Alternative to surgery (due to cost and GERD fears)

[Devi 15]

I am once again considering how to fix my health without surgery. I am self pay and was planning to go to Mexico to Endobariatric. I’ve decided that the potential need for revision due to GERD is going to hold me back. I would not be able to afford a revision and my health insurance would not cover any part of it. Part of me feels let down by this, but I know GERD is no fun. I have it from medication and a handful of times before not medication related.

I did notice that Dr. Alvarez mentions the sleeve surgery can potentially heal GERD in those that have it. I do find that interesting since so many end up with revisions. It makes me wonder if I would get lucky and not end up with it. That’s a big roll of the dice though as I would be stuck if I did.

This forum has been incredibly helpful to me. Most people here are really kind, which is so nice to see these days. Perhaps if my insurance changes I will reconsider this option. I just wanted to share where I am with it and thank you all for sharing your stories and hopes and struggles and successes.

Edited March 3, 2023 by Devi

[hills&valleys 130]

GERD is often caused by a hiatal hernia. If during VSG surgery a HH is discovered, most surgeons will repair. GERD is also more common among people who are overweight and can sometimes improve or completely disappear with weight loss.

I would suggest forwarding your medical records to Dr. Alvarez, specifically any pertaining to your Upper GI issues so that he can review and then tele- consult. Have you had an upper endoscopy?

I am currently at Dr. Alvarez's Endohospital (Endobariatric.com). I have met Dr. Alvarez a couple of times since arriving earlier today. He is most impressive! It is not exaggerating to say the facility is like a Luxury Resort Spa. My surgery is scheduled in the morning and after talking to several patients one & two days out of surgery, I know I have chosen the right surgeon.

I hope you can find the answers you are seeking.

[catwoman7 11,210]

8 hours ago, hills&valleys said:

GERD is often caused by a hiatal hernia. If during VSG surgery a HH is discovered, most surgeons will repair. GERD is also more common among people who are overweight and can sometimes improve or completely disappear with weight loss.

very true - although the structure of the sleeve itself can also cause GERD in some people. I've read about this and can't remember exactly what the deal is, but it has something to do with the size and shape of the new stomach causing high pressure in the stomach, which can cause the acid to back up into the esophagus. It's not the majority of people - I seem to remember reading that about 30% will have reflux issues. But that means 70% won't. Some people are willing to take that risk. I wasn't because I already had GERD even before I had surgery.

[catwoman7 11,210]

oh - forgot to mention: for those who do end up getting GERD, often it can be controlled medically (i.e., by PPI's or another type of antacid). It seems to be people with the more severe cases who opt for revision. I honestly don't know what percentage of people get it severely enough that revision is recommended.

[Sleeve_Me_Alone 656]

Is RNY not an option? If GERD is a concern but bariatric surgery is the goal, I would consider RNY and see if that fits your needs.

[Merri Beth 96]

3 hours ago, catwoman7 said:

very true - although the structure of the sleeve itself can also cause GERD in some people. I've read about this and can't remember exactly what the deal is, but it has something to do with the size and shape of the new stomach causing high pressure in the stomach, which can cause the acid to back up into the esophagus. It's not the majority of people - I seem to remember reading that about 30% will have reflux issues. But that means 70% won't. Some people are willing to take that risk. I wasn't because I already had GERD even before I had surgery.

My surgeon in Las Vegas repaired a small HH during my sleeve surgery. I didn't know I had the HH but am glad he saw it and took the initative to repair. I had my surgery through the Surgical Weight Control Center, the surgeon was Dr. Marc Leduc and he is absolutely wonderful, very knowledgeable and professional, great bedside manner. I had my three month check up yesterday and am down 54 LBS. I have gratefully not had any complications and did not even have to take one pain med after the surgery. Highly recommend SWCC and Dr. Leduc.

[Recidivist 1,141]

Hi, Devi. I went with the RnY in large part because of GERD. As others have said, the sleeve can actually cause GERD, although I'm certainly no expert on that. I can say that I've had no GERD issues whatsoever with RnY,

As for whether or not to get the surgery: that's a very personal decision. I can tell you that I tried for decades to lose weight, never successfully. Over the years I lost the same 50 pounds more times than I can count--and then gained back even more. Statistics show that most people who lose a significant amount of weight without surgery don't keep it off. Your body will always want to return to the weight at which you started.

