Shimmy

Not to make your decision any more confusing, but there are actually recent studies (I saw it posted on BariatricPal, but can't find it now) that say there is no direct correlation between sleeve and increased incidence of GERD.
Whether or not someone develops or experienced increased GERD from sleeve seems entirely on a case by case basis. Example: My friend who encouraged me to have sleeve had GERD so bad she developed Barrett's esophagus. Hasn't had one instance of GERD since sleeve surgery. Me, I had what my doctor felt was "situational" GERD, which means that I had it because of my diet and overall obesity. I had sleeve, but about 3 weeks in I started getting heartburn and nighttime reflux. It is managed now, but I suppose it could easily be a problem if I wasn't pretty diligent with management and prevention (medications and lifestyle).
In terms of dumping, not all bypass patients experience dumping AND there are some recent mentions of dumping in a sleeved patient. I've had dumping because I ate something very out of the norm for my diet and my body just decided it didn't like the extreme. That can happen to ANYONE, regardless of whether they're a bariatric patient or not. Plus, while we like to tout dumping syndrome as a deterrent to specific behaviors, I'm not sure I'd agree that it will stop you from eating things you shouldn't. That's entirely up to you.
Then, there are the statistics with how much weight you can expect to lose. On average a bypass patient can expect to lose about 70% of their excess weight, whereas a sleeved patient will lose about 60% of their excess weight.
For me, the primary determinant was that I absolutely did not want to deal with the malabsorption of the bypass procedure. I did not feel that the additional weight loss I could expect with bypass was worth the malabsorption, so I went with the sleeve. While the possibility of intractable GERD was considered, I truly felt that my risk was low. In all honesty, even though I developed GERD, it's not worse than any exacerbation of the condition that I experienced before surgery. In fact, I'd say I feel better than I did before surgery all around and specifically in terms of the GERD. I would do sleeve again, no hesitation.
Advice: have a heart to heart with your doctor, consider the risks and benefits, and make the best decision for YOU

I've read probably 100 posts...which have all been amazingly helpful here. Every time I tell myself I'm going with the sleeve, I read the next post and believe full heartedly I should go with the bypass??? I know this is an ever-popular question but I am feeling so confused. I don't currently have GERD but is sounds horrible. I also don't like the idea of "dumping". I want to lose 150 pounds. I am 100% committed and ready for surgery which will probably be this November or early December. I want to make the best, most informed decision for myself. I don't want a revision down the line...not that anyone does. One question I have is does artificial sugar/sweeteners cause dumping with the bypass? I'm 45, 298.6 pounds today. Just got approved yesterday and am super excited---------just confused LOL. Wishing all the PALS here the best!

Or is that Snow White...
Which one feeds/loves animals?

Bypass

Just my 2 cents, but personally, I would pick the bypass over the sleeve. I had the band, that worked a bit then issues, revised to the bypass because of the band scaring. But the sleeve is also just a restrictive procedure and doesn't have the same nutritional reduction that the bypass has, so, you can totally eat around the sleeve, just like the band. You can work against the bypass, but you can't "eat around it" (eating sliders and all the bad for you foods that just pass through the reduced stomach size). Again, my opinion on the subject, there have been plenty of people that have the sleeve and love it. There are a decent number that had it and need to be revised to the bypass now. Either way though, if you work with your WLS tool, you'll hopefully get the outcome you are looking for.

I wish I never had the band, wish I went with the bypass back in 2011.

