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Hi! I have been living in a foreign country (South Korea) for about 9 months now. It took a long time to adjust to the different foods and nutrition labeling. The medical system here is also different. But I've continued to lose weight (more slowly than before) and hadn't encountered any serious stomach-related problems until a month ago. That was when I experienced severe abdominal pain, enough to send me to the ER. It turned out to be gas in my stomach along with a little reflux (seen via endoscopy); my stomach is otherwise in good condition. They said my liver function numbers were 5X normal as well, and ultrasound showed moderately fatty liver (seems weird to me after so much lost weight). They put me on medicine (morning PPI, evening Zantac, after meal digestive stimulator, and liver medications) and said there was nothing else to be done except eat wisely and exercise more (I walk/run 4-6 km on steep hilly terrain a few times a week). Over the past month, though, my liver numbers have been up and down seemingly at random, and the gas pain is coming at greater frequency. It is so bad I can't think about anything else and just rock back and forth in front of the toilet hoping burping or vomiting or something will help (have only vomited once due to this). If it happens before bed I cannot sleep. Sometimes the gas won't head into my intestines for 7 hours; once it does the pain resolves quickly. About all I can tolerate eating right now is rice porridge with soft tofu. I'd rather not fly back to the U.S. for treatment but am frustrated that nothing seems to be helping here. I've seen four different doctors now. Experiences? Suggestions?

Thank you! I will look into it; that's a lot closer than the U.S.

Keep in mind this is based on my personal experiences so far. If yours were different or you have more to add, please chime in! No particular order: 1a. UIC's info session was short and to-the-point, highlighting the essentials. 1b. The Kane Center seminar was thorough and over two hours long. For someone who has already done a lot of research and spent time in the forums here it would be almost 100% redundant. But I did like that they brought in four post-op patients for unscripted testimonies/Q&A. The surgeon also showed footage of the actual procedures being done (bypass, band, and sleeve). 2a. UIC offers patients a lot of options with respect to the pre-op diet and Vitamins. During the pre-op diet, as long as I'm not getting too many carbs, any Meal Replacement Protein shake is fine. My vitamins can be cheap prenatals combined with any brand of deficiency-specific supplements. They will use regular follow-up labs to determine if a patient needs more or less of certain vitamins. 2b. The Kane Center has a 'partnership' with Bariatric Advantage and wants everyone to buy (expensive) B.A. shake powder and vitamins through them. 3a. UIC does not offer bariatric support groups. The psychologist might recommend OA or group therapy, but that's it. 3b. The Kane Center holds and strongly encourages patients to participate in local bariatric support groups. 4a. UIC accepts Medicaid. It is located in an urban area and attracts a lot of diverse patients. 4b. The Kane Center does not accept Medicaid. It is located in the suburbs, and the info session was attended by, well, suburban people-- some diversity, but much less than in Chicago. 5a. The UIC surgery office is often crowded, chaotic, and disorganized. Some appointments must be scheduled well in advance. 5b. No significant basis for comparison yet, though the coordinators were above average in making me feel welcome, comfortable, and directed. It was easy to get an initial appointment for the week after my inquiry. 6a. The UIC medical staff are down-to-earth, efficient professionals who always provide customized care. 6b. No basis for comparison yet.

Skin is just one of many indicators that you are dehydrated. All your other symptoms fit dehydration. Keep in mind there is nothing wrong with going in for IV fluids if you feel dehydrated, and it will make you feel much better. On the fast mode it only takes a few minutes to get a bag of the good stuff in your body. Ask your surgeon where to go (usually ER, urgent care, or sometimes the clinic). Bonus: when you go in they will also test your electrolyte levels. Please please please do not try drinking from a straw, especially this soon after surgery. The gas and pressure from doing so can be intensely painful and make things worse. Speaking from experience. I can relate to the feeling of Water feeling like a marble hitting your sleeve. It does take time to feel comfortable getting in your liquids. Press on, keep trying different temperatures as others have mentioned.

