Mhy12784

Does your doctor advise eating all these carbs ? I was under the impression you should be building your meals around protein

Just be honest with your surgeon and anesthesia and tell them you smoked weed. You make your own educated decisions on what you do with your life, but theres no good reason to not tell them the truth, as it will only help them provide better care for you

If you gain weight from stopping diuretics itll be water not fat. You want to lose fat, not water. Should not be a problem, take your blood pressure medicine as long as you need it

Severe anything Is bad. But dumping syndrome helps reinforce diet changes

This is mostly out of curiosity. But i know you're much more likely to get drunk quicker with alcohol after bariatric surgery but what about vomiting from alcohol? Do you puke your brains out like a person normally would from excess alcohol consumption? Or does that not happen since you're consuming a much smaller quantity of alcohol. Like I have no idea if you could end up puking excessively from 6 oz of alcohol even with impaired digestion

I'm in the same boat as you OP, and after discussing with my surgeon we came up with a reasonable plan. My GERD is severe, as in heartburn all the time while on medication and occasional regurgitating. I'm going to have my preoperative endoscopy like all his patients do. If they see a large hiatal hernia (3 cm +) then it would be a reasonable assumption that having a sleeve with a Hiatal hernia repair would likely improve my reflux from repairing the large defect coupled with weight loss. If my preoperative Hiatal hernia is small or non existent however, I will likely go the conservative route and stick with a bypass. Truthfully I don't think it's that big of a deal getting the bypass anyway as dumping syndrome is a mostly good thing. But I'll let the endoscopy be my ultimate determinate

My concern is about yoyoing my weight My BMI was 37 at my first weigh in but below 35 at my general practitioner (not bariatric) and my weight fluctuates. Will this make it harder to qualify? Do weights matter from other doctors I see?

It's up to anesthesia as well, since they are responsible for the patient under (and shortly after) anesthesia. If something has a reaction with cautery, or swelling, or gets caught on a gown the patient should have an injury. Not to mention as a surgical nurse who regularly assists with bariatric surgery I would prefer all my patients to remove all their jewelry. There's a reason we are forced to make patients sign all kinds of waivers if they keep their jewelry in, and that's because it's an unnecessary risk. And I'd say anesthesia and the nurse will likely care about the jewelry more than the surgeon will

The only one of those foods that would be a major heartburn trigger is the tomato soup. Any chance youre lactose intolerance or have other issues with dairy which could be causing problems?

For your own sakes I highly recommend taking them out for the duration of the surgery. Honestly I think many hospitals would be willing to accommodate your desires, especially if youre stubborn. Buts it not a good idea to have anything in during surgery. At the very least I would take them out immediately before surgery, and put them back as soon as you are fully awake from the effects of anesthesia. Even plastic ones are a bad idea. As far as timelines it will depend on your previous surgery and skill of your surgeon and how you react to anesthesia. But I think for your typical sleeve patient/surgeon youre talking about 5 hours (including surgery and wakeup time) without your ring in.

I do know that galbladder problems are fairly common. Im purely making an educated guess but I would imagine its somewhere close to 15-30% of patients that end up needing their gallbladder removed (which is why generally many patients at least where I work have their gallbladder removed during the bypass if they have any stones even if they arent symptomatic) Other than that I know internal hernias are fairly common. Dumping Syndrome very common, especially if you dont behave with your diet. Ulcers can be common, especially if you do stupid crap (ie smoke drink) As for the shots cant they be given at home ? I mean diabetics take insulin at home all the time, no idea why someone couldnt give once monthly vitamin B injections at home. The shot isnt a big deal, so much as having to go to the doctor and sit there and wait

Google local bariatric surgeons many have free seminars for potential new patients. And they'll gladly walk you through the process and answer all your questions

Lean body mass doesn't mean muscle, it means anything that's not fat. Water glycogen stool digesting food are all included. Yes you'll lose some muscle but not much

Worrying about muscle atrophy is silly and ridiculous honestly. Unless you're a hardcore bodybuilder at their peak or end up with a feeding tube (which I have no idea why this would even happen) , expecting substantial loses in muscle mass isn't going to happen especially over a relatively short period of time. Follow your diet, get your protein, work out and you'll be fine. That said there's nothing wrong with working out preoperatively before your surgery, in fact it's probably a good idea

I was planning on getting a sleeve, but I do have severe GERD (but not barret). I think it would be a mistake to have a sleeve with both. If you have a huge Hiatal Hernia then maybe a discussion about the sleeve with your surgeon is warranted but other than that you're better off with the bypass

For those with HTN how long did you have to be diagnosed with it to qualify for surgery (ie you had it for a month) How were you "diagnosed"? If I go to my GP and have 140/100 one time does that qualify? And how do I need to prove to my surgeon/insurance company that I have it (does your GP have to write a letter etc) I'm curious because I've never been actually diagnosed, but my blood pressure tends to run a little high. And I may need HTN to qualify.

