Complications 8 years out and depressed!

[dexter 205]

I had my sleeve 8 years ago and have been battling severe GERD for two years and serious weight gain since my hysterectomy just last December.
Now, I am miserable and weak. 10-20 tums a day, unable to properly take my medications because I throw them up. Cannot eat because I throw it all up too. Just ordered some syntax iced tea and Protein Soups. I’m taking 80mg protonix daily and wake up choking on my bile bile at night.
My PCP dismissed me. Saw her PA and at no time did she even look down my throat.
Got a referral to a GI and they called to have a consult in a month! A consult! Only!
Called my old bariatric surgeon and he’s not in my insurance network and I can’t afford him. Called one in town and have an appointment on the 9th. But if it requires a revision, I don’t know if it’s covered on my insurance.
I’m losing hope. I feel like everyone else has since I’ve been dismissed at every turn.
My brain is fuzzy, my eyes are sunken. Work is hard. I pretend I’m fine and eat at company meetings then go quietly to the bathroom to throw everything up. I’m miserable.
I need an answer but no medical professionals seem to be in a hurry.

[Prestonandme 107]

So sorry to hear about the pain and suffering you are going through.

I know that your GI appointment is a month away, but if the GI doc is any good, s/he may be able to diagnose your problem and help you. I have chronic nausea and gastric cramping. I visited my bariatric surgeon, PCP, and a GI doc. They all ran tests but the GI doc did the most thorough job. Both he and the PCP suggested prescription meds for me which have helped ameliorate but not resolve my condition.

If you can, ask to be placed on your GI doc's cancellation list so you might get seen sooner. And you can call the office every once in awhile to ask if any appointments have opened up.

Best wishes to you.

[RickM 1,753]

It could be a number of things, most common this far out would be a hiatal hernia that could cause these problems. Is your protonix once a day, or split into two doses, morning and evening? If it is consistent with the labelling, try taking it in the evening, as that is where your biggest problem seems to be, or splitting it morning and evening (if it is two 40mg pills.)

Short term to help with the overnight problem, try elevating the head of your bed 3-6", or elevate your head and torso with a wedge pillow, or sleep in a recliner if you have one - anything to get your upper body (not just your head) angled down toward your stomach. Avoid eating anything 2-3 hours before bedtime. These are classic DIY reflux mitigations that the gastro will probably also suggest.

You can consider going to the ER and hopefully they can get some of the tests done necessary to diagnose your problem (likely an endoscopy and/or barium swallow imaging. The may also just send you home with a larger dose of protonix or maybe a switch to dexilant and possibly carafate. An urgent care clinic may be able to help, particularly if you have one affiliated with your hospital - they may be able to short cut getting the tests done that you can then take to the bariatric surgeon (who would likely order the tests anyway. Many hospitals run these clinics for just this purpose - not really an emergency, but too urgent to wait a week or two for an appointment. This may save you a couple of weeks.

Don't worry about insurance coverage as if a revision is needed, it would not be considered a second WLS (which some insurance limits) but as corrective surgery for you complication.

Good luck in getting some resolution soon (er, rather than later)

[SleevedK 25]

Ugh, I am sorry that you are dealing with this problem. Rick's advice is solid. I suspect that he is correct that this nasty reflux is probably happening because you ended up developing a hiatal hernia. Hiatal hernias seem to be a VERY common complication of the sleeve long-term sadly, and reflux is the number one symptom they cause.
You will very likely be offered a revision to bypass, since that is the "tried and true" way of fixing this kind of problem. However, some people have had good results just repairing the hernia and not doing a whole revision.
If it does turn out you have a hernia, check out these recent discussions we have had about the issue:

Edited August 2, 2021 by SleevedK