Possible VSG complication 2 years out

[4dogcrazy 6]

I'm a little over two years out and since I was 3 or 4 months out I had sever hunger pains. Like within 15 min of eating my stomach would growl and roll like I had not eaten all day. When I asked my doctor he laughed at me and said ya your little stomach is having hunger pains and told me to go see a therapist because the pain is in my head. I asked if it was reflux but he told me no that it is in my head. Up until then I had done great from a starting weight of 260 down to 235 on the day of surg. to 189 in less than three months. Once the stomach issues started I stopped losing and I know I was grazing because I felt hungry and if I ate it would stop rumbling. I have not seen my doc because when I had scheduled my last appointment his office cancelled me 5 times and never rescheduled the last appointment. So now I don't even want to go back there between what was said to me before and them cancelling so many times.

But within the last 6 months I have really started to gain a lot of weight were I had been holding at about a 15 pound gain . But my problem now is I have had three episodes recently where I would get a sever pain in my mid stomach region. I started taking omeprazole to help with the acid but it does not seem to work. I tried prevacid also but no help. Yesterday I had another attach and I could barely sit my mid stomach area hurt and then I had this burning feeling all the way across right below my rib cage. I had my gallbladder out over 10 years ago but i have also had a similar dull ache on the right side right at the bottom of my rib cage for a few months. Just not sure if this is a complication of the VSG, Has anyone had anything similar. I'm thinking I need to find a new doctor but not sure if that is possible as I don't want to see my original doctor after he blew me off and would not even listen to me and see if there was something going on. I don't get acid up in my throat like normal acid reflux does so not even sure what that part could be.

[Bufflehead 6,358]

I think you definitely need to see a new doctor, either another bariatric surgeon or a gastroenterologist. You can get copies of all your medical records from your previous surgeon, you are legally entitled to them. Don't keep suffering like this!

[VSG AJH 499]

I have a similar issue and had since a few months post-op. My surgeon kept blowing me off, too, until I was still complaining about pain at my one year visit, and hadn't had much of a weight loss in months (3 pounds in 6 months). He sent me for an upper GI, which revealed nothing, and an endoscopy, which revealed I had retained find us at the top of my sleeve. It would pouch out with the camera inside, and the GI could turn the camera completely around in the stretchy bit. My surgeon promised to repair it, but since I'd had an insurance change and bariatrics was an exclusion on the new policy, reports from the GI doc were "unreadable," and peer-to-peer conversations between docs resulted in a change in the way the GI described the pouching he described to me in the recovery room following the endoscopy. (I have a feeling my surgeon possibly threatened to reduce the number of patients his office referred to the GI practice.) After several more months of pain, I was finally able to get through the gatekeeper at another Bariatric practice where the surgeon himself does the endoscopy in the case of possible complications, rather than relying on an external GI. He too determined I have retained fundus at the top of my sleeve that, by now, two plus years post-op has stretched out markedly. I've regained 25 pounds from my very lowest weight, and 10 pounds from my longest stable weight. I've always had a greater capacity than other sleeve patients, and have dealt with pain after every meal of solid food since about month four post-op (pain that is now constant, whether eating or not). In my case, the pain is to the left side, and radiates across my lower left rib cage (pain to the right might not be the same. Liver issues, maybe?). I am currently working with this new surgeon's office to be "resleeved" to remove the retained fundus, and hopefully resolve my pain issues. I'm in the appeals process with insurance now since I'm dealing with medical issues and not having a repeat Bariatric surgery (though the process is identical). I would suggest you seek medical attention with a GP or new Bariatric surgeon, and if you can, have all the necessary tests to determine what you're actually dealing with, rather than just having your pain issue dismissed (as I've found many doctors prone to do).

[CowgirlJane 14,259]

This is the first I have heard of a retained fundus. It would explain some of the complaints I have heard from others over the years.

Not trying to be a dolt. ..but how does that happen? I mean sleeve is not a technically difficult surgery for virgin WLS patients.

