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I had the exact same symptoms/excruciating pain starting at 21 months post-op. I went to the ER twice, hospitalized twice, had a CT, an upper scope, multiple lab tests-all negative. I even had my gallbladder removed as a last-ditch effort, to no avail. My bariatric surgeon said he was "all tapped out" & had nothing else to offer me surgically. Fortunately, my surgeon referred me to a bariatric subspecialist who said he did not believe the upper scope results since a GI doc did it & not a bariatric specialist like him. Sure enough, my marginal ulcer was hiding beneath the cuff/anastamosis; the first doctor did not go far enough down & retroflex the scope. Read about marginal ulcers. Up to 26% of RYBG patients get one, usually in the first yr post-op. There is a very informative story in Bariatric Times regarding the healing of marginal ulcers which my surgeon did not know. You need immediate-release liquid omeprazole w/ sodium bicarb, not the sustained-release caps. If you have a marginal ulcer, I feel for you. I am still struggling with it 4 months later. Hope you are feeling better soon. Keep us posted re: your diagnosis & progress.

I don't have what I would consider an eating disorder in the purest sense, so this advice is not from someone who has battled it. I can tell you that when I was going through the process, the psychologist wanted to know if I ever ate so much I purged. I explained there were times where I wanted to, but I didn't. She simply reasked the question, and when I said no I never actually purged, she was fine. I'm guessing they are concerned about self-destructive I also would note that it is really dangerous to overeat yourself after any of the bariatric surgeries. I had the lap band before, and yes, I did eat way more than I should have, and I was one of the "lucky" ones, but other people had band slips, esophageal dilation, or band erosion. With this and the sleeve, I would presume staple line leaks would probably be the largest danger, but even the best case would probably be a stretching of the pouch or sleeve. I have a friend who is an alcoholic. At least that is what he would say to you as soon as he introduced himself. He went through the AA program and hasn't had a drink for nearly 30 years. He explained to me that AA teaches "Once an alcoholic, always one". He was very concerned about transferring his coping method (food) back to that of alcohol. He went into the process very conscious of that, and thus far is doing very well with no problems. So I'm not saying it can't be done, but I would definitely not have the surgery until you can satisfy yourself, and your psychologist that you have it under control. I don't know if they have Overeater's Anonymous (OA) in Australia, but if they do, you might be able to find some people that had ED and had bariatric surgery, and see what they say. I'm mostly concerned about you causing physiological damage from even a single "binge" episode. I do say to take all of this with a grain of salt, I'm not that far out there myself. I wish you the best and hope it works out best for your health. One of these days I really want to visit AU, the home of Holden, which brought us the modern Pontiac GTO and the Pontiac G8...I only wish we could have gotten the Holden "Ute" but that body style doesn't do very good over here.

That's a good start, so there is hope. Look for a surgeon who specializes in reconstruction after massive weight loss - there is a big difference between tummy tucks, etc. after bariatrics and a mommy makeover.

This is in no way meant to alarm you. I'm just stating what happened to me... Back in 2004, I started having pains similar to what you are describing. It radiated from my collar bone into my neck. I went to the doctor and he sent me to a specialist, who after some tests, found a small pulmonary embolism, a blood clot in my left lung. I was put on a blood thinner for six months. After the six months, they checked again and it had dissipated by itself. My bariatric surgeon has told me that pulmonary embolisms are a complication and that is why he will give the anti-blood clot medicine during my hospital stay and a prescription for when I go home. (I did not tell him that I had had one previously) Please call your doctor...

And keep sharing with us as time goes by, and when your date does come,letus know so we can celebrate with you. This journey is scary, wonderful, life changing, life altering all at once,but,it is vibrant and far from dull. I myself,am just finishing,up my pre Surgery preparations, I've come a long way but still have a distance to traverse. But I will make it thtough, do you have the guts to join me, do you have the commitment to let nothing stop you, to jump over barriers if they come up? Are you scared less of Surgery than continuing to exist as you are? Can you battle nay-sayers, be they doctors, clergy, friends, or even family? Do you believe,this what you need at this time, even if it means changing parts of your body? If you can answer these questions with a YES, then Welcome aboard the Good Ship Bariatrics, we always can use a new crewmate or two. And when you come into the Safe Harbor,of Weight Loss Goal you will be so proud of YOU! That is a guarantee.⛵😝

