10/30/18 First Appointments On My Bariatric Journey

[Cala B. 39]

Today was my first set of appointments to start the process; nurse practitioner, dietician/nutritionist, and physical therapist. In addition, I got my bloodwork and EKG done. I already have a mammogram and colonoscopy on record. I went in with a positive attitude and I think that helped, I was more excited than nervous. I mentioned that I had been reading the forums on this site to learn what I could and I think it helped me comprehend the massive amount of information I was given because I sort of studied ahead, plus, they gave me a notebook

The dietician noted that I take a lot of supplements, and she stressed that I will be restricted to taking only a few after surgery, at 200% the regular dose; Multi-Vitamin that includes Iron and other minerals and B12 sublingual at night, calcium citrate 500mg liquid or chew three times a day, plus Vitamin D, liquid or small gelcaps. I forgot to ask about my Wellbutrin and allergy medicine. Oh well, there's time! A lot of people in these forums say NOT to try the drinks, food, or supplements pre surgery, but my dietician encouraged me to try different things to find what I like (even though my preferences may change post surgery). I have already purchased some Protein20 drinks, Premier Protein shakes, sugar free Gatorade, Propel electrolyte Water, Bone Broth, and some Millie's sipping broth samples.

My choice is the gastric sleeve but they will probably try to convince me that the bypass is the best option (and "gold standard" as I keep reading everywhere). I was scoped in July and they found a hiatal hernia, some non-bloody ulcers, and Schatzki's ring. I was instructed to continue with the Omeprazole in order to continue to calm my esophagus and stomach. I hope they let me stick with the sleeve, I don't want to deal with malabsorption issues and I prefer being able to take NSAIDS. I have enough dumping from having my gallbladder removed and being sensitive to grease/oil. Today while at the hospital, I had a long break so I had brunch consisting of an egg-salad sandwich (which they said was freshly made that morning) and half a bag of chips. Let's just say I had to visit the restroom 4-5 times during the rest of my time there, ugh!

The insurance company has told my hospital (OHSU Portland Oregon) that the procedure is covered, but have not yet responded regarding what they require from me. The hospital requires two nutrition classes and a few more tests. My EKG came back "borderline" so I am being referred to a cardiologist to make sure everything is ok. I made my two nutrition class reservations and psychological evaluation appointment, as well as my sleep study consult. I'm 58 and have had a hysterectomy (1 ovary left) so I'm not required to get a pap smear, review birth control, and they're not requiring that I be screened for drugs & alcohol (I quit smoking 31 years ago). I'm hoping to have it all done by February, but won't know what else I need to do until my insurance company forks over some information!

This facility only requires 24 hours of Clear Liquids before surgery (yay). While I was given my diet information, I think I'm going to slowly incorporate better habits and definitely pay attention to my Protein and Fluid intake for now. Since my BMI is slightly over 41, I was cautioned not to lose more than 10 pounds because it would put me below the required 40 BMI. That is unless I end up being diagnosed with sleep apnea (I have high cholesterol); neither joint pain or depression qualify as co-morbidities.

My lab results have already been provided and they found my ferritin to be low, so I need to begin taking carbonyl iron with Vitamin C right away.

I've read a lot of different posts of people sharing their program information, so here is my post-surgical diet information from my booklet:

STAGE ONE - first day following surgery - CLEAR liquids

STAGE TWO - starting day two post surgery, for 14-21 days - FULL LIQUIDS

STAGE THREE - starting 2-3 weeks post surgery, for approximately 6 weeks (depending on how the patient is doing) - SOFT FOOD

STAGE FOUR - approximately two months post surgery - solid food (low sugar & low fat)

Over the weekend I cleaned out my cupboards of a bunch of food and food-like substances; what wasn't expired I took to work. Fed the crows some expired Cereal and crackers. Haven't tackled the freezer yet. Since my surgery isn't scheduled yet I have plenty of time!

I just wanted to thank everyone who posts their experiences and questions and advice, I think people are very supportive here for the most part!

Edited October 31, 2018 by Cala B.

[gabybab 696]

If you want the sleeve, I would stick to your guns. My Dr wants me to do a different surgery, due to gerd, but I'm not willing to do the bypass.

I'm in Wa and 53. I've been through the wringer and am almost in the home stretch. My surgery will be in January sometime. Just waiting on A date.

Best of luck to you!

[Matt Z 4,140]

Just be aware that if you have GERD or other stomach acid issues, the sleeve will more than likely make that worse. And, the sleeve is the *only* surgery that's not reversible as 90% of your stomach is going to end up in medical waste and contrary to popular belief, the bypass is reversible, just under specific conditions due to the added danger in reversal, but, it can and does occur.

With the Vitamins you are taking now, that's more than I'm required to take... I don't think you'd have an issue with the bypass in my opinion based on what you've written.