Is there a military hospital that you can go to and get the sleeve if that is the surgery you really want. I refused RNY/bypass when I had to revise from the band and I listed the reasons below. I've also included the basic information about both surgeries. There are many reasons why I chose VSG instead of RNY, and my VSG was covered at a military hospital 100%.
I would recommend checking out the obesityhelp.com website, look under surgical forums, check out the Revision forum so you can see how many people are looking to revise from RNY because of weight regain or complications, and then check out the failed weight loss surgery forum just so you can get an idea of people that are further out.
Here are my reasons for getting VSG instead of RNY:
The Vertical Sleeve Gastrectomy procedure (also called Sleeve Gastrectomy, Vertical Gastrectomy, Greater Curvature Gastrectomy, Parietal Gastrectomy, Gastric Reduction, Logitudinal Gastrectomy and even Vertical Gastroplasty) is performed by approximately 20 surgeons worldwide. This forum is titled “VSG forum” to include the two most common terms for the procedure (vertical and sleeve). The earliest forms of this procedure were conceived of by Dr. Jamieson in Australia (Long Vertical Gastroplasty, Obesity Surgery 1993)- and by Dr. Johnston in England in 1996 (Magenstrasse and Mill operation- Obesity Surgery 2003). Dr Gagner in New York, refined the operation to include gastrectomy(removal of stomach) and offered it to high risk patients in 2001. Several surgeons worldwide have adopted the procedure and have offered it to low BMI and low risk patients as an alternative to laparoscopic banding of the stomach.
It generates weight loss by restricting the amount of food (and therefore calories) that can be eaten by removing 85% or more of the stomach without bypassing the intestines or causing any gastrointestinal malabsorption. It is a purely restrictive operation. It is currently indicated as an alternative to the Lap-Band® procedure for low weight individuals and as a safe option for higher weight individuals.

Anatomy
This procedure generates weight loss solely through gastric restriction (reduced stomach volume). The stomach is restricted by stapling and dividing it vertically and removing more than 85% of it. This part of the procedure is not reversible. The stomach that remains is shaped like a very slim banana and measures from 1-5 ounces (30-150cc), depending on the surgeon performing the procedure. The nerves to the stomach and the outlet valve (pylorus) remain intact with the idea of preserving the functions of the stomach while drastically reducing the volume. By comparison, in a Roux-en-Y gastric bypass, the stomach is divided, not removed, and the pylorus is excluded. The Roux-en-Y gastric bypass stomach can be reconnected (reversed) if necessary. Note that there is no intestinal bypass with this procedure, only stomach reduction. The lack of an intestinal bypass avoids potentially costly, long term complications such as marginal ulcers, Vitamin deficiencies and intestinal obstructions.
Comparison to prior Gastroplasties (stomach stapling of the 70-80s)
The Vertical Gastrectomy is a significant improvement over prior gastroplasty procedures for a number of reasons:
1) Rather than creating a pouch with silastic rings or polypropylene mesh, the VG actually resects or removes the majority of the stomach. The portion of the stomach which is removed is responsible for secreting Ghrelin, which is a hormone that is responsible for appetite and hunger. By removing this portion of the stomach rather than leaving it in-place, the level of Ghrelin is reduced to near zero, actually causing loss of or a reduction in appetite (Obesity Surgery, 15, 1024-1029, 2005). Currently, it is not known if Ghrelin levels increase again after one to two years. Patients do report that some hunger and cravings do slowly return. An excellent study by Dr. Himpens in Belgium(Obesity Surgery 2006) demonstrated that the cravings in a VSG patient 3 years after surgery are much less than in LapBand patients and this probably accounts for the superior weight loss.
2) The removed section of the stomach is actually the portion that “stretches” the most. The long vertical tube shaped stomach that remains is the portion least likely to expand over time and it creates significant resistance to volumes of food. Remember, resistance is greatest the smaller the diameter and the longer the channel. Not only is appetite reduced, but very small amounts of food generate early and lasting satiety(fullness).
3) Finally, by not having silastic rings or mesh wrapped around the stomach, the problems which are associated with these items are eliminated (infection, obstruction, erosion, and the need for synthetic materials). An additional discussion based on choice of procedures is below.
Alternative to a Roux-en-Y Gastric Bypass
The Vertical Gastrectomy is a reasonable alternative to a Roux en Y Gastric Bypass for a number of reasons

