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Your port is most likely located on your left side. As a result, sneezing, and anything that contracts your abdominal muscles will cause some discomfort. This is a normal symptom. When we attach a port to your tissues (aponeurosis-tissue that covers muscles), it tends to irritate a bit causing this discomfort. This will go away if you give it some time. Best,

By the time the tablet reaches your stomach the sharp edges will be long gone. You CAN break it in half with out worrying. This med doesn't stand a chance with your new stomach!! Let me know if you have other issues.

Your post humored me a lot...especially the bow-chick-a-bow-wow Unless you are running a fever, you experience nausea, and vomiting, these sympoms are somewhat usual after major surgery. Take things in stride and you will get back to normal, with only one difference, you will be thinner! Like other's said...some of these things are not bad at all. All the best,

It is pretty unfortunate you had to put up with this, but this 'co-pay' has been something that they have wanted to implement for a while. Expect those fees to stick around or even rise. Until there is some reform by the government, insurance companies will make you jump through so many hurdles to have a procedure that can give you a better quality of life, and that can even save it. Take things calmly, maybe you can find some loop-hole to go through. This may just be a minor set-back. Stay focused and you will eventually have your surgery.

And another one: Sleeve gastrectomy and type 2 diabetes mellitus: a systematic review. Gill RS, Birch DW, Shi X, Sharma AM, Karmali S. Source Department of Surgery, University of Alberta, Edmonton, Alberta, Canada. shahzeerkarmali@hotmail.com Abstract BACKGROUND: Existing evidence has suggested that bariatric surgery produces sustainable weight loss and remission or cure of type 2 diabetes mellitus (DM). Laparoscopic sleeve gastrectomy (LSG) has garnered considerable interest as a low morbidity bariatric surgical procedure that leads to effective weight loss and control of co-morbid disease. The objective of the present study was to systematically review the effect of LSG on type 2 DM. METHODS: An electronic data search of MEDLINE, PubMed, Embase, Scopus, Dare, Clinical Evidence, TRIP, Health Technology Database, Conference abstracts, clinical trials, and the Cochrane Library database was completed. The search terms used included LSG, vertical gastrectomy, bariatric surgery, metabolic surgery, and diabetes (DM), type 2 DM, or co-morbidities. All human studies, not limited to those in the English language, that had been reported from 2000 to April 2010 were included. RESULTS: After an initial screen of 3621 titles, 289 abstracts were reviewed, and 28 studies met the inclusion criteria and the full report was assessed. One study was excluded after a careful assessment because the investigators had combined LSG with ileal interposition. A total of 27 studies and 673 patients were analyzed. The baseline mean body mass index for the 673 patients was 47.4 kg/m(2) (range 31.0-53.5). The mean percentage of excess weight loss was 47.3% (range 6.3-74.6%), with a mean follow-up of 13.1 months (range 3-36). DM had resolved in 66.2% of the patients, improved in 26.9%, and remained stable in 13.1%. The mean decrease in blood glucose and hemoglobin A1c after sleeve gastrectomy was -88.2 mg/dL and -1.7%, respectively. CONCLUSION: Most patients with type 2 DM experienced resolution or improvement in DM markers after LSG. LSG might play an important role as a metabolic therapy for patients with type 2 DM. Copyright © 2010 American Society for Metabolic and Bariatric Surgery. Published by Elsevier Inc. All rights reserved.

Here is an article I came across a while ago: Laparoscopic Sleeve Gastrectomy is a Safe and Effective Bariatric Procedure for the Lower BMI (35.0-43.0 kg/m(2)) Population. Gluck B, Movitz B, Jansma S, Gluck J, Laskowski K. Source Mercy Health Partners, 1325 E. Sherman Boulevard, Muskegon, MI, 49444, USA, bgluck@aol.com. Abstract BACKGROUND: The laparoscopic vertical sleeve gastrectomy (LSG) is derived from the biliopancreatic diversion with duodenal switch operation (Marceau et al., Obes Surg 3:29-35, 1993; Hess and Hess, Obes Surg 8:267-82, 1998; Chu et al., Surg Endosc 16:S069, 2002). Later, LSG was advocated as the first step of a two-stage procedure for super-obese patients (Regan et al., Obes Surg 13:861-4, 2003; Cottam et al., Surg Endosc 20:859-63, 2006). However, recent support is mounting that continues to establish LSG as the definitive procedure for surgical treatment of morbid obesity. We will report our experience with the LSG as a primary bariatric procedure and evaluate if this operation is suitable as a stand-alone procedure. METHODS: The study is a nonrandomized retrospective analysis of 204 patients from a single surgeon operated between July 2006 and April 2010. The study comprises of 155 women and 49 men with a mean age of 45 years (range, 19-70 years), a mean preoperative weight of 126.6 kg, and body mass index (BMI) of 45.7 kg/m(2). RESULTS: The mean percent excess weight loss (%EWL) was 49.9% (n = 159), 64.2% (n = 138), 67.9% (n = 77), 62.4% (n = 34), and 62.2% (n = 9) at 3, 6, 12, 24, and 36 months, respectively. For patients with BMI ≤43.0, the mean postoperative %EWL was 58.9% (n = 72), 74.1% (n = 67), 75.8% (n = 39), 72.1% (n = 17), and 78.7% (n = 5) at 3, 6, 12, 24, and 36 months, respectively. Operative complications include leak (0.0%), abscess (0.5%), hemorrhage (1.0%), sleeve stricture (1.0%), and severe gastroesphogeal reflux disease with need to convert to laparoscopic Roux-en-Y gastric bypass (0.5%). CONCLUSIONS: LSG yields excellent outcomes with low complication rates for morbidly obese patients. We advocate LSG as a safe and effective stand-alone procedure, especially with the lower BMI population (BMI 35.0-43.0 kg/m(2)).