Either way, you decide what you want to do, just be open to what your doctor has to say about it. I was set on the sleeve myself when I was looking at revising from the band. My surgeon wouldn't do the sleeve due to reasons specific to my case. She advised that others in her practice would do the surgery and outlined why she wouldn't. After talking with her, I agreed that her reasons were sound and decided to go with the bypass rather than the sleeve and I'll tell you this, I'm 100% glad I did. Found out I had Grade 4 Esophagitis during pre-op testing, and I had no idea. If I had gotten the sleeve, this would have gotten much much worse. But since the bypass reduces or reverses acid reflux issues, my Esophagitis is now Grade 1 after only 6 months and may be completely healed at this point (won't know until my next scoping).

Just be open to *all* the facts and information and make the best choice for you based on that information rather than assumed or perceived personal preference (speaking from personal experience on this one)

[Lynnlovesthebeach 627]

Trust what your doctor says but ultimately it's your decision.

[Cala B. 39]

7 hours ago, Matt Z said:

Just be aware that if you have GERD or other stomach acid issues, the sleeve will more than likely make that worse. And, the sleeve is the *only* surgery that's not reversible as 90% of your stomach is going to end up in medical waste and contrary to popular belief, the bypass is reversible, just under specific conditions due to the added danger in reversal, but, it can and does occur.

With the Vitamins you are taking now, that's more than I'm required to take... I don't think you'd have an issue with the bypass in my opinion based on what you've written.

Either way, you decide what you want to do, just be open to what your doctor has to say about it. I was set on the sleeve myself when I was looking at revising from the band. My surgeon wouldn't do the sleeve due to reasons specific to my case. She advised that others in her practice would do the surgery and outlined why she wouldn't. After talking with her, I agreed that her reasons were sound and decided to go with the bypass rather than the sleeve and I'll tell you this, I'm 100% glad I did. Found out I had Grade 4 Esophagitis during pre-op testing, and I had no idea. If I had gotten the sleeve, this would have gotten much much worse. But since the bypass reduces or reverses acid reflux issues, my Esophagitis is now Grade 1 after only 6 months and may be completely healed at this point (won't know until my next scoping).

Just be open to *all* the facts and information and make the best choice for you based on that information rather than assumed or perceived personal preference (speaking from personal experience on this one)

Matt, thank you for your input. I have read a lot of your posts so I'm somewhat familiar with what you've experienced.

I know part of my mind set is that my mother had the bypass in 2007 and she was diagnosed with multiple myeloma in 2012 (but I think she was already stage four at that point). During her cancer treatments she had a difficult time consuming enough calories (dry mouth, loss of appetite), and some members of the family were convinced that part of the problem with her not getting enough nutrition was due to the bypass. In no way is anyone saying the bypass caused her cancer, just that we think it may have interfered with her getting enough calories. We tried to convince her to eat like it was her job, but I lost her in 2016; they had estimated she had 5 years but she only got 4. To be fair, that type of cancer is terminal no matter what you do, it's always just a matter of time.

Another thing is, I rarely have GERD and the Schatzki's ring issue is mostly under control as long as I take my time, chew my food thoroughly, etc......which is what we need to do no matter what surgery we have! I don't know if the bypass would be any different from the sleeve for that specific issue. They suspected I had EoC when I got scoped but the results came back negative, and I had no symptoms with the ulcers. They said I might need to be scoped again to see if things have improved. They put me back on Omeprazole but from what I've read, all bariatric patients are directed to take it post-surgery.

I like having the option of NSAIDS and feel like I already have enough dumping in my life, even when I'm not committing dietary crimes! In my mind, I'd rather have a little GERD now and again rather than dumping every day. But of course I would rather have surgery once and not have to get a revision down the line, so I need to consider the bypass.

Thank you Lynn and Gaby :)

[FluffyChix 17,418]

42 minutes ago, Cala B. said:

Matt, thank you for your input. I have read a lot of your posts so I'm somewhat familiar with what you've experienced.

I know part of my mind set is that my mother had the bypass in 2007 and she was diagnosed with multiple myeloma in 2012 (but I think she was already stage four at that point). During her cancer treatments she had a difficult time consuming enough calories (dry mouth, loss of appetite), and some members of the family were convinced that part of the problem with her not getting enough nutrition was due to the bypass. In no way is anyone saying the bypass caused her cancer, just that we think it may have interfered with her getting enough calories. We tried to convince her to eat like it was her job, but I lost her in 2016; they had estimated she had 5 years but she only got 4. To be fair, that type of cancer is terminal no matter what you do, it's always just a matter of time.

Another thing is, I rarely have GERD and the Schatzki's ring issue is mostly under control as long as I take my time, chew my food thoroughly, etc......which is what we need to do no matter what surgery we have! I don't know if the bypass would be any different from the sleeve for that specific issue. They suspected I had EoC when I got scoped but the results came back negative, and I had no symptoms with the ulcers. They said I might need to be scoped again to see if things have improved. They put me back on Omeprazole but from what I've read, all bariatric patients are directed to take it post-surgery.

