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Thanks for the reference. I ended up having a capsulorrhaphy procedure on my right shoulder about two months after my VSG surgery. They also repaired the labrum, rotator cuff, and she spent over 45 minutes just cleaning up the bursitis. She put in 4 anchors during the procedure just to try and stabilize the shoulder. I used Alison Cabrera @ UTSW, and would highly recommend her. I ended up on daily hydrocodone just to get me to that surgery, however, I was still able to maintain my daily steps. Shoulder surgery is no joke! And this was all done to try to get me another 10 years so I can get reverse shoulder replacement 😐 My range of motion is limited now, but that was to be expected. I'm doing my best to protect my left shoulder so I can avoid surgery as long as possible. I've finally gotten used to sleeping flat on my back. For VSG follow up, I ended up about 80lbs lost. Right now I'm sitting about 75lbs down (gained 5lbs back) as I am noticing I can eat a little more (but still really restricted). I have a little anxiety about that as I am just over 10 months post VSG surgery. The last thing I want to do is undo all of the work. I'm still staying positive and using the Streaks app (iOS) to help with motivation (70K steps a week, plus 360 minutes of workout per week (includes walking)). I need to get back into putting all of my food into the fitness pal app. After the VSG surgery and the shoulder surgery, I ended up in a depression. Talking with a therapist who had experience with bariatric surgery helped. I don't think it was a depression just because of the VSG. I'm sure the chronic pain followed by a shoulder surgery (sling for 6 weeks post-op; and PT for 5 months) contributed significantly. As I mentioned previously, make sure your are taking care of your mental health. @Humikrig Good luck on your surgery!

What’s the difference between the sasi and the Sadi. I am contemplating the Sadi and I just learned it’s the same as sips but this is first I heard of sasi. Wow there are alot more bariatric surgeries than I ever realized.

Hello, I had a sleeve gastrectomy in 2016. Recently I had an endoscopy due to swallowing issues (I have multiple sclerosis). The biopsy of my stomach came back with changes and i had mild damage in my distal esophagus. I do not have a GI and have not been being followed by the bariatric center for several years. I have an appointment to see my bariatric surgeon as it seems that the recourse for bile reflux is a revision. Has anyone else dealt with anything like this?

I agree with NickelChip, your PCP not knowing about the surgery is not a big deal IMO. What is most important is that YOU understand your surgery and whatever anatomy you end up with, and that you are able to communicate that to emergency responders and ER doctors in an emergency. Everyone close to me knows what surgery I've had done, knows the technical term for it, and it is in my phone's health info that emergency responders can access. A lot of SADI and DS patients carry a card illustration of their surgery in their wallets or on their phones. When I was considering the SADI and two surgeons recommended I do the DS instead I had reservations. I live in North Carolina and we have some really stellar bariatric surgeons here in Raleigh. But I plan on moving back to New Zealand in the next few years and DS surgery is really rare there, there are only 2 surgeons I know of in the country who can perform it and they are both in Auckland. My surgeon here told me as long as I planned on having the first few years locally here in Raleigh, and as long as there was one surgeon that could be consulted about my care in the area I move to, I should be fine with the DS... The same applies to the SADI. What we tend to forget is that people have surgery on their small intestines for a variety of reasons besides bariatric surgery. Cancer, Crohn's, etc... Many people have designer insides and while not every gastro doc is trained to do a DS or SADI, they have the technical skill to find a surgeon to consult with about your surgery should they need it. In terms of your PCP what she most needs to know is that it is vital to order a FULL panel of bariatric labs for you at least once a year, as well as at any point if you start having symptoms of a vitamin deficiency or protein deficiency. She'll also need to watch your iron levels. These are things a PCP can do. She also needs to be in good communication with your surgeon if she has any questions. Doctors act like they can't talk to each other, but they can. I have an autoimmune GI condition that causes ulcerations sometimes (like Crohn's) and my bariatric surgeon actually called and consulted with my GI doctor to ensure they were on the same page about the surgery and to ensure it was a safe surgical option for me. That made me feel SO well cared for! My PCP has a sister who had the sleeve done so she's familiar with the bariatric surgery options. She is well read, researches what she needs to, knows how to consult when she needs more info, and trusts me to tell her what I need when I need it. For me, that's the perfect PCP. I don't need her to understand the complexities of my surgery. I just need her to know when she's out of her depth and needs to refer out to a GI doctor, my bariatric surgeon, or the ER.

