Search the Community

You certainly need to get a second, and probably third, opinion to find out what's going on; they should be able to explain to you, in layman's terms, what your situation is and what the options are for treating it. That is usually a straightforward and insurable step here in the States, but I don't know what hoops you may have to jump through in the UK. It does sound like something's not right in what they did (which is why you want a second, impartial and uninvolved opinion,) as strictures are not common with sleeves that are done correctly; they are common and easily treated with an endoscopic dilation in and RNY, and that may work with a sleeve stricture, or may not depending on what caused it (usually a misshaping of the sleeve.) I did quite a bit of research on these topics a few years ago when they found a cancerous polyp in my stomach; fortunately it was very early and all treatable endoscopically, but all of these various options were discussed and researched. There are some Facebook groups specifically for patients with partial or total gastrectomies, which is what they are proposing for you. The most common approach here, and what it sounds like they are proposing for you, is a Billroth 2 gastrectomy, which has been around for about 140 years, and is the basis of the RNY gastric bypass, The main difference between a partial or total gastrectomy is whether they can use some of the remaining stomach to form an RNY like pouch (partial) or remove all of the stomach and attach the esophagus directly to a loop of intestine, or an additional roux limb as in the RNY, and form "stomach" pouch in the intestine where the esophagus is attached. So, going without the stomach is possible and entirely livable (there are several books on Amazon about "eating without a stomach" which go over what is basically a normal bariatric diet progression.) To the surgeons I was dealing with (at a major regional cancer center,) the total gastrectomy was a much bigger deal surgically and recovery wise than the partial, as attaching the esophagus directly into the intestine was a much touchier procedure with a more extended recovery and healing time (on a feeding tube for several months,) than going through even a small pouch of stomach tissue - something else to consider with whatever choice you have in surgeons (try to find one who has done a lot of these.) One of the things that stood out as fairly common amongst the Facebook group was problems with bile reflux, and you can see how that could easily happen by looking at the altered anatomy. The surgeon I was dealing with said that he did not experience those problems if he kept the various limbs within certain minimum lengths (which presumably some other surgeons didn't do in order to minimize malabsorption and weight loss,) so another point to consider in finding a surgeon who has some direct experience with these problems.

Hi I have Kaiser NorCal and I went to my primary and just told them I want weight loss surgery. She sent a referral to the Bariatric department as I had a BMI of 38 and high blood pressure so I met the requirements, which for NorCal are a BMI over 40 or BMI over 35 with a health condition. I was contacted by the Bariatric department and I had to watch a video and take a test it was easy. Then I had to weigh in with their department and meet with a nutritionist. After all that was done, I was able to meet with the surgeon and he gave me a go away of what I had to lose in order to qualify. I had to do a psych evaluation. Once I lost weight I did some bloodwork and now I am scheduled for surgery on October 12 of this year. I started this process in January, I was scheduled for surgery in September, but got pneumonia the week of the surgery so it was postponed and now Kaiser is supposed to strike so I’m hoping that it doesn’t get postponed again you do have to maintain your weight the entire process and can’t even go over half a pound of your goal weight. Hope this helps.

No I haven't I am just on the first step to get scheduled for my surgery so right now I am doing WW trying to lose the 15lbs and then keep it off till surgery. I am doing a good job of trying to mirror the bariatric diet with lots of protein so the hunger isn't there its the crazy cravings. I like to have a cocktail or two every night and I have stopped drinking so I am missing that part.

Has anybody had surgery in Mexico bariatric Center in Tijuana Mexico? Could you share your experience? Thinking abt getting a revision DS there.

https://samabariatrics.com/quit-smoking-before-bariatric-surgery/

at three weeks out, I could barely eat anything! the amount you'll be able to eat will gradually increase and at some point level off. I probably eat about half as much as I did pre-surgery - but at this point, no one would be able to tell I've had bariatric surgery. They probably just assume I'm a "light eater", like many of my never-been-obese women friends are. If I go out to dinner, I usually just eat half of it and bring the rest home. Before surgery, I'd eat the whole thing - and sometimes dessert, too!

