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Did most of you have outpatient surgery? Deciding to have the band to sleeve revision.

They did a full Endoscopy yesterday in the main OR and my stomach is totally twisted and kinked, in order to fix is revision is required. This is VERY UNCOMMON and happens in less then .02 % of sleeve patients. :/ I just happened to be in that lucky percent, ugh

Oh Kyle! I hate to hear this! I'm so sorry you have to, once again, go through surgery. What is the reason for the revision? I'll definitely be sending positive thoughts and prayers your way for a smooth and speedy recovery. You already know you'd better keep me updated!! I'll be worrying about you until I hear back from you! Oh how your anxiety must be going nuts right now! Just plz try to stay calm and don't miss a dose of your meds! I set alarms for mine so I have a consistent level of Ativan in my system at all times. We both know how traumatic attacks can be. I was under the impression that your sleeve was doing great, what happened? What symptoms did you get?

Welcome Alex and Janie! You have come to the right place for friendship and support! I'm pre op... I'm having a lapband revision to sleeve next month.

My highest recorded weight was 270lbs(morning of my lapband surgery), standing 5'2" short. The day of my revision from band to VSG, I weighed in at 263lbs. My BMI was just shy of 50 when I revised from the band. I did not work out at all for the first 4 months. At 4 months post-op, I started strength training 3-4 days a week, and doing cardio with a primary focus on my ab/core area one day per week via Hip Hop Abs. That only lasted 4 months and then I had gallbladder surgery with an exploratory surgery of my abdominal cavity because I was having random pain. My surgeon removed hoards of scar tissue and adhesions from my liver to colon. I was on restricted activity for 8 long weeks, and since I hate working out, I never got back into exercising formally. I was one of the skinniest, unfit chicks you'd meet. Now after pregnancy weight gain, losing all but 10 pounds of the weight, and now pregnant again, I'm not even attempting to diet/exercise. Unfortunately, my body has been through hell and back in less than 3 years. I have a least another year before I'll be able to get back to where I was before pregnancy. Working out not only helps with weight loss, but it helps with overall heart, mind and bone health.

Hi, I've been through a band to sleeve conversion after an initial band and then a revision. My band removal and sleeve surgery were done 8 weeks apart. I had my sleeve surgery 6 weeks ago. The surgery went really well even though I had to have an unexpected second hiatal hernia repair. Apparently the surgery took longer than expected. I didn't have much in the way of gas pains. My pain meds worked well and I went home day 2. The recovery was more painful than I'd anticipated so I stayed on narcotics over 2 weeks. I'd heard sleeve surgery is easier than a gallbladder removal. I'd say it was the same as my gallbladder removal. More painful than band surgery, but I'm 18 years older now so that may have something to do with it. It was really hard to bend over for a while and then voila about 2 1/2 weeks in it got a lot better. sleeping was tough bc I'm a side sleeper and I had to sleep on my back for a while. I took four weeks off from work and I'm so glad I did because I needed the time to get my energy back. Now I'm feeling great and am SO happy to have made this change. It's such a different experience physically and emotionally. Good luck to you! Sent from my iPhone using the BariatricPal App

I'm looking forward to my revision in mid June! Yayyy!!

Hi, I had the sleeve in 2016. I lost about 30 or so pounds, which I have since regained. The sleeve was not very successful for me. On Monday (8/21/23), I had the SADI-S DS surgery. The doctor said that weigh loss will be slow. I am just worried of failing again. If anyone else had had the SADI-S revision, I would like to hear positive stories to inspire me and know that it is really possible this time. Thanks! Melody

http://www.verticalsleevetalk.com/topic/77969-sleeve-revision-to-gastric-bypass-tomorrow/page__fromsearch__1

I need to revise this: according to my Drs. Visit today, the don't allow Tramadol in the first six weeks, so if you are in that timeframe you may want to stick with Tylenol. I was sent home from surgery with tramadol, works great for me. I also use Tylenol once in a great while for sinus pain.