I'm not sure a PCP would have too detailed an understanding of complications from any bariatric surgery, even a more common one. At least I wouldn't rely on that. Although I have a feeling if she has a patient who gets a certain procedure, she might be more likely to read up on it. Is your surgeon attached to a weight loss center of some kind? Mine is, and I'm expected to go for a follow up at the center yearly, basically forever, so I'll always be in close contact for questions. Honestly, I think you need to choose your surgery based on which one will work best for you, which could very well be the SADI. A long term complication is going to be rare, but also you'll know to bring it up if something happens. You don't have to rely on your doctor to think of it, and any doctor will know how to find out more of needed, even if they don't really know much about it now.

Update. I just met with my PCP and it was a total waste of time in terms of getting my questions answered but it gave me more to think about. I mean I appreciate her honesty but she hadn’t even heard of the SADI procedure. She said in terms of whether I am fit for surgery or whether she thinks I am a candidate for bariatric surgery she can answer that and I am but in terms of which surgery is the best fit she would defer to the specialist. It kinda scares me a bit her not knowing much about it. Not that I can’t make a decision now without her just that what if I have a long term complication that’s surgery related and she doesn’t know it because she doesn’t known the surgery. I can just see me on a wild goose chase trying to get to an answer on something that someone familiar with the procedure would know about. I guess if I have a medical issue I can always ask her if it could be related to my surgery and she will search it online?? She said if I had any issues immediately post op we would call surgeon and ask if it could be related to surgery or if I should call my pcp but I don’t know if something happened say two years out whether she would realize if it was related to my altered anatomy.

I know I have been active on here for a while now, and probably made far too many posts for someone who hasn't even had surgery yet, but today I put down my deposit payment for my gastric bypass surgery with Spire Gatwick in the UK, for the 14/05/24. It officially feels real! Until now, I had so many anxieties as to whether or not it would happen in case I couldn't find the money, or get approved for a loan etc, so it just feels like so much relief now that it is all finalised and I know it is gonna happen. I have my 1st dietetic consultation & my pre-op assessment on 05/04/24, and then my 2nd lot of pre-op bloods on 13/05/24. I am trying to log it all in my bariatric surgery journal which I am finding really useful! I guess I just wanted to post to just express how happy I feel right now, to people who I know will understand ❤️

Wow, great job on walking. Sounds like you have the right attitude and drive to be very successful with the bariatric surgery. I would like to swim, but there's not very many places near me with indoor pools. Which would be ideal with my knee. Keep up the great work.

Thank you!! I am incredibly happy. Getting my Vitamin D from 13 to almost 100 has done wonders for my depression. The extra energy DOES feel amazing, especially because I have Chronic Fatigue Syndrome and I never really expected the surgery to impact that favorably. The first 4 weeks were hard energy-wise. I remember how exhausting even taking a shower was until I was past a month out. Bariatric surgery is major surgery and it takes our bodies a while to heal from that. Add in our dietary restrictions as we slowly incorporate food again and it is a great recipe for fatigue. I'd say by about week 8 the nausea disappeared and I noticed I was gaining energy steadily. I could stand in the kitchen and cook. I could go for a short walk. I could shower and actually leave the house without a nap first. I had not been able to do those things in several years so it was a striking difference. Hang in there!! It is a good sign you feel about back to normal energy-wise right now! Yes, according to everything I've read, the goal is 50% by 6 months for a DS surgery, so I'm ahead of my goal. I really hope things continue on steadily. A lot of people lose a chunk early on and then taper down slower after month 3. My body doesn't like to follow general trends, so I stalled out for most of that time and then suddenly my weight loss sped up! It is quicker now than it has been since about a week post op. Isn't that funny? Everyone's body has its own rhythm. It is so, so hard to trust that, but it seems to be true the more people I see go through this surgery.

