PatientEleventyBillion

Yes. When I did two second opinions because I had wanted the bypass, after meeting with the other two surgeons I then realized my appreciation for having Gill. They say he's a big fan of bypass, but it's clear he's reluctant to do them on people our age, even in my case with advanced liver disease (although mine is controlled and improving). Is he doing yours in Edmonton? If so I feel bad for him in running back and forth between there and Calgary. I know he has an office in High River, which is where I'm going Monday to see him for my endoscopy.

Richdeep Gill? LOL. I think we might have the same surgeon.

I see you're also in Alberta, would you mind me asking (you dont need to answer if you're not comfortable) - Do you have any fatty liver or staged fibrosis? - How long is your liquid diet, in weeks? - Have you had this weight for a significant amount of time or has it climbed recently? It's weirding me out the fact that even other people in my group and classes with comparative diseases are only going on a liquid diet for 4-6 weeks at most and I'm forced to 12. Even though I'm fighting the odds, I have my endoscopy on Monday w/my surgeon and I'll have him look at my liver and see if I can have a new OR date if it's shrunk, or modify diet a little. Doubt they'll do it but worth a shot.

For a lot of people it's worth it because alleviating the comorbidities that associate with weight gain supersedes temporary superficial annoyances that may or may not occur.

I've gone 24 days on mine and while the insane hunger has gone away (the hunger torture lasted a few days), I still occasionally get shaky, dizzy, etc. especially if I get up quickly.

For me, the first appointment was a general QA session with surgeon and several patients followed by private consult. Second appointment wasn't much of an appointment just walked into the office, signed surgery papers, and left. YMMV.

I understand, and see your decision is indeed a tough one. Crossing my fingers everything works out.

My surgeon and two second-opinion surgeons all chose sleeve but did not force me to make a choice. Their arguments stemmed from the following: - My age (34) - Despite having stage 3 liver fibrosis and diabetes they were both new and controlled (w/blood workups showing improvements via dietary changes) - Sleeve can easily later be remedied with a bypass (not an option to everyone, esp those worried about insurance coverage) - If one ever needs invasive surgery done later in that abdominal region (including liver transplant) the bypass can later cause complications. Those who aren't considered "dire" bypass patients (in a risk assessment bypass is almost always more risky, even if the gold standard) might be coaxed into a sleeve because of it being minimally invasive in comparison - less cuts, less routing, etc. If it's left up to you, it's your choice. I would ask a lot of questions, especially on if bypass is an option later, both from your surgeon and your insurer if you're going through them.

I know exactly how you feel.. I have to drink Glucerna and the only way I can tolerate even one flavor is if I don't let it touch the front of my tongue, otherwise will regurgitate it.. unlike most people I have to deal with this for 12 weeks

most people I know that had this issue were simply eating too much

In my case I was given a choice but I had a couple second opinions and every surgeon, even one who prefers a bypass, suggested sleeve. When they first said "your age", that was, to me, an utterly ridiculous assertion. However, having seen a number of complications for surgery in the area of the stomach or liver down the road with those who had a bypass, it was clear sleeve was the better option. Plus, if you have a good surgeon, they will give you the option of a bypass 1-3 years after sleeve if it's not working out for you the way you want it to. In my case, while I have a number of serious issues, they were all stabilized well and the indications were that they could all be easily reversed. Every situation is different though.

I think of it in a Charlie Sheen sense regarding hemorrhoids, if I tell them about it, they'll leave me alone and quit speaking to me. Win/win.

I concur, it's no one's business. If a person wishes to tell others anyways that's their prerogative. However, outside my wife, a best friend, and the Leaner Services department of my university, and of course wide array of medical professionals I see, nobody else knows or will know.

yes and no When I was in high school and thrown off the football team for chewing out the coach I went through a huge weight gain -- coincided with drinking tons of soda and such Normal weight was 180, but shot up to 240, but easily lost it within a few months doing tons of situps, pushups, and eating nothing but a couple Peanut Butter and jelly sandwiches a day. Weight was fine for years until a post-relationship depression went on (when you work hard for years to keep a relationship going then decide fuck it), in my mid-late 20s, a bunch of health issues arised and shot up again but instead of from 180 to 240 in a matter of a year or so, went up to 360 in 5 years. So I'm here in my early-mid 30s with newly diagnosed stage 3 fibrosis and type 2 diabetes. I'm not accustomed to weighing a lot so the changes I went through were all debilitating to me. Apparently after MRI's and such I had fractured my spine as a kid but never knew it until I had this weight gain, then moving to another house caused me serious injury to where I need facet injections in my lower lumbar (soon to be some sort of ablation) as simply taking out the trash caused extreme amounts of pain to my back. In the US, we're not educated enough how utterly useless carbs and especially sugar are in the diet, and how easily we can get into dangerous territory without thinking about it. Given how it's turned into a serious societal issue where kids in their 20s are having fibrotic/cirrhotic livers without even being alcoholics or drug addicts, it really points to an education being necessary. Since being in Canada, I've noticed the education is a little better, but still needs improvement. It's definitely a western problem, where we're taught to be good little excess consumers with little regard for our health. It's up to us to change that. My surgeon decided on a 12 week pre-op liquid diet that I started Feb 1st, far longer than I see anyone else with, already I went from 350 pounds to 314. I'm thinking if I really have to go all 12 weeks (OR date already confirmed April 20) I'm likely gonna be in the 200s before surgery. Some have said why not be on this miserable diet for so and such amount of time to get back down to normal weight, but sometimes for us mechanisms of hunger (satiety) we can't control are required to be corrected. In my case, the surgery should accomplish this. Also, a very important point, that for many of us who "become" this way, it's up to us to recognize where we screwed up and work to change it. Personal responsibility is a must.

