Weight Loss Surgery Questions

[Booze Raccoon]

Wait, you're going to have WLS while pregnant?

[berbles]

You may want to do some research on pregnancy and WLS. You may have to wait. Additionally, after WLS you ABSOLUTELY CANNOT get pregnant for at least 18 months. Something to keep in mind.

What kinds of questions do you have? What kind of research have you done?

[mongoose]

Did you ask your doc how soon he recommends? Weight loss surgery is hard. It's painful. Complications are common and can get very scary. With your history of Barrett's Esophagus I would proceed very cautiously. You're going to be on a liquid diet for some time after surgery. Even after you get home, you're diet will be immensely restricted.

I would get multiple opinions from docs. I'd also follow their recommendations- likely to start eating the diet they'll need you to follow post op. It varies by surgeons but some want you to be on the diet for weeks to months before the surgery. They need you to be sure you can be compliant with the diet - many complications happen because the diet is strict, hard to follow, and people give in.

You know yourself best. You will need to have a big enough support system to deal with the needs of a newborn and a possible very stressful post op course.

[screwedup]

Mongoose - I'm not sure what where you're getting your information. "Complications are common" - this varies HIGHLY with the surgeon/surgery center and procedure.

My WLS and my husband's (same surgeon, same facility and same procedure) were flawless. I'm part of an online support group of 1000 WLS surgery patients. Of those, 5-10 have reported some level of complication. Most were not severe. Yes, bad things can and do happen but that can be avoided by using a Bariatric Center of Excellence for your surgery along with an experienced surgeon.

To the OP - I have a robotic-assisted vertical sleeve gastrectomy on 10/30/13. I've lost 91 pounds (14 to go). My husband has lost about the same amount (his surgery was 6 weeks before me). Our recoveries were quite easy (physically). I can tell you about the specifics of our approval process, pre-surgery prep, post-surgery diet, etc. However, all of this is HIGHLY dependent on the procedure you select, your insurance and your surgeon.

In short, I'd do it again. It's been the best thing I've ever done for myself and my health. I do know several people with Barrett's esophagus who had WLS and were quite pleased with their results.

[Deleted]

I don't have any suggestions or experience, but I wanted to wish you all of the best luck with your birth and for continued health.

I would get a second opinion before proceeding with any surgery.

[berbles]

What surgery are you considering? VSG, DS, RnY?

[berbles]

Also, have you looked at the obesity help forums?

www.obesityhelp.com/

[screwedup]

Sept 26, 2014 12:11:34 GMT -5 rvan0905 said:

Sept 26, 2014 11:56:19 GMT -5 mongoose said:

Did you ask your doc how soon he recommends? Weight loss surgery is hard. It's painful. Complications are common and can get very scary. With your history of Barrett's Esophagus I would proceed very cautiously. You're going to be on a liquid diet for some time after surgery. Even after you get home, you're diet will be immensely restricted.

I would get multiple opinions from docs. I'd also follow their recommendations- likely to start eating the diet they'll need you to follow post op. It varies by surgeons but some want you to be on the diet for weeks to months before the surgery. They need you to be sure you can be compliant with the diet - many complications happen because the diet is strict, hard to follow, and people give in.

You know yourself best. You will need to have a big enough support system to deal with the needs of a newborn and a possible very stressful post op course.

My GI and the patient advocate at the hospital said I could schedule the surgery as soon as 6-8 weeks after the C-section, as long as my OB signs off on it.  My OB is one of the doctors who has recommended the surgery; I am high risk for multiple reasons, and he is also my GYN.  He works with my GI and other specialists to create a care plan for me.

I'm highly skeptical of this.  My pre-surgery approval process took 4 months (all of the dr visits and various approvals).  Unless you're planning to start the process while pregnant or if it's different because of your Barrett's esophagus.  I had to do 3 months of  nutritional counseling, 3 months of psych evaluations... it took a total of 19 dr visits in total to get my letter saying I was approved for surgery.