I'm more than nine months out now, and it has flown by! Down 92 pounds since my first appointment (66 since surgery). I've come to realize that this is about as far as the sleeve alone will take me "easily". My winter stall only ended when I upped the duration and intensity of my exercise. Need a few solid hours of power walking or jogging minimum to continue losing. Thankfully the loss has made exercise more fun and easy; I can run without knee pain (wearing correct shoes)! Overall I feel much better, am healthier, more comfortable, more confident. But at the same time, I'm noticing my body's deflation-- not bad in the most visible places but very noticeable in others. That skin fold above my groin chafes when I exercise and gets infected no matter what I do to keep it clean, dry, secure, treated, etc. Other areas rub and flap, too. Knew I'd probably need plastic surgery but held out hope that losing gradually and being young might work in my favor. In front of the mirror I fold in my tummy skin and pull up the extra skin on my legs and butt and can see and feel the potential for a more normal body, yet I know major body contouring is more dangerous than the sleeve surgery itself and a experienced, high-quality surgeon in the U.S. will cost a year's salary. I look smaller in clothes but still have lumps and rolls in the same places. My hair is still falling out, too, currently at less than half its normal thickness. Yes, have been taking all those extra recommended Vitamins, but it hasn't helped. Oh, well. Despite these things I am so happy to have gotten the sleeve and come this far! Wouldn't trade the experience!

I'm more than 3 months out now and finding regularity difficult to achieve. Prior to surgery I had no problem with this, as I have always enjoyed 100% whole grain and fruits/veggies. Even though I am back to a normal diet now and my Fiber intake is around 30g per day, the plumbing just doesn't work well. Thankfully I am able to go #2 every day, but it is difficult and not particularly productive. I can feel the volume build up over time, and my weight loss is rarely apparent until an especially good release (might not see the scale move for two weeks but then drop five pounds in a day). There are a few things that sort of work. Stool softeners and kimchi work but give me the runs. Wheat Chex with milk works if taken in a large portion but irritates my sleeve and is high in calories. Surprisingly, Fiber One products and various other types of fiber supplements have not really helped, and I always take them with liquid as appropriate. I eat the following fiber-rich foods each day: a small Romaine salad, 2-3 servings of cooked veggies, 1-2 servings of fruit, and 1-2 servings of 100% whole grains (cooked barley, brown rice, whole wheat noodles, oats, etc.). Do you have any tips or similar experiences to share? I'm aiming for everyday regularity, not a 'cleanse'. Does it just take time? Thanks!

Thanks for all your insights and suggestions! I will try them out.

Everyone's experience is different. My surgeon recommends that all patients plan on being 'out of commission' for three weeks. Other people will try to tell you a week is all you need, or perhaps two. This could be true for you, but so could the opposite. I am 31 and of good overall health status, but it did indeed take me about three weeks to function at low normal again (as in, 50% energy with very little pain). Stamina quickly returned after that, though. Half the battle following surgery is taking your meals/fluids/vitamins/medications, caring for wounds, walking regularly, managing anxiety (is XYZ normal or a sign of a major complication?), and remembering not to lift heavy things (like babies and grocery bags).

This is normal and not necessarily sliming. Since your stomach is very swollen and small, gas cannot escape as directly as before, so drinking and eating are likely to cause bubbles, gurgles, and burps. Sliming on the other hand is when you produce thick excess saliva as your stomach contemplates vomiting after eating/drinking too fast or too much.

Yesterday at the grocery store I wanted something on the bottom shelf. Instead of bending over, I did a full squat and was able to pop back up without any knee pain, trembling muscles, or hand/arm support.

We're at about the same point post-op, and I've been turning to moderately soft sources for protein until supper (eggs, light fish, milk, low-fat cheese/cottage cheese, shaved deli meat) with 3oz substantial meat at supper (chicken, hamburger, pork, salmon). Maybe you could try something similar? Also, I set an hourly water alarm (outside of meal waiting windows)--8oz per hour (but you could also set it for 2oz every 15 min). DING! Sip sip sip til it's all gone. You're doing great!

Now that my incisions are feeling better I feel some gentle core exercises would be helpful. My belly and sides in particular are beginning to feel heavier/droopier. Any suggestions?

I would not have been able to work a week post-op; it took 2 1/2 weeks for me to feel moderately functional again. My surgeon recommends planning for at least 3 weeks off; you can always decide to return earlier, right?