Because there is no intestinal bypass, the risk of malabsorptive complications such as vitamin deficiency and Protein deficiency is minimal. There is no risk of marginal ulcer which occurs in over 2% of Roux en Y Gastric Bypass patients. The pylorus is preserved so dumping syndrome does not occur or is minimal. There is no intestinal obstruction since there is no intestinal bypass. It is relatively easy to modify to an alternative procedure should weight loss be inadequate or weight regain occur. The limited two year and 6 year weight loss data available to date is superior to current Banding and comparable to Gastric Bypass weight loss data(see Lee, Jossart, Cirangle Surgical Endoscopy 2007). First stage of a Duodenal Switch
In 2001, Dr. Gagner performed the VSG laparoscopically in a group of very high BMI patients to try to reduce the overall risk of weight loss surgery. This was considered the ‘first stage’ of the Duodenal Switch procedure. Once a patient’s BMI goes above 60kg/m2, it is increasingly difficult to safely perform a Roux-en-Y gastric bypass or a Duodenal Switch using the laparoscopic approach. Morbidly obese patients who undergo the laparoscopic approach do better overall in their recovery, while minimizing pain and wound complications, when compared to patients who undergo large, open incisions for surgery (Annals of Surgery, 234 (3): pp 279-291, 2001). In addition, the Roux-en-Y gastric bypass tends to yield inadequate weight loss for patients with a BMI greater than 55kg/m2 (Annals of Surgery, 231(4): pp 524-528. The Duodenal Switch is very effective for high BMI patients but unfortunately it can also be quite risky and may be safer if done open in these patients. The solution was to ‘stage’ the procedure for the high BMI patients.
The VSG is a reasonable solution to this problem. It can usually be done laparoscopically even in patients weighing over 500 pounds. The stomach restriction that occurs allows these patients to lose more than 100 pounds. This dramatic weight loss allows significant improvement in health and resolution of associated medical problems such as diabetes and sleep apnea, and therefore effectively “downstages” a patient to a lower risk group. Once the patients BMI is lower (35-40) they can return to the operating room for the “second stage” of the procedure, which can either be the Duodenal Switch, Roux–en-Y gastric bypass or even a Lap-Band®. Current, but limited, data for this ‘two stage’ approach indicate adequate weight loss and fewer complications.
Vertical Gastrectomy as an only stage procedure for Low BMI patients(alternative to Lap-Band®and Gastric Bypass)
The Vertical Gastrectomy has proven to be quite safe and quite effective for individuals with a BMI in lower ranges. The following points are based on review of existing reports:
Dr. Johnston in England, 10% of his patients did fail to achieve a BMI below 35 at 5 years and these tended to be the heavier individuals. The same ones we would expect to go through a second stage as noted above. The lower BMI patients had good weight loss (Obesity Surgery 2003).
In San Francisco, Dr Lee, Jossart and Cirangle initiated this procedure for high risk and high BMI patients in 2002. The results have been very impressive. In more than 700 patients, there were no deaths, no conversions to open and a leak rate of less than 1%. The two year weight loss results are similar to the Roux en Y Gastric Bypass and the Duodenal Switch (81-86% Excess Weight Loss). Results comparing the first 216 patients are published in Surgical Endoscopy.. Earlier results were also presented at the American College of Surgeons National Meeting at a Plenary Session in October 2004 and can be found here: www.facs.org/education/gs2004/gs33lee.pdf.
Dr Himpens and colleagues in Brussels have published 3 year results comparing 40 Lap-Band® patients to 40 Laparoscopic VSG patients. The VSG patients had a superior excess weight loss of 57% compared to 41% for the Lap-Band® group (Obesity Surgery, 16, 1450-1456, 2006).
Low BMI individuals who should consider this procedure include:

Those who are concerned about the potential long term side effects of an intestinal bypass such as intestinal obstruction, ulcers, anemia, osteoporosis, Protein deficiency and vitamin deficiency. Those who are considering a Lap-Band® but are concerned about a foreign body or worried about frequent adjustments or finding a band adjustment physician. Those who have other medical problems that prevent them from having weight loss surgery such as anemia, Crohn’s disease, extensive prior surgery, severe asthma requiring frequent steroid use, and other complex medical conditions. People who need to take anti-inflammatory medications may also want to consider the Vertical Gastrectomy. Unlike the gastric bypass where these medications are associated with a very high incidence of ulcer, the VSG does not seem to have the same issues. Also, Lap-Band ® patients are at higher risks for complications from NSAID use. All surgical weight loss procedures have certain risks, complications and benefits. The ultimate result from weight loss surgery is dependent on the patients risk, how much education they receive from their surgeon, commitment to diet, establishing an exercise routine and the surgeons experience. As Dr. Jamieson summarized in 1993, “Given good motivation, a good operation technique and good education, patients can achieve weight loss comparable to that from more invasive procedures.”
Next: Advantages and Disadvantages of Vertical Sleeve Gastrectomy >>
This information has been provided courtesy of Laparoscopic Associates of San Francisco (LAPSF). Please visit the Laparoscopic Associates of San Francisco.
Advantages and Disadvantages of Vertical Sleeve Gastrectomy
Vertical Sleeve Gastrectomy Advantages