It should be something that is in one's calculus in deciding upon surgeon and procedure. Practicality is a variable - with a DS, local choices are usually limited if not non-existent, so travelling is always a consideration, weighing differences in experience and technique with the convenience and cost differences of staying local. I traveled for my VSG as at the time, no one local had much experience with it, even in a major market such as southern California. This can weigh in on choice of procedure, too. A bypass done by someone well experienced with them (fairly common in the bariatric world,) may be a better choice than a sleeve done by a noob - even if that is the same surgeon under consideration - as even a fairly straightforward procedure such as a VSG has its subtleties and nuances that only get mastered with practice. One can mitigate this some by exploring what kind of training the surgeon went through to learn the procedure in question. The DS (at least the "traditional" BPD/DS) is acknowledged to be complex enough that most surgeons seeking to offer it go back to school to learn it, often doing several months of residency with an established practice to learn the in's and out's of it, while the VSG is deemed to be simple enough that most just learn it on their own, and the results often show that. Going the residency route helps to get the doc further up the learning curve before he starts in on his own patients, and helps him gain confidence in the different post-op protocols that benefits the new procedure; looking at the number of practices that combine their RNY and VSG dietary and supplement protocols is a good way of seeing how many are still working up the learning curve on the newer procedure. It is a choice as to whether one wants to be a guinea pig, but it should be a choice that is made with knowledge. I have spoken a couple of times with my wife's surgeon's DS patient #1, and she came out just fine, as did, presumably, most of his other early DS patients, though patients 500-1000 no doubt, on average, did somewhat better techniques (both his and the industry in general) improved. But she did make an informed choice between a bypass that he was well experienced with and this newer and better procedure that he had just come out of residency on and was still learning.

What made me choose my surgeon? Don't laugh , my peeps, but first I looked at his picture. Yeah I know it sounds shallow, life isn't always a beauty contest, true but it wasn't true beauty I was looking for. I was looking for a kind yet steadfast expression. The surgeon at facility # 1 (curses be upon them) was as cute as a speckled pup, but there was something about his demeanor in even his picture, "Here I am, kiss my feet and do it NOW".Oh I tried to stuff this feeling to the back of my mind, said to myself You're asking too much, the papers say he's experienced, maybe he will be okay, and sadly,i was right. Yes surgeons do have to have confidence but this dude was so full of himself there was barely any airbleft in the the room for anyone else. And as time went by he did not dispell this uneasy feeling. I tried to rationalize it away, he's just a people mechanic, he knows how to perform the surgery and perform it okay. Its not as though he is filling out an application to be your lover And when he rejected me it hurt, oh it hurt so badly like having a limb traumatically severed. I had jumped through every consultation hoop he required, traveled 100 miles round- trip for each and every one.Gave up my drinks, foods , tried to realign my diet to his specifications. Placidly remitted my co-pays, know he raped both my insurance carriers line's satyr, even paid his facilitie's blood money of $200 cash, for pre and post- nutritional & dietary consulting which i didn't receive or have that money, which I'm sure with his wealth he regarded it as chump change but it was a lot of money to me. I affiliated myself with his facility for 2. and a half years , went through his program not once but twice. But when it came time to put up or shut up, commit himself to a surgery date he said " Nah I don't think so!" he had 2 partners, for all I know, he still does. I had met them in passing so they were not total strangers. Did he offer either of them in exchange? Nope, no way. it was " Go away little girl, we've bleed as money out of you as legally possible, now just Go Away!" There way one member of his staff I liked, she called the week after this happened to apologize. No she couldn't get me reinstated or change his mind n but she did have the decency to apologize So I entered program #2 with fear and a little trepidation. But it has been a totally different experience, instead of having someone assigned to me by a hospital program , I had my choice of two. So I looked intently,at the 2 pictures side by side,then I pulled up everything I could on either one, their professional records, their biographies, their statements of purpose. I checked to see how old had their oldest and youngest patients had been. I'm high functioning aspie, we can be quite obsessive with our interests. Both were individually creme de la creme, I decided either would do me nicely. Why did I choose Dr Needleman? His partner's oldest patient had been 64, he had had. successful 70 year oldd before. He was a pioneer in this area and indeed in my state, Ohio. I found his statement of purpose on OHIO STATE'S website resonated with me. And finally he,is the Director of Bariatric Surgery and Metabolic Weight Loss at this facility, a full Professor,in the Medical College, I respect a man who doesn't sit on his laurels but wants to educate others. And although this might sound selfish and,egotistical, I said to myself " Frustr8 ,Old Girl, you are only going to go around,once, this is your one And only excursion into Bariatric Surgery, there are no longer "do overs" , why not give yourself an unsurpassed gift📦. The gift that you loved yourself enough,that you sought and obtained the very best. So that is how Bradley J Needleman MD and I formed a surgical alliance. I found him to be.personable, intelligent, treated me as a equal instead of talking down to me and the more we chatted the more I reaffirmed my choice, this was the man I would entrust with my very life. And on September 5th 2018 at 7AM in his operating theatre I will do so. No Fears , No Reservations and I go forth with hope and Trust in my ❤OF,❤!

