Search the Community

I could have sworn I saw a post this morning about post-sleeve diabetes management. When I got to my office to post something, it was gone. So, I thought I'd start a thread - would love to hear from other diabetics in the group. Before my sleeve surgery, I was on 1.8 mcg of victoza, 2000 mg of metformin, 60 units of lantus and 60+ (sliding scale) of apidra daily. My surgeon reduced my meds immediately after surgery - no victoza, half the metformin and 10 units of each of the insulins. Unfortunately my blood sugars, particularly my fasting sugars, were not where I wanted them after I began solid food, so I consulted with my GP and we went back to 2000 mg of metformin (less chance of hypo), 25 units of lantus and 5-10 units of apidra. That's just freaking amazing. We also developed a plan to begin backing me off the medicines as the blood sugars come down. Both my surgeon and GP agree that if all continues to go well, I should be off the meds in a few months. I'm limiting myself to around 30 grams of carbs a day (my surgeon's plan allows for 60) and getting daily exercise. So, how's everyone else doing? Anyone off meds altogether? CJ

Hi fellow tall sleevers! I am 6'1" and was 325 pre-op and 288 this morning so down 37 lbs 6 weeks post-op. I hope to reach 220 eventually. I am very shapely but carry most of my weight in my butt, hips and thighs. I also am hypo-thyroid so I expect my weight-loss to be slower than some. Now that I'm starting to eat more types of food it has already slowed to about 1.5 lbs a week as apposed to 4.5 a week. Kinda bummed by the slower loss rate but as long as I'm losing it's OK. I think it's true people often don't realize that a tall body can carry a lot of extra weight and not look like people's idea of what "fat" people look like. I had a couple of nurses who were involved in my pre-op testing say that I didn't look "fat enough" for the surgery. But my BMI definitely qualified me. I try very hard not to compare my weight or weight-loss to others but it happens inevitably. Right now I think I've left the honeymoon stage and am in the nitty-gritty stage of having to work at my weight loss. Pre-sleeve I would have been sabotaging myself by now! Sent from my iPhone using VST

I missed my six month bandaversary which was 11/26. I was at my mom's who saw me for the first time since before my surgery. She was very suprised when I walked into baggage claim at DFW. I got a lot of positive reinforcement at her house (not from her but from everybody else). Since I decided to do lap band back in January I'v lost about 84 lbs. I'm under 200 for the first time in 6 years and I wear size 14 pants. My arms are horrendous and I am going to focus on them with a trainer (still in 16W), but I'm very very pleased with it all. I had a terrible Thanksgiving. I am still very reactive to stress, and I was stressed out that morning trying to get everything done. At 52, you would think I wouldn't feel like a bad child around my mom, but I do. I took the first tiny bite of mashed potatoes and it CAME RIGHT BACK UP. Luckily in my napkin, but it was like potato slime. Nothing else would work so I just pushed food aound my plate and pretended to eat but my aunt and daughter caught me. I got better by Friday but I realize how stress affects me. This never used to happen. I just got home last night and I feel somewhat better. We worked out every day but Thursday and I lost another 4 lbs last week so I'm happy. My goal is to be at goal by my 1 year anniversary which is 6 months and about 50 lbs away. I have to go back to work this afternoon; I have an interview with a company closer to home this morning. Nice to "see everyone" again and wish me luck today!

1 pound peeled and deveined medium shrimp 1 cup fresh lime juice 10 plum tomatoes, diced 1 large yellow onion, diced 1 jalapeno pepper, seeded and minced, or to taste Place shrimp in a glass bowl and cover with lime juice to marinate (or 'cook') for about 10 minutes, or until they turn pink and opaque. Meanwhile, place the plum tomatoes, onion and jalapeno (and avocados and celery, if using) in a large, non-reactive (stainless steel, glass or plastic) bowl. Remove shrimp from lime juice, reserving juice. Dice shrimp and add to the bowl of vegetables. Pour in the remaining lime juice marinade. Add cilantro and salt and pepper to taste. Toss gently to mix. I love this on seseme tortilla chips 2 avocados, diced (optional) 2 ribs celery, diced (optional) chopped fresh cilantro to taste salt and pepper to taste