Reduces stomach capacity but tends to allow the stomach to function normally so most food items can be consumed, albeit in small amounts. Eliminates the portion of the stomach that produces the hormones that stimulates hunger (Ghrelin). Dumping syndrome is avoided or minimized because the pylorus is preserved. Minimizes the chance of an ulcer occurring. By avoiding the intestinal bypass, almost eliminates the chance of intestinal obstruction (blockage), marginal ulcers, anemia, osteoporosis, protein deficiency and vitamin deficiency. Very effective as a first stage procedure for high BMI patients (BMI > 55 kg/m2). Limited results appear promising as a single stage procedure for low BMI patients (BMI 30-50 kg/m2). Appealing option for people who are concerned about the complications of intestinal bypass procedures or who have existing anemia, Crohn’s disease and numerous other conditions that make them too high risk for intestinal bypass procedures. Appealing option for people who are concerned about the foreign body aspect of Banding procedures. Can be done laparoscopically in patients weighing over 500 pounds, thereby providing all the advantages of minimally invasive surgery: fewer wound and lung problems, less pain, and faster recovery. Vertical Sleeve Gastrectomy Disadvantages

Potential for inadequate weight loss or weight regain. While this is true for all procedures, it is theoretically more possible with procedures that do not have an intestinal bypass. Higher BMI patients will most likely need to have a second stage procedure later to help lose the rest of the weight. Remember, two stages may ultimately be safer and more effective than one operation for high BMI patients. This is an active point of discussion for bariatric surgeons. Soft calories such as ice cream, milk shakes, etc can be absorbed and may slow weight loss. This procedure does involve stomach stapling and therefore leaks and other complications related to stapling may occur. Because the stomach is removed, it is not reversible. It can be converted to almost any other weight loss procedure. Considered investigational by some surgeons and insurance companies. Next: >> Frequently Asked Questions About Vertical Sleeve Gastrectomy
This information has been provided courtesy of Laparoscopic Associates of San Francisco (LAPSF). Please visit the Laparoscopic Associates of San Francisco.
Bypass information

I brought too much, most people do. The *ONLY* Things I used were:
Cell phone and extra long charging cable/charger Dry mouth spray (made things so much more tolerable the first day post op, highly recommend this!) Lap balm of some nature (This and the dry mouth spray made a world of difference!) Sweatpants/pajama bottoms Slippers Blindfold (hospitals are still pretty bright at night) Ear Plugs (hospitals are still pretty noisy at night) Pillow (extra pillow for the overnights and for the ride home)
That's it. I brought a bunch extra, clothing, book, etc etc... but I didn't even touch them.

You are totally right. Also good call out.

The great thing about message boards is 100 other people will benefit from your words even if the OP doesn’t