I like having the option of NSAIDS and feel like I already have enough dumping in my life, even when I'm not committing dietary crimes! In my mind, I'd rather have a little GERD now and again rather than dumping every day. But of course I would rather have surgery once and not have to get a revision down the line, so I need to consider the bypass.

Thank you Lynn and Gaby

Welcome to the boards. I'm sorry for the loss of your mom! ((hugs))

Just do tons of research and ask LOTS of questions--of us, your doc/team, etc! You'll know what's right in the end.

I just wanted to add about your mom...I had to force myself to eat during cancer treatment. I was pretty young-ish at dx with a 3C breast cancer. Different animal and likely much different treatment than your mom had, but I had 3 months of very high dose chemo, 33 or 35 (can't remember now) radiation treatments and multiple surgeries.

I did make myself eat, and eat healthy stuff during that time, but also fasted for treatment reasons. Had terrible mouth issues, so I don't know if this info helps ease your pain of some of what she endured in order to fight, but IMHO, I think someone receiving the therapies your mama did would have issues with eating.

I'm now healed and can eat way more than enough now to support life very easily, without trying. But if I have to go through a recurrence and treatment, I know my desire for food will go again and eating will be something that I endure and a real challenge to make happen.

Maybe that will ease some of your burden from your decision? ((hugs))

[Cala B. 39]

2 hours ago, FluffyChix said:

Welcome to the boards. I'm sorry for the loss of your mom! ((hugs))

Just do tons of research and ask LOTS of questions--of us, your doc/team, etc! You'll know what's right in the end.

I just wanted to add about your mom...I had to force myself to eat during cancer treatment. I was pretty young-ish at dx with a 3C breast cancer. Different animal and likely much different treatment than your mom had, but I had 3 months of very high dose chemo, 33 or 35 (can't remember now) radiation treatments and multiple surgeries.

I did make myself eat, and eat healthy stuff during that time, but also fasted for treatment reasons. Had terrible mouth issues, so I don't know if this info helps ease your pain of some of what she endured in order to fight, but IMHO, I think someone receiving the therapies your mama did would have issues with eating.

I'm now healed and can eat way more than enough now to support life very easily, without trying. But if I have to go through a recurrence and treatment, I know my desire for food will go again and eating will be something that I endure and a real challenge to make happen.

Maybe that will ease some of your burden from your decision? ((hugs))

((hugs)) back at you, thank you! I can't believe you had to go through that so young, I'm glad you are better! My mom had mouth issues as well, she had canker sores, and she kept losing her teeth. She definitely fought to live, she was only 72; before she passed I teased her about how many sewing projects she had started, she'd have to live to over a hundred to complete them all!

I have been doing a great deal of research, on these forums and elsewhere on the internet; I am reading the good, the bad, the ugly, etc., everyone's experiences are different! BUT I will trust my medical team to answer questions I have, they seemed pleased that I DID have a few when I was there yesterday. I am worried about having to wear adult diapers if I get the bypass, only sorta kidding! And I would miss my Aleve horribly!

It might be time to change your name to FluffyNoMoreChix? You've accomplished a lot, congrats!

[Briswife15 890]

Just a quick thought...does your surgeon actually allow sleeve patients to take NSAIDS? Mine does not allow NSAIDs for either procedure. I rely on NSAIDs, too, and will just have to suck it up and find some other pain relief. I'm having bypass because of GERD. good luck to you! I hope you get the procedure you want.

[Cala B. 39]

43 minutes ago, Briswife15 said:

Just a quick thought...does your surgeon actually allow sleeve patients to take NSAIDS? Mine does not allow NSAIDs for either procedure. I rely on NSAIDs, too, and will just have to suck it up and find some other pain relief. I'm having bypass because of GERD. good luck to you! I hope you get the procedure you want.

Good question, thank you Briswife! I've got homework to do before I get to see the surgeon, so I will have to ask him/her. I've just been going by what I've read here and there. If it's not allowed for either that issue is a moot point and I'd just be concerned with dumping.

[Jazzy1125 1,010]

20 hours ago, Briswife15 said:

Just a quick thought...does your surgeon actually allow sleeve patients to take NSAIDS? Mine does not allow NSAIDs for either procedure. I rely on NSAIDs, too, and will just have to suck it up and find some other pain relief. I'm having bypass because of GERD. good luck to you! I hope you get the procedure you want.

I was just thinking the same thing. I just got my medical ID Bracelet and i was told specifically to add No NSAIDS on it along with the no Blind NG Tube. I am having the sleeve, and i will not be allowed to have the NSAIDS afterwards either.

[catlady.2012 22]

Best wishes on your journey.

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