I'm a year out from my surgery and at my last dietitian meeting we discussed maintenance calories which I have been looking forward to that discussion for forever but I was really shocked and I can't believe I didn't know this after all of my research before and after surgery. He said my calorie goals for life should be between 1300 and 1500 and I had no idea that was going to be so low. I honestly went into surgery thinking that the average calories a person eats is 2000 so I must be eating 3000 or more to be so over weight and I just needed to get back to normal. I thought that I would be able to use the surgery and lack of hunger to eat super low calories and lose the weight and since month 3 I've been at 1000 a day. My hunger is back and 1000 is a struggle now and I'm using all my years of diet experience to fill up on low calorie food as well as hitting all my protein and water goals. I thought that soon I'll be able to eat more so it's just a temporary situation, but now I'm worried about long term success. If I'm hungry at 1000, I don't think 300 more calories is really going make a huge difference. So now I'm wondering if the reason why so many people gain the weight back after surgery is because to keep it off we have to keep our calories so low forever? Also, why do we have to keep our calories so low? Why is the average calories 2000 but for bariatric patients 1300 to 1500 is the goal? I always thought that anything under 1500 wasn't a safe number but when I asked my dietitian all of these questions he didn't know. He just knew that to maintain the weight loss, that's the normal goal and that if I wanted to eat more I could exercise more. So did everyone else know that the calories after surgery were going to be low for life and I just somehow missed this important fact? Anyone know why our average doesn't match the so called normal average? I was really excited to be close to goal but now I'm scared because I can see now how easily it can all go away.

I actually had diabetes when I started the process. My A1c was around 7.6 or so and my glucose levels were usually around the 160-170 rang when I would test. I was on 3 diabetes meds, a cholesterol med, a blood pressure med, 2 anti-inflammatory meds. Not only did having diabetes not delay things, having comorbidities actually helped speed up the approval process for me. I know you wanted gradual changes to your eating, and to a certain extent you can still have that. But it's important to start getting your mindset and habits changed at least a little before surgery. Once you have it, you have to make drastic changes pretty fast. Better to start now. I would start by eliminating soda and anything carbonated. Get caffeine from coffee (the kind you can make at home) using sugar free sweeteners and low/no calorie creamers (or almond milk) and tea (personally, I prefer tea). Swap out regular chocolate, candy, popsicles, pudding, etc to the sugar free kinds. Start lowering your carb intake and try cutting down on pasta, bread, potatoes, etc... There's keto versions of bread that taste fantastic. Look at the way the bariatric diets require you to eat (protein first, then veggies, then carbs) and try to plan your meals around that (protein helps you feel full longer). Practice getting in at least 64oz of water now so you can be used to drinking it a lot. You can still eat yummy foods, just change the way you do it. It's less jarring if you start the process now.

I went to see my GP this week to get some testing done. I actually looked forward to going, knowing things would to be better than the last time I saw her pre-op. She along with everyone in the office flipped out when they saw me. I'm down over 80 pounds in 5 months. The nurse said I lost a small person. LOL I could fit comfortably in the chair when they drew my blood. You know that little table that folds down in from of you? I had room to spare. She asked if I was having fun buying new clothes. I told her yes. I love thrifting and now able to get around to do it. The head nurse had to come in and take a gander at me. She called me yesterday and told me my bloodwork results were amazing. Everything is in normal range now. I am no longer pre-diabetic. Even my liver and kidney functions are normal. Those things scared me the most and my main reason to get the Gastric Bypass. Don't ever let anyone tell you those things aren't reversable. My GP said she can't believe my numbers. Told me all her sleeve patients don't have these kinds of results in a year, even after prescribing them Ozempic. She sees patients from a local surgeon who only does the sleeve with no follow up support. I'm guessing most of those people aren't following any protocol because I see the good results on here, every day, of sleevers' success stories. I love reading them. I went out of town to get my bypass in April that thankfully has a great Bariatric support team. I go back to see them for my 6-month checkup Oct 11. They did a vitamin panel on me last time and all was well except my B12 was a bit high but nothing to worry about. And I go back in January for my annual physical with GP. Was told they can hopefully start taking me off my meds. I will be closer to goal weight by then. Something else to look forward to.

Hi, I had gastric sleeve on 8/17 and developed an itchy hives rash on my chest, back and butt around 2 weeks after. I still have them, but it has slowly gotten better. My bariatric office had no concrete answers. I think my bariatric multivitamin chew may be the culprit. High in niacin B3…I may be having a reaction. I stopped taking them a few days ago and started to get a little better. I have had the random skin infection in the past, but nothing like this. Unfortunately I have no answers.

