Not feeling much restriction

[ryan_86 335]

So I'm now about 16 weeks past surgery, and I'm not feeling much restriction. I measure most meals, but I'm finding that I can eat what seems like a lot in a short period. Today, for instance, I ate an entire slice of pizza at an office lunch.

I'm edging up on 1,000 calories per day, which my surgeon okayed, but I'd rather be coming in under 800. I'm hungry, which isn't a good reason to eat, and feeling deprived, which is making it a harder to say no.

I'm pretty bad about eating slowly and usually finish meals in less than 15 minutes.

Any suggestions on how to extend meals? I've been thinking about putting a timer in front of myself.

Should I be concerned at the lack of restriction? I'm concerned I'm inadvertently stretching my sleeve. Perhaps going back to a liquid diet for a couple days will help reset things.

[ShelterDog64 2,364]

First, you can't really stretch a properly done sleeve. The stretchy fundus of your stomach is removed and what's left is very thick, dense tissue.

Do you feel restriction if you eat dense Protein, like chicken, beef, pork, hard cheese? Slowing down will help, for sure, as you'll give your body time to get the satiety signal to your brain. Are you getting all of your Protein daily, and your Water? I'm just over 6 months out and if I eat the protein I need and drink 64 oz of Water, I'm not hungry and definitely can feel restriction if I push even a spoonful past what I know fills me up. The things that DON'T trigger any restriction are carbs, almost all of the simple ones. I could probably eat crackers until I got tired of chewing them, soft cheeses, yogurt, anything sugary.

The best thing, IMO, is to clean up your diet (there's no way I could eat a slice of pizza right now, the dough would kill me) and get back to focusing on protein and fluids, and see if that helps with your hunger. Good luck, and you're doing great by your stats! You're almost at goal!

[O-Town Body Rock 148]

Yes you can definitely stretch your sleeve!! I just got the results of my Upper GI results 15 minutes ago and it reads:

1. LARGE AMOUNT OF GE REFLUX.

2. DEFORMITY OF THE GASTRIC FUNDUS. CORRELATION WITH THE PATIENT'S GASTRIC

SURGERY.

My doctor said my sleeve has stretched. It did not stretch back to regular size and shape...but it has stretched. I eat the same amount now as i did prior to my surgery 2 years ago. My metabolism is jacked up and I am 18 pounds away from my surgery weight from before. I fell into old habits listening to people tell me that my sleeve would not stretch and that it was the end all to my weight problems and now im right back where i started, except worse. Now, im in the process of trying to qualify for a sleeve to bypass revision to help with the persistent GERD and daily nausea. ????

Sent from my SAMSUNG-SM-G900A using the BariatricPal App

Sent from my SAMSUNG-SM-G900A using the BariatricPal App

[Dairymary 533]

Yes you can definitely stretch your sleeve!! I just got the results of my Upper GI results 15 minutes ago and it reads:

1. LARGE AMOUNT OF GE REFLUX.

2. DEFORMITY OF THE GASTRIC FUNDUS. CORRELATION WITH THE PATIENT'S GASTRIC

SURGERY.

My doctor said my sleeve has stretched. It did not stretch back to regular size and shape...but it has stretched. I eat the same amount now as i did prior to my surgery 2 years ago. My metabolism is jacked up and I am 18 pounds away from my surgery weight from before. I fell into old habits listening to people tell me that my sleeve would not stretch and that it was the end all to my weight problems and now im right back where i started, except worse. Now, im in the process of trying to qualify for a sleeve to bypass revision to help with the persistent GERD and daily nausea.

Sent from my SAMSUNG-SM-G900A using the BariatricPal App

Sent from my SAMSUNG-SM-G900A using the BariatricPal App

A couple thoughts about your post.....

1) if you have fundus deformity then your surgeon did not do your surgery correctly. A properly performed VSG Removes all of the fundus, which, as explained above us the stretchy part of your stomach.

2) sounds lime you were grossly misinformed about WLs and what is actually required for long term success. Any surgery (including bypass) is only one small part of what is required for long term weight loss. It was drilled into me over and over that it's the lifestyle changes we make that play a much more vital role. You can out eat any physical changes created by any surgery. Success is much more psychological than surgical. I'm truly sorry you weren't told the truth when making your decision to have surgery.

3). If you are having severe GERD, then yes, bypass is probably the answer for you. But again, your long term results as far as weightloss goes will be the same as your VSG without the often overlooked psychological tools. I suggest finding a good therapist if you find yourself going back to your old eating habits.....or developing new, just as destructive habits customized to eat around your bypass restriction. I saw this all the time in group.

[O-Town Body Rock 148]

Yes you can definitely stretch your sleeve!! I just got the results of my Upper GI results 15 minutes ago and it reads:

1. LARGE AMOUNT OF GE REFLUX.

2. DEFORMITY OF THE GASTRIC FUNDUS. CORRELATION WITH THE PATIENT'S GASTRIC

SURGERY.