Hi mike54, I have 'choking' from the band at night and a lot of vomiting during the day and night. I had gastroscopy and it proved that my esophagus is all pebly instead of smooth. The Doctor took biopsy and luckily I don't have cancer. He loosened the band and suggested revision surgery. Now it is up to me to decide whether it will be sleeve or mini GBP. Did you have revision and if you did how is it with the reflux now?

I had my lap band placed in 2008 and did really well, with it, until last November. I ended up in the er unable to keep anything down and waking up choking with reflux. Band was unfilled and, turns out, has slipped. I got my insurance approval, for revision, on Thursday and will be getting my surgery date on Monday! I'm so excited and scared! What advice can you guys give me???

Chanelle, my heart is going out to you. On doing a cursory search of the academic medical journals on pregnancy after bariatric surgery (because as of yet, I have not found one which encompasses 'surgery whilst pregnant' and I concede the procedures documented do not encompass VSG), I found the following. Go straight to the abstracts/conclusions to get the gist of the research and findings. Sorry to everyone else for the information splat taking up your screens. This is clearly not merely an issue of the fetus being exposed to radiation through an x-ray or the impact of the anesthesia on the fetus during the VSG procedure (which is not to be overlooked and if you'd like me to send you a complete article privately, I can - 'cause it's very long to post here and you'd need to read all of it to get the baseline). It is also about the severe nutritional, Vitamin and mineral deficiencies present in the first weeks after the operation which appear to have a significant impact on the progress of the fetuses growth and development in utero. A point that would need significant evaluation, monitoring and intensive hands-on care. If you would like to ask any questions on the below, please do not hesitate to contact me. Much love x Analgesia, Anaesthesia and Pregnancy A Practical Guide 3rd Edition By Steve Yentis Chelsea and Westminster Hospital, London By Surbhi Malhotra St Mary’s Hospital, London Publisher: Cambridge University Press Print Publication Year:2012 Online Publication Date:December 2012 Online ISBN:9781139012966 Paperback ISBN:9781107601598 Book DOI: http://dx.doi.org/10.1017/CBO9781139012966 Subjects: Anesthesia, Intensive Care, Pain Management ,Obstetrics and Gynecology, Reproductive Medicine Chapter 3 Anaesthesia before conception or confirmation of pregnancy Many women will require anaesthesia when they are pregnant and many will be unaware that they are pregnant at the time of the anaesthetic, especially in the first 2–3 months of their pregnancy. The thalidomide catastrophe initiated the licensing arrangements for new drugs and their use in pregnancy; the current cautious stance of the pharmaceutical industry is reflected in the British National Formulary’s statement that no drug is safe beyond all doubt in early pregnancy. The anaesthetist should have a clear knowledge of the time scale of the developing fetus in order to balance the risks and benefits of any drug given to the mother. A teratogen is a substance that causes structural or functional abnormality in a fetus exposed to that substance. Problems/special considerations The possible effect of a drug can be considered against the stage of the developing fetus: Pre-embryonic phase (0–14 days post-conception): The fertilised egg is transported down the Fallopian tube and implantation occurs at around 7 days post-conception. The conceptus is a ball of undifferentiated dividing cells during this time and the effect of Downloaded from Cambridge books Online by IP 129.215.17.188 on Wed Jan 29 01:41:58 GMT 2014. http://dx.doi.org/10.1017/CBO9781139012966.004 Cambridge Books Online © Cambridge University Press, 2014 drugs on it appears to be an all-or-none phenomenon. Cell division may be slowed with no lasting effects or the conceptus will die, depending on the severity of the cell damage. Embryonic phase (3–8 weeks post-conception): Differentiation of cells into the organs and tissues occurs during this phase and drugs administered to the mother may cause considerable harm. The type of abnormality that is produced depends on the exact stage of organ and tissue development when the drug is given. Fetal phase (9 weeks to birth): At this stage, most organs are fully formed, although the cerebral cortex, cerebellum and urogenital tract are still developing. Drugs administered during this time may affect the growth of the fetus or the functional development within specific organs. Management options The anaesthetist should always consider the possibility of pregnancy in any woman of child- bearing age who presents for surgery, whether elective or emergency, and should specifically enquire in such cases. If