Caffeine is usually restricted for the first few months in a virgin DS/SADI surgery to help prevent dehydration. You may not have this restriction put on you since you already have your sleeve and should keep food and fluids down fine post-op since they probably won't resleeve you unless yours was done wrong. Even if they put you on caffeine restriction, it is only for a little while. There is no reason to restrict it long term, it doesn't harm the digestive system. My partner loves to dine out and we don't have kids, so I've been eating out since a month after surgery. I am careful with my choices, the first thing I ate out was grilled swordfish and sauteed green beans. It was fine. I've since eaten Thai curries (mild), pho without the noodles (they put veggies instead), sashimi, fajitas with guacamole and cheese sauce (no tortillas, rice, or beans), steak (ribeye is my favorite and digests better now than it even did pre-op), wings, traditional Chinese food (nothing fried, no rice), Peruvian chicken, the list goes on and on. I try to stick to protein/veggie options. Anything I wanted to eat at a restaurant I tried to have a version of at home first to know how it would affect me. I tolerate most things pretty well, though it seems my digestive system prefers baby spinach over iceburg or romaine lettuce, but that's not a huge sacrifice. And I can't eat beans at all, but I never really tolerated them pre-op either. Also I try not to have too many cruciferous veggies at once (broccoli, cauliflower, cabbage), as they cause bloating, but I had that problem before surgery too. (I have had IBS and an inflammatory bowel disease since I was a teenager.) That said I try to make healthy choices in general whether eating out or eating at home. DS patients don't really need to restrict fat because we malabsorb so much of it (regardless of what the dieticians tell you) and SADI patients can eat a moderate amount of fat as they malabsorb a moderate amount of fat. Too much fat in one sitting can cause diarrhea, but you'd have to really make an effort to do that, and any bariatric surgery other than the sleeve can cause that issue. Coke Zero does not have sugar alcohols in it, it has Splenda, so it is fine from that perspective. Carbonation is only an issue if it bloats your sleeve. However, it can cause you to be hungry faster, or cause gas due to the air bubbles, so it isn't the best habit to have long term. But it won't piss off your intestines. I switched to unsweetened iced tea and carry Splenda or Equal packets with me! Sugar alcohols are things like erythritol, xylitol, and malitol. Allulose can also cause gastric upset depending on how tolerant you are of it. I can usually have a little of any of those, but more than a tablespoon and I'll be in the bathroom half the night. 🤣

On the pre-op diet, I liked the Bariatric Fusion chicken soup flavor, and I also was able to do two scoops of Syntrax Nectar unflavored in a tomato basil soup. It gave it a creamy consistency, similar to if you added some milk or cream. Post-surgery, the only one I can still stomach other than the unflavored powder is Syntrax Nectar Naturals in orange flavor, which is somewhat convincing as an orange-juice-adjacent drink. Think TANG.

I take a lot of vitamins, more than that list. My advice is to buy these containers, enough for a month, and dose out all your vitamins for the month. https://www.amazon.com/gp/product/B08QR78YP3/ I spend about $200 every other month. You could do it a bit cheaper depending on the brands you buy (for instance, Citracal Petites are more cost effective than the bariatric calcium chews and both are calcium citrate) and which ones you take. I take a lot because I had some deficiencies pre-op. But they all fit in those cases! I just grab my little container for the day and carry it around with me. I set alarms to remind me to take them. I put my meds in with the vitamins. The way I look at it, my junk food budget is now my vitamin budget, and I feel a lot better taking those vitamins than I ever did eating junk food! LOL

Yes, you have to take more vitamins than you did with the Sleeve. The most common to supplement are a multi twice a day, calcium 4-5 times a day in divided doses, and vitamins A, D, E, and K which your bariatric office will tell you to get in one ADEK supplement, but often you have to break down into the individual vitamins as labwork dictates, depending on your individual absorption. You'll have labs drawn several times the first year, then yearly afterwards to make sure you are getting enough vitamins and iron. But yes, vitamins daily are a way of life for SADI patients. It is also smart to take a probiotic, and sometimes you need extra B1 or B12. Learning about macros is important! I highly recommend tracking your food through the Baritastic app, it will track your macros for you. Don't be surprised if your dietician is useless about things. Sadly, a lot of dieticians don't understand the proper eating routines for a SADI or DS patient and will give you advice meant for a RNY or Sleeve patient. That is why support groups like the Facebook one are so important, because the veterans of these surgeries often know a lot more about them that the surgeon or dietician do. I know a lot about the SADI because I considered it before going with the DS surgery. So ask whatever you want and I'll see if I can answer it!