[smile715]

I had it done August 19th and it was the BEST decision I have ever made. I had the sleeve done.

Recovery was really easy compared to the 5 sinus surgeries and 1 kid I delivered. The pre op liquid diet was the hardest part but that was because I went thru sugar, carbs and caffeine withdrawal.

Ask whatever you want...I happily talk about it.

Good Luck with your decision!

[orangeglow]

What will the weight loss accomplish to help the Barrett's?  Have you had a pH test, motility test and an EGD done (at the minimum)?  

Weight loss may help it slightly, but if you are at the point of Barrett's I am going to assume your reflux isn't the generic kind that weight loss will help with.  

I had surgery to fix my esophagus (I do not perform peristalsis nor did I have a valve at the bottom of my esophagus)  and in turn lost weight because of how the surgery was performed.  

Because I've been down the road (I lost 40 lbs and that did nothing for my reflux or ulcerations) I really truly think you need a second opinion or more.  You MAY be overweight, but without knowing all the factors, weight loss surgery may only then be step one before having another surgery.  A GI doctor is only one part of the equation.  Please consider a surgeon as well that works with GI patients in your situation.  

[smile715]

Sept 26, 2014 12:13:36 GMT -5 screwedup said:

Sept 26, 2014 12:11:34 GMT -5 rvan0905 said:

My GI and the patient advocate at the hospital said I could schedule the surgery as soon as 6-8 weeks after the C-section, as long as my OB signs off on it.  My OB is one of the doctors who has recommended the surgery; I am high risk for multiple reasons, and he is also my GYN.  He works with my GI and other specialists to create a care plan for me.

I'm highly skeptical of this.  My pre-surgery approval process took 4 months (all of the dr visits and various approvals).  Unless you're planning to start the process while pregnant or if it's different because of your Barrett's esophagus.  I had to do 3 months of  nutritional counseling, 3 months of psych evaluations... it took a total of 19 dr visits in total to get my letter saying I was approved for surgery.

My process was nothing like that. My first appointment was mid June and I had the surgery 2 months later. It would have been faster if I qualified based just in my bmi but I had to get a cpap machine for my sleep apnea.

[screwedup]

Sept 26, 2014 12:17:16 GMT -5 rvan0905 said:

Sept 26, 2014 12:07:47 GMT -5 screwedup said:

Thank you for the reassurances!  I really appreciate them!

Would you mind sharing how you chose your surgeon, and how you found the support group?  I have to have a hiatal hernia repair done when I have the surgery, so I am planning on letting my GI make whatever decisions he feels are necessary.  I just want to make sure that I am doing the homework that I need to do.

I chose my surgeon based on his reputation and the fact he's the only surgeon who does the sleeve at the only Bariatric Center of Excellence in my town.  I'm required by my insurance to use a BCE so it really narrowed down my choices.  My surgeon had also done several friends' procedures with excellent outcomes.

I would use the forums at obesityhelp.com for doctor reviews, if you have more choice.

[smile715]

Sept 26, 2014 12:17:16 GMT -5 rvan0905 said:

Sept 26, 2014 12:07:47 GMT -5 screwedup said:

Mongoose - I'm not sure what where you're getting your information. "Complications are common" - this varies HIGHLY with the surgeon/surgery center and procedure.

My WLS and my husband's (same surgeon, same facility and same procedure) were flawless. I'm part of an online support group of 1000 WLS surgery patients. Of those, 5-10 have reported some level of complication. Most were not severe. Yes, bad things can and do happen but that can be avoided by using a Bariatric Center of Excellence for your surgery along with an experienced surgeon.

To the OP - I have a robotic-assisted vertical sleeve gastrectomy on 10/30/13. I've lost 91 pounds (14 to go). My husband has lost about the same amount (his surgery was 6 weeks before me). Our recoveries were quite easy (physically). I can tell you about the specifics of our approval process, pre-surgery prep, post-surgery diet, etc. However, all of this is HIGHLY dependent on the procedure you select, your insurance and your surgeon.

