AmusedMuse

@@James Marusek,

Thank you for telling me about Muscle Milk. I tried it this morning and it went in very smooth - no nausea (I still get slight nausea frequently when I eat even a bite of something) and tasted ok (a bit sweet for my liking). I then had plenty of energy for my morning. This is a great recommendation!

@@lisylooby, I hope you talked with your surgeon about what the nutritionist said about you eating too quickly. It is poor practice to make such generalizations, especially when the patient is in a professional field and likely to be following directions. I also hope it is smooth sailing for you from here. What a lot you've been through!

I went with the sleeve. It was recommended over RNY unless you had acid reflux (which I didn't). I also think that RNY results in a quicker weight loss thanks to malabsorption.

The pluses of the sleeve are:

1. It's less likely to stretch because the stretchy part of the stomach is removed. Since an RNY pouch is constructed from the esophagus, it can stretch.

2. My surgeon told us no alcohol or NSAID'S with an RNY for life. I'm a weekend social drinker with arthritis, so this was my primary reason for going VSG.

3. I love the simplicity of the sleeve. Once I healed, I'm basically "normal" with an itty bitty stomach. Who doesn't love that. Yes, they say that that RNY is reversible, but I've never heard of anyone doing it and why would you?

4. I have also heard that the malabsorption factor goes away down the road and your left with just the restriction of the pouch, which can stretch (at least a little).

5. Finally, remember that VSG was first developed as stage one of a DS surgery, so I suspect you could always go back to get the malabsorption part done later if needed (at least I think this is true).

Btw, there is nothing I can't eat - no hint of dumping whatsoever!

There is a huge difference in what doctors recommend. My surgeon was a top European specialist who trains many American docs. Did y'all realize there are many US docs who fly to Europe for bypass procedure training? He also spends one week per month in the Middle East, doing surgeries for the wealthy there. He commented to me that all his Middle Eastern patients want the sleeve and he tries to talk them out of it for a number of reasons (I wasn't paying a lot of attention to them because I never considered the sleeve). In my case, and there are multiple general ways of performing RNY surgery, I essentially have a sleeve but the bulk of my stomach is sutured closed and food passes through a small sleeve. You say you love the simplicity of the sleeve but in most cases the RNY is more simple.

As for your question about why someone would have this reversed, there are multiple reasons. My neighbor had been obese for years and after a broken bone and hospitalization suddenly developed malabsorbtion syndrome in which food just passed through him without being absorbed. In short order he became scarily malnourished and emaciated. I have known folks with cancer who have also gone through serious weight loss, and a couple of people I know were told by their docs at the time of diagnosis to gain weight and stop trying to take it off. These were people who were already obese.

I have the RNY, my stomach is just smaller than it was before, and my doc said drinking is fine. Only 6 weeks out and I've been indulging in a couple of drinks per week for 3 weeks now. It is inaccurate to generalize that RNY patients can't drink.

Yes, I have a lot of dumping 6 weeks out, but I think my situation is unique. First, since I am a 'low BMI' patient, my surgeon removed almost no intestine, less than 2 inches. There is likely no correlation between the amount of intestine removed and dumping in my case. For years I had bad stomach pain, at times so awful that I was incapacitated. After 3 years of trying to find a solution I found an expert who solved my problem. In short, the source of my pain was that my intestines are sluggish and don't work well, and my stomach was contracting harder and harder to push food through, I suspect that my frequent dumping is caused by my stomach still contracting super hard - it's been doing that for years so I doubt it will change very quickly. Also (apologies if this is TMI), for years I had pellet BMs and frequent Constipation, and suddenly post surgery my BMs are soft and normal. I am so happy about that and about not having to daily think about pills or supplements.

There is no single 'best surgery' or guaranteed avoidance of particular issues which should make the selection of surgery simple or generic. Do good research of RECENT studies. Look for a doc who does a LOT of GBs and listen to his/her advice.

@@MsMiniMe,

That was helpful, thanks. I emailed my surgeon and he sent me a comforting response. He said all patients lose according to a percentage.

First 6 weeks loss is 20%

First 3 months loss is 30%

First year loss is 40% (if I remember correctly without looking at his email).

Mine seems to be a bit slower but I am exhausted and suffering through a Florida summer so taking things pretty easy (and have also hurt my foot so couch time is good right now).

We'll get there!

@@LowBMISleever,

Hey, we are both low BMI patients. How is your weight loss going? Mine is slow but steady.

I am post RNY nearly two years and still cannot eat eggs without getting sick. It is the only thing that makes me sick.

Keep pushing the Protein and fluids with no sweeteners and you will continue to lose weight.

Drinking with your meals at all is a huge NO NO for RNY. If you drink you can push food through too quickly possibly causing a blockage and certainly flushing food before you even get the nutrients and causing you to be hungry. This is one of the most important rules and it really is for life.