Check out Fluscheeitaway on IG. She had the SADI 2 years ago and her husband had it as well a few months back. She also recently started a podcast with her bariatric surgeon so that might be a good source of information. It definitely isn't as common as the sleeve and bypass since it's a bit newer and not all insurances cover it, but I have heard it is slightly easier to go from a sleeve to the SADI since they may not have to resleeve you just reroute the rest.

For me the decision was fairly easy, I didn't want to risk GERD chances (I have the worst luck and if there was a chance - even a small one I'd get it) and I didn't want to risk yet another surgery AND the possibility of my insurance declining another bariatric surgery. The second reason was usually you lose more weight with a bypass and I've had a few surgeries with organs removed...I just wanted at least one after a surgery (my stomach) to not being one of them, stupid I know but ...its what helped me decide. Lastly, I'm a researcher and all the numbers in the medical studies journals / research papers looked better to me they pointed to better overall outcomes with bypass, more weight lost, less weight regain, better chances of reducing my pre-diabetes etc. I'm fairly anal retentive so I knew I'd be the same way on making sure I took my vitamins so I didn't worry about that aspect of it. I listened to my surgeon who didn't really help..he said both were good choices for me, so that left me having to research on my own. Good luck on your journey!

If your levels are low then I would definitely recommend adding the injection and seeing how you feel afterwards. Do you take a bariatric vitamin?

I've been using them for 3 years now and have had no issues my blood work has been great since been using them. Where the regular bariatric vitamins weren't working at all even taking extras I was always lacking against my teams advice I started using the Gastric Bypass package vitamin patches And even my team was surprised at how high my numbers were

Stalls are stalls. There is absolutely no rhyme nor reason to them, they just happen. People try to break them by upping or lowering calories, changing exercise regime, whatever. And when the loss restarts they SWEAR that what they did caused the renewed loss. The fact is, stalls last a few days, or worse, a few weeks and then they end. If you stick to your programme you'll start losing again soon. You don't need to do anything drastic.

Same on heart rate! In fact I thought it was hypersensitivity to the few carbs I was having. My bariatric team had me wear a glucose meter for two weeks because of it. I wonder why the heart does this? At second thought I felt maybe it was due to different stomach placement with in the thoracic cavity and I was just noticing it beating "as normal" and perhaps it always beats that fast, but my heart on average beats 68bpm. When I checked when full it raised to 90bpm. I'm glad someone else experiences this as well!

I second the suggestion of getting a few four packs and seeing what you like after surgery. I drank protein shakes the first couple of days when I could barely stay awake to drink them and get my water in. I liked the Fairlife ones the best but many like Premeir. I’m on day 8 of post-op full liquid now (3 weeks for my program) and have shifted toward the savory. I made a turkey bone broth and a beef Asian spiced bone broth before surgery and froze in pint containers. You can buy bone broth or bariatric broth packets as well. I've been rotating between those and “healthy” canned cream soups mixed with Fairlife milk - adding additional protein powder as needed. I spotted my miso in the back of the fridge tonight and am going to add that to the mix tomorrow. I strain everything I make through a fine mesh strainer and add plain protein powder to meet requirements. I think the variety of options is helping me get thru.

there are 17,501 posts here on Bariatric Pal about the infamous "three-week stall" (it often strikes the third week after surgery, but not always - it can be the second week - or fourth - or fifth - but in any event, it hits most of us very soon after surgery. And no, I am NOT kidding about there being 17,501 posts on it. Here they are: https://www.bariatricpal.com/search/?q=three-week stall best thing to do is just make sure you're following your program - and then stay off the scale for a few days. As long as you're following your program, the stall WILL break. It usually takes 1-3 weeks. And just so you know, this is likely the first of many stalls..

