PatientEleventyBillion

You have surgery tools thrust through your abdominal cavity. I imagine there will be pain post-op. Are you on pain relief meds?

Holy.. That is night and day.. great job! You can PM me if you feel at all comfortable answering, but did you need any skin work done? This a thing that concerns me going from a 30 inch waist to 61 (down to 52 now).

Good luck with the clot. I hate being such a picky eater.. I don't know if it's my hyperactive taste buds or my hyperactive brain. I love popsicles but have tried those sugar free ones and can't stand them. Really am wondering what I can tolerate immediately post-op.

Fat is a heat insulator. Lose a lot of fat, lose a lot of insulation.

Yeah, I'm thinking some people don't need both or don't get both so they might think there's only one procedure. But given my GERD that's lasted quite a long time regardless of my weight, they said I was a must for both of these. If one just goes into a clinic with an Upper GI stated on a requisition, they're likely doing the barium swallow. If they go to a day surgery department in a hospital, that's the EGD. Edit: I've heard that some people have it done at private doctors offices in the US. Never had surgery my entire life living in the US (this will be 2 in Canada) so take this post here with a grain of salt.

Oh yes, before I forget.. the tangy pellets they gave me were gas pellets that effectively inflated my stomach causing gas to build up. I could not burp or swallow or else they would give me more. Not to mention the swallowing thing would give tremendous gas. Thankfully I made it. Afterwards was also burping my head off.

I was wondering where the outrage was all those years ago with the "pink slime" controversy. Just came and vanished. This is like nothing..

Yes, that's the EGD aka "endoscopy", "scope", etc. Depending on one's surgeon and doctors, likewise depending on GI issues, one could need both. I had the barium swallow in like January, and the EGD last monday. Despite the barium swallow showing "moderate reflux" (which concerns me for post-op since I'm already on PPI's, although I was an idiot and dosed myself every other day to every other two days), both were perfectly fine so have the thumbs up for surgery day.

Cannot fly fast enough. First few weeks I lost like 35-40 pounds.. I was pretty much ready for surgery then. All these extra weeks is just torture.

Mine was a barium swallow. Couldn't eat or drink anything for 8 hours.. as a diabetic this was torture. Then I was given some super tangy pellets that looked like uncolored dippin' dots. Then they made me swallow 6 cups of barium fluid, which is just disgusting.. not sure what's worse, barium drink or Glucerna. Then they took some x-rays of me. Then I had to drink more barium drink, they flipped me nearly upside down on this same machine, took more x-rays, then I lied down in different positions with them taking more x-rays. I hadn't started my liquid diet yet at that point so I rushed to get a burger to stop feeling sick to my stomach. Then of course poop turned fricken pale gray for 2 days because of the barium.

Yeah might be among the handful of things to ditch post-op.

I imagine there was a valid reason for your surgery (especially if done in Canada).. comorbidities associated with obesity, and the severity of these that leads to decreased lifespan, tend to drastically outweigh the annoyance of taking PPI's for reflux.

Only ever ate the mealball marinara anyways, but they don't have a sub small enough for a VSG patient and neither my daughter nor wife like my specific sub to share (meatball marinara on italian herbs and cheese, cheddar, sprinkle of parmesan, and loaded with lettuce.. not toasted) so I can't see how I'll manage subs anyhow.

Does your doctor require a pre-op liquid diet? My surgeon required a 12-week pre-op liquid diet. My dietitian (RD) was pissed off and said she would set him straight and get the diet time reduced. I dunno what occurred but the surgeon won as I expected. If so, how long are you to be on it? 12 weeks. What foods are recommended? My RD actually put me on a specific diet of Glucerna (6-7 a day), 1 serving of Sugar-Free Jello, Broth, and 3.7L of water a day, along with allowing a cup of non-starchy veggies (wouldn't even know if there are starchy vegetables) What foods are allowed and not allowed? Very simple diet.. low carb (incl. sugar), low fat, high protein diet. I have deviated substantially from the diet my RD wanted me on, sticking to the premise of the diet, having less calories and carbs than even her diet would have got me, and am still dropping weight pretty fast. My fav cheating foods during pre-op are natural peanut butter (low carb, low cal, high protein -- stuff is very watery), unsalted peanuts, and string cheese (0 carbs). I had thought pepperoni was fine but after reading more studies against processed meats during pre-op I decided against it. No matter what I drink tons of water.. doing my best to be 30+ mins before/after food. Water is very important especially during this kind of diet. Is the goal ketosis (liver shrinking)? Of course. Two aspects. Advanced liver disease can crack and bleed, causing major artery/vein hemorrhaging that's incredibly difficult to deal with. So improving liver disease and shrinking it is beneficial two-fold. Secondly, large livers or ones with fat on them can make it difficult to move out of the way. The big one is slipping. Fatty livers are more slippery. This diet, when done properly, reduces the fat around it to make the job for the surgeon easier, or in some cases, do-able. I've heard of cases where surgeon went in with laparoscopic tools, saw either too large/fatty of a liver, or too much of a damaged liver, immediately patched them up and said "no". Obviously nobody wants this to happen. I had others issues that have greatly improved since. My HBA1c has dropped to normal levels.. by my next HBA1c test I likely will be tested without meds as it will drop more than sufficiently (high was 7.9mm/180 on US glucose a year ago, recent test was 5.7mm/180 US glucose after numerous drops), the swelling around my lower legs and feet has resolved almost completely, and liver function tests have gone back to normal after a year of being highly elevated. This combined with the weight loss, as my surgeon said, shows the liver is shrinking well, but most people don't have my problems so..