You have to get a handle on that.

One way to do that is to ensure that you start your day well hydrated. I have learned to drink at least a 20 oz bottle of Water first thing in the morning. Then I wait, drink 1 Protein shake that gives me a 30gr boost of protein. Then I wait at least 30 minutes and drink another 20 to 40 ounces of Water. If I do that I find that I am not thirsty at all when I eat my meals. I wait at least 30 minutes before eating and in the beginning it is important that your protein is moist and my nut has always had me eating lots of veggies and fruit. She taught me that 2 bites of dense protein for every 1 bite of fruit and veggies. In the beginning I measured everything and I still track what I eat in my fitness pal. I have since learned to trust my tummy to tell me when I am full.

If you follow these simple rules, you will lose the weight.

Thanks Djmohr,

I am going to try and hydrate more, though my body feels it is doing ok with that already (my urine was almost brown in the weeks after surgery but with more water it seems regular these days). It doesn't matter how hydrated I am, when I eat I crave liquids. I was always the one at the table drinking 2 or 3 glasses of water with dinner - the no drinking thing is super hard for me. Sadly, I also dump when I drink nothing with a meal, though it seems less dramatic. I am just trying to 'embrace my dumping' as part of the weight loss process for now. It's a pain, though!

Thanks all,

You were right, it was just a stall. After that week I started dropping pretty regularly, an ounce or two per day, sometimes more. Thanks too for the advice about Protein. I am pleased that I can tolerate milk just fine (yay!) and fresh fruits too. The biggest issue I'm having now is dumping, and it is odd. I am not (nor could I tolerate) eating sugar or much in the way of carbs, but still experience frequent dumping. This morning I ate one scrambled egg with cheese and spent the next hour plus in misery. The only thing I can tie at all to the dumping is drinking with meals, which I'm doing my best to stop. Anyone else experience this?

Did you find any resolution? I'm 5 weeks out of RNY and experiencing dumping all the freaking time. This morning I had one scrambled egg with cheese and spent the next hour plus in misery. I suffered from frequent Constipation before the RNY and am loving the fact that my bowels seem far more 'normal' now and I have a BM nearly every day. I can't eat any sugar whatsoever or will have dumping, but seem to tolerate fresh fruit quite well - blueberries, watermelon, and peaches so far. The other thing I can count on eating with no dumping is whole milk (and Atkins products, but I prefer whole foods to chemical products). I suspect one of the dumping triggers for me is having more than a small sip of liquid with a meal - I have always had a lot to drink with meals and being mindful of small sips until 30 minutes have passed is quite a challenge for me. Has anyone had dumping like this?!?

I am 5 weeks out of RNY and have frequent dumping which has little to do with carbs. This morning I had a scrambled egg (and chewed every bite quite well) with cheese and spent the next hour in misery. Thank goodness this is summer and I have nearly a month before I go back to work - I would have to leave my classes to lie down on my office floor if this happened during the semester. It is miserable. I am still happy to have chosen the RNY for its reversible aspect. I have a neighbor who became malabsorbtive and got absolutely emaciated - if that happened to me my stomach could take over again if necessary.

So basically choosing one surgery over the other is no guarantee, nor is diet in some cases. Make the healthiest decision and listen to your doc (mine had a long list of reasons he tried to talk patients out of sleeves).

I am 5 weeks out of bypass and have dumping practically every day. Btw my doc uses a triple suture technique which does not cut off the stomach but closes off a large portion of it, the advantage being it is reversible if needed (cancer, malabsorption, etc...). This morning I ate a scrambled egg with cheese and spent the next hour in misery. From what I am reading the problem may be my drinking with meals. Even with small sips the food goes through the stomach too quickly. Uggg.... I do fine when all I eat is Atkins bars and shakes slowly, but I don't like the chemicals and would rather have whole food. I sure hope this resolves at some point!

Thanks InnerSurferGirl. I'll try to keep things in perspective and drink Protein shakes. You are certainly right that I am still healing and I don't feel particularly good.

And a response to Inner Surfer Girl. I AM FOLLOWING MY PROGRAM and still gaining weight. That is the ENTIRE POINT of my post.

Thanks James,
That was helpful. One of the reasons I had this surgery is that for the past 8 months I have had a foot problem which has left me unable to walk much, in fact walking (which i used to do a lot) makes my foot incredibly worse.

My Portion Control was already good before the surgery - I was amazed that I could eat so little and still be gaining weight, and the surgery has not changed that. The only real issue I had with eating is that I am taken out to eat so much that I was taking in too much food on the weekends, and I do think the surgery will help with that as now feel no desire to overeat.

