silverwhitemoon

How are you doing now?

Here's my story, it's kind of long but I'll try to keep it short. June 30th I found a revision surgeon in Mexico who was able to take out my band and do a sleeve in one surgery. He is board certified in bariatrics (in MX) and is the president of the Mexican College of Bariatrics. Anyway, shortly after surgery, I got horrible GERD. Started off with one prilosec a day, quickly moved to two, and Gaviscon for symptoms, then on to dexilant. After a couple of days the dexilant wasn't working completely and I had to add some pepcids at night. I went to a local bariatric surgeon and he told me that because I had the revision in one surgery, that there was absolutely no way that my sleeve was the right shape. He said that the surgeon would have had to cut around the area of the band, leaving an area where acid would get caught and cause GERD forever. He said my only options were either: to take PPIs forever for the GERD or revise to bypass. And, insurance would never cover the revision to bypass. He said it was too early to do any kind of contrast study and told me to come back in three months. Yesterday I ran across this story: https://houstonsleevesurgeon.com/interesting-case-severe-acid-reflux-after-gastric-sleeve-surgery/ This patient's case is so much like mine. She had GERD for 10 years and mine has just started, but similar. She was "placed on escalating doses of PPIs in hopeless attempts to control her symptoms" and had "an incompletely resected gastric sleeve". In other words, it was pretty much what the bariatric surgeon had told me: "A retained gastric fundus may contribute to intermittent relaxation of the lower esophageal sphincter leading to reflux. Furthermore the gastric fundus may allow for an acid pocket to form in the vicinity of the gastric cardia leading to acid reflux. A retained gastric fundus may also cause delayed gastric emptying further exacerbating acid reflux. The gastric fundus is a posterior structure and it can easily be incompletely resected during sleeve surgery. " So, I contacted the doctor that wrote this and he wrote me back and we've emailed back and forth a bit. He is telling me that - if the surgeon left gastric fundus then it would be an easy fix to resect it and avoid conversion to bypass. He also said I would need endoscopy and a contrast study to determine what is going on with my sleeve. I see a GI on Tuesday and I hope he will help me with this. I'm excited about the prospect of getting rid of this GERD and keeping my sleeve, but this surgeon is in Houston. I'm in Florida. He suggested I find a reflux specialist or a surgeon here that could handle my case. If - the surgeon left fundus - I would have to find a surgeon here that would be willing to resect the fundus. That's clearly not the surgeon in town that told me "PPIs or bypass" I would have to find someone who would be willing to try the procedure that this Houston doc is suggesting. This is going to be difficult - and possibly expensive.

Here's a question - just curious... Do people who can eat just about anything prior to surgery find that they can eat just about anything afterwards? And do people who have tummy issues pre-surgery find that after surgery their sleeve is still sensitive - or more sensitive than before? Or is there no correlation? Discuss..... -Anne

Don't know what to say except sorry that you are struggling so much with everything. I know what it's like to want to eat everything in sight. I hate it. I struggle with it every day. Good luck to you.

I'll let you know in a year, how does that sound? Is that the appropriate time?

Yes, yes, and yes! It's like there is a cult of the almighty Sleeve and any negative talk is met with, "Give it time!" and "You'll feel differently later." I have even met people who say they love their sleeve and talk about how wonderful it is and then later will tell you about their complications - acid reflux, food aversions, vomiting, and then when I say, "woah! Why didn't you tell me about this earlier?!!?" and they will just say it's no big deal and change the subject. I know someone that I talked to before surgery. After I had the VSG she told me she has an atrophied kidney - (probably because of more than 9 years on PPIs that she's been taking for reflux.) I said that would have been nice to know before surgery. She said she wasn't sure it was the PPIs that caused the kidney damage. Oh, and she only throws up once a week because of reflux - it's not that bad. That's right - she didn't tell me that last part until after I got a sleeve. [ btw, "ad nauseum" - nice choice of words, Gina] I went to a post-op support group last week and met a woman who had a VSG 7 years ago. During the support group, she was talking about the joys of having a sleeve and she brought a friend who is planning to get one in October. But... on the way out the door to our cars I asked her about her reflux: "worse than ever" she said. She is on more medication than she was before the sleeve. Sleeve groupies. It's the cult of the sleeved. I swear if I end up liking this sleeve later - not sure I will - but if I do, I will never be a sleeve groupie. I will be honest with the pre-ops. When I b*tch about my reflux, I get "didn't you know that was a complication of the sleeve?" Well, yes, but I didn't know it was a permanent one, or that I was likely to develop it forever if I didn't have it already.

Exactly. I was under the impression that I would be able to eat anything - just in smaller amounts. That really isn't the case. I feel like I have set myself up for having digestive problems for the rest of my life. Also, I can't ever just eat. I have to worry about eating too fast, not chewing enough, whether the food I am going to eat will digest properly or whether it will contribute to the reflux that I now have after VSG that I didn't have before. I am two months out and regret doing this to myself. I am feeling less regret than I did immediately afterwards and I've been lucky so far (knock on wood) to avoid some of the major complications that others have had. I lost 35 pounds the month after surgery and haven't lost any more weight since then. I haven't gained any either, but I could have lost 35 pounds and kept it off without this surgery. If I could go back to before the surgery I would talk myself out of it.

