I tolerated the surgery well and am adapting to living with a feeling of heartburn in my sternum with each swallow. AND, for now, I'm okay with all that. I'm having a hard time getting the anesthesia out of my system. Historically, it's taken months after general anesthesia for me to feel 'normal' again. Thanks to my liver disease (PBC and NASH), my liver drags on processing toxins. I rarely drank before I knew I was sick, because one drink would make me really buzzed. Dental numbing would last hours longer than they would tell me to expect. Pain pills were always knocking me out. With some out-patient procedures, there were several times they were about to admit me because they couldn't get me to wake up. This forum is great for offering support to us. I hope I can meet others with liver disease (especially PBC or NASH) and those with problems with anesthesia to compare notes with and share helpful hints with.

Immediately after my GS surgery (April 17, 2013), I read a post here about having a drippy nose when they know they've eaten too much. When I read that, I thought, "Ew! I'm not gonna!" The idea of my nose just dripping - without warning - was disgusting and I was arrogant enough to think it was something that we could control. Later, when I *DID* eat too much, I leaned over the table and *DRIP*... there went my nose! ACK!!! Did I just DO that?!? My nose had not dripped uncontrollably since I was 4 years old! WASSUP WIT DAT?!? Since then, I have experienced the nose drip, the "slime" feeling in my mouth and sneezing after eating a meal - all things I've seen mentioned in others' posts. What I don't understand is this... WHAT does eating food have to do with our respiratory system going slimey, causing our noses to drip and sneeze? Where is the corrolation? What anatomically is happening to connect the gastric system to the respiratory system?

While I don't have Lupus, I do have a host of other auto-immune diseases, including PBC, which is just like Lupus, only it is targeting my liver. My Liver Transplant team (on standby when I eventually go into Stage 4 and on 'the list') encouraged me to do this! My endocrinologist and infectious disease specialist both supported this decision. Getting my body as physically fit as possible will slow down the progression of deterioration. A gut leak is a minimal risk, but staying 100+ lbs overweight was much riskier. I agree. That surgeon you saw is too hung up on liability and his own insecurities about leaks. I would go to an accredited hospital and ask for a referral to a Dr or group specializing in weight-loss surgery and see what THEY think. There are a lot of "boutique" store-front practices. My Liver Team told me to stay away from them and do it through a real hospital. I'm so glad I did!

My VS is done, but I'm curious about all the international travel procedures I've seen here in chats. I'm sure someone has weighed the pros and cons for why they chose to go outside the US. How much (ball park estimate) is it in Mexico? Canada? What are the pros/cons?

This is one of my favorite threads ever!

I clicked on the drop down screen arrow by my name (top right in window), selected My Settings. I see no selection called "Member Title." Is there another missed step?

EAS makes a Rich Dark Chocolate in 11 oz. servings with 17 gms of protein that are my favorite. Very tasty. I'm not fond of the vanilla ones, tho. I buy them in 4-packs at Kroger's for around $11.50. They make me feel like I've had a full meal and for less than $3.00 each. I'm lucky if I can drink 2 a day with lite snack-meals in between. I also like Atkins Advantage - 11 oz w/15 gms protein each. Also sold in 4-packs.

You are 5' 3" and 136 lbs and you think you look too skinny? That sounds like a healthy proportion to me. I wouldn't recommend gaining weight with higher fat intake. I would recommend getting a personal trainer to help you tone what you have. You are a diamond in the rough, Darlin'! Maybe you spent most of your life heavier and this just looks foreign and unfamiliar to you. I bet you look beautiful, and you just can't see it yourself. What does your closest friends say? Have you asked for their opinions? Have you bought any new outfits lately? Tried a new look? I know I haven't seen any photos, but I envision a woman who looks great! Go to www.mybodygallery.com. You can enter height and weight and see what REAL people look like. Maybe that will help your self image. Frankly, I think you are being too hard on yourself. You deserve a celebration.

