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In recent years I’ve noticed a spike in the “Hiatal Hernia Surprise surgery” stories shared on the forums. That’s when you wake up to your surgeon telling you he fixed a “surprise hernia” while doing your sleeve. What gives? My 15 years of suffering with GERD after VGS, (I never ate a Tums before sleeve) has lead me to extensive research on this topic. I’ve read ever medical paper, report, blog I can get my hands on. I’ve met with and spoken to MANY surgeons on this subject. THEORY ABOUT “THE SURPRISE” I have a sneaking suspicion that the sleeve surgery itself leads to a hernia in many patients. (See stats about De Novo GERD and VGS). The new stomach is lighter and thinner, with more internal pressure and can now easily slide into the esophageal area past the diaphragm to create a HH because the new shape allows it to. I wonder if VSG surgeon don’t want to scare patients with the stats (30-40% chance of GERD without HH repair), so they just throw in the “hernia surgery surprise” to skirt the conversation. if this happened to you, please share the details- so many would benefit from your story. Knowledge is power! For those who haven’t had it yet - have the convo with your surgeon- let’s eliminate the “surprise”. I’m also sharing my journey to find a solution for those currently suffering from GERD after VSG. Not sure why post VLS GERD is still the “Wild West”. So many different opinions on how to fix it - sheesh. What I’ve been told to do by different surgeons over the years, and what I’ve learned: 1) “convert to rny” This was an instant turn off, but I get why so many do it. The pain is that bad for some. A seasoned WL surgeon recently told me the conversion to RNY is problematic long term (yet many still recommend it). He doesn’t do it anymore. He’s fixed hundreds of these HH post sleeve with a basic HH repair, no- and only had to covert 1 stubborn case. He said the conversion often leads to gas, malabsorption, vomiting, exhaustion, nausea, with many converts still ending up with GERD! If you’ve had the conversion and are a few years out - please share your experience. 2) “go with a partial wrap” This particular Doc said he’d “figure out what was best to do once he was in there.” I lost all confidence in him with that last statement, but I didn’t even realize this was a possibility if your fundus has expanded. 3) “get the LINX” I’m allergic to fake metals (I get hives), yet this particular surgeon was ready to slap this metal puppy around my esophagus. Luckily, the maker ( J&J) posted a warning on their site for sensitive skin types: “do NOT, under any circumstances, put this in your body”. I might have considered it if I didn’t have the allergy, although it seems very problematic for some. 4) “get the ligamentum procedure with repair” This is an old surgery for GERD that involves using your internal umbilical cord. Because it’s so new for WLS GERD, I asked the surgeon if one of his success stories could call me. He obliged. A very sweet women called me, and went on and on about how great the surgeon was. But then she told me she was still on PPI’s and now had chronic diarrhea and dumping syndrome…sooo…back to the drawing board. 5) “Get the basic HH repair”. I’ve consulted with 3 seasoned WLS surgeons who are all on the same page (finally). These 3 say that they pull my stomach back into the right spot, tighten the diaphragm, and call it a day. One uses mesh, but the other 2 sited a recent research paper saying there is no advantage to mesh. They all said I’d have a 80-90% chance of being able to go off the PPI’s. Sorta a fantasy promise- but I’m liking those odds. Of course I’ve done my research and discovered the fail rate over the long term is high (30-40%) after 10 years. and I might have minor swallowing problems, and bloating- yea! But I can have it adjusted if it gets bad, so that’s reassuring. So I’m going in with my eyes wide opened and doing the basic repair, I hope it works. The recovery is long and difficult, but my alternative is PPI’s that are cancerous. Wish me luck and thanks for reading my rant:) I hope it helped a few of my Gerdy sisters, and if you’ve had the “surprise”, please share your experience!

Hi, everyone, first of all, English is not my native language, so please, take it easy. I went through Gastric Bypass surgery on May 19th, it's been 45 days today, July 3rd. I found out that I had a stricture 10 days ago (anastomatic stenosis), the diameter of the stricture was 8mm and through endoscopy, the doctor could enlarge it to 12mm. But even after it, it was difficult to eat soft foods, so I was hospitalized once again and yesterday I had my stricture enlarged again, now to 15mm. The doctor told me to eat only pureed foods for 30 days until I get another endoscopy done and see if it's okay to eat solid foods again. So in the best scenario, according to the doctor, I would reintroduce solid foods only within 1 month and 1 week. It feels like an eternity, I crave to eat something else than creamy soups and fruit and protein shakes. I'm thinking about trying to introduce soft foods a little before that to know how it feels, like chicken soup, with soft potatoes and minced chicken. Would you do that too? Have you ever had a stricture? If so, how did you take care of it? I'm so worried and impatient about my case. Thank you!