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[VSG AJH 499]

@@CowgirlJane -- I don't think a retained fundus is a common thing, but it is one of the occasional complications that happens, probably primarily with the sleeve. Essentially, the doctor leaves behind part of the fundus he was supposed to remove during the sleeve procedure. Instead of having the upside down Y-shaped stomach of a typical sleeve patient, I had a stretchy pocket on top of a narrow middle. That pocket has expanded over the last two years since surgery, and now I have kind of a barbell shaped stomach. Intead of having a slight increase in capacity (as is common two years after the surgery), I have almost the same capacity I had before surgery. The pain I experience is related to food being sort of spread out in the stretchy pouch just under that initial valve into the stomach, then squeezing down into the non-stretchy, restrictive part of the stomach that was sleeved properly. This is not something that struck me all of a sudden after year two or anything, but rather something that has been ongoing from day one. I had a noticeable restriction the first many weeks after surgery and lost weight fast (very probably from post-surgical swelling), but I could always, always eat and drink all of my Water and Protein from day one with no trouble. Surgeon's office insisted that was a blessing, and not a problem, but I mentioned it at every follow-up appointment, and on phone calls between appointments. The pain came on with the introduction of solids foods at month four post-op, and the weight loss stalled/stopped shortly thereafter. I continued mentioning pain, lack of restriction, lack of weight loss, etc. despite measuring food and counting calories. I was put back on Omniprazole for a few months as they ruled out GERD, but because I had no symptoms of a leak, my pain issue wasn't a priority to my surgeon's office. At my one year visit, they finally seemed to recognize I'd been complaining about pain for a really long time, and began sending me out for other testing. Problem was discovered right away when visualized internally, but the aforementioned run around and complications with those doctors was ultimately fruitless. Though I have a new connection with a new surgeon who sent me out for or completed his own battery of tests, I've been in the pre-approval (and now appeals) process with insurance for a correction/repair since November, one month before my two year surgiversary. Again, this is not the regular old slight expansion that happens a year or two post-op, the one you read about every Monday after a weekend bender. I don't think that kind of "stretching" happens. When doctors tell people "they can't stretch their sleeve," I think they mean it the majority of the time. In fact, the properly sleeved portion of my stomach looks lovely and textbook in a radiology lab. There are, however, those occasional cases where something like a retained fundus occurs, and unfortunately, it's been my experience that I've had to really fight and fight and fight to get someone to believe that I've been having issues and not just eating too much and on the sly.

[CowgirlJane 14,259]

Thank you for the explanation. It clarifies many things. I do not have a"small" sleeve as my surgeon felt that is riskier, so I have often thought that people who say they can eat/drink so much early on (but after swelling subsides) actually don't FEEL the tightness either due to nerve damage or just being used to that stuffed feeling (more of an issue for revision from band). This is why I always tell people to eat by the clock and measuring cup those first few months while the nerves and everything get back to normal. I notice variations in"capacity" frankly based mostly on what I eat. ( note I don't test or push capacity). I still think my basic advice for people is good, but this is new information - and really helps make sense of some things.

I am so glad you are able to finally get it addressed. I think a normal healthy sleeve should not be painful, just a smaller stomach!

[swimbikerun 1,045]

This is sad. This is not the first story that I've heard of bariatric surgeons' being a problem in fixing things: whether or not it is their issue or not.

[villa2924 17]

I had the same problem my primary care physician gave me diet pills. I have to say it worked I eat it's not a problem I just don't feel hungry so often. Thank god because I was not gonna keep feeling that way. I completely understand it was so annoying I think that's the only reason I was able to keep my 100 lbs off. Now If I could find a surgeon who will replace my knees I would be so happy to work off the next 80lbs I would like to lose!! I did tell me doc I never thought I'd see another diet pill after surgery and she said it's not for diet just hunger pains and well it worked and continues to work 5 months in a row hunger pains suck!!

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