I can also tell you that my only regret about surgery is not having done it many years earlier. You look relatively young, so having surgery could give you a lifetime of health and well-being. As you will see on this forum, almost nobody regrets their decision to have weight loss surgery.

As for having surgery in Mexico: please make sure you research the doctor and facility before committing to it. I know that some people have had less than optimal outcomes after having their surgeries in Mexico.

[Devi 15]

On 3/3/2023 at 12:57 AM, hills&valleys said:

GERD is often caused by a hiatal hernia. If during VSG surgery a HH is discovered, most surgeons will repair. GERD is also more common among people who are overweight and can sometimes improve or completely disappear with weight loss.

I would suggest forwarding your medical records to Dr. Alvarez, specifically any pertaining to your Upper GI issues so that he can review and then tele- consult. Have you had an upper endoscopy?

I am currently at Dr. Alvarez's Endohospital (Endobariatric.com). I have met Dr. Alvarez a couple of times since arriving earlier today. He is most impressive! It is not exaggerating to say the facility is like a Luxury Resort Spa. My surgery is scheduled in the morning and after talking to several patients one & two days out of surgery, I know I have chosen the right surgeon.

I hope you can find the answers you are seeking.

I think I will reach out to ask him about this. I have not had an endoscopy, but I did have a barium swallow a few years back. Honestly, I would want to go to him over an American surgeon. I am not sure why. Just a feeling. I hope your recovery is off to a great start!

[Devi 15]

I very much want to feel better. I am planning to reach out to Dr. Alvarez. I did lots of research and while I could have self-pay surgery in Florida, I just have a gut feeling that tells me to choose him if I go forward. I have photos of a healthy version of me from 2017 and I miss that version of myself. My fear is complications like Gerd once I get back to the states. Maybe he will have some helpful thoughts on this.

[Fred in Pa 234]

Keep at it, don’t give up…pray. Your answer and day will come!

Would a SADI-S work for your situation?

[hills&valleys 130]

9 hours ago, Devi said:

I very much want to feel better. I am planning to reach out to Dr. Alvarez. I did lots of research and while I could have self-pay surgery in Florida, I just have a gut feeling that tells me to choose him if I go forward. I have photos of a healthy version of me from 2017 and I miss that version of myself. My fear is complications like Gerd once I get back to the states. Maybe he will have some helpful thoughts on this.

Before moving forward with a bariatric procedure, you might want see a gastroenterologist to get to the root of the problem and see what treatments are available and which WLS would be best with your history and condition.

Dr. Alvarez has done over 20K VSG surgeries and is a Master Surgeon of Metobolic & Bariatric Surgery but he focuses strictly on VSG, which may not be the best option for you.

I can feel your frustration when reading your posts and my heart goes out to you. Please move cautiously and seek the proper specialists so that your GERD is not worsened. Once the cause is identified, a plan of action can be devised to address both the GERD and WLS.

Best you you.

[Devi 15]

7 hours ago, hills&valleys said:

Before moving forward with a bariatric procedure, you might want see a gastroenterologist to get to the root of the problem and see what treatments are available and which WLS would be best with your history and condition.

Dr. Alvarez has done over 20K VSG surgeries and is a Master Surgeon of Metobolic & Bariatric Surgery but he focuses strictly on VSG, which may not be the best option for you.

I can feel your frustration when reading your posts and my heart goes out to you. Please move cautiously and seek the proper specialists so that your GERD is not worsened. Once the cause is identified, a plan of action can be devised to address both the GERD and WLS.

Best you you.

I am self pay and hesitant about rny in Mexico. My insurance has a bariatric exclusion and won’t cover complications. In fact, I am pretty sure United Healthcare is so terrible that they would find a way to link any future issues to the surgery just to deny me. They stopped paying for a medication I was on for five years with other insurance. I am alone and have zero family and the sleeve seems like a simpler option. I know that I am not ready to consider rny at this time. I will wait until I can get more testing in the states. An endoscopy with my insurance is $1000. Eventually I will find the right answer. Many thanks.