JamieLogical

I had sleeve over bypass for several reasons: Lower BMI - On the day I scheduled my surgery, my BMI was right at 40 Rerouted Plumbing - I was kind of "freaked out" about several aspects of bypass. The main thing was that they leave your old stomach inside you still where it could potentially develop ulcers or cancer or other complications and since it is disconnected from your esophagus, it can no longer be checked out with a simple endoscopy. I also was concerned about the loss of use of the pyloric valve. I kept thinking, without the valve, won't the food just go straight through your stomach? And I also had this crazy thought that with my old stomach still inside me, would my brain get signals from my pouch to open and close my pyloric valve even though it didn't actually control the passage of food anymore? Just that whole process and my lack of understanding about it weirded me out. Restricted Food- I wanted to be able to eventually eat whatever I wanted again, just in smaller quantities. The truth is now, post-op, there are foods I probably won't ever eat again. Not because I'm physically incapable, but because I'm just not interested. But when I was choosing my surgery, the idea that I wouldn't HAVE to give up all the foods I love forever was somewhat comforting. Absorption - I was very worried about the possibility of malabsorption of essential vitamins and minerals that can be associated with bypass. While it is possible to develop absorption issues with sleeve, it is less common and they are less severe. Self-pay - My insurance wouldn't cover WLS for me because I hadn't had a documented BMI over 40 for at least 5 years. I had lost 90+ pounds "on my own" in 2011 and was well under a 40 BMI for a while as I regained the weight. I had just peaked back over 40 this summer. So I would have had to wait 5 more years to be eligible under my insurance. Since I was self-pay, sleeve is a much cheaper procedure than bypass.

Day of surgery is kind of a blur. When I woke up, I remember moaning a lot. Like with every breath out I made this moaning sound. Not even sure why. But it was not a great feeling. I think I asked for some Water or ice chips right away. And I slept a lot. By late evening I was up and walking around a lot. Just up and down the hallway. Managed to use the bathroom on my own. The next day I was discharged back to the hotel (I had surgery in Mexico). I just took everything slowly, didn't do much, tried to drink water. I had two episodes of dry heaving. That is the only time post-op that I have experienced anything close to vomiting. I walked to a corner store and bought some Vitamin Water Zero. I drank tiny sips of it and maybe finished 1/3 of the bottle over the course of the evening? I also tried some chicken broth, which I got maybe 3-4 spoonfuls in. Morning of the next day I had TERRIBLE cramps. Low down in my pelvis, like menstrual cramps. It was super painful. I went back to the clinic and they did my leak test and removed my drain. As soon as they removed the drain, my cramps stopped. It was like a miracle. My main issue in the first couple of weeks was how uncomfortable it was to swallow. With every tiny sip, I went through this whole process of esophageal constriction/spasms, followed by bubbling in my chest, followed by burping. It was definitely a result of the swelling and once the swelling had gone down a couple weeks out, it was 100% better. I also had a little pain in the area of one of my incisions, but nothing I couldn't handle. It was muscle pain from where they had to spread apart my ab muscle, not any kind of skin irritation or infection.

As long as you're not making yourself sick, I don't see the problem. You will likely have a much more challenging time when you progress to solids, so make sure you take it VERY slow. Don't just jump in there thinking you can eat a half cup of solids the way you are doing with purees. You will be VERY VERY uncomfortable if you do!

My go-to Snacks are string cheese, Dannon Light & Fit Greek yogurt (other brands have that gritty greek yogurt texture that I hate), peanuts (in very limited quantities when I need a non-refrigerated snack), and meat sticks (like beef sticks, but not necessarily beef... I like turkey pepperoni sticks). If you are really craving chips, Quest Nutrition (same people who make Quest Bars) make Protein chips that are available at GNC and Vitamin Shoppe. I tried them once. They were okay. But I think it's probably best just to wean ourselves off that style of snack altogether so we stop craving them.

I was immediately prescribed 40mg omeprazole, so I didn't really experience bad reflux until my prescription ran out at 2 months post-op. I have since been taking the over-the-counter dosage (20mg) twice daily. Have you experimented with taking your PPI at different times of day?