Yes, makes perfect sense. When I do what I'm supposed to do I can take off weight fairly easily but not as easily with the band and I haven't been as motivated to keep it off. I had my band removed in 2018 and I am now 2 weeks post op VSG. I'm glad to hear that you have done the work and have a supportive circle. Now, it's up to us to commit, remain consistent and do what we know to do.

The amount of sugar from the fruits prob caused dumping.

The pain for upwards of month after, not being able to tolerate food or foods that I enjoy, diarrhea, vomiting, heartburn, no alcohol for 6 months to a year, no nsaids, potential gallstones, hernia , hair loss to name a few.

I can handle the protein shakes, fortunately. I get 60 grams of my prescribed 60 to 80 from to of the Pure Protein brand shakes. Eight or so more from 3 ounces of cottage cheese. I may still try the GENEPRO to see whether it's palatable mixed in oatmeal. For me, water doesn't taste bad, I just can't drink very much at once.

Thank You. Yes I'm home and recovering. Trying to slowing take in my liquids, but Thank Goodness everything went well and I'm home with my boys . Thank you so much

Nope… I consistently lost 15 pounds a month for like the first 4-5 months. I thought I was going to be a slow loser since I “only” lost 15 that first month, but it just kept happening. Usually weight loss does slow after the first month or two, but if you stick with your plan you will keep losing and it adds up quick. We all lose at our own rates, so try not to compare yourself to others. 21 pounds the first month is awesome. You are doing great! Just keep on keeping on, and stick with your plan. 😊

I had surgery in November of 2020 and I'm 32 lbs away from my goal weight of 175lbs. I can relate to what you are talking about. I am way smaller than what I was and I have pictures to compare myself to but it isn't how I "feel". I still feel really big and sometimes feel very bloated and puffy. I think I really have a distorted view of my size. My boyfriend tried to help me with my perspective when we were on a hike this past weekend. He very discretely and quietly showed me women who were larger or smaller than me. Friends in WLS please don't think we are judging these people. He was only trying to give me a visual perspective of my journey so far. He also reminded me of times we went hiking in the past and how I would sweat profusely and be out of breathe and so very tired when we finished a hike. It really helped me realize that the main reason I did this was to get healthy and my size or number on the scale doesn't matter. It only mattered that I was able to continue to do what I love (hike) more easily and with greater energy so that I could better enjoy this hobby with him.

I have not yet received any bills for the two issues I'm about to discuss, just the EOBs (Explanation of Benefits). For non-US readers, this is a notice that an insurance company must send the patient whenever the insurance has received a bill. It explains to the patient about the bill: the medical provider, the service rendered to the patient, the charge from the medical provider, how much of that charge will be covered by insurance, and how much the patient can expect to self-pay. My original surgery date was delayed/changed due to the hospital's COVID-related closure to elective procedures. I therefore ended up having surgery about 6 weeks after my original date. I just received the EOB relating to the hospital's $55,000 charge. The EOB states the charge has been denied due to "preauthorization was not obtained". I went through all the paperwork I've collected since my journey began and found the preauthorization approval notice for the original date of surgery... but it seems I never got a preauthorization approval notice for the new surgery date. Naturally, the surgeon's office has several people whose job it is to get insurance approvals/preauthorizations prior to surgery... I'm worried that the person handling my case dropped the ball... The second billing issue concerns an EOB that shows I will owe $900 for the nurse anesthetist's bill ($500 deductible plus 50% copay). The anesthesiologist's bill was covered at 100%, but the issue is that his assistant (the nurse anesthetist) apparently doesn't participate with my insurance so I'd be responsible for the high out-of-network charges! Naturally, I as the patient only get to pick my surgeon... I don't get to pick the anesthesiologist or the nurse anesthetist or any of the nurses, for that matter. Again, the team used for my procedure is something that my surgeon's office and the hospital should have put together properly. I called my surgeon's office a week ago and was transferred to the insurance specialist's voicemail. I've not received a call back. I'll try again tomorrow (Monday) but I'm worried... should I be? I know a lot of people here have had their surgery dates moved around due to COVID, so this can't be the first time this issue has come up...? I'd appreciate advice and opinions. Thank you!