MarinaGirl

It is best to wait to have plastic surgery until you’ve maintained a BMI less than 28 for at least 3-6 months. If you have surgery when you haven’t lost enough weight, you may require additional surgery when you lose more weight. It is also important to not gain weight after PS as it will negatively impact your body shape results.

Another point to consider is if your insurance limits you to one bariatric surgery per lifetime. If that’s the case, you should consider RNY over VSG, cut once, as there are a number of people that are requiring revision surgery after VSG and you would hate to have to self-pay for a 2nd surgery. As well, weight loss is typically better with an original surgery than a revision surgery. Long term use of PPIs is also not recomneded as they cause risks for serious health issues/diseases.

Not sure if either is better for weight loss but the MGB has a risk of bile reflux, whereas the RNY does not have this risk. Unfortunately, I developed bile reflux 8 months after MGB so my recommendation is to find the most experienced RNY surgeon and have that procedure.

FYI - I’m 5’8” and my weight range is 121-126. I do not plan on having my intestinal bypass lengthened. My revision surgeon is also not overly concerned with my weight. Aside from my reflux issues, my health is great in every other measure, and being lighter has most especially improved my arthritis pain. I had GI surgery in July 2018 to remove a LINX device that had migrated at the GE junction, repaired a hiatal hernia, and had a Nissen Fundiplication as there was a large fundus left. I am now awaiting results from an EGD endoscopy in Jan 2019 to see if I still have Barrett’s Esophagus and bile reflux, and determine if my gastric bypass loop (aka MGB) should be converted to an RNY.

There are many concerns with being on PPIs for an extended period of time (i.e. more than 6 months) as they weren’t designed/approved/studied for that kind of dosage. Do your research regarding increased health risks with long term PPI usage (e.g. dementia, bone fractures, heart attack, kidney disease, liver issues, hypomagnesemia, c. difficile & pneumonia infections,...).

Yes, my bile reflux causes stomach pain and is visible on an EGD endoscopy. It is worse in the mornings. Neither PPIs (Prilosec, Nexium, etc.) or ursodeoxycholic acid help ease the symptoms. If I could do it all over again, I would have RNY instead of MGB.

Have you tried different toothpaste brands or flavors? I wonder if you’re more susceptible to this issue depending on chemical ingredients (e.g. sodium laurel sulfate, fluoride) or if the toothpaste is foamy?

Whey Protein Isolate (WPI) is lactose-free and is a superior form of protein. Try it before plant-based protein products as they have a lot less protein which isn’t as absorbable by our bodies, and they taste worse compared to WPI products.

I recommend you buy Whey Protein Isolate powder and make your own lactose-free protein shakes. I really like protein powder from UNJURY. You can order single-serve packets to determine which flavors you prefer before committing to a large container. I like the unflavored powder as I can add it to a lot of food and beverages to bump up my protein intake.

I had coccyx (tailbone) pain when I reached goal weight. I tried the special pillow but it didn’t help, so my PCP recommended I see a pain specialist. He did steroid injections under fluoroscopic guidance twice and I haven’t had pain since then. Note that I’ve been below goal weight for 14 months now.

I would stick with full fat dairy for satiety but reduce the simple carbs and sugar you’re consuming and minimize snacking, or swap out the processed food for nuts or jerky if you need a small snack. Your diet doesn’t have a lot of dense protein and seems heavily laden with slider food, which may be why you want to eat more when you finish a meal. Are you drinking any fluids during or right after your meals too? If so, that could be contributing. I disagree with your NUT; I don’t think the issue is consuming more calories but is the type of food you’re eating, which is making you want to eat more. I suggest just eating dense protein and vegetables for a week to see if you can break your cravings.

Congrats on making it through your first round of plastic surgery! Are you at goal weight and in maintenance at 201 lbs? When was your DS surgery? And what other plastic surgeries are you considering/planning?