I'm only 5/6 WEEKS post-op, so perhaps I’m not the person you hoped to hear from.
First, I want to applaud you for trying to think ahead. All these unknowns can mess with your mind.
Yes! Yes! Yes! You have every right and you deserve to be treated with respect in an honest and thoughtful way. It's not easy to ask questions when you're unsure about what kind of answers you'll receive.
Anyway.... The first thing that popped out at me was the general bargaining tone of your questions. What I mean is this: You love eating X , drinking X, and doing X so much that you’re hoping to bargain your way out of the commitment that you'd need to make in order to be truly successful. Kindly notice that I didn't say that doing any of these things would be 100% terrible. My point is that you need to be prepared to give up some things that you genuinely enjoy NOW in order to get the ONE thing that you apparently want the MOST. Is losing weight and improving your health what you want the MOST? If it is, then you've established your top priority.
I know these sentences will sound silly the first time you read them, but they are meant to make you really think hard about what is truly important to you versus what seems important NOW. It all boils down to you being willing to give up something in order to get something else that's better. Again, I didn't say that you must give up any of these things, but you have to plant the seed deep into your head that you would be willing to give up one or all of these things if it meant the difference between being getting what you like or love NOW versus what you really want LATER.
1. My favorite food chain is in LA, In-N-Out Burger where I like to eat a cheeseburger and small fry with like a milkshake, but losing weight and improving my health is what I want the most.
2. I absolutely LOVE sparkling Water like La Croix and San Pellegrino, but losing weight and improving my health is what I want the most.
3. I like to have myself an occasional couple of social beverages, such as mixed drinks (hard liquor) and wine, but losing weight and improving my health is what I want the most.
4. A lot of people have a sweet tooth, and I love the occasional scone, croissant, cookie, French macaron, etc., but losing weight and improving my health is what I want the most.
5. I'm ADDICTED to coffee and espresso beverages; lattes, macchiatos, cappuccinos, matcha lattes sweetened with flavored syrups like a pump of lavender or simple Syrup or matcha powder, but losing weight and improving my health is what I want the most.
6. I'm not stupid. I know it's an addictive habit and I'm trying to quit smoking cigarettes and e-cigs like Juul's, but losing weight and improving my health is what I want the most.
7. I eat I like to sip on Water or unsweetened iced tea, coffee while eating a snack or meal, but losing weight and improving my health is what I want the most.
I’ve spent more time on this post than on any other so far. That’s because you and your topic are both important and you deserved my full effort. I’m not implying that my full effort is worth more or less than anyone else’s effort, but you deserved more than just a quicky reply with no real time or effort invested in it.
We all started where you are now. We’ve all wondered about how our lives would change after weight-loss surgery. Would we be able to handle all the new and different lifestyle changes or would we end up having regrets?
Please take my post in the caring spirit in which it was written. I had other, more pressing things to do tonight, but I chose to write to you instead. Did I waste my time?

So, I have promised to share my story with anyone who is interested. I’m not simply a bariatric surgery patient. Feel free to ask questions about what I have gone through. I am not shy about talking about my travails and have lots of experience with surgery in general. The photos I am sharing may be disturbing to some people. I am scarred and have an ileostomy. If you are squeamish, you may want to skip the photos.

Here we go… Get your popcorn, this is a very long post.

My name is Andy. I turned 52 in early July. I am single and live alone with my dog. I’ve been heavy most of my life. But, my journey is about my chronic illness and the effects it has had on me and my body.

I have Crohn’s Disease. I started having symptoms when I was 15. It got really bad when I was in the Navy, but it was in 1990 that I was first hospitalized because of it. I was, at first, diagnosed with ulcerative colitis and started on medication. This seemed to help for a while, but it kept getting worse. In 1995, when my doctor said I had to start taking Prednisone again, I opted to have a radical surgery to “cure” me by removing the organ of choice for this autoimmune disease. On April 20, 1995, I had the first of three major abdominal surgeries at Northwestern University Hospital, in Illinois. I had my entire large intestine removed and an internal pouch was made out of my small intestine to take the place of my large intestine. The surgery took almost 12 hours to complete. It was done open incision; laparoscopic surgery of this type was not perfected until the early 2000s. (My youngest brother had this exact surgery performed in 2012 laparoscopically. Crohn’s disease runs in my family.) This pouch was connected to the exit and I had a loop ileostomy for three months while the internal pouch healed. Yes, I pooped into a bag hanging from my stomach for three months back then. Then, after the three months, I went back in for another surgery where they closed the ileostomy and dropped my intestine back inside. Things went well for a couple of years, then I got sick again.