Frequently Asked Questions About BariatricPal's GLP-1 Weight Loss Program How does BariatricPal's Weight Loss Program work? BariatricPal offers a comprehensive and convenient solution for weight loss through our telehealth platform. Our process is designed to be straightforward yet thorough, ensuring you receive personalized care tailored to your needs. Here’s how you can start your journey towards a healthier lifestyle with us in three easy steps: Complete the Eligibility Quiz: First, take our eligibility quiz. Telehealth Appointment: You'll have a telehealth consultation with your new healthcare provider to discuss your health and treatment options. Medication Delivery: If it's medically appropriate, you'll receive your medication directly from our mail-order pharmacy provider every 30, 60, or 90 days, depending on your provider's decision. We aim to foster a long-term relationship between you and your provider, offering ongoing care tailored to your needs. The BariatricPal GLP-1 Weight Loss Program is crafted for those seeking a sustainable, long-term solution to weight management. Is the program confidential? Absolutely. Your privacy is paramount to us. Only our medical team and prescribers can access your medical data and order history. For more details on how we protect your information, please refer to our Privacy Policy. Do I need a prescription? No pre-existing prescription is required. If you're eligible for treatment following your consultation, our medical team will issue you a private prescription. This streamlines the process, allowing you to focus on your health and progress without the hassle. How much does the BariatricPal Medical Weight Loss Program cost? We offer a customized prescription plan designed specifically for you, guided by our experienced doctors. The first month costs $247, including your medical telehealth consultation, a month's supply of weight loss medication (GLP1-s), and shipping directly to your home. For subsequent months, the cost is $297. How often will I receive a shipment? Your medication will be shipped promptly after our doctors review your progress and renew your prescription. Shipments are scheduled every 30 days to ensure you consistently have your medication on hand. Please allow 7-10 business days after your consultation for your order to arrive.

Great questions! HSA/FSA Payments: Payments made through HSA and FSA cards are not accepted. However, we are working on integrating this payment method in the near future, as it is currently in the product roadmap. About the Medications: We're excited to start offering compounded Semaglutide and plan to soon include compounded Tirzepatide. The decision to initially provide compounded options stems from our commitment to affordability without compromising quality. As the prices of branded versions become more accessible, we'll be sure to include them as well. Quality and Safety Standards: The pharmacies within the BariatricPal network uphold the highest standards of quality and safety, adhering to regulations set by state boards of pharmacy, the FDA, the DEA, and the USP Convention. This includes strict compliance with USP General Chapter 795 to ensure our compounded medications' safety, potency, and quality. Each batch of compounded Semaglutide undergoes rigorous quality assurance and control checks, including: Verification of Active Pharmaceutical Ingredient (API) Certificate of Analysis from FDA-registered manufacturers. Aseptic compounding processes to produce specific lots. Independent third-party laboratory testing for potency, sterility, and endotoxicity. Unique lot numbering and electronic tracking for dispensing. Post-Bariatric Surgery Considerations: The timing for starting GLP-1 medications post-bariatric surgery is a personalized decision that should be discussed with your bariatric surgeon or one of our telehealthcare providers. Individual needs and recovery processes vary, making it essential to tailor this aspect of your care to your specific situation.

For those that are interested in this, is HSA and/or FSA accepted for payment? Is this compounded and not the commercially available stuff? How long after you have bariatric surgery do you have to wait before you can take this medication?Personally, I won't be partaking, but I've seen many posts on here from others who want to, so I was just thinking of questions that weren't mentioned in the original post.

I had surgery on 12/4/23 and I’m currently down 58 lbs. I’ve hit a few stalls and it seems like I’m not losing much at all anymore BUT it’s the non scale victories for me honestly. Like clothes fitting loosely. Joints feeling wonderful. Energy levels finally returning. Stairs being easy!! Confidence levels rising!! I’m feeling happy and healthy. Honestly choosing to enjoy this whole journey to better myself and my habits has been the biggest key. You have to change your mindset. I think the stubborn belly fat is the last to go for most all of us. I got a facia roller… I use it about every other day on my stomach, thighs, and batwings lol and I think it helps break up the tissue and my skin is appearing smoother. As far as others not noticing… it sucks but sometimes when you see someone daily you don’t notice changes. It takes time away that creates the shock. Don’t let that deter you or make you feel like this whole process has been worthless. You’re doing this for you! No one else! Also, my doctor seems to be the only one that would prefer me to fast and only eat once a day. He says to focus mainly on protein, but never gave me a daily goal. I eat what fills me and then I put whatever’s left away. Feeling the need to always finish my plate is what got me in this mess in the first place. That’s why we are suppose to be taking our bariatric multi daily. To help assist with nutrients we can’t fit. You’re doing good. Keep up with your routine. You won’t be disappointed!