Frankly, I can't believe you found a doctor who would actually do the surgery. That is a low BMI. Yes, at 22 you could have done it yourself and kept it off. Maybe not 52 pounds, but 35? You'd be 155. That's a great weight. "Yes, at 22 you could have done it yourself and kept it off". I feel like this comment is pretty hypocritical. Regardless of age, if we could do it ourselves we wouldn't have resorted to surgery. I'm now 33 and have been doing it myself for 10 years, losing, gaining, losing etc. Why not do it now so she can save herself the heart ache of going through what so many of us have gone through for 10, 20, 30+ years? Sent from my iPhone using the BariatricPal App I said that because IF she can keep that off then that would always be preferable to surgery, with its possible risks and complications. And, she asked. Hypocritical? No. It would be hypocritical if I had similar stats to hers. I don't. I am much older and have a lot more weight to lose.

Why did you want to revise from sleeve to bypass?

I am so sorry that you are having all of those complications, but I have to say I LOVE everything you had to say and the way that you said it. I recently voiced my regrets about having this surgery and got blasted by the sleeve fans on this site. It is not a popular opinion, but someone should voice it. Thank you!

I sure hope so if I have to have one. I see your surgeon was Dr. Aceves - he was the partner of my surgeon - Dr. Juan Arellano.

Frankly, I can't believe you found a doctor who would actually do the surgery. That is a low BMI. Yes, at 22 you could have done it yourself and kept it off. Maybe not 52 pounds, but 35? You'd be 155. That's a great weight.

You vomit from time to time and you are ok with that? It sounds like you gave yourself an eating disorder by getting a sleeve.

I was at my PCP's today and she gave me a funny look when I said the dexilant I'm taking wasn't taking care of all the acid and that I was taking two pepcid every night too. That's unusual I'm sure, but how unusual is it for a sleeve patient? I've had a local bariatric surgeon tell me that I will have no choice but to revise to bypass if the GERD is this bad at this point. My surgeon tells me nothing - just that it may improve, or might not. Is there anyone here who had really bad GERD after surgery that improved over time - even went away? Please, give me some hope. I really don't want another surgery. -Anne

Are you talking about gas? or gastric reflux? I'm talking about acid reflux.

I am about a month post-op band to sleeve revision and am having a horrible time with GERD. I started off with one prilosec a day and quickly figured out that that wasn't going to be enough. Moved on to two prilosec a day and that was working but I was going through a bottle of Gaviscon pretty quickly. I was still getting some acid in my throat every day. So my PCP gave me some dexilant samples and for about four days I thought that was the answer. No symptoms of GERD at all. On the fifth day, though, I was taking the dexilant in the morning and getting some acid at night. Yesterday, I got acid burps in the evening and today, in the afternoon. It's like even the dexilant isn't working like it did at first. I've been tracking my food and haven't been eating anything that would offend. I've cut out coffee, even though I used to love it. Staying away from tomatoes and potatoes too. I am really scared that this will get worse and then what do I do? What I'd really like to know - especially from sleeve veterans - is there anyone who had a big problem with GERD at the beginning and then got better? I hear so many of the other kind of stories - the ones where the GERD got so bad that conversion to bypass was the only option. -Anne

I am 25 days post op sleeve and I have been anxious ever since surgery. I feel like I always have butterflies in my stomach. Last week I went to the ER because my blood pressure was scary high and I felt like I was going to jump out f my skin. My bp was down in the ER and the doc gave me some xanax and sent me home because nothing was physically wrong with me. My pcp gave me some wellbutrin because she thinks that I'm not getting the dopamine response that I was getting by eating. I took that for about four days but the last two doses I had horrible nausea. I skipped it today and no nausea, so that might have been it. I hate this anxiety. Everyone tells me just to think positively but I can't shake the anxiety. I was happy before surgery. Worried about my weight and my health, sure, but happy. Now, I am anxious all of the time. I am losing a lot of weight and everyone else seems to be confused that I'm not more happy about that. I should be. I would rather be fat and happy than this. I would like to try some anti-anxiety medication but they have so many bad side effects. I could be trading one problem for another.

I donated blood just last week...no ill effects here! (and I was banded in June '07)

definitely! I noticed it when I order Chinese food and can make three meals out of what I used to eat in one sitting.

Before the band I needed to eat a large quantity of food to stave off hunger and to maintain my large body size. If I went out to eat the thin people around me would eat a 1/4 of their meal and stop and I'd have to eat the whole plate, the rolls, a side salad, etc. I knew if I didn't I would be hungry later. The difference after the band is this: I no longer need to eat large quantities of food. I could still get in 4,000+ calories a day if I really wanted to (by eating junk and sweets or by drinking a lot of calories) but I don't have to. I can have a lean cuisine for lunch and feel full until late afternoon. Before the band I would have been hungry less than an hour later after that small serving of food. I can't pig out at buffets or family dinners any more but if I continued to eat and washed it down with something to eat I still could eat more than I should. but I don't I could eat all day - but I don't. I don't count calories but I do watch what I eat. I know if I eat an entire quart of Ben and Jerry's (and I still could) I will be taking in about 1800 calories. so, to sum it up: pre-band: I had to eat a lot to fill up w/the band: I don't have to eat a lot of food - it gives me more control over my eating

I am also looking into having a lap band put in by Dr. Herrera. Did you have the lap-band done in March? How'd it go? How was Dr. Herrera? -Anne