Hello, I had GB on 8/16/23 I developed slight acne along my jaw line and chin around 2 weeks post op. I am now 5 weeks post op and my acne has subsided but left me with acne scars. I was just told it was my hormones fluctuating and to make sure to reach protein and water goals as well as take my bariatric vitamins.

I like Chewable FloraVantage Probiotic from Bariatric Advantage. Tastes like grape smarties.

Yes. They said it looked like a possible hernia, so I have an appt with my bariatric surgeon (he also repairs hernias) and he's going to take a look at it.

I would also recommend getting your gall bladder checked! Gall stones are very common post bariatric surgery, and can lead to nausea, vomiting and loss of appetite. I would reach out to your doctor about it, for sure!

It is 1000000% normal and generally unavoidable. Your hair naturally goes through growth and shed cycles and any major trauma to your body (surgery, stress, pregnancy, etc.) can impact that cycle. You just had major surgery and now your body is losing a significant amount of weight in a very short period of time, which triggers that shed cycle to accelerate. For most folks it lasts a couple months, slows down, and then you start to see regrowth. Take your bariatric vitamins, hit your protein goals, and stay hydrated. Those are your best tools for helping minimize it and ensure regrowth comes in strong. Some people also supplement with collagen and biotin, which certanily can help, but they won't stop the shed. Hang in there, its totally normal and doesn't last forever!

What is his reasoning for all these restrictions?? I'd consult a dietician trained in bariatrics, most doctors and surgeons have NO CLUE about nutrition and come up with these odd plans that have no medical basis because they don't think about the patients who will actually try implementing them. If the dietician there supports his weird restrictions, find another one. There is no medical data saying bariatric patients should avoid cheese and protein shakes post surgery. Are they checking your vitamin and mineral levels? You'd become deficient eventually without proper supplementation on a plan like that. Early post op recs are different than maintenance when you are over a year out and your restriction has eased up some. I know some docs favor a no snack plan because they think snacks will lead to mindless eating, but planned snacks can actually PREVENT mindless eating. Anyone can hold out for an hour or two when they know when they will eat next... Again, some people can survive on this sort of plan long term after the first year, but to try forcing it when you are still healing is cruel and misguided. You will end up with a lot of fatigue and weakness because you aren't getting enough nutrients.

Thank you so much!!! I have to put it off until I finish my medical assisting program, but we're looking at January or so for the surgery. So just a few more months and then no more period!!! I do have an appt with my bariatric surgeon in Oct to see if that bulge just above my belly button is a hernia or not. If not, then we have to figure out what it is. But I can still work out without pain, I'm still incredibly healthy, and all in all I'm happy. I just want the rest of this nonsense to be finished. I never want to have another surgery, yet as I say that, I know I'll eventually have my skin surgeries lol But I actually WANT those, so maybe that'll be different.

Ugh, I'm so sorry that you have to have another surgery! I had a hysterectomy 2 years ago (cancer) and the doctor is right, it IS major surgery and man do you have to for real do nothing...and more nothing...and get really good at rolling out of bed and not clenching your abdominal muscles for things! The recliner was my best friend, along with a small pillow to brace against my tummy and an abdominal binder helped a lot! Oh and post partum underwear because you don't want anything tight on your tummy... Feel free to message me if you want some tips for surgery and recovery...or just to vent. I had reproductive issues for years before the cancer. I don't do nothing very well so I had to take up diamond painting and adult coloring books to keep my brain occupied. But, like with bariatric surgery, you only get one chance to heal well so best to go along with it. You have had so many other procedures I can't imagine this will keep you down for long. I was upset I had to have one, but now I am honestly soooo glad. It is fun to pack for travel without period gear! LOL I was one of those women who would bleed for months on end and no longer dealing with that is a huge relief...

I don't think I've ever been told that could be a problem? The surgery can make your hair fall out in some cases, but I don't think I've ever heard of anyone having issues with coloring it. Do you know why that would be a concern for a bariatric patient?