Okay so this is getting really annoying. I have posted 3 blogs that have disappeared. =( Anyway, I have had a rough last couple of weeks. My grandmother is really ill and was in the hospital for a few days. Her liver is screwin up big time. I have gotten her into a different doctor because the one she was seeing is a quack and shouldn’t have a license. I am the only one close that can take care of her. And I’m pretty sure she is ready to give up. But I don’t want her to yet. She has to see my babies, if that ever happens, and see me finish RN school. DH was also sick. He has chemical pneumonitis and Reactive Airway Disease. He couldn’t breathe and went to the ER. They wanted to admit him but he refused and took an AMA. So they gave him breathing treatments, that we couldn’t afford, and steroids. So other than that drama. I have lost a couple more pounds. I talked to my doc, who was on my floor seeing another patient, and he said that 1 pound a week is plenty of weight loss. So that made me think about how much weight I have been losing. I started counting my calories on a website and I am sooooo not taking in enough calories. We are supposed to take in like 1200-1800 right? I am not even sure but its hard to reach that with how little I am able to eat. I know that my diet says that I am supposed to eat 3 times a day and nothing in between meals but that’s just not possible. I am eating very small snacks every couple of hours. That has helped me up my calorie intake quite a bit. I am down 2 more pounds which I am very happy with. In a couple more weeks I can go in for a fill if I need one. I think I am doing pretty well without one, lol. But anyway I have to go to class now. Its not for another hour and a half but the roads are icy and people don’t know how to drive and parking is DREADFUL at my school.

I'm 18.5 weeks pregnant. I won't have any issues losing the pregnancy weight. I'll just low carb it again until I get the weight off. I gained a few pounds over the holidays and dropped those pounds in a little over a week just by cutting alcohol and carb consumption. As for the breakdown of weight gain with a pregnancy, this is what they've outlined for my weight gain: Maternal Fat- 7lbs Baby- 6-8lbs (average is 7.5lbs) Increases Fluid (blood volume)-2-4 ( a mother's blood volume typically doubles during pregnancy) Amniotic Fluid- 1-1.5lbs Placenta- 2lbs Breast tissue/mammary system weight increase - 1-2lbs Watch out for the ROSE procedure, it has an 85% failure rate. This is also discussed heavily on the obesityhelp.com Revision forum. ERNY (extended RNY, where they remove more intestine to start malabsorption again since intestinal adaptation has taken over at this point for you) is also an option. They will shorten your common channel by another 50-100cm. You definitely want to know before you agree to a revision if you have a pouch or stoma dilation because if you have actual mechanical failure with your RNY even a band over the pouch isn't going to do much because once the food passes through the band pouch into your RNY pouch, you will still be able to more food, and your malabsorption is gone. As for Jerusalem clinic, honestly, out of over 3 years on weight loss forums, I have never read of one patient having a RNY take down and revision to the VSG being performed there and honestly that is possibly why they are recommending the band over the bypass pouch to give you restriction again. Seriously, I can name 4 surgeons worldwide that are experienced with these surgeries, and with self-pay patients the cost just for the surgeon run upwards of 20-30k because it is such a complicated and exhausting surgery to take down an old RNY. I promise I researched revisions for months once I knew my band had to come out. The risks for complications especially leaks from scar tissue and adhesions literally quadruples with revisions vs. a virgin, unaltered stomach/intestinal tract. I had a leak with a band revision to VSG after only having the band for 8 months, and actually lost more stomach tissue because of the damage the band had done. My surgeon was experienced with revisions, and I happen to be a statistic of his that I'd like to take back. I was his first and only VSG leak so it can happen even with really experienced surgeons. I'm not slamming Jerusalem Clinic, but revisions are super tricky, complicated, and I would hate to see you fork out the money, get a surgery that is as high maintenance as the BOB procedure and then continue to struggle with your weight and be looking at or for another surgery. There have been RNY to VSG revisions performed due to reactive hypoglycemia symptoms and diagnosis after RNY, but again, it's a very complicated surgery with high risks. Just choose carefully, and continue to research your options.