I moved to California and started a new job in 2002. When I found a new gastroenterologist in southern California, he did some tests and said I did not have ulcerative colitis, but Crohn’s Disease. (The difference between these two irritable bowel diseases is ulcerative colitis only attacks the large intestine, but Crohn’s disease can attack any part of the digestive system.) This doctor started me on an infusion medication called Remicade. This was the first medication that ever really worked. I took it for about 14 years until I developed antibodies to it. I kept taking it even though it was not working because the doctor never had me tested for antibodies.

In 2014, I moved to Idaho. I found my current gastroenterologist, who is the best doctor I have ever had. He put me on Humira. This is a self-injectable medication that also worked for a while, this time about two years. When he saw that the Humira was no longer working, he ordered a blood test that would see if I had antibodies to it. This is when I found out that I had antibodies to both Humira and my previous medication, Remicade. I was then switched to Cimzia, which never worked. I just keep getting sicker and sicker. (The worst part of having Crohn’s disease is there are no outward signs that you are sick. I looked fine but felt like crap all the time. No one at work believed I was sick)

One of the side effects of my surgery in 1995 was scar tissue in my small intestines where the ileostomy was. Because of this, I periodically have small bowel obstructions that usually require hospitalization. To date, I have had 17 small bowel obstructions. These usually clear themselves while I am in the hospital, by not eating anything (NPO) and having an NG (Naso-gastral) tube inserted up my nose and down into my stomach, to remove any contents using suction.

Let’s jump ahead to last year – May 2017. I had yet another small bowel obstruction. I was hospitalized as usual, but this time it did not clear. I had been in the hospital for two weeks and then they decided I needed surgery to clear the blockage. When I was talking to the surgeon before the surgery, he said I had a 90% chance that I would come out of surgery with a permanent ileostomy. This was not the case. In this second major open abdominal surgery, the surgeon was able to remove scar tissue strictures from the outside of my small intestine and they immediately inflated and the blockage passed. I got lucky. The surgeon told me that if I had another small bowel obstruction, he would be forced to remove my internal pouch and give me a permanent ileostomy.

In August of 2017, this is exactly what happened. A bit after 4 am on August 21, 2017 (yes, the day of the total solar eclipse – I’ll say more about this in a minute), I went to the emergency room and was admitted about 8:30 am for yet another small bowel obstruction. I had been up all night throwing up and getting sicker, so I was exhausted by the time I got to my room. About 10 am, the nurse came in and asked if I wanted to go out to the parking lot and watch the eclipse. I was so sick and exhausted that I said no and slept through the entire event. (I live in one of the areas where people came to view the event (eastern Idaho) and I missed the entire thing because of this damn disease…) When the surgeon came in later that day, he said that he had scheduled me for surgery on Wednesday, August 23, 2017,, for the removal of my badly diseased internal pouch and give me a permanent end ileostomy. So, again, I poop into a bag.

So, on August 23, 2017, I had the third major open abdominal surgery. One thing to note here is this was the third time I had been opened up in the same place – from just above my belly button, vertically down into my groin. My wound had barely healed from the surgery in May and the surgeon was cutting me open again. This ended up being a long recovery.

There were two issues with this surgery: the first was the placement of the ileostomy. The surgeon placed it in the scar tissue from my ileostomy that I had back in 1995. This has caused issues with the seal on my bag.

The second issue was the surgical wound. While I got much better since the badly diseased part of my small intestine was surgically removed, the wound did not want to heal. I was in the hospital for over three weeks and eventually sent home on with a wound vac. This device keeps constant suction on the wound and removes any blood and body fluids from the wound, preventing infection and speeding healing. The problem with my wound this time is it was not closed properly and it took over four months for it to close enough for me to stop using the wound vac. I was able to finally return to work in January of 2018.

Back to my gastroenterologist. I went to see him in Februar 2018 for a checkup and an intestinal scope, called a sigmoidoscopy. This is basically the same as a colonoscopy, but they use a much smaller device. It is about the same size as an endoscope. When this procedure was over, he said to me that I needed to lose weight. (He basically says this every time I see him, about every three months) This time, I was sick of hearing about it so I asked him for a referral to see a dietician to help me with my weight and my eating.

