KateinMichigan

I am so glad to hear it’s still going well after 2 months! As you off the PPI’s?

I am so excited for you! What you’ve been through sounds horrible!!! So glad you’re on the mend. I think there are a lot of people who will want to hear how going off the PPI’s go. Please share with us! Many of us are on PPI’s - and they have their own host of problems long term. If this procedure allows people to get off the PPI’s - your surgeon will have patients lining around the block:)

Wow! I’m so glad to hear this worked for you! Could you share the results? How bad was your GERD? Are you off all PPI’s now?

The acid has nothing to do which what you eat. It’s the shape of your new tube stomach that causes it to slide into your esophagus and also the pressure from the new shape (drop a stone into a narrow vase, and then drop a stone into a bulbous bottomed shaped vase. See how the narrow vase has water splash all the way out? That’s acid on your new throat and esophagus.) A cup of water gives me acid reflux. I think it all depend on the elasticity and shape of the stomach after it heals. If your internal stomach is all stretched out like an old bag, you probably don’t have to worry. If it heals taunt- you’re part of the 40%. 6 day old cohort study fresh off the presses: https://assets.cureus.com/uploads/original_article/pdf/82323/20220310-21437-wv3yrx.pdf Ask him about a larger final size. Ask him about bougie size and how he decides which size to use. Ask about what he does to ensure it doesn’t slide into your esophagus. Ask- because once it’s done, there’s no going back. Lastly, please consider a second opinion from someone who leaves more of your stomach in tact. My surgeon said it was a insignificant percentage and downplayed it when I asked. When I developed the problem, he pulled a Gerd specialists card out of his pocket - on the ready. Ask who he send his gerd patients to, make an appointment, and get the real story. If your surgeon is really that good- the gerd specialist will tell you how few patients he sees from him.

The study of 40% of women having acid reflux after came out in 2022. (Google with "2022" and you'll find the cohort study). My surgeon was at the forefront of this surgery, and taught others how to do it...he wasn't a newbee - I chose the best - lol. A male friend of mine had it with him 18 years ago had no problems. Another male friend of mine who had it with him 10 years later is on the PPI train - go figure. From what I see - nothing has really changed except they now "fix" the hernia you didn't know you had. This "fix" has a high failure rate - but probably buys the surgeon time. You won't have problems until a year or 2 down the line, and now you're someone else problem. I'd really look into the mini sleeve. It leaves a lot more of the stomach, and the fundus...which in theory will prevent your new tube stomach from sliding up into your esophagus. They're doing it in Europe and Mexico with some success. Ask your surgeon if he'll consider it. Maybe a larger Bougie - done by some surgeons - not others. If your doctor does a "one size fits all" bougie selection - find someone else. Plus - if you do have GERD, you'll need the some fundus for GERD surgery - which you won't have with the traditional sleeve. https://mexicobariatriccenter.com/services-list/mini-sleeve/ best of luck! PS - you are brilliant for asking these questions.

AMEN. And women get if at a far higher percentage - so 35% is a bit low for us ladies. My biggest mistake was coming on here before surgery and only wanting to hear the success stories. I wish I would have asked - "are you currently on any reflux medications?" You'd be surprised by how many people are on high doses of PPI's and singing the surgery praises. I'm a 17 year vet, I know the truth, and I was a lucky one - I didn't have it so bad that I had to get a bypass. These early praisers might not have experienced the PPI side effects yet. The iron infusions, the emergency room visits for kidney stones, the energy crashes, the daily nausea, etc. You can't undo or fix or medicate this...I've been searching for years. Listen - my sister is "fat" like I was. She didn't have the surgery. She is still fat, and is prediabetic...but her last 17 years have full and happy. She's enjoyed life, traveled, enjoyed her career, found and maintained a loving husband, enjoyed life with her children, etc. Here laugh is real, and deep ... I miss having that. I couldn't play with my kids a lot - too tired. I couldn't enjoy eating with them - not really. I was in the emergency room this christmas with kidney stones - again. Several times in the ER when my iron plummeted and needed an infusion (I take all my vitamins - doesn't matter). I vomited out the window on my husbands birthday because my PPI failed and I forgot my tums. If I could trade my size 2 body for her size 24, I would in a heartbeat. I sometimes get someone saying "aren't you glad you got the surgery - you'd be like your sister if you didn't". They always get a shocking earful. Now if you are unable to get out of bed, or walk, or function - get the surgery!!!! But be careful of the cheerleaders, especially those who are still trying to convince themselves that they "made the right choice". Many here are freshly out and still in the honeymoon stage. I remember that stage - lol.