its funny I lost about 20% in the first few weeks and they want me on 12.. will be seeing surgeon for endoscopy on Monday hope he can change the date

Hello fellow bariatric patients, I'm in Canada, my surgeon wanted a 12 week liquid diet pre-op. Before I get into the details here's my story in highlights: - 34 Male, 5ft11in (180cm) - Severe weight gain over a few years (from 180 to 360 peak in 5 yrs) - Caused a number of sudden issues (stage 3 liver fibrosis, pre-diabetes/diabetes, increased GERD, L5/S1 compression fracture, high bp/pulse, depression, etc.) - S3 Liver fibrosis: initially diagnosed cirrhosis w/fibrotic scan but after biopsy (which they did after I told them I'm not an alcoholic) revealed stage 3 fibrosis&no cirrhosis - prior ultrasound suggested 19cm or larger, not sure - Diabetes (5.4 1 year ago to peak 7.9, down to 6.1-6.4 now and likely will drop again w/March 1st A1C workup) - Everything is currently contained w/meds (10mg forxiga, 2x metformin tabs 2 times a day, hydrochlorathiazide (1 small tablet a day), cipralex (1x tablet a day), metoprolol 75mg 2x day, 1 capsule of prevacid generic, 2 Vitamin D tablets because Canada) - resting hr 50-80 (previously 80-110), bp 110-130/60-80 (previously 150-175/100-115) - Initially suggested bypass but because of age (34) had my surgeon and two second opinions all suggest sleeve so I wasn't gonna argue, they said if I didn't like results of sleeve could get bypass after 1 yr - 12 week Liquid pre-op diet started Feb 1, OR date April 20 - Dietitian was pissed off at 12 week diet saying she will talk to surgeon, obviously didn't convince him - Weight changes: (ignore the column to the left, I haven't figured out how to change it) ∙ Feb 1: 350 ∙ Feb 4: 336 ∙ Feb 15: 322 ∙ Feb 17: 319 ∙ Feb 22: 314 Daily Pre-op diet plan (1400 cals): - 6 bottles of Glucerna (<- yech) - 1 serving of sugar free Jello (4x per container) - 4-9 cups clear fluids (i.e. broth) w/extremely low cal/carb - 2 scoops Beneprotein - 3.7L water I have to say, this has been the hardest thing in my life. Not so much the sticking to diet part, but keeping down this Glucerna stuff. It's so disgusting! I couldn't help but regurgitating the stuff in the first few days. I had 1-2 Glucerna for the first few days, resulting in being extremely calorie deficient. Even with my wife helping trying to flavor w/spices (i.e. cinnamon) for berry/vanilla I just couldn't take a few flavors, wound up settling on chocolate, making sure the stuff never touches the front of my tongue, otherwise I'll upchuck. Stomach was going nuts w/hunger the first few days, since then haven't been able to stomach more than 1-3 Glucerna a day, eventually it stopped bothering me so much - but has resulted in first couple occurrences of "lows" (low blood sugar). Have been eating more broth though closer to the 9 cups, and taking multivitamins, and having daily amt of Jello. Body seems to do fine. Haven't had a normal stool the entire time, all liquid.. (I assume thats normal?) The concern of mine is my paranoid dietitian freaking out and nearly wanting to call off the surgery because I wasn't having the amount of Glucerna she wanted. To the point where I had to lie to her about how much I was having a day, as I've waited 1.5 years to get to this point. Can't see how going nuts on me is productive. Already have my wife nagging at me. Has anyone had an issue w/not having sufficient calories not causing liver to shrink going into surgery? Or light malnutrition affecting whether or not surgery was done? Pretty much everyone I read has like 2-6 weeks and I'm stuck with 12. This is absolute misery, but I'm perfectly ok doing what I'm doing as long as the end goal is met and nothing causes my surgery to be cancelled (i.e. liver not shrunk enough). Steven