gallbladder and sleeve gastrectomy

[KChoudhry 0]

Hi, I'm new here. Let me give you a bit of my history. I'm 43, weigh 290 pounds, and have diabetes. On November 24, I experienced stabbing pain on the right side below my rib cage. I went to the ER, where the doctor gave me pain medication and an ultrasound, which revealed gallbladder stones. He scheduled a visit with a surgeon for mid-December. I had another gallbladder attack before the appointment, but luckily, apple cider vinegar (ACV) and Aleve helped relieve the pain.

On the appointment day, the surgeon suggested I consider getting sleeve gastrectomy along with gallbladder removal. I was shocked to hear that and, in a panic, declined the VSG. However, after researching, I found it's a potential solution for weight loss and reversing diabetes. Now, with only three days left before my surgery, I'm trying to add VSG to the gallbladder removal. I'm unsure if it will work out with the surgeon, and it might be too late to make changes. I don't want to go through another laparoscopic procedure and double the cost. I'm feeling nervous about how this week will go.

[SpartanMaker 830]

I guess I have a couple of things for you to think about:

1. Many insurance companies don't cover weight loss surgery. Those that do, typically have very specific requirements that take months to accomplish. Do you know for sure this would be covered, or are you prepared to pay out of pocket?
2. Most bariatric surgeons have their own set of requirements from patients aside from those that the insurance company requires. These too can take weeks to accomplish. If your surgeon does not have any requirements, this would go against best practices. Do you really want a surgeon willing to take shortcuts?
3. Most bariatric surgeons want to have you do a pre-op diet of 2-4 weeks. There are multiple reasons, but the most important is to shrink your liver to make the surgery safer. Are you okay with extra risk just to get the surgery ASAP?
4. Most bariatric surgery is done by a specialised bariatric surgeon, not a general surgeon. I'm not sure I'd even want a general surgeon to do the bariatric surgery even if they say they could do it. Remember, experience here is highly predictive of positive outcomes. Are you sure about the experience of the surgeon what would be performing the surgery?
5. Long term success from weight loss surgery is a lot more than just having the surgery done. Are you mentally ready for a lifetime of changes to how you eat?
6. Do you really know that VSG is the right surgery for you? Gastric bypass is typically recommended for larger people with more weight to lose, especially if they have comorbidities like diabetes. I think it's worth taking your time to research and discuss various surgical options before jumping straight into this.
7. On a more practical level, even if you could overcome all of the above, most surgeons and surgical suites are scheduled based on the length of the planned surgery. I can't imagine either of them changing this on short notice.

Overall, while I think bariatric surgery is a fantastic, life-changing choice, it's not for everyone. Take your time and go through the process to mentally and physically prepare yourself before jumping in.

[KChoudhry 0]

Your post is eye opening. I have no idea since the post. I do not think surgeon will agree to such short notice.

Generally what is the pre op requirements for vsg.

What lifetime of changes are after the surgery?

Edited yesterday at 07:26 PM by KChoudhry

[SpartanMaker 830]

A typical pre-op is dependent on your insurance and your surgeon, but most require things like:

• A series of monthly visits with a dietitian. 3 to 6 monthly visits are fairly common
• A visit with a psychiatrist or psychologist. Depending on the outcome, you may need to undergo treatment for an undiagnosed eating disorder
• One or more education sessions typically done over a series of weeks. This is to better prepare you for both the immediate post-op diet, as well as long term expectations. These are sometimes, but not always done together with the dietitian visits.
• Clearance from your primary care doctor and depending on your health history, clearances from other doctors such as a cardiologist or endocrinologist.
• Numerous blood tests, both to look for potential problems and to set a baseline.
• Again depending on your health history and your surgeons preferences, you might need to have things such as an endoscopy and/or a swallow study done. Some people may even need additional imaging done such as CT or MRI scans.
• As a diabetic, they may require your A1C to be below a prescribed value. This is for your safety.

Honestly I'm probably forgetting some stuff. If so, I'm sure others here can chime in.

In terms of lifetime changes to your eating patterns, you need to make sure you're prepared to make better food choices for life. It's a sad fact, but a pretty high number of people that have weight loss surgery eventually gain the weight back. This can be avoided by learning how to make better food choices now, so you don't fall back into old habits once the stomach restriction eases off.

It's often misunderstood by those not familiar with bariatric surgery that weight loss post surgery is "easy". Yes, the initial loss can be easier that it would have been otherwise, but keeping the weight off is just as hard, if not harder that it would have been had you not had the surgery. This is why learning how to eat better is so important.

People that lose weight naturally and keep it off do so through repeatedly making good food choices and strict discipline. That knowledge carries over really well to long term weight maintenance. The people that fail weight loss surgery often found initial weight loss easy, but sometimes really struggle once they get to maintenance since they don't know how to eat like a "normal" person. Add in the fact that a formerly obese person trying to maintain weight typically can't eat as much food as someone that was never overweight even if they are the exact same body size, and you can see why retraining yourself here is critical.

Throw in the fact that (at least in my opinion), most obese people either have an eating disorder, or at least suffer from disordered eating, and it's obvious that the surgery is just a small component to overall success.

TL;DR: IMO, It's better to take your time and do it right.

[Arabesque 7,378]

@SpartanMaker is pretty much on point as usual. 😁

If you decide to go down the weight loss surgery path, I’d still probably look at doing the gall as soon as possible. I had mine removed 2 years after my sleeve. My surgeon (who did my sleeve too) said once you start experiencing gall pain it will only get worse & you ‘ll experience it more and more often. I had one stack & it was horrendous - was rolling on the bed writhing in pain fir about 40 minutes until it passed & I have a pretty high pain threshold. My surgeon removed my gall about 2 weeks later. The alleve may have worked but it was more likely to have been the just wave of the pain passing. The cider vinegar wouldn’t have done anything - just a co incidence. A dose of cider vinegar isn’t going to dissolve the stones to stop the pain or get rid of them (like some old wives tales advise and influencers selling cider vinegar promote).

Checkout the you tube channels of Dr John Pilcher and Dr Matthew Weiner (under pound of cure as is website). They are excellent resources for anyone considering weight loss surgery or who’ve had surgery. They have a lot of videos so you may have to scroll through a lot. Dr Weiner also has podcasts.

Edited 19 hours ago by Arabesque