knormlaver

I originally wanted a sleeve; however, the surgeon strongly recommended a mini gastric bypass owing to my history of insulin resistance (PCOS, gestational and prediabetes). I heeded his advice; however, am now dealing with significant reactive hypoglycemia. This results from carbohydrates being rapidly absorbed causing immediate high blood sugars and then rapid reactive lows. These lows can be unpleasant and sometimes scary. I'm now on a drug that slows the absorption of carbs, but I have to take it every time I eat and there are some unpleasant side effects. So while I'm generally happy with the results of my surgery (I'm within 5 pounds of my goal), in my situation I do wish I'd gone with the sleeve.

I was about 220lb and 5'2'' prior to my MGB last September. I look fine and feel good around 150lb and since this is my 2nd go round with WLS (I had a lap-band reversal in 2016 due to malfunction- regained a bunch of weight), I knew that the weight wouldn't come off as fast or as easy. I'm also in my mid 40's. So my goal is pretty conservative. The surgeon made my pouch pretty "generous," so I can eat a relatively decent amount of food (at least a cup almost from the get-go). However, my diet needs to be something that I can live with in the long term and life with food is good for me now. I eat a healthy diet (which I never could with lap-band), avoid simple sugars (I've been having issues with reactive hypoglycemia and I'm also a "dumper") and I continue to exercise 5-6 days/week as I've done for the past 12 years. My advice is to not worry about charts and BMI's. See where you're body leads you and think of the long game. We know that dieting and restriction doesn't work in the long term and usually eventually leads to regain. You need to find a way of eating that is liveable for you.

I weighed once a week in the early months when weight loss is relatively quick. I now weigh once every 2 weeks now that I'm in the home stretch and weight loss is slow. Once I'm at goal, I plan to weigh monthly. I have a long, uneasy history with the scale and I find the less focus placed on it, the better.

I hear ya, Redmaxx. Avoiding/delaying the onset of DMII was also my main reason for having this surgery. I was on metformin for PCOS and prediabetes prior to surgery. I was able to come off the metformin briefly after surgery, but then started having significant issues with reactive hypoglycemia. Now I'm on two meds to help control this and my diet is even more restricted than if I had diabetes!! Very frustrated and leading me to question my choice. However, in your case it demonstrates that weight isn't the only factor in DMII. Hang in there!

My personal experience with Smart Shape wasn't the greatest. This was my first foray into private health care and I wasn't super impressed. Pre-op everything went ok; however, on the day of my surgery, the surgeon came in to see me just prior and said, "So we have you booked for a gastric sleeve..." I was for a mini gastric bypass, so this was a little unnerving that he had me down for the wrong surgery in his notes, but I guess it's good he checked! The surgery itself went alright which I guess is the main thing. However, post-op care was not spectacular. I found pain management to be an issue as they prescribed dilaudid IV push every 4 hours for the first 24 hours. Push drugs work for immediate relief, but they also wear off really fast, so it didn't hold me for 4 hours. They never offered pain relief on a regular basis, so I felt like I was badgering them for it. Nobody wears an ID tag, so I wasn't sure if they were actually RN's or LPN's and I found it strange that when I mentioned I was experiencing a some urinary retention/hesitation (ie. "a sleepy bladder") post op, the nurse didn't seem to know what I was talking about. This is a very common complication after a general anesthetic (up to 70% of patients). I didn't have a proper call bell and I had to let them know that my oxygen tank and IV bags were empty (these should be monitored). Months later, I began to experience significant reactive hypoglycemia and sought guidance from Smart Shape nurses and nutritionists. However, they really didn't know much about this and weren't very helpful. I requested a consult with my surgeon to discuss it and was told by the nurse that I needed to follow up with my own GP (who knows little about bariatric surgery). Eventually, I was referred to an endochrinologist who tells me that this is a well known and potentially serious complication of gastric bypass. I'm disappointed that this possibility was not part of the "informed consent" that I gave for the procedure. I'm a health care professional, so perhaps my standards are high, but I think we all should have high standards when considering our health and safety. And for many of us, it's a hell of a lot of money. So, if I had to do it all again, I'd go with a different organization. Best, Kerri