It's encouraging to me that you are still plugging away at it 16 months out. So much of what I read on these forums is about the "honeymoon" period and it really makes it sound like you have to lose all the weight in the first 6-12 months or you're out of luck. I know I won't make goal within my first 12 months, so it is good to hear that there are people more than a year out that are still making progress.

I think this thread took an ugly turn somewhere. It's just as valid for the OP to talk about his/her decision NOT to have WLS as it is for us to talk about our decision to have WLS. These forums aren't just for people who have already had surgery. They are a great tool for people who are just now considering surgery. Is it not valuable to those people to read about why someone might choose NOT to pursue surgery? I wish the OP the best of luck. They have made their decision and we have made ours and I hope everyone has incredible success in whichever path they choose.

For sure! Do that before signing any loan agreement!

I suspected as much. He seems like a competent doctor and he makes it pretty clear when he is unhappy with a patient's non-compliance. I remember him even talking with a patient and confirming that she had the packet with all the nutritional info in it before discharging the hospital, then once she was actually home she complained that she hadn't received proper instruction. I could tell she was just using it as an excuse, because they had her ON CAMERA acknowledging that she HAD received the information.

They've done that a few time on Fat Doctors, so I think that's what you are talking about. The gastric balloons haven't been FDA approved in the US, as far as I know.

That doesn't sound right. Yogurt was considered a "full liquid" for the purposes of my diet stages, so I was allowed to have as much of it as I could tolerate.

It's funny how I went from never working out at all, to feeling like a complete slug if I ever have to miss a day. Even on my scheduled rest days I sometimes feel like I'm being lazy!

I have read on these forums about it getting better for some people further out from surgery. I am a little over 6 months out and it hasn't gotten better for me. In fact, within the last month or two I started taking two 20mg doses a day, after having only initially been taking one after my prescription ran out. I'm still hopeful it might get a little better by the time I'm close to a year out, but if it doesn't it's not the end of the world to have to take a couple of pills a day. I'm already taking a ton of Vitamins and supplements anyway!

If you can get a new prescription, it will likely save you some money, since you will only need to cover a co-pay. The over the counter stuff can be a little pricey.

Not to disparage peanuts, because I eat them myself as an occasional snack if I don't have a refrigerator handy for cheese or yogurt, but a CUP of peanuts? Sure, it's 38g of protein but it's also 828 calories and 72g of fat! sicne I only manage just over 1000 calories a day right now, that seems pretty extreme! Also, I was instructed not to eat nuts until 3 months post-op, but I know some people are allowed to eat them sooner.

It sounds to me like you did plenty. I would encourage you to take it slowly so you don't risk injury. I know the temptation is to jump in and go all out right from the start, but an injury will set you back a long ways. So you are right to ease into your 5k training and not push too far too fast.

Sounds like your head, heart, and body are all in the right place to begin this journey! Keep up the good work and stay determined. I think you are doing yourself a huge favor by taking on some of these challenges and changes pre-op so you are all the more prepared for your post-op life.

Congratulations on making the best decision for YOU. It takes a lot of introspection to reach a decision one way or the other and there is just as much merit in deciding it's not for you as there is in deciding to pursue surgery. I am sorry you were made to feel like a lab rat. It's never nice when the medical industry makes us feel sub-human. Good luck to you with your pursuit of weight loss! I wish you much success!

