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!