Being dizzy, lightheadedness, fainting can also be caused by low blood sugar. There is a condition that occurs in Gastric Bypass patients called Reactive Hypoglycemia. One man in our bariatric surgery support group developed that condition. After fainting one time, he figured out the cause and then learned how to control the condition. Here are a few links. https://www.ridgeviewmedical.org/services/bariatric-weight-loss/enewsletter-articles/reactive-hypoglycemia-postgastric-bypass/ https://www.stjoes.ca/patients-visitors/patient-education/f-j/PD 7972 Reactive Hypoglycemia after Bariatric Surgery.pdf

hair loss is another thing that most (maybe all?) of us vets, in retrospect, wonder why we worried so much about. It's temporary - and for many of us, we're the only ones who notice the loss (I know some people lose a lot - a very noticeable amount - but most of us don't). It's a minor annoyance in the grand scheme of things. whether or not you need Spanx depends on where your loose skin is - and how much you have. I was apple-shaped, so I don't/didn't have much on my hips, butt, and thighs. Mine was almost all in my gut. And yes - I just tucked it into jeans or "tummy control" leggings, and always wore a slightly oversized, long-ish top. Ta da! Excess skin gone. I'm sure I was the only one who noticed it. Spanx would work, too, if you're not wearing something that it can be tucked into. as far as 500 calories, that's really just the first month or so. From about that point until maybe a year out, I was eating 600-800 calories a day, usually closer to 800. At around the year mark, I was at around 1000-1200. Now, in maintenance, I eat 1500-1700 a day. I did develop what we think was reactive hypoglycemia at about two years out, but I was told to eat something every 3-4 hours and, if I eat a carb, to be sure to pair it with a protein. That seemed to take care of it...

I wonder if I'm having a form of reactive hypoglycemia. From what I read, it's all lumped together but reactive hypoglycemia has a drop in blood sugar too. I'm still in the pre-diabetic range but my Dr isn't concerned nor has advised me to test sugar. Just one of those things I wonder about. But the bottom line is always 'don't eat that'. I wish it was that easy! Sent from my XT1254 using BariatricPal mobile app

I had this issue really bad at my heaviest. I was on medication for it. A couple years ago I carried my eldest to bed - I'd just laid her down and boom - if I'd have been pregnant I swear my Water had broke. Pee just ran down between my legs and onto the floor. I ran to the bathroom freaking out. I didn't know what was wrong with me. My doctor tried to narrow it down. Blamed a lot of it on my thyroid condition (hypo). That seems to be the "blame catcher". Anytime something is going on weird with my period, blatter, or body it is my thyroid. That's what they tell me anyway. It seems that my 275+ frame was putting excess pressure on my bladder and causing it to spasm. I was eventually weened off of the medication. As I've lost weight I've noticed the - run like hell and unbutton your pants as you go urge has become less frequent.

Thanks James...I am a Type 2 diabetic and know all about hypoglycemia. Used to have reactive hypoglycemia prior to turning full blown diabetic, so I know the signs. I actually did check my blood sugar this morning (I do every morning anyway). It was fine, so that wasn't it. I really do think it had to do with the Protein. I didn't think I hit my protein the day before, and most everything I read said protein and fluids are usual culprits. Thanks for replies. Feeling better now.

I was reactivating into the program so the process for me was a tiny bit different. I got my referral July 13. I had a health education class July 27 that covered general details about bariatric surgery and the program. After that you need to talk to doc again and say you're interested they then refer you into the program. August 4 was my orientation (4 hours long!!!!!) This where they weigh you and only this weight and their scale will be the one that matters. Since I'm reactivating I had to take 4 bariatric lifestyle class (extremely helpful). They are every Wednesday. On my 4th class day I called to schedule my psych eval, I was SO lucky I called when I did because it was either the next day September 8 or all the way until October 4, I took the 9/8 because I would be on a trip for the next available appt. Dr. Z (psych) cleared me and scheduled me for my surgeon appt w/ Dr. Mostaedi October 11 (where I'll get my goal weight) I've already lost 23lbs so that must be why Dr. Z cleared me quickly. I have to wait till December for surgery because of school but I would have to wait anyway because I was a vaper. If you are a smoker you will have to be 3 months nicotine free before surgery. If I wasn't a vaper and didn't have school I would probably be having this surgery in October.