Working Out: I was encouraged to do up to 60 minutes a day of "brisk walking" immediately post-op and cleared to do more intense exercise at 2 months post-op. Water: Hydration is SUPER important post-op. You top priorities will be getting in your required Protein and Water every day. It is tough at first for some people to get all their water in, due to the swelling of the sleeve, but you will ultimately be able to drink water just like normal. You will only be taking small sips in the beginning, but likely will be able to take several large swallow at a time. The only catch is that you will not be able to drink before, during, or after eating. Every surgeon has different recommendations for this. Mine told me no drinking for 5 minutes before eating or until 20 minutes after eating. I find that I really am not comfortable drinking until about 40 minutes after eating a full meal. I can drink sooner after my Snacks. Alcohol: Yes. I have had alcohol several times post-op. It's not a great thing to do frequently, because there are a lot of calories in alcohol, but it is fine to do from time to time. I have found that post-op, I get "buzzed" or "drunk" from much less alcohol than I did before, so be cautious if you do decide to drink post-op. Make sure you do it in a safe environment and don't have to drive anywhere. Restricted Foods: I was eventually cleared to eat all foods, however, I have steered clear of rice, bread, Pasta, and starches for the most part. I am very strict about getting my "protein first", and have not had any room in my sleeve for anything other than primary protein sources. If I were to eat some of these other foods, it would be at the cost of not getting all my protein in and I don't feel they are worth it. Also, no carbonation, as you mentioned. Recovery: I live in the eastern United States and had my surgery in Tijuana, Mexico. My surgery was on a Monday and I returned home on that Friday. I could have returned home on Thursday, but I couldn't make the flight schedule work with the border crossing, so I had to stay an extra night in San Diego. The point is, you shouldn't have an issue flying home 4 days post-op, barring any complications of course. I can't answer that last question for you, but I will say for myself that I wish I'd had the surgery sooner. If you continue to put it off for the "right time", that time may never come.

The success rate for WLS is much higher than dieting. While it is true that some WLS patients never reach their goal or regain some/all of the weight, it is much more rare than the failure/regain rate of dieting. The highest number I have ever heard as an estimate of the percentage of people who regain weight after WLS is 50%. Whereas the failure/regain rate for dieting is estimated to be around 95%. When I was researching sleeve and reading studies about failure rates, I found it very encouraging. VSG as a stand-alone procedure is fairly new, so there aren't as many studies as there are for bypass, but one study I read defined "failure" as a regain of 20 or more pounds. In that study, 20% of patients had "failed" by that definition at 5 years post-op. I will take those odds any day! If I lose 100 pounds and regain 20, I'm still down 80 pounds! Meanwhile, I've lost 90+ pounds "on my own", not to mention 40 pounds here, 50 pounds there, only to regain ALL of it and then some 100% of the time! But, I don't want to make it sound like there are any guarantees. It's all about risks versus rewards. Can I lose weight on my own? Heck yes! If losing weight was an Olympic sport, I'd be a gold medalist! Can I keep weight off on my own? Clearly not, since I have yet to manage to. I am hopeful that with my sleeve, it will be easier for me to maintain my weight loss in the long run. I have always been a binge eater. When I was "done" with a diet, I'd go right back to eating a whole pizza and a pint of ice cream. No wonder I piled the pounds back on. That won't be an option with my sleeve. I would really have to work against my sleeve by eating slider foods, grazing, or drinking my calories to regain the weight and I feel like I'm very unlikely to do those things. I've never been a snacker/grazer so why would I start now? I haven't drunk caloric beverages in years and years... since LONG before my sleeve, so why would I start now? It's on me to eat right and exercise, just like it was when I did diets in the past. But now I have a great tool to help train me on portion sizes and prevent me from bingeing.

Congratulations on the start of your new life. You will have some ups and downs along the way, but you have taken the first step and that is HUGE!

Glad you are feeling so much better. "Patience" is the absolute best trait to get you through this journey. Pre-op you need it to help calm the nerves and make it through to your surgery date. Post-op you need it for your recovery and as you move through your food stages. And you definitely need it when it comes to the scale! Glad you persevered and are improving daily. I suspect your prolonged clear liquid diet may be partially to blame. 4 weeks is a long time to be on clears! No wonder you felt so crappy!

I think the best advice would come from your doctor, since no two people are the same. I didn't experience anything like you are describing, but it does seem like cause for concern. Hopefully your doctor will get back to you quickly. Hang in there!

Some surgeons don't require a pre-op diet at all. I'm sure that if yours does, he will let you know in plenty of time. For most people it is either 1 or 2 weeks. Some people just have a 2 day clear liquid diet right before surgery. It really does vary a lot depending on your surgeon.

Has no one figured out the cause of your weight loss? I assume with all of those people monitoring you, you were tracking your food intake and your exercise to get a sense of where you might be coming up short. What have you changed recently that allowed you to gain a few pounds?