Let’s not pressure anyone into a surgery with risks. This isn’t “treatable” GERD. Many convert from a VSG to a bypass because the “gerd” is that bad. (A simple search here will show you what kind of GERD this is.) in fact, I don’t thing they should call it GERD at all. It’s like calling a “cluster headache” just a headache. I do agree with one thing - if obesity is killing you - get the surgery (the risk makes sense). If it’s not, then pass. For some weird reason, men aren’t experiencing this sort of GERD at the same rate or intensity - (Google 2022 study). Best of luck with whatever you choose. This is one time when you need to look at overall statistics- not individual experiences. Not even mine. If you’re OK with a 40% chance of horrible acid reflux (I never experienced it until after surgery) because your health is failing you - then I completely understand that. But it’s not a “pop a few tums” sort of GERD. Google long term PPI use.

A new 2022 study was just published about results 6 months out. 20% of men /40% of women end up with reflux. This is not the reflux you think you know. This is a sip of water needs meds /and or tums. If you’re just fat, but relatively healthy - this isn’t for you. I regret it. If you’re going to die without it - then YES - get it. If you have kids, jumping and playing with them gets risky - so does most exercise. Yes, you might get lucky and be part of the 60% - but those aren’t great odds….and many get reflux a few years later, and this study is only 6 months out. Many are ok taking the PPI medication because it seems to do the trick and doctors just want you out of their hair. The meds are a huge cancer risk and makes many nauseous. I’ve been nauseous for 17 years! I’m thin, but have been sickly the entire time. I so miss the “fat” me. I had to leave a profession I loved, am always exhausted, need iron infusions, etc.…search “iron infusions”, “vsg revision”, . “gerd”in here. I find the people who are most happy with vSG are people who were losing their life to obesity. if you’re just “fat”, but can walk, work, love, play, etc. - don’t do it.

In recent years I’ve noticed a spike in the “Hiatal Hernia Surprise surgery” stories shared on the forums. That’s when you wake up to your surgeon telling you he fixed a “surprise hernia” while doing your sleeve. What gives? My 15 years of suffering with GERD after VGS, (I never ate a Tums before sleeve) has lead me to extensive research on this topic. I’ve read ever medical paper, report, blog I can get my hands on. I’ve met with and spoken to MANY surgeons on this subject. THEORY ABOUT “THE SURPRISE” I have a sneaking suspicion that the sleeve surgery itself leads to a hernia in many patients. (See stats about De Novo GERD and VGS). The new stomach is lighter and thinner, with more internal pressure and can now easily slide into the esophageal area past the diaphragm to create a HH because the new shape allows it to. I wonder if VSG surgeon don’t want to scare patients with the stats (30-40% chance of GERD without HH repair), so they just throw in the “hernia surgery surprise” to skirt the conversation. if this happened to you, please share the details- so many would benefit from your story. Knowledge is power! For those who haven’t had it yet - have the convo with your surgeon- let’s eliminate the “surprise”. I’m also sharing my journey to find a solution for those currently suffering from GERD after VSG. Not sure why post VLS GERD is still the “Wild West”. So many different opinions on how to fix it - sheesh. What I’ve been told to do by different surgeons over the years, and what I’ve learned: 1) “convert to rny” This was an instant turn off, but I get why so many do it. The pain is that bad for some. A seasoned WL surgeon recently told me the conversion to RNY is problematic long term (yet many still recommend it). He doesn’t do it anymore. He’s fixed hundreds of these HH post sleeve with a basic HH repair, no- and only had to covert 1 stubborn case. He said the conversion often leads to gas, malabsorption, vomiting, exhaustion, nausea, with many converts still ending up with GERD! If you’ve had the conversion and are a few years out - please share your experience. 2) “go with a partial wrap” This particular Doc said he’d “figure out what was best to do once he was in there.” I lost all confidence in him with that last statement, but I didn’t even realize this was a possibility if your fundus has expanded. 3) “get the LINX” I’m allergic to fake metals (I get hives), yet this particular surgeon was ready to slap this metal puppy around my esophagus. Luckily, the maker ( J&J) posted a warning on their site for sensitive skin types: “do NOT, under any circumstances, put this in your body”. I might have considered it if I didn’t have the allergy, although it seems very problematic for some. 4) “get the ligamentum procedure with repair” This is an old surgery for GERD that involves using your internal umbilical cord. Because it’s so new for WLS GERD, I asked the surgeon if one of his success stories could call me. He obliged. A very sweet women called me, and went on and on about how great the surgeon was. But then she told me she was still on PPI’s and now had chronic diarrhea and dumping syndrome…sooo…back to the drawing board. 5) “Get the basic HH repair”. I’ve consulted with 3 seasoned WLS surgeons who are all on the same page (finally). These 3 say that they pull my stomach back into the right spot, tighten the diaphragm, and call it a day. One uses mesh, but the other 2 sited a recent research paper saying there is no advantage to mesh. They all said I’d have a 80-90% chance of being able to go off the PPI’s. Sorta a fantasy promise- but I’m liking those odds. Of course I’ve done my research and discovered the fail rate over the long term is high (30-40%) after 10 years. and I might have minor swallowing problems, and bloating- yea! But I can have it adjusted if it gets bad, so that’s reassuring. So I’m going in with my eyes wide opened and doing the basic repair, I hope it works. The recovery is long and difficult, but my alternative is PPI’s that are cancerous. Wish me luck and thanks for reading my rant:) I hope it helped a few of my Gerdy sisters, and if you’ve had the “surprise”, please share your experience!