I haven't tried Protein shakes as i am allergic to nickel and react to many preprepared foods, plus the idea of a chemical shake just seems unhealthy, but it seems I should give those a try. It seems odd to me to add food in the form of a Protein Shake since I am eating so little to begin with and still gaining weight?

Muse

I wish it were that simple but I am not 'stalled', I am gaining weight. I misspoke above and am only 2 weeks out of surgery, not 3. I am following exactly the diet the nutritionist gave me, but your point about Protein is a good one. I've been eating salmon for Protein, and sugar free yogurt, but still have several days to go before I can begin to add things to my diet. The nutritionist seemed more concerned about malnurishment than weight loss and though I was told to have protein, I was given no target amounts. For years I have tracked my foods and weight and I have never eaten much in the way of starches, sugar, or fried foods and haven't started in the 2 weeks since my surgery. In fact, having had 1 day of terrible pain and vomiting since my attempt at a scrambled egg gave me a blockage, I am scared to eat much at all and am very careful not to overeat.

You don't need to say anything other than "Thank you for noticing!". Your business is your business and your social worker's advice is spot on.

I had my operation 3 weeks ago, an RNY bypass, and weighed this morning. To date I have lost 3 pounds. That loss includes the fasting before surgery and the day of 1 cup of yogurt only, plus the day I tried a scrambled egg and ended up blocking my pouch and not eating all day.

A low BMI patient with a starting weight of 187.3 (at 5'4" my BMI was 32), I already had a very controlled caloric diet, eating only 900-1200 calories per day and essentially low carb. I was slowly gaining weight on that which is why I opted for the surgery. When the nutritionist went over my post-op diet I told her it was the same number of calories I was already eating but she had no reply to that. Some of the items I was to eat daily were things I would never have had before my surgery, such as toast, jam, and mashed potatoes.

I also still have a large lump a couple of inches below (internally, down in my belly) the hematoma which remains where my drain was placed, and basically no energy.

I am upset and very frustrated especially when I think of what I've put my body through and the expense, only for no results other than scars and lumps. Does anyone have any suggestions?

Awesome! Congratulations and keep going!

Ask to speak with the office manager and explain your situation. There is no reason your credit should be in such bad shape so pay the minimum on your student loans every single month and pay on time.

First off, I am considered a 'low BMI' patient and recall asking my doc over a decade ago about GB with insurance paying for it. She laughed and told me I'd qualify if I gained 40 pounds, kept it on for 2+ years while trying to lose weight, and developed co-morbidities. I was fairly trim until my 30s but have 2 problems contributing to consistent weight gain. First, I have really big boobs, and if that sounds silly try exercising with them. Second, I can eat the same amount as everyone around me but I gain weight while they lose or stay the same. I had anecdotally seen this for years when I discovered 'myfitnesspal' about 6 years ago and began tracking. I discovered I have to stay below 1000 calories per day not to gain weight, and drop to below 800 to lose. That is simply unsustainable. 5 years ago I went on phentermine and lost 35 pounds. While that was great, like most dieters I cannot sustain the weight loss. I stumble home exhausted, with no energy, and at night begin to crave food. That pretty much goes along with the research on those who have lost weight but not been able to keep it off; reduced metabolism by about 50% and the necessity to eat 500 fewer calories than a 'normal' weight person in order to sustain the weight loss. My weight has been climbing steadily for the past 3 years, and as I've gotten close to my highest weight my energy has returned and my weight leveled off. Still, though, I am frustrated at not being able to keep it off.

After reading the latest articles on the inability of 99% of weight losers to successfully keep weight off, I began to think about bariatric surgery. I was considering India for its low cost, but English friends told me a lot of Brits have serious problems with their surgeries there. I have a cousin in Belgium, though, an American who married a Belgian man, and she has glowing things to say about medicine in Belgium. In looking around I discovered Dr. Bruno Dillemans and the International Surgery Group ('ISG' based in Ireland) and contacted them. Dr. Dillemans reviewed my information online and suggested a standard Rouen Y gastric bypass. He told me that in his experience this is the gold standard and patients who demand other surgeries such as the sleeve, which many of his international patients request, end up coming back for the full bypass. He asked several questions via email and the ISG. For reasons of cost and convenience I elected to have my pre-op tests and consult done the morning of my surgery. I know some people have an aversion to this, but I did my research, knew my general health was quite good, and didn't see much reason to have a consult one day and operation the next, as my mind was made up.

