KateinMichigan

You are a saint for keeping us updated! We are all rooting for you and I’m so glad to hear that it’s getting better! I’m assuming that there is no acid reflux - but without food to trigger it Im sure it must be an odd feeling. These updates are going to help so much when I have the surgery- now I know what to expected. I can’t wait until the day where you don’t have any diaphragm soreness and the day you have your first real meal!!!! Hang in there:)

I am in your boat and it's been 15 years. It's important that you're in here sharing...it's a gift. Now people know what questions to ask, what doctor to avoid, etc.

Actually - this isn't rare. 30-50% of patients struggle with this INTENSE VGS GERD after (it shouldn't even be called GERD because it's unrelenting. I'm only correcting you because so many downplay it - and it really is a painful side effect that everyone should be aware of before choosing this surgery. EVERYONE should ask their surgeon how they are preventing this from happening with their patients - and check here to see if the doctor's name is associated with a sufferer. Many patients just live and suffer with it and don't post. I was one of them. Unfortunately, the drugs that manage it eventually cause Cancer....

This is always true. Nurses know; I'm glad they are advocating for you. The stinginess with the pain meds has gotten out of control...I get they don't want to create an addiction but 5??!!! Let me know how your surgeon responds to your request. I just had a call with someone who had the same surgery in March - she had the same issues but said the pain subsided within 2 weeks. She's happy she did it. She said she did have a bit of Reflux the first week but it went away (could have been an intense rebound from the PPI's working their way out of her system). She also said her stool is now loose/runny. I have no idea why/how this would happen - but it's still only been a few months so she's still recovering. I'm going to be checking in on you. Please keep me filled in - bad and good.

I’m so sorry you are going through this pain! Thank you so much for sharing your experience. I’ve met with several doctors, and they never tell you about things like this. It’s so important for people to share their experiences. Please keep me updated as the days go on. I praying to hear that it all gets better. How long did your surgeon tell you you’ll be in pain for?

Hi! I’m scheduled for this surgery as well. Wow! Did they detect that much sleeve in the esophagus before surgery or did it come up in pre tests? How are you feeling? Any acid?