Happy Birthday!!! Nachos and a beer without a side of Acid - lol. Sounds glorious.

Hi Lee - just doing my weekly check in - how’d it go this week? Is the pain better? Is it easier to eat?

Thank you for the detailed reply! You are such a success story and it’s so helpful for people to be able to read different experiences. I’m really curious about your fall. My surgeon told me today that “the bigger the hernia, the less weight loss success”, which made me wonder if hernia and weight gain go hand in hand. Did you have weight issues before your accident?

Hi Lee, I thought after a month it was supposed to get a lot better. The weight loss is a bonus, but the pain when eating sucks! Has the pain stayed constant - or is it slowly getting better? Is it really tight when you eat meats? Does it feel like it’ll get stuck? When does your surgeon say it’ll get better? What are some of your favorite foods/go to’s during this time? I’m guessing a lot of shakes - but do mash potatoes hurt too? Thanks!

Hi K- My surgery (and surgeon) has changed to August. (original Surgery clinic told me last minute that my insurance was “out of network and I’d be on the hook for the bulk of the cost). Found a surgeon locally and just saw him this morning. He does it robotically. He was a straight shooter. Said my success rate is more like 70% - not 90. Why? Because over time scar tissue causes the HH bubble that formed above the diaphragm to become less amicable to reshaping back into a natural shape once pulled below the diaphragm. a lot depend on how much scar tissue and how I heal. This misshape could still cause gerd. I’m just hoping that the surgery doesn’t make it worse. My new surgeon doesn’t feel it’ll make it worse. Gosh - such a hard decision.

Be glad that it was addressed! Wow - you’re on day 3! How are you feeling? I hear the HH repair is the bulk of the pain…don’t worry, it’s gets way better. If you get a chance to share your recovery steps, I’d appreciate it. I’m going into the HH repair soon and would love to hear what that’s like.

Hi Creekimp, I noticed you had the HH repair with your sleeve - brilliant. I also noticed you had no reflux. The reason you might have skirted reflux is because your surgeon addressed this. (Many still don’t). Do you know how big your hernia was? Did you have any signs the you had a HH before surgery such as reflux? How was the recovery? I’m Going in for a post HH repair because of de novo GERD, but hardly anyone in here talks about the actual HH part of it. Did you feel any tightness around you esophagus? Swallowing issues? Any feedback would be greatly appreciated!

So glad to hear many are being told upfront about the HH surgery with sleeve. Did you all know this in advance? (Already had gerd), or did they find it pre op? Recently read a new study that found a 50% increase in HH repair during Sleeve vs. bypass…so it’s obvious docs understand sleeve carries higher risk of GERD from HH than bypass.

Cont.. the new stomach is lighter and thinner, slides into the esophageal area because the new shape allows it to. The seasoned docs now realize that the sleeve surgery actually causes this, so after they create the sleeve, they tighten the diaphragm so a hernia can’t slide up right away. (HH repair has a large fail rate). why not be upfront about this? Why are so many waking up to the “hiatal hernia surprise!”

Observations. I’ve noticed a ton of people on this site who get VGS are waking up to a HH repair from a “surprise” HH. I had all the tests, and it didn’t show pre-op. It wasn’t until I experienced excruciating acid for the very first time when I awoke from surgery that I was sent to a specialist who found it. in my life I’m guessing that when they remove the stomach, the newly reduced and lighter banana stomach

This is such great news! I'm so excited to see this!!!!! Thank you for sharing... it's given me such hope.

I forgot to ask - did your doc use mesh? Did she tell you how many stitches?

Wow! I’m so glad it’s getting better. Are you off all PPI’s? I can’t even image what that would be like. I can’t even have a few sips of water without gerd. I’m surprised to hear it’s like the first few weeks of sleeve - did they do any resleeve/reshape touch up? I’m going under in 2 weeks. How’s the brick on chest feeling? How’s the pain? Any tips/advice or surprises would be super helpful.

Hi Lee, just checking in. How are you doing?

OMG - that kind of heat without air conditioning while recovering is a big challenge! The weather is just crazy everywhere. I'm in Michigan and our town flooded. Everyone's basements completely ruined because the sewer backed up into the homes. Everyone has spent the weekend emptying out their basements onto the sidewalk - it looks like a tornado hit. When we bought our house the previous owner had cemented the basement sewer drains and put in a sump pump, and we couldn't understand why. Now we know. They lived here for 80 years. Apparently, this sewer backup happens every 10-15 years - and they had had enough - lol. We were one of the only houses not flooded. I'm so glad to hear you're not getting any acid. I was wondering if you'd have the rebound effect from the PPI medication. How bad was your acid reflux? Was it at night, after meals, etc?