Gaining 9 pounds in a week either means you went on absolutely insane binge eating 10s of thousands of calories in a week (you're talking realistically 50,000+ calories) or it's something else and not body fat. Most likely it's water, glycogen, stool, and something like that. If it continues trending upwards I'd bring an accurate food diary and go see a nutritionist or your surgeon

It's not just about safety. If you're gaining weight you didn't make changes and develop habits that the surgery will help you continue.

In addition to insurance (which is super important) ľ would look at the surgeons volume and how recently they did their cases. I would absolutely not go to a bariatric surgeon who isn't doing a substantial amount of cases, specifically the case I'm going to them for.

That's old lazy guidelines. My hospital had the exact same guidelines and changed them two years ago to follow the most up to date material (which is you can have clear liquids up to two hours prior). The honest answer is nothing to eat or drink after midnight is the simple and easy to remember, there's no confusion. But if a patient is having their surgery at 7 am and another at 4 pm and they're not following NPO after midnight that's a very different thing. And the other issue you frequently have patients who get confused with the guidelines (oh I had coffee with milk this morning) (yes back coffee counts as clear liquids). I understand the logic of simplifying things as you don't want to confuse people. But the whole nothing to eat or drink after midnight is simply outdated guidelines that some are too lazy to update because they're creatures of habit

The bigger issue is why/how do you have NO spleen ? If you had emergency (or even elective) surgery extensive adhesions could be an issue. Which if bad enough could cause them to complicate, substantially extend, or cancel your surgery. I recall a patient who had an emergency splenectomy from a trauma, and the surgeons spent 4+ hours taking down adhesions before canceling the case. The patient eventually came back (this time they were prepared to do the case open if need be) but were ultimately able to finish the case after 6-8 hours. The surgeon should have a good idea of your circumstances before the case, and would hopefully discuss any concerns he has

Weight loss surgery is always elective. That said not drinking water for 13 hours before surgery is complete crap. And most likely means they are using some extremely outdated guidelines. Per the most updated anesthesia guidelines (anesthesia usually makes the calls on food and drink not the surgeons, as they're the ones maintaining and responsible for the airway although the surgeons obviously have some input) you can have clear liquids up to two hours prior to surgery. If you have bad reflux you might want to be a little more cautious since you're higher risk especially if you have GERD or a hiatal hernia (and bariatric patients in general are higher risk for reflux) That said I'd follow my surgeons and anesthesia guidelines since they're the ones taking care of you. But nothing to eat or drink for 13 hours is about lazy organizations not updating their guidelines and nothing else

I have empire BCBS insurance and this is one of the requirements "The individual must have serially documented active participation in a non-surgical weight reduction regimen for at least 6 continuous months, in the 2 years prior to surgery, to enable both behavioral changes and adequate assessment of anticipated postoperative dietary maintenance. These efforts must be fully appraised and documented by the physician requesting authorization for surgery; " Does this mean I need to have followed a diet plan from my physician ? Or I could have done my own thing, and simply had it appraised and documented by my surgeon ? IE could I just have journal-ed my own diet plan that I followed, bring it into my surgeon say here you was this good, and have him sign the box ?

Was that stated in the policy or did the plan say something like a surgeon directed plan , or was your policy worded similarly to mine? I'm purely just interpretating the vague wordedness of my own plan

The surgeon I work with requires them on all patients. It really doesn't make sense to me why you wouldn't do one preoperatively. For starters they could identify a hiatial hernia that they would repair during your surgery (even if you don't have GERD this could prevent you from getting after your sleeve) . And if you have GERD or more importantly barrets esophagus depending on the extent of it, it could influence your choice of bariatric surgery (ie if you have bad GERD/barretts they might steer you to a bypass instead of a sleeve or band). I guess if I didn't have insurance or had crap insurance I would consider attempting to skip the endo. But to me it just doesn't make sense not to have one as this is incredibly minor compared to the life-changing bariatric procedure