I would want to look closely at this, verifying the bile reflux and determining if there is any acid reflux component to this before getting into long term treatment options as the treatment can differ widely depending upon that diagnosis. If it is bile, then I wouldn't expect Pepcid or other anti acid meds to do much as the are treating acid and not bile, a base. I'm not sure what meds they do use but likely different ones. Bile is used to neutralize the acid coming out of the stomach along with the digested food into the intestines. Is your surgeon in the loop on these findings (I assume so, but check if you haven't heard from them yet,) as that may change his prescriptions. If it is strictly a bile problem, then a bypass will probably correct it, but not guaranteed as it moves the stomach/pouch outlet downstream into the natural path of bile secretions; the key, according to one surgeon I discussed this with, is the length of the roux limb, as that is the one that connects the pouch with the mainstream intestine and how far any bile would have to travel to reflux into the stomach. This doc noted that at 80cm or greater (IIRC) he didn't run into any bile reflux problems. The basic RNY procedure has been around for some 140 years for gastric cancer and gastroparesis (it is usually termed just a partial gastrectomy, or likely some other fancy latin names as well,) and it that use, bile reflux is a not uncommon complication. My non-MD take on it is that in those cases, they tend to keep the limbs short to minimize malabsorption and weight loss (last thing a cancer patient usually needs is more weight loss!) So, the longer limb makes sense here. Discuss this and make sure that your surgeon is up on this aspect of it. The other option if it is basically a bile problem is the DS, duodenal switch, which is pretty much a guaranteed cure for any bile problems owing to the very long path between the bile ducts and the stomach, but relatively few bariatric surgeons offer it owing to its greater complexity. Note this only applies to the "traditional" or Hess DS and not the newer SIPS/SADI/"loop" or simplified DS, which like its mini-bypass cousin has bile reflux as one of its common complications. The DS will not help any acid reflux problem as it uses the existing sleeve (though may resleeve it if it was malformed causing GERD rather than just overproduction of acid,) while adding the intestinal rerouting for malabsorption. The DS is a better choice over the RNY revision if slow or inadequate weightloss is an issue, too, as it is a stronger metabolic tool. Good luck on this - bile is surely a much less common problem with the sleeve than acid reflux, so the industry isn't quite as settled on solutions for it.

I use Vital Proteins ( currently on sale in Costco ). I mainly add it to my morning coffee - typically a protein coffee as it is. I have used it for years prior to surgery and I continue to use it. As others have said, nothing can stop the hair shed - I am still shedding at 5 months, but a tiny bit less than when it started at 3 months. However I know the collagen will help new hair growth. I take a bit of extra biotin - more than just my bariatric multi - and keep up my protein intake. I use a Biotin & Collagen shampoo and conditioner - though I know that won't truly help, lol. It's a mental thing and it was on sale at Marshall's. At worst, my hair is still clean, lol. I take the collagen more so for joints and skin since as we get older our collagen depletes. It takes a few months to even really notice any differences so it is something you have to stay consistent with.

Greetings, So as most people do from time to time - I fell off the wagon for about two weeks while on vacation and in the process of that, I noticed that I was able to eat more without any discomfort. I wasn't gorging on food like I did to gain the weight that I had, but I was able to handle bigger portions or that 3rd slice of pizza. I screwed up and I know that. I actually feel guilty, especially considering all the weight I have lost. It was just the first time where it was harder to stay focused as I wanted to enjoy my vacation. I know next time I have to plan better. Now I am aware that the stomach does stretch again, but it is my understanding that it takes years for that to happen per what I have read from doctors - which is why some people who have bariatric surgery tend to gain some or all the weight again years later if they haven't maintained their better eating habits. I am only 5 months out from the sleeve, so I was just curious why I was able to eat more than usual at this early point. I am back on track now, but just wanted to ensure that this is normal - that the stomach can stretch temporarily in the short term and things should be back to normal now that I am eating smaller portions again/proper foods. That I haven't already stretched out my stomach a bit. I would appreciate any feedback here. Thanks, HM

From what I remember they cover all obesity-related surgeries, but I do not remember ESG being on the list specifically. I also think that members in Virginia had fewer hoops to jump through than members in DC and Marylin. This is from the CareFirst site. Blue Distinction® Specialty Care The hospital you select can have a direct impact on the care you receive and your procedure results, but finding the right facility can sometimes be a challenge. The Blue Distinction Specialty Care recognition program identifies health care facilities with proven expertise in delivering specialty care. There are two designations: Blue Distinction Centers - Health care facilities recognized for expertise in delivering specialty care. Blue Distinction Centers+ - Health care facilities recognized for expertise and cost efficiency in delivering specialty care. Blue Distinction focuses on high-volume, high-risk and high-cost areas of specialty care, including: Bariatric Surgery centers provide a full range of bariatric surgical care services, including inpatient care, post-operative care, follow-up and patient education.