If I have carbs of any kind, my blood sugar will shoot up above 10 mmol/l because of the rapid emptying into my small intestine. This then causes an over production of insulin leading to a crash as low as 2.2 mmol/l within a couple of hours. The glucobay helps slow the absorption of carbohydrates reducing spikes and then consequently reducing lows. My sugars are a lot better now; however, the meds don't do much if I have any simple sugars (ie. I had a piece of cake at my parents' anniversary and still got the spike and felt awful, but I didn't go as low as I once would have). One of the frustrating things is that when this was out of control, my weight loss stalled majorly for a couple of months. This was because my body was pumping out insulin which is responsible for storing fat. Since I've been on the meds, I've started losing again. I'm about 10 pounds or so away from goal. I'm still worried about the future as if it's this bad now, I worry about 1-2 years from now; however, the endochrinologist said that dumping syndrome can improve with time so this could also settle down. We really don't know as research in this area is still in its infancy.

I had mini-gastric bypass in September and started having issues with reactive hypoglycemia after only 4 mos post op. I had revision surgery after having a band for 10 years. I originally planned to get a gastric sleeve, but the surgeon strongly recommends the bypass for patients who are insulin resistant (I'm prediabetic and have PCOS). The hypoglycemia can be scary and I find my diet is now far more restricted than a Type 2 DM diet. I've seen an endocrinologist and am managing with diet (low carb, no simple sugars, high protein, regular snacks) and with taking Glucobay 4 x/day and a calcium channel blocker at bed time. I have to tell you, I regret not getting the sleeve and wish I'd been informed of this relatively common phenomenon prior to surgery (it's connected to late dumping in my case). However, one must weigh the pros and cons. I wish you all the best outcomes. Kerri

I had MGB in Canada in Sept/17. I was told that it was a less invasive surgery than RNY (one anastomosis vs 2) with fewer surgical complications, but similar outcomes to RNY. I had mine as a revision surgery 9 months after having my Lap-band removed. I lost steady in the first 3-4 months, but then slowed due to issues with hypoglycemia related to late dumping syndrome (blood sugar was spiking immediately after eating any carbs then dropping rapidly. Too much insulin production = poor weight loss.) Now that I'm getting this under control with medication, I'm losing again (only 14 pounds from goal). However, taking into account these complications, if I had to do it all over again, I think I would have gotten the sleeve.

Try not to be too hard on yourself. I had to have my band removed after 10 years and gained back a good portion of my lost weight in the 9 months before I had mini-gastric bypass. If you look at the research, over 90% of people regain after removal. Your body and metabolism have become accustomed to a small amount of food, so it's no surprise that you're gaining even if you're eating a "normal" amount of food. You have no restriction and there aren't many who could only allow themselves 1/2c of food per meal without that help. I'm 6 months out of surgery and have lost all the weight I regained and more. Just eat well, stay active and don't beat yourself up. The weight will come back off.

Thanks! I think the pouch size can depend on the surgeon's preference. Also, I was originally considering a sleeve and one thing he mentioned is that you're generally able to eat more with the mini-gastric bypass in comparison. Honestly, I could do almost a cup of solid food at about a month out which initially had me worried, but my capacity has stayed fairly constant. Definitely depends on what I eat. Solid proteins certainly fill me up faster, but I'm also pleased that I can eat a good size portion of salad (one of the many things I could not tolerate at all during my 10 years with the Lap-band). My diet is much more balanced and sustainable this time around. Like most people, diets do not work for me. What I've got going on now feels like a reasonable, realistic, long term way of eating.

I did the usual progression of liquids, full fluids, purees and soft food for the first 4 wks, but otherwise started eating fairly normally by a month out (60-80g protein, low carb etc). My surgeon gave me a fairly "generous" pouch that allows me to eat about a cup of food comfortably. At first I was worried as I was used to being way more restricted when a had my Lap-Band; however, the weight is coming off (I'm 6 mos out and I only have another 15lbs or so to make my goal) and I don't have that ripped off feeling after meals that I did with the Lap-Band.