there is doubt, a pregnancy test should be offered. If pregnancy is suspected, the use of nitrous oxide is now generally considered acceptable, despite its effects on methionine synthase and DNA metabolism, as there is little evidence that it is harmful clinically. Similarly, although the volatile agents have been implicated in impairing embryonic development, clinical evidence is lacking. Some drugs cross the placenta and exert their effect on the fetus, e.g. warfarin, which may cause bleeding in the fetus. Key points The possibility of pregnancy should be considered in any woman of childbearing age. No drug is safe beyond all doubt in pregnancy. Further reading Allaert SE, Carlier SP, Weyne LP, et al. First trimester anesthesia exposure and fetal outcome. A review. Acta Anaesthesiol Belg 2007; 58: 119–23. 6 Section 1: Preconception and conception Pregnancy shortly after bariatric surgery. Transliterated Title: Svangerskap like etter fedmeoperasjon. Authors: Skogøy K; kristin.skogoy@nordlandssykehuset.no Laurini R Aasheim ET Source: Tidsskrift For Den Norske Lægeforening: Tidsskrift For Praktisk Medicin, Ny Række [Tidsskr Nor Laegeforen] 2009 Mar 12; Vol. 129 (6), pp. 534-6. Publication Type: Case Reports; English Abstract; Journal Article Language: Norwegian Journal Info: Publisher: Norske Laegeforening Country of Publication: Norway NLM ID: 0413423 Publication Model: Print Cited Medium: Internet ISSN: 0807-7096 (Electronic)Linking ISSN: 00292001 NLM ISO Abbreviation: Tidsskr. Nor. Laegeforen. Subsets: MEDLINE Imprint Name(s): Publication: Oslo : Norske Laegeforening Original Publication: Chistiania : Alb. Cammermeyer, 1880- MeSH Terms: Bariatric Surgery/*adverse effects Pregnancy Complications/*etiology Adult ; Bariatric Surgery/methods ; Duodenum/surgery ; Female ; Fetal Development ; HELLP Syndrome/etiology ; Humans ; Infant, Newborn ; Infant, Small for Gestational Age ; Obesity, Morbid/metabolism ; Obesity, Morbid/surgery ; Pregnancy ; Pregnancy Complications/metabolism ; Pregnancy Outcome ; Risk Factors; Time Factors ; Ultrasonography, Prenatal ; Weight Loss Abstract: Bariatric surgery is increasingly used to treat morbidly obese patients. Fertility in women may be enhanced after these procedures, owing to substantial weight loss and possibly a decreased absorption of oral contraceptives. We report a pregnancy that occurred two months after biliopancreatic diversion with duodenal switch in a 32-year-old woman. She subsequently developed haemolysis, elevated liver enzymes and low platelets count (HELLP) syndrome and had a weight loss of 43 kg (from the bariatric procedure) until the infant was delivered preterm by caesarean section (due to low activity). The infant was small in relation to the gestational age, with a weight of less than 50 % of the expected (780 g at 29.6 weeks). Histological examination demonstrated a small placenta with insufficient spiral artery trophoblast infiltration, possibly caused either by severe preeclampsia or by maternal nutritional deficiencies. Severe metabolic aberrations may complicate pregnancies after malabsorptive bariatric surgery. Patient preparations before weight-loss operations should include information on fertility and birth control in the postoperative period. Protocols for monitoring of patients that become pregnant after bariatric surgery are needed. Comments: Comment in: Tidsskr Nor Laegeforen. 2009 Mar 12;129(6):536-7. (PMID: 19291887) Entry Date(s): Date Created: 20090317 Date Completed: 20090319 Latest Revision: 20110330 Update Code: 20131125 DOI: 10.4045/tidsskr.09.34019 PMID: 19291886 Database: MEDLINE with Full Text The risk of adverse pregnancy outcome after bariatric surgery: a nationwide register-based matched cohort study Mette Mandrup Kjær, MD; Jeannet Lauenborg, MD, PhD; Birger Michael Breum, MD; Lisbeth Nilas, DMSc OBJECTIVE: The aim of this study was to describe the risk of adverse obstetric and neonatal outcome after bariatric surgery. STUDY DESIGN: Nationwide register-based matched cohort study of singleton deliveries after bariatric surgery during 2004-2010. Data were extracted from The Danish National Patient Registry and The Med- ical Birth Register. Each woman with bariatric surgery (exposed) was in- dividually matched with 4 women without bariatric surgery (unexposed) on body mass index, age, parity, and date of delivery. Continuous vari- ables were analyzed with the paired t test and binary outcomes were analyzed by logistic regression. RESULTS: We identied 339 women with a singleton delivery after bari- atric surgery (84.4% gastric bypass). They were matched to 1277 un- exposed women. Infants in the exposed group had shorter mean gesta- tional age (274 vs 278 days; P .001), lower mean birthweight (3312 vs 3585 g; P .001), lower risk of being large for gestational age (ad- justed odds ratio, 0.31; 95% condence interval, 0.15– 0.65), and higher risk of being small for gestational age (SGA) (adjusted odds ratio, 2.29; 95% condence interval, 1.32–3.96) compared with infants in the unexposed group. No statistically signicant difference was found between the groups regarding the risk of gestational diabetes mellitus, preeclampsia, labor induction, cesarean section, postpartum hemor- rhage, Apgar score less than 7, admission to neonatal intensive care unit or perinatal death. CONCLUSION: Infants born after maternal bariatric surgery have lower birthweight, lower gestational age, 3.3-times lower risk of large for ges- tational age, and 2.3-times higher risk of SGA than infants born by a matched group of women without bariatric surgery. The impact on SGA was even higher in the subgroup with gastric bypass. Key words: adverse pregnancy outcome, bariatric surgery, gastric bypass, pregnancy Pregnancy after bariatric surgery: a current view of maternal, obstetrical and perinatal challenges Ronis Magdaleno Jr • Belmiro Gonc¸ alves Pereira • Elinton Adami Chaim • Egberto Ribeiro Turato Received: 6 May 2011 / Accepted: 14 December 2011 / Published online: 29 December 2011 Ó Springer-Verlag 2011 Abstract With the increase in the number of bariatric surgeries being performed in women of childbearing age, physicians must have concerns regarding the safety of pregnancy after bariatric surgery. The aim of this review is to summarize the literature reporting on maternal, obstet- rical and perinatal implications of pregnancy following BS. Methods English, Spanish and Portuguese-language arti- cles were identied in a PUBMED search from 2005 to February 2011 using the keywords for pregnancy and bariatric surgery or gastric bypass or gastric banding. Results The studies show improved fertility and a reduced risk of gestational diabetes, pregnancy-induced hypertension and pre-eclampsia, macrosomia in pregnant women after bariatric surgery. The incidence of intrauter- ine growth restriction and small for gestational age are increased. No conclusions can be drawn concerning the risk for cesarean delivery and the best surgery- to-conception interval. Deciencies in Iron, Vitamin A, vitamin B12, vitamin K, folate and Calcium can result in maternal and fetal complications. Conclusions Pregnancy outcome of women who deliv- ered after BS, as compared to obese populations, is better and safer and comparable to the general population. Close supervision before, during and after pregnancy following bariatric surgery and nutrient supplementation adapted to the patient’s individual requirements can prevent nutrition- related complications and improve maternal and fetal health. Keywords Bariatric surgery Pregnancy Pregnancy complications Morbid obesity Weight loss Vitamin A Deficiency in Pregnancy: Perspectives after Bariatric Surgery Cristiane Barbosa Chagas1, 2, Cláudia Saunders3, 4, 5, Silvia Pereira1, 6, 2, Jacqueline Silva7, 2,Carlos Saboya8, 9, 6, 2 and Andréa Ramalho3, 10, 11 (1)Clinical Medicine, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil (2)Center for Research on Micronutrients, Josué de Castro Institute of Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil (3)FIOCRUZ, Rio de Janeiro, Brazil (4)Nutrition and Dietetics, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil (5)Research Group in Maternal and Child Health (GPSMI), Josué de Castro Institute of Nutrition, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil (6)Clínica Cirúrgica Carlos Saboya, Rio de Janeiro, Brazil (7)Human Nutrition, Center for Research on Micronutrients, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil (8)Universidade Federal de São Paulo (UNIFESP), São Paulo, Brazil (9)Brazilian Society for Bariatric and Metabolic Surgery, São Paulo, Brazil (10)Social Applied Nutrition Department, Federal University of Rio de Janeiro, Rio de Janeiro, Brazil (11)Instituto de Nutrição Josué de Castro, Centro de Ciências da Saúde, Universidade Federal do Rio de Janeiro, Av. Carlos Chagas Filho, 373. Edifício dos Institutos Bloco J, 2° andar, sala 26, Ilha do Fundão, 21941-590 Rio de Janeiro, Brazil Andréa Ramalho Email: aramalho.rj@gmail.com Published online: 12 December 2012 Abstract This study aims to describe the clinical consequences of vitamin A deficiency (VAD) in pregnant women after bariatric surgery. Included are studies on VAD during pregnancy and after bariatric surgery conducted in humans from 1993 to 2011. There are few investigations on the relationship between pregnancy and bariatric surgery and on the damage to the binomial mother–child resulting from VAD in this relationship. The high percentage of VAD in the postoperative period is a cause for concern, especially considering the function of this vitamin in certain biological moments and in moments of intense nutritional demand. This vitamin serum evaluation is recommended during the prenatal period. Keywords Pregnancy Vitamin A Vitamin A deficiency Obesity Bariatric surgery Retinol Beta carotene Night blindness