I am not sure what type of surgery your wife had. That can make a difference on answering your concerns. I had gastric bypass and this the approach. The three most important elements after RNY gastric bypass surgery are to meet your daily protein, fluid and vitamin requirements. Food is secondary because your body is converting your stored fat into the energy that drives your body. Thus you lose weight. So the first step is to assess these three areas. Your wife should have been given a detailed list of daily requirements. You said that she is 10 months post-op and that "Damn near everything she eats makes her sick." That is a problem that needs to be resolved. Some individuals that undergo weight loss surgery develop strictures. This can cause them to be unable to take in small amounts of food without vomiting it back up. Others develop ulcers which can give the same symptoms. According to the internet: Nausea and vomiting are the most common complaints after bariatric surgery, and they are typically associated with inappropriate diet and noncompliance with a gastroplasty diet (ie, eat undisturbed, chew meticulously, never drink with meals, and wait 2 hours before drinking after solid food is consumed). If these symptoms are associated with epigastric pain, significant dehydration, or not explained by dietary indiscretions, an alternative diagnosis must be explored. One of the most common complications causing nausea and vomiting in gastric bypass patients is anastomotic ulcers, with and without stomal stenosis. Ulceration or stenosis at the gastrojejunostomy of the gastric bypass has a reported incidence of 3% to 20%. Although no unifying explanation for the etiology of anastomotic ulcers exists, most experts agree that the pathogenesis is likely multifactorial. These ulcers are thought to be due to a combination of preserved acid secretion in the pouch, tension from the Roux limb, ischemia from the operation, nonsteroidal anti-inflammatory drug (NSAID) use, and perhaps Helicobacter pylori infection. Evidence suggests that little acid is secreted in the gastric bypass pouch; however, staple line dehiscence may lead to excessive acid bathing of the anastomosis. Treatment for both marginal ulcers and stomal ulcers should include avoidance of NSAIDs, antisecretory therapy with proton-pump inhibitors, and/or sucralfate. In addition, H pylori infection should be identified and treated, if present. So this can be a major problem that will need to be addressed. In a severe form, she might even find it difficult to consume liquids. If that is the case, it must be driven to ground. After my surgery, I found that softer foods (such as chili and soups) went down much easier than harder foods (such as chicken and steaks). Therefore I relied on softer foods for my meals. I have included some recipes at the end of the following article. http://www.breadandbutterscience.com/Surgery.pdf When you say that your wife looks emancipated, "Her legs and arms are twigs with extra skin and some flab." That was the way I looked several months after surgery. I looked like Dopey in Disney's cartoon movie Sleeping Beauty. I would receive comments that I looked like I came from a concentration camp. But it was all in perception. I had to replace my entire wardrobe including all my jackets and coats. It was because when I lost the weight I also lost the fat in my shoulders and as a result all my jackets and coats hung down way lower than the times of my fingers. I looked like Dopey. After I replaced the wardrobe with clothes that actually fit me, all those comments disappear. So make sure you buy her some new clothes. As far as "she has aged about 15-20 years on her face". I experienced that. I had very fine paper thin wrinkles all over my face. I looked like I was 100 years old. My wife suggested that I use a product called Bio-Oil (which can be found in stores like CVS, Krogers, Walmart). I followed her advise and it took all the wrinkles away. I have been using it for 5 years now.