I had my Lap-band removed after 10 years last year (got too tight). Despite giving it my all, I gained back quite a bit of weight over 9 mos (most people do). I had a mini gastric bypass in September and that weight is gone again. My advice is to do your best. Keep up with good habits like regular exercise and eating well and try not to be hard on yourself if you put some weight on. Good luck!

I'll admit that I'm having a few. I am dealing with some serious reactive hypoglycemia 5 months post op. I had the surgery to avoid diabetes. Now when I eat, my blood sugar spikes (even with careful avoidance of simple sugars etc) and then drops dangerously low about 2 hours after meals. I'm learning that this is a more common consequence of gastric bypass than I initially thought. I had originally wanted a gastric sleeve, but the surgeon felt mini gastric bypass was a better option for someone who is prediabetic. I was not warned about this potential complication.

joy59: Did you try acarbose? Are you finding this issue has affected your weight loss? Things have slowed down for me considerably since this became an issue. My biggest worry is that the hypoglycemia will continue to get worse as my surgery was relatively recent and most people don't start having this problem until at least 1 year post op. Kerri

I'm only 5 months post mini gastric bypass and have been experiencing this for the past couple of months. My sugars spike (10.7 mml/l) about 15min after eating and then drop at about the 2 hour mark (2.1-3.0 mmol/l). My fasting sugars are normal. I've tried really hard to modify my diet (ie. no simple sugars, only complex carbs, lots of protein etc), but it isn't making a whole lot of difference. I called my surgeon's office for support, but they weren't helpful at all and directed me back to my GP who knows little about this phenomenon. I did get her to start me on a trial of acarbose to help prevent the spikes, but I'm only on a very low dose to titrate, so it's not doing much yet. I see an endochrinologist next week. From the research I've done, it seems this is a fairly common issue after gastric bypass; however, many individuals are asymptomatic with low blood sugar, so don't actually realize it's happening. I was very symptomatic in the beginning, but less so now. However, it's scary seeing my sugars go to 2.1 mmol/l. I read these scary articles about people needing to have partial pancreatectomies and ending up with G-tubes and it scares the hell out of me! I had my surgery to avoid Type 2 diabetes (I was prediabetic). Be careful what you wish for I guess!

I had MGB at the end of September and did fairly well the first 3 months and then didn't lose much for a about a month despite my best efforts (eating well, exercising lots). I was starting to think maybe I'd hit my set point as I was at the weight I'd been for many years before I had to have my Lap-band removed. But low and behold, the scale started moving again last week. I did wind up going back to the protein shakes in the morning to help me get the protein in (I was slipping a bit with this), so this may have tipped the balance. I agree: stay away from the scale. I only weigh myself a maximum of once per week. And I skip the weekly weigh in around my period!

I had my Lap-band removed after 10 years because it got too tight even completely defilled (apparently they lose their flexibility over time). I'm from Canada, so the removal was covered by our national health care (I paid for the initial surgery myself, but the removal was covered as it was deemed "medically necessary"). Although I tried my very best, ate a very moderate diet and continued to keep up with my fitness routine, I gained back 50 lbs in 9 month, so had a mini gastric bypass in September 2017 (self pay again- yay!). So far I'm much happier with this surgery and wish I'd done it in the first place.

Have you had any previous issues with blood sugar prior to surgery (ie. insulin resistance)? I'm having a lot of problems with low blood sugar since my surgery in the fall and that can certainly make you feel dizzy and tired...