Congratulations on making this choice and props to you on taking action now! Here's some unasked-for advice. Not knowing how BCBS responds typically, but knowing how my insurance resisted, I strongly recommend keeping a journal of each interaction pertaining to this surgery, with insurance, with Drs, nutritionists, etc. if you use a computer a lot, use it. I kept an electronic journal in Microsoft Word. I logged the date, and just wrote brief broken sentences that cut to the chase, like, "09/12/12. Phone call w/insurance rep, Bianca L. (936-999-9999). Requested list of criteria required to get insurance approval. She will email it to me by 2 pm." "10/04/12. Met surgeon, Dr B, on 1st appt. Was set up with monthly appts with Nut Counselor for 6 months." "03/17/13. Pre-op appt with Dr B. Scheduled surgery 4/17." Keep track of what BCBS requires yourself. Don't rely on them or the surgeon's staff. Do they require months of nutritional counseling? If so, how many? Do they require a psychological evaluation? Do they require a 6-month log of what you ate every day? Will they want to see your Dr's records showing what your weight has been over the past 3 years? And, don't take for granted that your PCP (primary care physician) and surgeon are shaking hands smoothly on everything. If you call and verify the PCP provided the necessary records, and confirm the surgeon's staff received it, things will go easier and quicker. And, if your insurance requires several months of counseling, don't despair. I learned a lot in those appts and the time allowed me to really make peace with this permanent lifestyle change. By the time they wheeled me into the OR, I was so happy, as soon as my gurney crossed the OR threshold, I raised my fist in the air and pulled it down fast yelling out, "YES!" I worked hard to arrive at THAT moment and I marked the success with a mini-celebration. I was soooo ready! We are all here on this site to exchange ideas, questions, and reassurances. If you haven't yet, fill out your profile. Post a before picture. Take your measurements the night before surgery. There will be times your weight loss will stall, but the inches will continue to melt away. Good luck on your journey!

Go gluten-free. Gluten may be irritating it... Or even causing it.

You have a new friend in Texas. . Good luck!

I agree that hydration is priority one over Protein. In the first 2 weeks post-op I was told to set my protein goal to 30 gms... To strive for it, but don't beat myself up if I can't. After 30 became easy, I was to set my goal to 60 and know it will take time to be able to consistently do it. I'm 6 weeks out and still struggle to get in 60. I'm averaging about 40. So, don't focus on just protein right now. Like the earlier post said, sip, sip, sip. The gurgling is just recovery noises that will dissipate with time. Take one bite. Put down the fork. Wait 3 minutes, take another bite.... Repeat. And LISTEN to what your body says in between bites. I find its a delayed reaction. I still have a bad habit of wanting to chow down three bites quickly. My body (I call her "Ethyl") will tell me, SLOW DOWN. Just listen carefully. Old habits die hard. When you are more healed, you will be happy you did this. Just give yourself time.

I would like information on how the results of the sleeve procedure are affected by the presence of Hashimoto's or any form of thyroid disease. Should I expect my results to be less than everyone else's because of my thyroid?

At my 1 month post op, I had lost 15 lbs (according to his records... He had my pre-op weight lighter than my scales.... 24 according to mine). He said he wants to see me at 25-30 lbs TOTAL LOST by my 3 month check up. Seriously? I hope I hit that goal by Month 2! You are doing GREAT!

I'm not touting Hashimoto's = Cancer. My original point is that it is not wise to leave an abnormal thyroid ignored or unchecked. And, the article shared was to support the fact that this disease is linked to cancer. The article happened to be about liver cancer. Long-term untreated Hypothyroidism is linked to other cancers, too. My message was - and still is - don't run in the wrong direction from this diagnosis. As for ME, Hashimoto's, combined with PBC and NASH (both auto-immune diseases attacking the liver) (aggravated by pre-Diabetes) puts me at a much higher risk than most people for liver failure and (not "or") cancer.... Many forms of cancer. I'd hate to see someone ignore their condition and get sicker.