I wanted to preface this post with this optimistic fact. My husband had the surgery with amazing results and no problems whatsoever 15 years ago - it saved his life. He lost over 150 pounds and kept if off. He's gained and lost the same 25 pounds like your typical middle aged person, but it's been nothing but a blessing for him. We had different surgeons. My experience wasn't so awesome, and I feel it's so important to share a few facts so you choose the RIGHT surgeon and ask the RIGHT questions. I hope I can help people avoid the avoidable. I'm a big believer in the surgery - but I want you to not suffer. Let me help:) What's the problem? The sleeve has a common and serious side effect that I suffer with, and that many surgeons downplay. GERD. But this isn't the GERD you think you know - I'll jump into that later. GERD has up to a 30% rate of occurrence after VSG - that's a lot higher then what my doc told me. https://nyaspubs.onlinelibrary.wiley.com/doi/10.1111/nyas.14467. Not only did my doctor gloss over it, and convey that it was "really rare", but he didn't really explain what this type of GERD is. I'm going to explain what this type of GERD is, and then I'm going to arm you with the right questions and research to do before you pick a surgeon. Because once it goes bad, your surgeon will pawn you off on a GERD doctor and that's that. Let me help you get proactive and avoid a bad result! What is VSG GERD? Gastroesophageal reflux disease, or chronic acid reflux is when acid shoots into your esophagus and throat. VSG GERD is different - that's why I'm giving it its own name. I never had GERD before the surgery. Now I get VSG GERD after drinking 4 oz. of water. It's NOT triggered by food. This isn't occasional, it's constant without dangerous meds. I now weigh 115 pounds, so it's not triggered by overindulgence or weight gain brought on by binging. Now you might think you already know GERD. Who hasn't had to pop a tums here and there? Not a bad trade off for a morbid obesity cure, right? THIS IS NOT THAT!!!! VSG GERD is an unrelenting tidal wave of persistent, burning acid that causes chest pain (and emergency room visits) that can only be somewhat managed by daily, longterm use of a class of drugs called PPI's. These PPI's lead to malabsorption and a host of side effects. I sit in my local cancer center to have my bi-annual 4-hour iron infusion with chemo patients to name just one. https://journals.lww.com/ajg/Fulltext/2018/10001/Effect_of_Long_Term_Proton_Pump_Inhibitor_Use_on.1227.aspx PPI's are a class of drugs that are only intended for 2 weeks of use because of their fairly horrific side effects. PPI's are linked to depression, blindness, cancer, and early death, (and this is the short list). There are several law firms dedicated to compensation for PPI victims. PPI's makes me feel like I've just downed a bottle of Mayo. I've been nauseous for years. I alternate between taking a bottle of tums a day so that I can take breaks from the PPI - but I always revert back to them after a short break to alleviate the pain. I am seriously at risk for a ton of really serious diseases, and my liver tests are really bad. PPI's are deadly. I'm in the process of finding a surgeon who can help. https://www.nature.com/articles/s41598-019-53622-3 The amount of VSG patients converting to the bypass/Linx system/etc. to rid themself of GERD and get off PPI's is exploding. Common sense would tell you that this isn't a" tums" sort of reflux! Hope for post VSG GERD As someone with no energy, horrible anemia, and low final weight - the bypass conversion sounds like a disaster because of the increased risk of malabsorption, but one surgeon told me it might be my only option. Some surgeons are discovering that a revision surgery to treat a hiatal hernial (HH) is the key to relief. I've had several scopes over the years, and they can never find a HH, but according to my husband's VSG surgeon, that isn't uncommon. He feels there is a possibility that my past the doctors missing it. I'm waiting on my barium swallow results. This gives me hope - that's why I wanted to share it. Hope is everything. I'm also going to talk with the doctor who wrote this article. "Laparoscopic Ligamentum Teres cardiopexy to the rescue; an old procedure with a new use in managing reflux after sleeve gastrectomy". Follow me and I'll keep you updated. https://www.americanjournalofsurgery.com/article/S0002-9610(20)30814-X/fulltext#gr2 Future VSG patients - ASK QUESTIONS! A few surgeons are now doing the sleeve with hiatal hernia repair at the same time, and some understand how important it is to consider GERD while doing the surgery. Different surgeons have different techniques. Some doctors "get it", and are being proactive because they've seen the pain that GERD causes. Some downplay it. I would suggest that ALL sleeve pre op patients have this discussion with their surgeon before moving forward. If he downplays it, RUN. ASK!!!! Ask your surgeon how many patients has he had who've had GERD. How does/or will he address it if you are unlucky? Ask about his follow up - does he even know what's going on with his past patients? How does he keep track? Has he sent any patients to a GERD specialist? If he says, "oh, only a few of my patients had that" - ask him how he handled it. (My surgeon sent me to the GERD doc and then cut off ties. He was not curious about my results - he did not want to know. He probably still tells patients that it is rare. He has no idea I've been suffering for 14 years.) Bariatric surgeons who've done the surgery and are on the forefront of GERD repair are a good bet. These doctors are rare and you need to really hunt for them. If your doctor does the whole "very rare", etc. (my doctor did), he's either: not reading recent studies, not listening to his patients, not following up on them, minimizing this horrific side effect, or all of the above. Don't settle for a doctor who acts like it's "super rare" or "no big deal". THIS IS A BIG DEAL. Find one that is proactive and discusses HOW they avoid it. I'm rooting for all of you! Let's get the surgery, but let's get it from the right people. Don't pick the guy in Mexico just because he's cheap. Don't pick the guy because he takes your insurance. Spend the money for a few consults to discuss the surgery with different surgeons. Come here and reach out to people who've gone to him/her. I went with a blind recommendation and didn't ask enough questions - and the price is really expensive - I'm still paying.

Everything SleevedK said is true! Same here.