ivonea No I haven't had the surgery yet. I am still in the process of all of the pre op testing and all that. I should be done with all of this in the end of June or Mid July. After that we will submit to insurance and I am hoping I can have surgery in August. I just did my second night in the sleep clinic to titrate to the machine 2 nights ago. I honestly have to say that I slept ALL night. I haven't done that in years. I was not uncomfortable with the machine or mask and I felt very rested the next morning. They told me that t hey will send the results to my doctor and he will prescribe my machine at the setting that it needs to be set at. I am hoping that I can get the same kind of mask and that it goes as well at home as it did there the other night. I asked the tech the other night if sleep apnea is pretty common and he states it is. He told me everyone has some sleep apnea but the 'normal' number of apnea episodes in an hour are 3-5 and I had 7 so really mild is VERY mild. He told me that I will probably not need the machine once I have the surgery and loss so weight but he couldn't guarantee that and I understand that but I can hope. HAHA. Anyway he also told me that even though my apnea is so mild the surgeon that I am having requires me to have a CPAP because it will help with the healing process and the already high risk because I am obese. I don't mind that either because I am thankful my surgeon is being so proactive instead of reactive if something were to happen or go wrong. He told me to think of all the pre op testing as the most invasive medical physical I will ever in my life have. He said they will look me up and down, inside out and around and around. I guess I am very thankful that he is being so careful. Good luck with your apnea and hopefully after some more weight loss you will not have to wear the mask anymore. Have you tried different masks? I started with a mask that just covered my nose but I couldn't use that because I am a mouth breather at night so then I used a mask that covered my nose and my mouth and I was fine.:clap2:

I thought this was a really great FAQ that answers a few more questions beyond the usual what is a band/how is it adjusted type of question. Also, interestingly, the doctor talks about the causes and repair of erosion, slippage, and pouch dilation. This docter says erosion has to do with the way the band is stitched to your stomach. If that's true, it might explain why erosion is more likely to happen with some surgeons than with others. Just a thought. liquids. That said, average weight loss is 50% of excess weight at 5 years. But this includes all patients, including those who have lost little or no weight. How is the Band adjusted? The Band is tightened by accessing the port with a needle. This is most commonly done in the office. Some surgeons do it at the hospital under x-ray guidance, but this is generally not necessary, and makes the procedure much more expensive. For patients with very thick abdominal walls, it may be more difficult to find the port. In our office we have an ultrasound machine which makes it possible to access most ports without need for x-ray. Can I adjust my own Band? In theory, yes. But the answer is NO. NO. NO :confused: (you just know somebody has tried this at home) Why do I have to take Vitamins? The LapBand operation is purely restrictive, so technically you don't need to take vitamins if you are eating a healthy diet. On the other hand, by definition you are eating a hypo-caloric diet, one which will cause you to lose weight. Because of this, we worry that you won't get all the vitamins and minerals you need. This is the main reason we ask you to take vitamins after the surgery. What about the gallbladder? We don't remove the gallbladder unless you already have gallstones that are causing symptoms. Weight loss is slow and natural, so the risk of gallstones is not sufficiently elevated as to make gallbladder removal worth doing. Can the Band be rejected by my body? The Band is made of silicone rubber, and cannot be rejected. Of course it can become infected and require removal, but this is not the same as being rejected like a transplanted organ. What happens after I lose my weight? The Band causes you to lose weight by restricting your caloric intake to less than your caloric expenditure. As you lose weight, your calorie requirements diminish. Once intake matches expenditure, you stop losing weight. How long does the Band stay in? The Band stays in forever. If it is removed you will regain all the weight you lost. What is a slipped Band, and what causes it? There are two types of slippage; anterior and posterior. This refers to whether the front or back side of the stomach slips. There is something else called concentric pouch dilation, but this is not the same as slippage. Slippage or prolapse is when the stomach slides up through the Band, making the pouch bigger. If this happens the Band usually becomes too tight, and patients experience symptoms of reflux (heartburn) as well as nausea and vomiting. This is because the amount of stomach being “squeezed” by the Band is increased, thereby obstructing the Band. There are several causes. Posterior slippage was more common when the Band was placed by the “perigastric” technique. With this technique the back side of the stomach was free to slide up through the Band. These days most surgeons use the “pars flaccida” technique, which was developed to prevent posterior slippage, and has more or less eliminated the incidence of this problem. Anterior slippage is when the front of the stomach slips up through the Band. We try to prevent this by suturing the stomach below the Band to the stomach above the Band, “locking” the Band in place in the right spot. In spite of this, slippage still occurs. It can happen because we haven't placed enough stitches, or they haven't been placed in the right place. Slippage can also occur if patients eat too much and vomit frequently. How is a slipped Band diagnosed? Fortunately, this is very easy. Often the diagnosis is made based on the history alone. A patient who has been going along fine, with no problems, and then suddenly develops reflux symptoms or symptoms of a too-tight Band will most likely have a slipped Band. The diagnosis is easily confirmed with an x-ray and barium swallow examination. Endoscopy is rarely necessary. How is a slipped Band fixed? A slipped Band needs to be fixed with an operation. The Band has to be dissected out, all the sutures removed, and the position of the stomach made right. Some surgeons remove the Band and place it back through a new tunnel. Others just straighten things out and re-suture the stomach over the Band. What happens if the Band slips again? That's a tough one. One could certainly try to fix the slip again, but my personal view is that, for whatever reason, the Band is just not working for that particular patient, and ought to be removed. What is a Band erosion? This is when the Band actually erodes into the stomach. It is a more serious problem, and generally requires removal of the Band. Band erosion is thought to be related to placing too many sutures (or too tight sutures) at the time of Band implantation. Surprisingly, Band erosion is often unnoticed. Occasionally the port will become infected if bacteria track along the catheter out to the port. Other times patients will stop losing weight. Diagnosis often requires an endoscopy. What is concentric pouch dilation? This is technically not the same as slippage. In this case the pouch just seems to be enlarged. Sometimes partial emptying of the Band may help with this. What is esophageal dilation? This is when the esophagus enlarges over time, and is probably related to either too tight a Band, or possibly improper placement of the Band around the junction of the esophagus and stomach. This requires loosening or removal of the Band. What happens if my Band has to be removed because of complications or failure to lose weight? One option, of course, is to give up on weight loss surgery. Another option is to convert to another procedure such as Roux-en-Y gastric bypass. This can be done at the same time the Band is removed, and is generally done laparoscopically. If you have questions that have not been answered by this FAQ, please send them to me and I will try to answer them for you. Mark A Pleatman MD 43494 Woodward Ave. #202 Bloomfield Hills, Michigan 48302 Office Hours: 9:00 AM to 5:00 PM Phone: (248) 334-5444 Fax: (248) 334-5484 Email: pleatman@laparoscopy.com

Yes I regret it and I wished I have never done it, I lost weight , I am thin but I'm not healthy. 3 years post op gbp and I'm battling what I suspect reactive hypoglycemia and dumping and vitamin issues. I am a wreck, I would advice nobody to get the surgery.

I have Hashimoto's Thyroiditis (autoimmune disorder that causes hypo) and I was sleeved Dec. 18th. So far, I've been doing okay with the loss. I was 20 lbs down on my 10 day appointment, and the doc said that was a good amount for the time period. Still early days though.

@@uni2424 I do not have a thyroid due to papillary cancer. So I am definitely Hypo. I lost 60 pounds prior to getting the sleeve on 12/16. I've lost another 14 with the sleeve. It is very possible to lose weight with hypothyroidism. Just need to make sure you are being followed by an endocrinologist, get blood work done periodically, have your meds adjusted and take your meds correctly. I lost the 60 pounds by eating a less than 1200 calorie diet and exercising on a regular basis. My weight loss was a little slow and had frequent stalls...you just have to be committed to changing your lifestyle.