Revision has gotta happen.

I am in my 60s. I just recently had a revision WLS. I will speak mainly about my first WLS since revision was made for other reasons. For the first few months, the post-op diet does feel like a sacrifice. Especially the liquid phase. Not actually physically since I had decreased hunger but more mentally, emotionally since eating was never really about physical hunger to me. After the first few months, things normalized. I was able to eat whatever I wanted, just a much smaller amount and social eating was pleasant again. Because of the rapid weightloss, and the positive feelings of losing weight, it was much easier for me to transition to a healthier diet naturally. Was the the weight loss worth it and did it offset the sacrifice? Absolutely. I feel so much younger now being able to move as my body intended. Most health issues resolved too. I would do it again and again in a heartbeat.

Personally, I do not put a lot of stock in studies. By the way that article was published in 2006 and not only have surgical techniques have improved but so did patient education. There also have been newer and better revisions of the bands themselves put out by the manufacturer. Don't take this personal but this type of post is the kind that will bring out the Anti-bandsters causing defensive backlash by pro bandsters. I am sure that is not your intent at all but I have seen these type of threads go south time and time again.

I just got my revision from a band to sleeve a week ago. Clearly, I did a lot of research on it. The largest five year study is coming out in a few weeks. So far things look fantastic for sleeves.

Okay, I did misunderstand. Sorry, I see what you are saying now. Six month diet, start it now and if you need it you'll almost be done by the time Oct rolls around. I agree, it's a stupid requirement. Something to consider... just throwing out prices here. I don't know band prices in the US for specific doctors, so just throwing out Mexican prices to make a point. Band: $7000 Sleeve: $9500 Revision from band to sleeve $12,500 (plus $7000 band surgery) Revision from band to band $12,500 (plus $7000 band surgery) Correction of a slip: $3500 - $5000 (plus $7000 band surgery)

My 2 week pre-op diet was 3-4 shakes a day with no more than 200 calories each and minimum 15g of protein, celery and cucumbers, and 1-2 cups of chicken or beef broth a day. Absolutely NO popsicles or sugar free jello. I would constantly be shaving celery with a peeler into “noodles” and then adding it to the broth for a soup of sorts. AND I was super lucky enough to do it twice in an 8 month period. 😂 (needed a hernia repair surgery that was coupled with a VSG to RNY revision to reduce chances of future hernias.)