My doctor said my sleeve has stretched. It did not stretch back to regular size and shape...but it has stretched. I eat the same amount now as i did prior to my surgery 2 years ago. My metabolism is jacked up and I am 18 pounds away from my surgery weight from before. I fell into old habits listening to people tell me that my sleeve would not stretch and that it was the end all to my weight problems and now im right back where i started, except worse. Now, im in the process of trying to qualify for a sleeve to bypass revision to help with the persistent GERD and daily nausea.

Sent from my SAMSUNG-SM-G900A using the BariatricPal App

Sent from my SAMSUNG-SM-G900A using the BariatricPal App

A couple thoughts about your post.....

1) if you have fundus deformity then your surgeon did not do your surgery correctly. A properly performed VSG Removes all of the fundus, which, as explained above us the stretchy part of your stomach.

2) sounds lime you were grossly misinformed about WLs and what is actually required for long term success. Any surgery (including bypass) is only one small part of what is required for long term weight loss. It was drilled into me over and over that it's the lifestyle changes we make that play a much more vital role. You can out eat any physical changes created by any surgery. Success is much more psychological than surgical. I'm truly sorry you weren't told the truth when making your decision to have surgery.

3). If you are having severe GERD, then yes, bypass is probably the answer for you. But again, your long term results as far as weightloss goes will be the same as your VSG without the often overlooked psychological tools. I suggest finding a good therapist if you find yourself going back to your old eating habits.....or developing new, just as destructive habits customized to eat around your bypass restriction. I saw this all the time in group.

1)The fundus deformity is a result of stretching my sleeve. I am over two years post op; my surgery was done correctly. All of my previous follow-ups indicated so.

2)I am not misinformed about WLS.

3)I do not need a therapist. I am aware of my role in my weight gain.

I hear people say all the time the sleeve does not stretch, when in fact it does.

Edited January 27, 2017 by O-Town Body Rock

[ShelterDog64 2,364]

A fundal deformity is indeed an indicator of an improperly formed sleeve. There should be none of that thinner, stretchy fundus left from your old stomach. Sounds like your surgeon is trying to blame you for his/her lack of surgical skill. What 'previous follow-ups' did you have that confirmed your belief that your sleeve was done correctly?

Here's a good read:

Laparoscopic Repair of Hiatal Hernia With Dor Fundoplication After Sleeve Gastrectomy in a Patient With Intractable GERD and Retained Gastric Body

Tweet

0 Share

0 Share

Andre Teixeira, MD MBA MPH, Carolina Ampudia, MD, Samuel Szomstein, MD FACS FASMBS, Raul Rosenthal, MD FACS FASMBS. Cleveland Clinic Florida

Introduction: Sleeve gastrectomy is one of the newest procedures and one of the fastest growing surgeries in the bariatric armamentarium. Technical details of the sleeve are important and failure to adhere to strict technical guidelines may result in complications.

Materials and Methods: A 26-year-old female status post vertical sleeve gastrectomy performed in a different institution 2 years ago presented to our office with severe gastroesophageal reflux disease (GERD) refractory to medical therapy. UGI revealed severe reflux and a hiatal hernia.

The patient underwent a laparoscopic reoperation. Using sharp dissection, the sleeve was dissected off the liver. The liver is cranially retracted. Adhesions to the anterior wall of the stomach were sharply taken down. Right and left crus of the diaphragm were dissected and a somewhat large fundic remnant was identified, isolated and reduced into the abdominal cavity. The diaphragmatic crus was closed posteriorly with a running double layer of quills 2-0 Prolene sutures. Anteriorly another 2-0 silk suture was used to reinforce the hiatus. An Ewald tube was passed and the retained fundus was then sutured with 2 interrupted 2-0 silk sutures to the lesser side of the esophagus in an attempt to create a Dor type fundoplication.

Result: The recovery of the patient was uneventful, with a normal UGI on POD1 without leak or obstruction. The patient presented to the office 2 weeks postoperative and she was completely off the PPI and no symptoms of reflux were present.

Conclusion: Sleeve gastrectomy is accepted as an effective surgical option for treatment for morbid obesity. Strict technical guidelines and an excellent preoperative workup need to be followed in order to prevent complications from the operation. Sleeve gastrectomy creates a high-pressure system that can make GERD unbearable for patients with hiatal hernia and incompetent lower esophageal sphincters. The use of an anterior fundoplication type Dor can be a feasible alternative for patients with GERD.

[sleevedviolet 52]

You art drinking while you eat right? My surgeon told me e0 mind b4 and 30 mind after to drink so I don't flush out my food with liquids

Sent from my SM-G900V using the BariatricPal App