In short, I'd do it again. It's been the best thing I've ever done for myself and my health. I do know several people with Barrett's esophagus who had WLS and were quite pleased with their results.

Thank you for the reassurances!  I really appreciate them!

Would you mind sharing how you chose your surgeon, and how you found the support group?  I have to have a hiatal hernia repair done when I have the surgery, so I am planning on letting my GI make whatever decisions he feels are necessary.  I just want to make sure that I am doing the homework that I need to do.

I had a hiatal hernia repaired at the same time as my WLS surgery. It didn't change my recovery.

I am part of a number of WLS groups on Facebook and thinner times. Everyone is super helpful.

[berbles]

Sept 26, 2014 12:20:48 GMT -5 rvan0905 said:

Sept 26, 2014 12:12:05 GMT -5 berbles said:

Also, have you looked at the obesity help forums?

www.obesityhelp.com/

Thank you!  I have not!

www.obesityhelp.com/forums/arthritis/4197884/Barretts-Esophagus/

www.obesityhelp.com/forums/amos/4581741/Barretts-Esophagus-amp-Lap-Band-Info-Request/

www.obesityhelp.com/search/action,search_forums/?q=barrett%27s&cx=000946886326336472648%3Au5ypdm9novs&cof=FORID%3A9

[karmasabiotch]

I had RNY before the more popular method turned into the Sleeve. I had complications. I also atrongly suggest 6 months of counseling before the surgery and to keep up the counseling for at least 1 year after. That wasn't suggested to me which meant I lost weight but it didn't change my relationship with food, so I gained a chunk back. Now I'm back to losing it the old fashioned way.

If how you think about food and yourself doesn't change you won't have long term success.

[orangeglow]

Sept 26, 2014 12:33:43 GMT -5 rvan0905 said:

Sept 26, 2014 12:15:20 GMT -5 orangeglow said:

What will the weight loss accomplish to help the Barrett's?  Have you had a pH test, motility test and an EGD done (at the minimum)?  

Weight loss may help it slightly, but if you are at the point of Barrett's I am going to assume your reflux isn't the generic kind that weight loss will help with.  

I had surgery to fix my esophagus (I do not perform peristalsis nor did I have a valve at the bottom of my esophagus)  and in turn lost weight because of how the surgery was performed.  

Because I've been down the road (I lost 40 lbs and that did nothing for my reflux or ulcerations) I really truly think you need a second opinion or more.  You MAY be overweight, but without knowing all the factors, weight loss surgery may only then be step one before having another surgery.  A GI doctor is only one part of the equation.  Please consider a surgeon as well that works with GI patients in your situation.  

I haven't had those tests done yet, but that may be because I found out I was pregnant right after I was diagnosed.  I didn't know I had GERD before the diagnosis because we've been so concerned about my IBD.  If you would have asked me last year I would have told you I never even get heartburn.  He did a biopsy during an upper GI scope to find out why I was throwing up for weeks at a time (I usually only have issues with diarrhea), and boom, Barrett's!

My GI is the main doctor who is recommending the surgery, and he is normally very conservative with his recommendations.  He explained to me that it would remove the stomach acid from the equation, and that made sense to me.  I will ask him to clarify what he meant.  Thank you for the information!

Unless they are cutting your vagal nerve off (which is scary and absolute worst case scenario) you will never not have stomach acid.  If they remove part of your stomach, your stomach won't produce as much acid (as there is less stomach).  My stomach is at about 50% because of what they had to remove/reuse to perform my surgery, I STILL get occasional heart burn and have stomach acid.  So... I guess I am confused.