Underactive Thyroid Linked to Liver Cancer Risk By Crystal Phend, Staff Writer, MedPage Today Published: May 06, 2009 Reviewed by Robert Jasmer, MD; Associate Clinical Professor of Medicine, University of California, San Francisco SAN FRANCISCO, May 6 -- Long-term hypothyroidism may nearly triple the risk of developing liver cancer, researchers found. The association was independent of established hepatocellular carcinoma risk factors, but significant only among women, according to Manal M. Hassan, M.D., Ph.D., of the University of Texas M.D. Anderson Cancer Center in Houston, and colleagues. These case-control study findings shouldn't be surprising, the researchers wrote in the May issue of Hepatology. Hypothyroidism has been linked to chronic liver diseases and implicated in the pathogenesis of nonalcoholic steatohepatitis (NASH), which is considered a predisposing condition for liver cancer. This may result from the essential role of thyroid hormones in lipid mobilization and degradation and fatty acid oxidation, Dr. Hassan's group said. When they're out of balance, "all of these conditions may enhance the susceptibility to chronic inflammation, DNA damage, and hepatocellular carcinoma development." In the study, an underactive thyroid increased hepatocellular carcinoma risk independent of hepatitis C virus (HCV) infection (adjusted odds ratio 2.0, 95% CI 1.2 to 3.3) and independent of diabetes (adjusted OR 1.9, 95% CI 1.2 to 3.3). Together, though, these factors appeared to have more than an additive effect (adjusted OR 34.3 for hypothyroidism plus HCV and 7.9 for hypothyroidism plus diabetes, respectively). "Screening and proper management of thyroid diseases in patients with diabetes or hepatitis C virus infection may help prevent hepatocellular cancer," they said. The ongoing hospital-based case-control study involved 420 hepatocellular carcinoma patients newly diagnosed at M.D. Anderson. The controls included 1,104 healthy, genetically unrelated family members (such as spouses and in-laws) of M.D. Anderson patients with cancers other than liver, gastrointestinal, lung, or head and neck. Overall, more of the hepatocellular carcinoma cases than controls reported a history of thyroid disease (15.0% versus 12.1%). Likewise, a history of hypothyroidism -- the most common type of thyroid disease -- was significantly more common among cases than controls (11.7% versus 8.0%, P=0.03). Long-term hypothyroidism of more than three-years duration conferred a significant, 2.1-fold excess risk of liver cancer, compared with no history of thyroid disorders. The multivariate analysis found the association only among women. Women with a prior, long-term history of hypothyroidism for three to 10 years had a 2.6-fold higher risk of hepatocellular carcinoma (95% CI 1.0 to 7.2). For women with a history of hypothyroidism lasting more than 10 years, the risk was 2.9 times as high (P<0.001). The two- to threefold increased risk of liver cancer remained for hypothyroidism in analyses controlling for obesity at different ages, for all established hepatocellular carcinoma risk factors, and even in analyses restricted to nondrinkers, nonsmokers, and those without hepatitis or diabetes. The greater susceptibility of women than men with the same condition may be partially explained by the liver's role as a major target tissue for the proliferative effect of growth hormones, their receptors, and binding Protein, the researchers suggested. They noted that further prospective study is needed in different populations to validate the findings and to determine the underlying mechanisms. While the self-reported thyroid disease may have been prone to recall bias, the investigators found no discrepancy in the medical records. The study was supported by National Institutes of Health grants and the Texas Tobacco Settlement. The researchers reported no conflicts of interest. Primary source: Hepatology Source reference: Hassan MM, et al "Association between hypothyroidism and hepatocellular carcinoma: a case-control study in the United States" Hepatology 2009; 49: 1563-70.

Conroe here. Sleeved April 17th.

I had the same problem early on. MoM is effective. I chew fiber tabs daily now. They are fruity tasting and work perfectly. Normal movements without cramping or straining.