This seems to be happening a lot anymore on Bariatric Pal. Did you come to this decision indepently, did you decide it together or did a doctor bring it up first?

This was somewhat common for me during early post op too. If it continues, I’d chat with your bariatric team. I only get this feeling now with ground beef so my team tells me it’s likely a food I’ll just have difficulty with. And if I want to avoid the feeling, eat something else! 😂

The reason I mentioned taking her to Anchorage Bariatrics is so they can figure out WHY she can't eat certain foods or get in enough. She may have internal problems that need endoscopy or other imaging to diagnose. She may be nutrient deficient in other ways than just protein. They can help figure it out and help her get healthy enough to begin working on strength training. Nutrition has to come first, and if she's not getting the right stuff, having a doctor who knows how to help is the first step. They can also answer YOUR questions and concerns about her health. I wouldn't want my husband to worry about me; I'd keep him involved and listen to his concerns and opinions.

Wow, that sounds pretty rough. There are two bariatric doctors in Anchorage - Dr. Sean Lee and Dr. Justin Clark at Anchorage Bariatrics. I know them; they are the doctors that got me this far in my journey. Dr. Lee did my surgery. I can't see them ignoring her situation. Call their office and get her in to see them; they will figure out what's going on. Best wishes.

I'm having trouble getting past "Ox Bile"! That's quite the assortment. I'm just a couple days post op, mixing my Bariatric multis into my breakfast and I haven't really gotten on board with the calcium yet. Will be way easier as my tummy heals.

I would say it's pretty low. The reason you hear so much about bad outcomes is because the people had good results are out enjoyng themselves and their renewed health, they don't have time to post😝🌻😝

I was put on a very strict 2 week diet that involved four protein drinks plus a normal meal every day. While not required, the bariatric coordinator did recommend drinking a bottle of magnesium citrate to "clean me out" before surgery. She said that she found that it makes it easier post-op. No bowel movements of (larger) proportions, and also less gas. If you're going to do it though, do it tomorrow morning. It took me several hours to kick in, and I was up most of the night. Doing it now makes sure you're not still in the "cleaning" stage when you come in for your procedure. BTW, I was a band to RNY myself. It is so nice not to choke and clear my throat every 10 minutes!

So we might be looking at November for a surgery date? You are not the only one, somebody started a November 2018 forum thread. so there are at least one or two on Bariatric Pal. I'll look and see if I can find it in a minute. In the meantime, in between times you have all of us as friends. We have all kinds of people, gay, straight, bi- the world contains them- we are a small micro of the world .But each and everyone of us will try to help if we can. We have had our sorrows but we've had victories too. That's just how l8fe is.

Gonna be a while , beef doesn't sit easy on a Bariatric Tummy. But,YMYC, your money, your choice.😰

The official ASMBS guidelines on Caffeine are: The American Society for Metabolic and Bariatric Surgery (ASMBS) is a leading organization for weight loss surgery. It suggests avoiding caffeine for the first 30 days after weight loss surgery because your stomach or surgery area is still sensitive. After that, be mindful of getting enough fluids and be sure to avoid high-calorie, sugary sources of caffeine. I wrote an article on Caffeine and WLS. You can read it here. IMO the only issues with caffeine are if it causes you acid reflux. I think we are going to release a caffeine free and caffeinated version to make everyone happy. We offer single serving size samples so you don't need to commit to an entire tub.