I hope I am not coming across as anti the weight loss surgery.  I just don't want your expectation to be that it will free you from the Barrett's when... I don't understand how and worry that you will have this and then in a couple years the Barrett's is back/worse and you have to have subsequent surgeries.  BUT, I am not a doctor.  I have just had 1 surgery, 2 corrective surgeries and will have a third (corrective) once I have this baby because of listening to the first doctor that insisted this was my best option when there were other options I should have considered before jumping in.  I had a toupet (look up nissan as the toupet is less frequent) fundoplication to alleviate the 21 ulcers I had that were starting to form Barrett's in my esophagus.  I am ulcer free, but still have major stomach issues associated with the surgery, the recovery and even the weight loss from the surgery.  

If you don't perform peristalsis (that would be the motility test that could tell you) then having a band surgery could be very very hard on you.  Peristalsis is when your esophagus does not help move food correctly down your esophagus so you get back up, not all food empties into the stomach quickly and acid works it's way up to break down the food damaging your esophagus further.

[Deleted]

Sept 26, 2014 13:07:29 GMT -5 orangeglow said:

Sept 26, 2014 12:33:43 GMT -5 rvan0905 said:

I haven't had those tests done yet, but that may be because I found out I was pregnant right after I was diagnosed.  I didn't know I had GERD before the diagnosis because we've been so concerned about my IBD.  If you would have asked me last year I would have told you I never even get heartburn.  He did a biopsy during an upper GI scope to find out why I was throwing up for weeks at a time (I usually only have issues with diarrhea), and boom, Barrett's!

My GI is the main doctor who is recommending the surgery, and he is normally very conservative with his recommendations.  He explained to me that it would remove the stomach acid from the equation, and that made sense to me.  I will ask him to clarify what he meant.  Thank you for the information!

Unless they are cutting your vagal nerve off (which is scary and absolute worst case scenario) you will never not have stomach acid.  If they remove part of your stomach, your stomach won't produce as much acid (as there is less stomach).  My stomach is at about 50% because of what they had to remove/reuse to perform my surgery, I STILL get occasional heart burn and have stomach acid.  So... I guess I am confused.

I hope I am not coming across as anti the weight loss surgery.  I just don't want your expectation to be that it will free you from the Barrett's when... I don't understand how and worry that you will have this and then in a couple years the Barrett's is back/worse and you have to have subsequent surgeries.  BUT, I am not a doctor.  I have just had 1 surgery, 2 corrective surgeries and will have a third (corrective) once I have this baby because of listening to the first doctor that insisted this was my best option when there were other options I should have considered before jumping in.  I had a toupet (look up nissan as the toupet is less frequent) fundoplication to alleviate the 21 ulcers I had that were starting to form Barrett's in my esophagus.  I am ulcer free, but still have major stomach issues associated with the surgery, the recovery and even the weight loss from the surgery.  

If you don't perform peristalsis (that would be the motility test that could tell you) then having a band surgery could be very very hard on you.  Peristalsis is when your esophagus does not help move food correctly down your esophagus so you get back up, not all food empties into the stomach quickly and acid works it's way up to break down the food damaging your esophagus further.

If you google you will find scientific studies supporting positive outcomes of bariatric surgery and Barrett's Esophagus.

OP, good luck with the rest of your pregnancy and talking with your doctors to figure out how best to proceed! Hopefully you can find the info you need.

[orangeglow]

Sept 26, 2014 14:50:14 GMT -5 @wandering said:

If you google you will find scientific studies supporting positive outcomes of bariatric surgery and Barrett's Esophagus.

OP, good luck with the rest of your pregnancy and talking with your doctors to figure out how best to proceed! Hopefully you can find the info you need.

I said I wasn't a doctor!  :-)

I have heard a lot of opinions and I don't regret my surgery to correct things one bit, BUT I went in blindly to mine and I was just kind of thinking out loud while trying to convey my thoughts.  I'm a skeptic ok??  

I've finally seeing someone at UPenn who has been fantastic, but it took me 6 years, countless tests, surgeries and issues before realizing I needed better to advocate for myself.  I just want OP to look at ALL the facts and issues with as many people as she can before making a decision. Women of childbearing age are often times overlooked with some issues when it comes to how to handle a problem.  