That's good to hear Amanda. Let us know if this bug gives you any more trouble!!

Hi there...this is not atypical at all. The stall you are referring to is due to an adjustment period the human body goes through after some constant weight-loss. Your regulatory centers that are constantly working to achieve a balance got a little 'thrown off' after the surgery and weight loss that came along with it. The important thing to keep in mind is that you will continue to lose weight if you continue your regimen. I would advise that you pay close attention to your clothes...they are the best weight-loss indicator. Stay strong and do not let this 'plateau' bother you. Soon you will be back on track. I hope this helps, Dr. JSA

I was in the OR all day and just got to your post. Please keep me posted on your status. Best of luck.

Hey Pamela...you should definitely have this checked out. Although, incisional hernias are very rare in laparoscopic banding, it should be considered in cases like yours. It may very well be swelling around your port since after all this is something that your body recognizes as foreign. If you do not have a fever and the size is decreasing you should be ok. Still, it would be a good idea for your physician to confirm this. Best of luck, Dr. JSA

Have you had a fever? Clammy hands? I definitely agree with the other answers...hydrate! In addition, keep track of your body temperature and call your dr ASAP if the fever doesn't subside. Also, did you finish your antibiotic regimen after your surgery? Best of luck, Dr. JSA

Hi!! Just wondering...are your hernias in L4-L5 % L5-S1? Let me know, that way I can give you some good advice on some novel treatments. Also, do you have numbness in your extremities, or tingling sensations? Congrats on the recent weight loss!!

Wow!! That is truly amazing...congrats to you!!!

HI...this should NOT delay your surgery. Vitamin D levels are not one of the parameters that we specifically look at when performing surgery. Among the most important parameters are: Hemoglobin, coagulation times, and white blood cell count. Of course we look at the whole lab report, but vitamin D is not typically as important as the one's mentioned. You are advised to ask your physician about taking Vit D supplementation after surgery. In addition, it would be advisable to find the specific reason for the low levels of Vit D. Let me know if you have any questions...best of luck.

I'm glad to see you worked out these issues and that you are in good health. Stay healthy!!

After losing so much weight, you deserve a vote! Congrats!!

Here is the bottom line on compression socks: USE THEM! Your nurse will put them on the morning of your surgery day. You will wear them for the following afternoon and possibly the next day. Here is the reason for their use. In medicine we refer to this phenomenon as Virchow's Triad. There are 3 main reasons that increase the probability of blood clot formation and subsequent dislodging of the thrombus (thrombosis). 1. Endothelial injury (Lining of your blood vessels) 2. Hypercoagular state (mostly genetic disorders) 3. Stasis The latter applies to you! When you are in a lying down position for a while (such as when you have surgery, or when a patient is in the ICU for a prolonged period) you increase the probability of thrombus formation. Research has showed us that compressing the lower extremities greatly reduces the formation of blood clots. Another helpful tip is to begin walking CAREFULLY the morning after your surgery. This should be done under the supervision of the nurse or the doctor him/her-self. If you want to take it a step further, let me know and I can send you an article from a journal. Best, Dr. JSA

You're welcome!

I would say you are safe after a month. It is imperative to follow instructions rigorously in order for this time frame to apply to you.

Good for you...keep it up!!

From a medical stand point I would stay away from appetite suppressants and anything similar. I would advise you to think about products like Alli (orlistat). This can help you significantly reduce your caloric intake. The down side...DO NOT pass any gas. It can get ugly. To try and prevent this as much as possible, stick with the 60mg version. My patients have told me that this dosage significantly reduces the side effects. Best of luck...

These are the indications I give my patients... 1. Wash twice daily with neutral soap and Water...no unapproved creams, ointments, home remedies etc! 2. Cover the incisions with a gauze and secure it with tape. 3. If it itches it is normal. This means that scar tissue is forming. 4. Warning signs: Purulent (pus) discharge that is white-yellow-green, etc Excessive bleeding that will not stop with pressure (applied by yourself) Bright redness around the incision Suture's 'pop out' High grade fever (over 39'C or over 100'F) To prevent all of this follow the cleaning instructions and take your medications as indicated! DO NOT take +/- 1 or 2 hrs 4. If none of this happens you are in the clear. 5. If for some reason your doctors left a penrose drain, contact me and I can give you further pointers. Let me know if you have other questions...I will be happy to help out. Best, Dr. JSA

My best wishes go out to you and the medical staff that will be treating you. Congrats!!

Wow! I was looking at your blog and it is great!! It is definitely going to help many people, but in the end it will help you the most. The best part is being able to look back and see how your way of thinking changed...oh and also how you dropped so much weight!! Best of luck!!

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