While I do have both a dog and a cat, most of my animals are a bit more cold-blooded. In addition to the dog and cat (and chinchillas), I have 10 cornsnakes, two boas, two geckos and a bearded dragon. Although in fairness, one of the geckos and the beardie belong to my daughter (but she's 10, so I help a bit with them) Pictured are Maya (dog), Boo (cat), Cupid (hypo Honduran boa), and Toothless (pastel bearded dragon)

No, the band will not prevent the symptoms of hypo/hyperglycemia. I was hypoglycemic for decades. Now I'm hyperglycemic. In both cases, I had to eat something every 3 hours to keep my blood sugar stable. Still do. .

I have hypo thyroid as well. I'm 5 1/2 mos post op and have lost 92 pounds so far. 74 since being sleeved. Still have 50 to go. I was surprised at my 2 month blood work that my T4 was actually high and my Doc had to decrease my meds.

Sorry I hadn't noticed this post sooner. Let me start by saying, I am a very lazy person, hence the reason I got fat. My time in the gym has been ZERO. I do walk a lot with my wife. I babysit a 3 years old 5-6 days a week 12 hour days. I love skateboarding again. But as far as exercise, workouts? Nope, not my cup of tea. 95% of my weight loss has come through the kitchen. I am blessed in as much, I am now reactive hypoglycemic. I cant cheat with sweets without paying a dear price. I have gone unconscious 3 times since surgery from low blood glucose below 50. Also my appetite has been a struggle. I have to force myself to eat. Trust me I could lose more if I wanted to. I am 6'3" and 163 lbs is already skinny enough. I was a very skinny young man, and I think post op my body went back to its natural state. I was about 145 lbs into my early mid 30's. So yeah I was quite skinny. Diet wise, I was probably stricter with myself than I needed to be. I eat eggs, cheeses, meats of all types, green vegetables. Very little fruit, sugars aren't my friend. I use TESPO liquid vitamins. I'm not a good example. I enjoy the occasional chili dog. I eat the occasional chip. My portions are obviously a fraction of what they were in the past. There are much wiser, better examples of peoples disciplines and diets on here than mine. Again, I am not typical in that I have to force myself to eat. I actually seek out fattier foods now just to maintain weight. Not necessarily junk food, but not the leans foods most of us have to eat. It has taken me many months to stop losing. My doctors were starting to get worried. for my health based on how rapidly I lost and my inability to maintain. I am doing much better now though.

I am more than 14 months post-op. I do not dump, which happens to approx. 30% of gastric bypass (RNY or MGB) patients typically after consuming sugar. Nor do I experience Reactive Hypoglycemia (RH), which may show up 1+ years after gastric bypass; it is low blood sugar occurring 1-3 hours following a meal. Eating too fast or not chewing food properly and then getting the foamies and/or needing to vomit is not the same thing as dumping (aka rapid gastric emptying). Make sure you’re eating small, moist portions of protein and to eat slowly, and then these incidents should abate. Good luck.

My feet used to burn up when I was having a hyperthyroidism flare, I would put a tub of cool Water in the room with me to stand in and cool off my feet. It was like my body heat was escaping through my foot bottoms. .. You might want to check your thyroid, are you on thyroid meds and have now lost weight? Or have ever had thyroid issues? (Sorry, on my phone, can't see your stats) This was when I was in my twenties and had hyperthyroidism so bad they were taking about taking out some of my thyroid, 20 years later and my thyroid is hypo now...

Update I I Ok so the Doc says I have severe obstructive sleep apnea with low oxygen and failure to up oxygen levels after an apnea event, plus hypo ventilation. So I am waiting to be fitted with a fashionable CPAP machine as we speak. Lovely. The only thing I can do is turn around my attitude, so I am happy that we have discovered the problem, that the office is working my insurance issue and that I may experience what I have read can be life changing sleep after receiving this machine. And guess what? I get to install it myself :-D

All us HYpos. Need to support each other..Im so worried it wont work...im doing everything tight I was sleeved 4/24. Lets all be each others support team...we are slow looser from what I read but truth is I was not looseing before sleeve I was gaining.13 lds last year 15 each year prior..so looseing steady even if its only 2 a week. Ill take iy...any one haveing issues with hiccups or gas in shoulder....also are u crushing your thyroid or taking hole.