Well you and Macadamia share a day, September 6th, he's in Idaho and I suspect you're in or near New Jersey, at least your surgeon is in Floram Park, because i looked up the Zip Code. Wish,i could put my Dr Needleman ' s on, I'm running off my cellphone and the phone app version of Bariatric Pal, you can't change and update things. Do you have a prediet and have you started yet? I always thought everyone did one WRONG , some doctors don't require any, the ones that do approach in diverse ways. 2,3, 4, and a few 1 seekers. Had one on here , being smart-alecky,no prediet, karma circled and bit her backside. She was on clear and murky liquids for a little over 2 months. Haha on her! I've been n on mine since August 1st, I wanted the most bang for my buck, at 72 you don't get "Do-Overs". this will be my own and only bariatric foray

Hi again @OhioSparkle. There's also @ CMD516, she will be going to Riverside late Autumn- Early Winter, hav8ng the same Dr Rana Nnoi had. There's Lynn in Cincinnati, Marcus,up in Fremont, DRoseman in NW Ohio, I think Bowling Green And there is my other Bari-pal Merc Merc, now she is extra-special. She had her surgery on July 25th at Nationwide Children's Hospital. Until her I wasn't aware they,have,an Adolescent Bariatric Program. Since she had her first,surgery there, she,had her Bypass done there also. And Dr,Marc, the head guy and Dr Needleman, my own guy ,did it together. Ask any of us any questions and we will do our,best to answer. You are a good mother by investing in their future, insuring they will have and keep their mommy. And you will,be a more fun mommy when you can do more, play more and be fun to be around. Don't believe the horror stories, that's all they are, stories. Keep talking to Nnoi and me, we will tell you the up side to it all, lots more joy than sorrow to this. And go ahead and answer Sosewsue61 if you like , I also will be a bypass, I havemy reasons why it's better for me, but notwithstanding, I love everyone of my sleeved buddies, we are all fighting the same weight wars, after all! So smile, be sweet to the kiddos and we will talk more when you have time, okay?😝

Let me give you the opposite challenge Is It Worth it to Postpone, WhimWah around until the Day your surgeon says you're in too poor a shape to be a Good Surgery Candidate. Do you have the strength and resolution to fight an uphill battle at 72, like me? Do you want to be tilting windmills like an Bariatric Geriatric Don Quixote? Do you want to have to prove you're healthy inside, many people my age aren't, you're committed enough, hear it may take you longer to heal, be told there is a higher risk of you dying than if you were 30 or even 40, to have to impress a medical community than once refused surgery to anyone over 60, to take a chance on you, to have friends and family tell you you're silly, only self-centered, you don't care about the outcome for them? Will you fold, give up this dream, die obese and in pain? Or will you persevere against these odds , go forward and receive your surgery? My battle would have been easier then, but the Victory can and will be Mine. To be brutally honest,if I can do it against all the odds I've faced and beaten, why can't you see IT IS WORTH IT?

I wish you success on developing your weight loss glossary. I am sure others on this board will find it useful. I have a pet peeve against abbreviations. They can make communications difficult unless you know their meaning. That is why I developed the list in the first place. I felt there was a need for it. Just like you feel there is a need for a glossary. As far as how I have the ability to pin, it seems like I have that ability because I have been on this board for over 5 years. Once you put together your glossary, post it and ask Alex Brecher (the owner of the website) if he could pin the glossary. Or if you stick around long enough, perhaps that ability will magically appear. There are many terms that are specific to weight loss surgery. There are many types of weight loss surgery and the list seems to expand every day. In order for Bariatric Pal to be an effective resource, clarity in communications is extremely important; otherwise many users will be left outside in the dark.

Sorry to hear about your scary episode. It is a little bit common for some individuals to experience a type of hypoglycemia called "reactive hypoglycemia". It seems a little soon because you are less than 5 months post-op. But in your case the alcohol may have played a part. I remember the first time I had a little wine post-op, it almost threw me for a loop. Here is a couple links to the condition. 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

Hi, I consulted with a bariatric surgeon before I even spoke to my primary about it ( you will need your primary to sign off as well so don't worry about the order, it's good to have them on board from the start, if they aren't try to convince them or switch) because I did not need a referral to consult with the bariatric program. From start to surgery just under six months. All of that time as just to complete the preop testing , there was not a required waiting period.

I did see someone was having theirs in Cary, N.C., not,Georgia, but. a etate away. And I believe there some surgeons in Virginia doing theme Besides there, maybe Missouri, around Saint Louis? And I know Bari-pal Lynn is having one through a hospital/bariatric program in Cincinnati Ohio. Most of the rest seem to be overseas.