What are your stats (height, weight, body fat %)? Do you have a small or large frame? A good surgeon will consider all of those things in determining whether you are a good candidate for VSG. If you don't have much to lose, VSG could actually be dangerous, leading to malnourishment and a too-low BMI. Two family friends struggled with this after their surgeries (despite starting BMIs over 35) and one still fights to stay healthy. Get a second opinion in the U.S. before insisting upon the VSG. Perhaps look into something like the stomach balloon you can get in Canada. Even surgery at the best hospital with the best surgeon in Mexico is risky, if only due to the language barrier (staff might be proficient in English but most likely won't be fluent), travel required soon after surgery (significantly increases the risk of clots), and limitations of follow-up with the surgeon who actually did the procedure. Complication rates will be more inaccurate than in the U.S. for a variety of reasons, and malpractice records could be more difficult to find. Also, I hate to say it, but 'medical tourism' surgeons fiercely protect their online reputation and routinely have negative reviews/posts removed or edited by bariatric surgery forums, which receive a great deal of their advertising revenue from foreign surgeons and want to protect themselves from libel lawsuits. Patients are often prohibited from posting their negative experiences publicly when there is pending litigation or as a condition of settlement, or they might, too, fear a libel lawsuit, even if everything they write is accurate. There are old, buried posts on this website discussing major complications after surgery with Dr. Alvarez. Example. Try using Google to search this forum for more recent posts regarding Alvarez and complications. That said, it is possible Dr. Alvarez has improved over the years and that to you the risks are worth the savings in going to Mexico, should you ultimately decide to go with VSG. I sincerely wish you the best and hope you will choose a procedure safe and appropriate to your low BMI. EDIT: I don't necessarily recommend that particular clinic for gastric balloon; it just had a page listing the appropriate BMIs and weight loss goals for the balloon. As always, do your own research.

Thanks for your replies! It makes this feel more normal. On mushy I was easily able to get all my Protein from meat (tuna, shaved turkey, lean ground beef, etc.), eggs, and dairy every day. The most challenging part for me so far has been getting green veggies in. Liquid and mushy green veggies are, frankly, gross, no matter how I try to season or disguise them. That's why I'm so eager to feel better with soft solids.

I just moved into the soft solids stage from mushies. What a leap! At this point I can comfortably consume at least 5 oz liquid & mushies in 20 minutes, but soft solids like dense salmon and soft-cooked veggies feel like boulders in my sleeve; just a few tablespoons and I feel uncomfortably full for an hour (thankfully still haven't vomited even once!). Although they recommend starting with protein and veggies, I do find it helps to put a bite of something soft in my stomach first, like potato. Do you think perhaps I should just have one soft solid meal per day until my stomach adjusts better, or is it better to keep trying throughout the day and just supplement with shakes if I can't meet my diet's nutritional requirements? What were your experiences transitioning from mushies to soft solids?

I had coverage with BCBS IL for less than half a year before obtaining surgical approval.

Have my IV in. Just waiting to be rolled into the operating room.

(This morning they said one week.)

Actually they said one week. I guess it's just in case. Staples will come out in two weeks.

Hi! Just wanted to give an update on the day's events. I am sleeved! They started around 1:30 and I officially awoke much later (don't know exactly how long the surgery itself was but I was finally able to read the clock around 6-something (had blurry vision for a bit before that). They brought my dad back at that point and worked on managing my pain, which was pretty intense--like awful menstrual cramps but higher up. I think most of it was gas though I think I could also feel the new edge of my stomach a bit. Unfortunately I couldn't burp so the pain persisted to a degree and is still at about a 4-5. They are trying to stay ahead of my pain with respect to meds. I was surprised at how tired I have been, barely energy to talk. They won't let me walk til morning because of my catheter and are only allowing a little foam-ended stick to moisten my mouth until the Water test tomorrow too. They have had me constantly hooked up to a leg compression machine which is good. It was tough getting comfortable on my back but I am now propped up a bit and slightly on my side. The nurses and staff all seem competent and caring but they aren 't terribly prompt when a machine starts beeping or I press the button. It is nighttime so I get that there are fewer people around. The night resident says he thinks my drain will stay in ten days. I'll find out for sure in the morning. They have me sucking hard through a tube every 6min while awake to get me to cough (prevent pneumonia) and burp. Tomorrow's water test involves drinking 30mL. If that is tolerated, 60 mL, then 90mL. After 90mL is tolerated they allow Clear liquids. Someone turned up the room temp to 80*! Nobody knows why but they turned the heat off for me. It' a shared room. Lots of waiting in the morning after the time they told me to come (10:30) and then it took a long time for them to find someone to cart me to my room from recovery. Sorry all this is so random and out of order.

For whatever reason I'm off the list again! August 5th. Sorry to be a pest. Anyway, the night hunger disappeared for me after some dietary adjustments (cottage cheese instead of yogurt and bottled Slim-Fast with fiber instead of EAS; it's still only around 60 total carbs per day). Broth tip: make it spicy.

@@Ddelrio - I've had a similar problem and plan to take generic colace if I go more than 24 hours without any action.

One week to go! I am proud of myself (and all of you) for getting this far. It's not my favorite diet, but it will be over soon.

@@astalsby Without a battle there is no victory. You fought the dark side and won!