Am I making any sense?  I swear to god this lack of sleep and food is making me brain dead.

[orangeglow]

rvan0905 - if you ever have any questions at all please feel free to ask them (you can PM me too).  I am in a pregnancy nightmare mood today (several days without sleep, kid is kicking all the time, I'm not hungry, etc), so I hope I wasn't short with you!

I've had the scares, the cries and all the in betweens with finding out that there is something wrong with me that could cause cancer that I have only a finite amount of control over.  It's scary and it sucks.  It also put me into a place that I just wanted things fixed.  So I can sympathize a LOT with you and I truly hope that if WLS is the answer for you that it works and works well!  If not I hope you find that thing that helps you get through this.  Good luck and plenty of support here!

[nikki25]

. [/quote]I said I wasn't a doctor!  :-)

I have heard a lot of opinions and I don't regret my surgery to correct things one bit, BUT I went in blindly to mine and I was just kind of thinking out loud while trying to convey my thoughts.  I'm a skeptic ok??  

I've finally seeing someone at UPenn who has been fantastic, but it took me 6 years, countless tests, surgeries and issues before realizing I needed better to advocate for myself.  I just want OP to look at ALL the facts and issues with as many people as she can before making a decision. Women of childbearing age are often times overlooked with some issues when it comes to how to handle a problem.  

Am I making any sense?  I swear to god this lack of sleep and food is making me brain dead.[/quote]



My father has struggled with these issues for a long time and went through similar issues as you unfortunately. He has been seeing, I am sure, that same doctor out of UPenn and it has been amazing for him! I am glad you had the same positive outcomes with this doctor. And, you are right about being your own advocate. I had major spinal issues/surgeries as a child which worsened has I aged and had children but fuck, it always feel like an uphill battle and once I fine a doctor that actual really cares I stalk them for life, lol. Sorry for all your issues with the surgery

OP: Best of luck to you!

[mommac]

Sept 26, 2014 12:20:09 GMT -5 rvan0905 said:

Sept 26, 2014 12:10:51 GMT -5 berbles said:

What surgery are you considering? VSG, DS, RnY?

I'm having an upper GI scope right after DS's birth, and then my GI (working with the bariatric surgeon) is going to make a recommendation for what procedure I should get.  I've been working with him for years, and I really trust his judgement.

I had VSG in march 2014.  awesome...would do it again...should have done it sooner.  Took 10 months to get approved with my insurance though.  Some plans are faster, mine was not.

If stomach acid is your problem - the sleeve is not the surgery for you.  VSG can actually cause an increase in GERD.  I'm not totally sure, but since the DS is sleeve plus intestine work but keeps the pylorus valve in tact that the DS would also not be good if acid is a problem.

RNY removes the pyloric valve which allows acid to drain out more freely - but with RNY, the stomach "remnant" is left inside you and can no longer be scoped by entering through the throat. Any tests on your stomach would be invasive.  I'm not sure what that potential cancer would do or require of you for testing, but that is something to consider.

For 100 pounds to lose, DS may be overkill - but if it is better for your disease, it may be an option.

I do not have acid issues, so I chose the VSG.  I had 150+ to lose and so far am down 110 in 6 months.  I am also pregnant post VSG (too soon I know, but BC failed us) and my doctors are not too concerned at this point b/c VSG does not change vitamin absorption too much if at all - my labs all came back in normal range so far.  RNY and DS are the ones that can have greater vitamin deficiency issues.

check out obesityhelp.com forums - it has been a great resource for me.  Also look for a bariatric center of excellence...they typically have more robust programs with better after care plans and support available. 

[kayl84]

Sept 26, 2014 16:51:00 GMT -5 mommac said:

Sept 26, 2014 12:20:09 GMT -5 rvan0905 said:

I'm having an upper GI scope right after DS's birth, and then my GI (working with the bariatric surgeon) is going to make a recommendation for what procedure I should get.  I've been working with him for years, and I really trust his judgement.