My surgery was 3 days ago, June 21st - hard to believe it's been just about 70 hours! I checked in at 7:30 AM with clear and good instructions from ISG. First up was a series of 3 tests; bloodwork, lung xray, and EKG. As has been my experience in another European hospital the results were processed right away and the doctor had them by the time I met with him at noon. In my room as I waited for them to take me to surgery I thought to myself, "Why am I doing this to a perfectly healthy body?!" But I am a professor and researcher and have read all the literature and the reality is our chance of losing weight on our own is almost non-existent. Once one has gained weight the body will fight forever to return to that weight. We should tell every young person this basic fact and try to prevent them from gaining weight in the first place. When they came to roll me from my room to the surgical suite I said to the orderly, "oh now I am really nervous," and she smiled kindly and said, "Everyone is at this point, everyone, and some are quite terrified." That, plus the surgeon's record, were quite reassuring.

The process itself was smooth and I remember little. I was interested in the side by side metallic operating room doors which opened as people went in and out - I could see another laparoscopic operation going on in mine. I was in a little bay outside the operating room and the anesthesiologist and a tech went over everything thoroughly. Interestingly, on the ceiling was a security camera dome - apparently they film everything that's going on so can review the tapes if there is a future problem. The very kind tech held a mask near my face and asked me to breathe deeply. I recall going under and saying, "Here I go, I'll see you on the other side..." I recall only a bit of the recovery room and asking several times if I could turn on my side as it hurt to breathe, but they would not let me. Finally I was taken back to my room and the Dr. and his resident came to check on me. My drain was bleeding a lot and they examined it. Dr. Dillemans explained that he had stretched the incision with the equipment and the edge was bleeding so they would need to put 2 more stitches in, which they did. The Resident commented that I was the "Stoic American" and, thank heavens, told me that I could (finally) roll onto my right side, I slept most of the rest of that day. I recall asking if I could get up and walk to the bathroom but the nurses wouldn't let me, saying it was too soon after surgery (I think in the US they try to get you up asap, so this was different). I finally called for a bedpan and that nurse was a bit short with me - I asked her to close the window blinds and she said "we will do it when we come in to check you," and I realized they were in the middle of rounds so simply told her, "Thank you, but I have no way of knowing that" and she seemed a bit chagrined. I only called for a nurse one other time and both times the response was within 2 minutes.

Overall I am thus far happy that I went ahead with this. At least now I have 'a chance' where before I feeling pretty hopeless about sustaining weight loss. The Belgian hospital and procedures were stellar, super clean (they tested me for MERSA as well as 2 other common bacterial infections), cleaned my room 2x per day, were state of the art and efficient. I don't like nurses hovering around me and they didn't, but checked up on me every hour or so and came immediately when I called. Total cost of the medical portion was $9,981. Since I was already coming to Europe anyway there was no added expense other than the hotel, which I split with my cousin since she wanted to visit friends in Brugge.

I weighed today, expecting my weight would be the same since I don't feel any smaller and they stuffed me full of IV drugs, but I've already lost nearly 10 pounds. I recommend this to anyone going through the same struggles and frustration with weight. I'm happy to share info or insights with anyone thinking of this route.

this is too of a major operation to trust and allow people who only care about money to be in the middle !!! Making big bucks from this situation is beyond comment .... How can 1st appointment and surgery be in same day?? A lot of this doctors say 0% complication rate, of course! You are sent home asap. Whatever happens after is not their problem. Very bad and this requires serious media investigation

this is too of a major operation to trust and allow people who only care about money to be in the middle !!! Making big bucks from this situation is beyond comment .... How can 1st appointment and surgery be in same day?? A lot of this doctors say 0% complication rate, of course! You are sent home asap. Whatever happens after is not their problem. Very bad and this requires serious media investigation

Actually, Dr. Dillemans requested quite a lot of information from me before he accepted me as a patient, and sent several questions about information I provided. If a patient meets the qualifications and is sure s/he wants the operation, I'm not certain why s/he would need multiple consultations. Your point about self-reporting of complications is accurate, though. I have never yet had a doc who sought accurate feedback about a procedure or followed up in a data-meaningful manner. Since I am in the field of applied research I find this to be quite a problem with the medical field in general.

Dublinwoman,

How was your weight loss? DId you lose all you hoped to? Any complications down the road?

I just had my GB with Dr. Dillemans and stumbled across your post. How has your long term weight loss been since surgery?

I just had a gastric bypass with Dr Dillemans. Glad to see you've had good progress!

Hi Amy,

I just had my surgery 3 days ago, by myself, in a foreign country. I remember thinking to myself, "Why am I doing this to a perfectly healthy body?!" But I am a professor and researcher and have read all the literature and the reality is our chance of losing weight on our own is almost non-existent. Once you have gained weight your body will fight forever to return to that weight. We should tell every young person this basic fact and try to prevent them from gaining weight in the first place. When they came to roll me from my room to the surgical suite I said to the orderly, "oh now I am really nervous," and she smiled kindly and said, "Everyone is at this point, everyone." That, plus the surgeon's record, were quite reassuring. 3 days out and I am doing great and glad I went forward. You will be too:-)