There is an article in the Washington Post that talks about patients that had bariatric surgery at Grand View Hospital in Tijuana and returned with a potentially deadly antibiotic-resistant strain of bacteria. https://www.washingtonpost.com/national/health-science/they-went-to-mexico-for-surgery-they-came-back-with-a-deadly-superbug/2019/01/23/ac0ca280-1dcb-11e9-9145-3f74070bbdb9_story.html

I find sugar alcohols and other artificial sweeteners make me gassy and they also cause me to crave carbs so I don’t consume them anymore. Problem solved. YMMV I’ve heard of Devrom but have never tried it. I think folks in the DS Surgery Forum may have more experience with it so you might try posting your question over there. Good luck! P.S. Eating processed food /simple carbs (e.g. cereal) could also be contributing. I would minimize eating them as they may impair weight loss & maintenance, and could cause smelly gas. Do you have the issue if you just eat dense protein and vegetables and nothing else?

Congrats on getting below 200 and here’s to continued success!

Nerves are cut during surgery so you may not feel proper restriction for a few months. Because of this, it is critical to not advance your diet too soon, eat too much, or seek out a full feeling. Instead, you should weigh your food so you don’t overeat, as it could lead to post-op complications.

VSG is contraindicated in patients with pre-existing GERD. MGB does a good job at helping resolve acid reflux; however, it does put some patients at increased risk for bile reflux. This is what happened to me. I had severe acid reflux prior to MGB surgery in Mexico. The acid reflux resolved post-op, which was confirmed with an EGD endoscopy, but now I suffer from bile reflux. If I had to do it all over again, my original bariatric surgery would be RNY, not MGB.

Have you seen any physicians about this issue yet? Are they concerned? Why do they think you’ve lost weight?recently?

Hope you’re doing well post-op and that your husband’s worries were for nothing. Welcome to the losing side!

Coexister - I’m so sorry you’re having a lot of post-op pain. Not sure if you were informed about this but it is common to have shoulder pain after laparoscopic surgery because that is where the CO2 gas, that was inserted in your abdominal cavity during surgery, goes afterwards. The gas likes to settle into the shoulder area and the best way to get rid of it and relieve the pain is by walking a lot and time. I hope by now you’re feeling better. All the best. By the way, I don’t shop at Walmart so I can’t comment on their pharmacy policies or roadblocks with fulfilling pain medicine prescriptions. I get my prescriptions from Walgreens and have not had any trouble with filling pain medicine RXs.

I had surgery with Dr. Keshishian in July 2018 (LINX device removal, hiatal hernia repair, and Nissan Fundiplication). It went very well; however, I have some other issues that I’m seeing him about currently - Upper GI in Dec 2018 showed previous repairs are great and now the next step is another EGD endoscopy at the end of Jan 2019. I really love and appreciate this surgeon as the ones in my home state were not able to do the surgeries or properly diagnose the GI issues I’ve been experiencing. Dr. K is great at DS surgery AND at complex abdominal/intestinal/esophageal conditions.

Do not take gummy vitamins as they don’t have the right level of vitamins for bariatric patients. Instead, purchase generic versions of Centrum or One A Day vitamins that you can buy at Costco (Kirkland brand) or at various drugstores (e.g. Walgreens, Rite-Aid, CVS) which often have Buy One Get One free specials.

Due to your pre-existing GERD you should definitely have RNY instead of VSG. Dumping only occurs in about 30% of gastric bypass patients and is controlled by not eating the offending food, which is usually desserts and sweets. Some GB patients are disappointed when they do NOT experience dumping as it can be a deterrent from eating food that may impair your weight loss/maintenance.

I disagree, the fastest way to weight loss occurs in the kitchen. Many studies have shown that weight loss is most impacted by your diet, not how much you exercise. Where exercise is good is for overall well being, cardiac & mental health, as well as maintenance of weight loss once you reach your goal weight. Not sure why the nurse said not to use the treadmill for quite some time; that sounds like bad advice. Walking post-op is very important for prevention of blood clots and to help with getting rid of the CO2 that is pumped into your abdominal cavity during laparoscopic surgery. It also helps build overall stamina and to keep your muscles & joints strong.

At this point in your recovery, hydration is the most important thing, more so than food or vitamins. The nausea you are experiencing is likely due to dehydration. Play around with temperatures; some people do better with cold beverages, others with hot beverages. Find what works for you so you can drink at least 64 oz of water a day.