I had VSG in march 2014.  awesome...would do it again...should have done it sooner.  Took 10 months to get approved with my insurance though.  Some plans are faster, mine was not.

If stomach acid is your problem - the sleeve is not the surgery for you.  VSG can actually cause an increase in GERD.  I'm not totally sure, but since the DS is sleeve plus intestine work but keeps the pylorus valve in tact that the DS would also not be good if acid is a problem.

RNY removes the pyloric valve which allows acid to drain out more freely - but with RNY, the stomach "remnant" is left inside you and can no longer be scoped by entering through the throat. Any tests on your stomach would be invasive.  I'm not sure what that potential cancer would do or require of you for testing, but that is something to consider.

For 100 pounds to lose, DS may be overkill - but if it is better for your disease, it may be an option.

I do not have acid issues, so I chose the VSG.  I had 150+ to lose and so far am down 110 in 6 months.  I am also pregnant post VSG (too soon I know, but BC failed us) and my doctors are not too concerned at this point b/c VSG does not change vitamin absorption too much if at all - my labs all came back in normal range so far.  RNY and DS are the ones that can have greater vitamin deficiency issues.

check out obesityhelp.com forums - it has been a great resource for me.  Also look for a bariatric center of excellence...they typically have more robust programs with better after care plans and support available. 

Um so my endoscopy I had done through my mouth, showing and not showing ulcers and such were never done through my throat? NO BLIND NG's unless life or death situation. Whoever said no test for your stomach cannot be done is 100% wrong.


I also recommend 6 months+(Minimum) prior of therapy or counseling, seeing their or another dietician to make sure you understand that it is a lifestyle change, no alcohol for really I'd say I was told a 6m to a year of no alcohol and was okayed at 8/9 months, finding a local support group through your doc or online, obesity help was kind of iffy for me and someone mentioned thinner times forum (all one word), but they are strict like with wording and such & in the past their moderators used to be actual members. So if you got in a heated discussion, their mods didn't like or agree with you, posted any 'racy' (ie: some people had JUST bra&undies before/afters and THAT was okay), but no discussions where it'd lead to disagreements.
Basically, if you posted like we tend to do here at times you could be banned or warned(reminds me of the knot message boards!) It was adults being treated like kids, running away a lot of old timers. That's why I even hate giving them publicity. You'd have new people telling 6-week outers that it's okay to have alcohol before a certain point, people so focused on what size they HAD TO BE that it was almost eating disorder-like, people taking their problems out on shopping/running up huge debt, their newfound attn from the opposite sex and saw a lot of splits/divorces or worse alcohol overindulgence. With your new system you tend to get drunk quick and lose that drunk feeling just as quick, but the BAC remains the same leading to blackouts or even worse DUI/DWI's.


Because I had RNY about 7 years ago with I cannot tell you how many issues because I blindly trusted my first surgeon, with whom previous family members & friends used for both Lap-Band in NJ at a center of excellence and stayed a lot of the time on a bariatric floor at a great northern NJ hospital. I blindly was opened up to the point of 8 surgeries with this guy, which we highly believe the amount of times he'd open me up to clear out scar tissue and things he should and could have waited on I even ended up having a PE at 27 in the recovery room. I now have an amazing surgeon who in 4 yrs has done 3 surgeries. 2 to fix the other guys fuuck up & one where we waited 15 months to do alternate things to see if that could change it. I'm one of 4 patients of his who are other surgeons screw ups, so please don't blindly walk into this thinking cause you did it all right that it won't happen to you. I never thought I'd be where I am now, trust me.

[fangoriagurkel]

Sept 26, 2014 12:12:05 GMT -5 berbles said:

Also, have you looked at the obesity help forums?

www.obesityhelp.com/

I second this! I had the vsg about 4 yrs out. I've lost 230ish lbs and have been in maintaining within 3-5 lbs for the last yr. PM me for anything!