Makes me wonder.. I'm on those meds myself (HCTZ/metoprolol). Thus far nobody has said anything about needing to be off those but still ages away. I believe I also have 1 more pre-op appointment with my surgeon a week or two before surgery so maybe I might get the news there.

I liked all your post until this part. I think you're putting the surgery up on a pedestal. While we wouldn't be here without it's obvious benefits, the real changes are psychological. It's easy as hell to "beat" the surgery if one isn't committed psychologically to the lifestyle changes required -- then one is back where they started. Then what? Another surgery?

If it were that easy we'd not be at this point, but your post certainly adds substance worth thinking about. The benefit of these surgery tools (and I call them a tool because alone the surgery is useless) is the added help with portion control -- the physical changes like dramatically decreased appetite and satiety changes. The other problems need to go, and the person needs to psychologically succumb to the necessary changes that need to happen BEFORE having the surgery. Some may compare it to AA, and in some ways it's similar. Food can destroy a liver and other organs just as potently as booze. In my case I also have severe ADHD so I've had to learn how to cope with that and the redundant signals my brain gets that I'm either hungry or need to eat for (insert reason here) has had to be trained to be ignored and to listen to my stomach rather than my abnormal brain.

What really matters is comorbidities associated with being fat. If your liver is fine, if you don't have advancing diabetes to a point where you take insulin, have some type of heart condition, etc., I don't see the urgency to get an RNY done. Even with me I had 3 surgeons (my surgeon in particular who, after speaking to many people who work with him, noted he LOVES the RNY) all convince me to go sleeve mainly because my liver fibrosis stage 3 and diabetes (which are definitely a big health risk) were very much under control and quickly improving. Post-op the VSG gives you more freedom without the RNY side-effects, plus the inherent risk to both the RNY surgery, which is greater than VSG, and the risk/complications later on if you require any major surgery in that area, should always be taken into consideration. People in the private industry who push certain surgeries may be doing so for their own benefit and not yours. If your surgeon recommends bypass get a list of why and possibly get a second opinion. If it's based on general assumptions rather than your personal conditions (if any) then it's doubtful that's much of a necessity. Bypass is supposed to be for people with more serious issues necessitating the increased risk of complications. That's why for people aged 50+ I see it's very much more often RNY. Keep in mind too that any good surgeon will offer a follow-up on a VSG so that in the case it doesn't work out as planned an RNY is still an option. This is the case with me.. am offered RNY after 1 year if I don't like the way the VSG is going.

I wouldn't say binge eat.. the last week before pre-op diet I had certain fast food once a day thinking I'd never be able to have it again. Problem with that mindset is you most certainly can. The difference therein lies in the portions, so plan ahead to split accordingly (easier if you're married/have kids). Also, frequency, of course. For example, even on the pre-op diet I'll have my wife order a Wendy's Triple, I'll steal one patty from her and she'll have the rest. That's maybe 100-200 cals and like 9-15 grams of protein, and maybe a few grams of carbs if any at all. Post-op I doubt I could even stomach a whole patty so I'd probably just share a patty with our daughter, with me having maybe a few very tiny bites. Wife would move back to her double, or less because I think I'm starting to convince her to get on my level with this low carb/cal and high protein diet. Therein I think lies the secret to nutrition that many of us have been unable/refusing to do.. portion control. For those who obviously would have no self-control post-op, would be better to avoid completely. I, however, would only impose such controls and not restrict myself in that way, other than to avoid utterly useless foods that have absolutely zero nutritional value like soda.

jeez that's like my preop thus far Really hope vsg works for me.. surgeon offered rny if sleeve doesn't go as planned

My surgeon is a poopie head. It's funny because I just saw him for a 4 week followup from start of liquid diet and he even admitted I was ready for surgery. We went over my weight loss, my liver function results (normalized liver function tests after 2 yrs of high/dangerously high), my HBA1c drop (from 6.1 to 5.7 -- 1 yr ago was 7.9), etc. Guess they didn't believe I'd follow the premise of the diet and not lose weight. Oh well. Good news is it's post-semester (due to them moving my finals for me closer by a week) so.. not gonna interfere with a lot. Just hope I'm not as tired post-op as I was at the start of the liquid diet. I feel like running around.

I just want to say that I hate all you 2 week liquid dieters. - a 12-week liquid dieter

Yes, also find out from your doctor what minimum and maximum dosages are for you to take yourself. For example, if I know I'll be having spicy food and the type of stuff that would piss off my GERD I'd make sure to couple it with things that would offset it, and maximize dosage. Every other day where I eat normal food I'd keep to the minimum required. One of the things I'm still in need to learn from is whether or not taking a PPI like Lansoprazole is ok post-op, but given all the responses of people taking PPI's post-op I'm guessing it's fine. I am definitely curious what meds will need post-op. Not looking forward to the 50 appts afterward.

Indeed, I'm turning back to being old fashioned.

Yeah, we are all different and if I hadn't gone through what I have, I would say for sure I'd need a tracking app.