I live in Memphis and was banded by Dr. Ortiz in Mexico on August 10. I went back to Mexico for my fill and have not required any follow-up other than that. I had a revision from a failed gastric bypass (staple line disruption) and am very happy with my band. My first fill was on the 18th of September and I have really good restriction.

I was 226 on day of surgery (HW was 242 at first revision consult) only have asthma and back pain. This was a revision for me. Started with a lapband 7 or so years ago at a hw of 239. So glad I had the revision.

My dear hubby and I have been married for nearly 20 years, and he is my EVERYTHING! He had band-to-sleeve revision in mid-November 2013. His goal is to lose 100 lbs. In the eight weeks following surgery, he lost 55 lbs. But in the past 3 weeks, the scale is not moving. I tell him all the time how great he is doing, but I can tell he is starting to get discouraged. I'm not sure how to best support him during the inevitable 'stalls'. I figure this group can give me the best advice - - so.... what do you recommend?

Basically what happened is.....I have UHC, but this particular plan does not cover bariatric care at all. So, I paid for the surgery myself. Well, in order to get insurance to pay on the surgery, they billed "unlisted liver procedure" instead of wedge liver biopsy...."unlisted procedure, stomach" rather than gastric bypass...."adhesion repair" rather than lap-band removal...and also charged for a (hiatal) hernia repair. Mind you, all of those things were to be INCLUDED in my revision surgery (that's why it's more expensive than a "virgin" bypass), but they had my insurance information from my (original) consultation and submitted it. Since the coding "appeared" medical, UHC covered a pretty significant portion of it. Thinking I should get a refund for anything that insurance DID pay, I phoned the office to find out when I'd get a refund check and, to my surprise, they said they would be keeping BOTH payments! Adhesions were expected, due to the band; I've had a hiatal hernia for OVER 10 years, but the op report reads as if it was "discovered" during surgery!!! Adding what they billed insurance PLUS what I paid up front, my surgery was nearly $58,000!!! That is ridiculous. The average for bypass is $22,000, which is what I "self" paid prior to surgery. Just a side note....I had NO complications, NO unexpected/unplanned procedure and the hospital and anesthesiologist both wrote off ALL charges except what I paid up front...only the surgeon billed/was paid by my insurance company. I tried to "appeal", but UHC wouldn't since it was not a denial. The insurance commission only regulates insurance, not MD's. The Medical Board only cares if you have "injuries" (for malpractice), they don't care about how the MD codes the surgery. Most patients don't mind because, had UHC NOT paid, they would not have billed me anything....they would have just " settled" for what I paid them up front. Because the patient usually doesn't get a bill, most don't mind and/or don't complain when the doctor submits "medical" codes and gets payment. It is a common practice by bariatric surgeons (even the "good" ones!), but it's wrong, wrong, wrong. I am continuing to pursue it because I work in the healthcare industry and I am just so infuriated by all the fraud, abuse and waste in "the system" that I am not going to let them get away with this, even though almost all of them do it!! Sorry to go on and on, but I am just SOOOOO frustrated and angry that I go on a rant when I discuss it. I asked all the right questions, reviewed the contract, etc., etc., and I STILL got "used". I am still trying to work with UHC to either ask the doctor for a refund or else tell him he needs to refund it to me...even if I don't get it, I don't want the doctor paid twice. If your insurance doesn't cover your surgery and you end up paying yourself....BE SURE that you have an "iron-clad" contract and understanding with your physician about what will be billed and HOW it will be billed. As a side note, even my PCP said it's "illegal as hell" (quote, sorry for the language) the way they billed it; it's not just me being upset because I didn't get a refund.

Have u had a recent xray? 3 yrs of a lapband, almost daily vomiting, I suffered severe nighttime reflux. My band had slipped. gained 30 lbs back during the year I was unfilled. Last July I had a sleeve revision. Sometimes reflux is the ONLY symptom of a slip. I had a minor slip that turned into a major slip and couldn't be fixed on it's own. Good luck! I know how miserable reflux is.