Hi Maryjo, I'm glad to hear from you. I had lap-band in 2006, did fairly well with it, but it got too tight and I had it removed last year. I tried life without it, but unfortunately gained a good portion of my weight back, so had a mini gastric bypass in September. I have PCOS and have had gestational diabetes 3 times. I'd been on metformin (long acting 1000mg) for several years to manage symptoms and as a preventative to DMII. All was going well and I was losing weight fairly steadily. However, about a month ago I started getting low readings (3.0) and was symptomatic. I went off the metformin about 3 weeks ago, but continue to have reactive lows (fasting is fine) about 2 hours after eating. I've cut out all simple sugars and am really trying hard with the protein, but still struggling. My GP thinks the metformin is still in my system. I'm trying to figure out if this is just big sensitivity to carbs and late dumping or something more significant. My GP isn't too concerned and the surgeon is across the country. I called the nurse and dietician at the surgeon's office, but they didn't seem to know much about the phenomenon. I'm thinking I'd like to discuss this with an endocrinologist. I'm pretty worried about this. Kerri MGB Sep 28/17

I'm also about 3.5 months out and haven't really lost anything for a few weeks. I don't feel like I've changed much eating wise and I work out 6 days/week. However, I had a Lap-band for 10 years and was about this weight for 7 or 8 of them. I'm wondering if I'm dealing with a bit of "set point" issue here.

I was on metformin for years for PCOS and as a prediabetes preventative measure. I had mini gastric bypass surgery 3.5 months ago and since then I've been having issues with low blood sugar. I went off the metformin a few weeks ago, but continue to be low (3.1-3.5) throughout the day about 2 hours after meals. It has me a little worried as hypoglycemia can be a side effect of WLS. This could be late dumping although I am consuming very little overt sugar. I likely have to be more judicious with my glycemic index and get more protein. I'm seeing my GP this week to discuss this.

Thank you both for posting these. I think this provides a more realistic picture of how the weight comes off. Also, it's great how it shows the difference between the rate of loss of those in higher and lower weight ranges. I think some patients in the lower 200 range find themselves disappointed or discouraged when they're are not losing at the same rate as another in the 400lb range. However, losing at that same rate is not the norm and in general, the body adjusts to the loss better when it isn't too rapid (especially those who are a little older with less elastic skin). Patience is rewarded.

I'd had my Lap-Band 10 years when I had it removed last year. It had become too tight even without the fluid. I'd maintained 60 of my 80 lb loss for 8 years, but if I'm honest, I was miserable with that thing. Instead of being disappointed when I was told it needed to be removed, I was relieved. I don't think I would have come to that decision myself as I was so afraid of gaining it back. Predictably, in less than a year, I'd put on 50lbs despite eating relatively little and upping my exercise frequency. I had a mini-gastric bypass almost 3 months ago and I'm really pleased so far with how things are going. The weight isn't flying off, but the loss is steady (I've lost 45 of the 70lbs I'd like to lose). I can eat more than with the band (about a cup), so I don't feel ripped off all the time. I seldom vomit and when I get full, it's gradual and feels natural. I tolerate most foods, so my diet is way more balanced and varied. I do experience dumping which is unpleasant, but I'm learning its triggers (sugar, high GI carbs etc) and am avoiding those foods. As I was an insulin resistant "sugar enthusiast," this is not necessarily a bad thing. I'm developing some aversions to sweets and therefore, don't really feel all that tempted or deprived (even at Christmas!). All in all, I think you will be really happy with your choice and only regret not doing it in the first place. Good luck!

I had a Lap Band for 10 years and so wish I’d had gastric bypass in the first place. Eating is so much more normal and I’m eating way healthier because I tolerate everything except high sugar foods. Fullness is gradual and my capacity is larger so I don’t feel ripped off. The weight isn’t flying off, but I think I’m doing well and feeling really good. I don’t think you’ll regret your decision. Good luck!

I only had to crush small meds for a few days. By a week out, I was given the ok to swallow pills the size of a jube jube. I've been stable on an antidepressants for many years and was worried that MGB might interfere with my response. However, I'm a month out and feeling just the same emotionally. My surgeon reassured me that it is unusual for dosages of psychiatric meds to require changing after MGB. However, if this is case for you, you should talk to your prescriber about whether you might need a higher dose. Good luck!