About a month later, I get an unexpected call from a bariatric surgeon’s office near where I live and was invited to a seminar. I went and after the presentation, I went to ask the surgeon a couple of questions about whether or not I was a candidate based on my surgeries. She said that it was not out of the question, but she would need me to make an appointment to be sure. I was seen in late March 2018. When I met with the surgeon, she asked me to lift my shirt and show her my abdomen. She took one look at my scars and said she could do nothing for me. She referred me to a bariatric surgeon at the University of Utah, who I met with on June 29, 2018. Because I had already started the journey, according to my insurance, back in March, the doctor placed me on the fast-track to get everything done. Since June 29th, I have had 14 appointments in Salt Lake City, about 210 miles south of where I live.

During this first appointment, I also talked to the bariatric surgeon about my other issues and he referred me to a colo-rectal surgeon, also at U of U. I met with him on July 20, 2018. We discussed revision surgery on the placement of my ileostomy and the removal of internal scar tissue around my small intestines on the left side of my abdomen. He said that these things need to be done and that he would coordinate with the bariatric surgeon. The bariatric surgeon was more hesitant and needed much convincing. I finally was able to talk him into performing both sets of procedures during the same operating room visit. I was finally approved for everything and am scheduled for surgery on September 6, 2018.

In early August of this year, I was finally approved for yet another Crohn’s medication – Stelara. This, by the way, is the second most expensive medication in the United States, behind only Harvoni (which is used for hepatitis C). Stelara costs about $20,000 per dose and I have to inject one dose every two months. So far, it is working.

So, to recap – on September 6, 2018, I will be having a vertical sleeve gastrectomy, performed laparoscopically (prepped for open, but he is going to attempt laparoscopically first) by Dr. Volckmann as the first procedure performed. While I am still under and after Dr. Volckmann finishes, Dr. Pickron will come in and perform a revision on the location of my permanent end ileostomy and attempt to remove as much scar tissue from my small intestines as he can. This will be performed open, through the same incision location and scar tissue that has been used now three previous times.

I am also posting photos of what I look like without clothing, with privates blocked out. Since my surgery on August 23, 2018, only my doctors have seen me this way. And the last photo is of my "surgery" haircut. I hate to deal with my hair in the hospital so I just cut it all off before I go in.

If you have made it to this point, thank you for reading my story. I have never written it all down before and as such, have never shared everything with anyone.

@Brissie
I agree with so much. If you can find healthier alternatives to things you used to find comfort in, go for it! Also for me, post surgery I find that I have things that are staples in my diet. I crave crunching on things, so I eat a lot, I mean a lot, of sugar snap peas with greek yogurt veggie dip. I used to be a big chip eater.
Maybe for other people this is a no-no but I suck on SF jolly ranchers if I get a inkling for something sweet and it won't go away. Now, that being said.... it is still 5 calories per piece of candy... but a couple a day might prevent me from raiding the vending machine when I'm on my lady friend.
Obviously, you change your life style and those "head hunger" eating habits will slowly diminish. You are training your body and mind to not resort to food in times of stress, boredom, ect.

It'll never fully go away.
But understanding the triggers helps.

For me, I stood in front of the candy Isle and looked at all the candy that I love, and internally said "F you candy, you are tasty but you are not good for me, you only work to make me feel like crap, yes, I'll enjoy you for a moment, but the damages you cause are not worth the momentary good taste."

I confronted everything I wouldn't be able to or shouldn't eat again, head on.

It's helped out greatly.
I also found swaps for things. Finding something that will satisfy the craving while still being within your diet restrictions helps greatly. I was a HUGE Ice Cream guy. Can't do that crap anymore, I found Halo Top "ice cream" that's super low in calories and fits my post bypass restrictions. I typically only eat 1/8th of a pint or so, but even if I ate the whole pint, it's still only a max of 320 calories or so. Things like that, find things you can substitute for the bad stuff. It helps get you through the mental BS. It did for me anyway, maybe it'll work out for someone else.

You look amazing! Congratulations!

Hi, wishing you the best of luck! I joined here yesterday. I'm attending my first seminar on October 2nd and am so excited for a lifestyle change resulting in a better me. Keep us posted!