See my post on My sleeve experience - it’s long and detailed. The pluses - weight loss to goal, no vitamin deficiencies. The negs - GERD!!! Do it again? Tough to answer, because it’s been 15 years and I don’t know where I’d be if I didn’t have it. Dead? Massive Stroke? Or maybe a healthy, but fat 51 year old? Who knows? Lol. Quality of life is severely diminished with GERD, but my friends have had the bypass, and that’s a tough road too. My advice? If your happy, healthy, but fat - don’t do anything. Wear beautiful clothes, don’t take yourself too seriously, laugh, enjoy your friends and your life! If you’re suffering and the future is looking bleak, grill your doctor about GERD and find a surgeon that understands it and mitigates the risks. See my post for all the right questions! I’d do the sleeve, but find the right surgeon. The ones who’ve been doing for over 20 years are the best - they know some tricks to avoid GERD, and they test you for GERD before surgery. If your surgeon doesn’t mention GERD or downplays it - RUN!

Who was your surgeon?

Yes!!! Congratulations! Could you share your HH surgeon?

I went to WL support groups for 1 year before I had the sleeve. GERD was very common; but I discounted it because I didn’t understand that it’s NOT Your garden variety Pop-a-tums GERD. (I don’t think many of the Doctors really know how bad this type of GERD is.) The Bypass patients seemed to have really intense energy problems “, mal-nutrition and gas - so I opted for what I thought would be occasion TUMS. LOL - yeah - NO. People don’t go in for revision for that! I wish I could jump in a time machine and cancel the surgery.

Same!

Don’t worry about the weight, it’ll happen. And the slow eating will be second nature after a while. The fluids thing is very important - sounds like you are off to a fantastic start!

https://www.sages.org/meetings/annual-meeting/abstracts-archive/laparoscopic-repair-of-hiatal-hernia-with-dor-fundoplication-after-sleeve-gastrectomy-in-a-patient-with-intractable-gerd-and-retained-gastric-body/

😀Always good to post the name with success stories. How are you feeling?

This is such good news!!! Who was your doctor?

It’s a class of drug. Prilosec/ Nexium / Prevacid/ etc

No PPI’s?

My surgeon did do a EGD. He did not find a hernia, and because I never had GERD, he assured me that the odds of me developing acid reflux were “extremely unlikely”. They’ve learned a lot since my surgery- it was so long ago. The real question is - how many of your surgeons patients suffer from it? What is the exact percent - not a guesstimate. How do they keep track? How do they address it when it happens? My surgeon told me “it’s really rare”, and his partner recently wrote a paper (2020) stating 30% of their patients ended up on PPI’s. That’s not “rare” to me. And the practice I went to was highly regarded and considered “the best” in California. I did extensive research. Unfortunately the internet wasn’t what it is today. When patients started begging to get a bypass because the pain/medicine side effects were too great, I think some Doctors started listening and altered techniques. Ask if he automatically puts you on a PPI after surgery. Not a good sign. Many put you on PPI’s, and are completely out of the picture when you start developing PPI problems - dependency months , years down the line. Some doctors attach the sleeve to something else in the body to keep it from slipping up and causing a hernia, some do a “hernia repair” using mesh. Some will tell you upfront - you should have bypass because.... always get a second opinion (and a third), and find a surgeon who doesn’t downplay it. I recently listens to a surgeon giving a presentation at a medical conference. He advised his fellow surgeons to decline sleeves to certain patients because “the reflux would keep them banging at your door”. He jokingly suggested that you send patients with HH or GERD to “your enemy” if they want the sleeve. This was a video from 2019. I am grateful for those door bangers, because while I just suffered silently- they demanded help and brought awareness. They are hero’s. Please share your story and your surgeon, especially if you are PPI free.

You are a wealth of knowledge! Loved both links. Hope!

I sent you an email with my phone number. Please text if you get the chance. I’m seeing 3 doctors in the next 2 weeks and thought we could share research!

It’s been a dance. PPI’s for a few weeks, then Pepcid and Tums, then eating window of 1-5 / protein only/ with tums. No sugar 95% of the time. Carbs and sugar hurt 😞 - below if from my diary on day three of going off PPI’s yesterday. I had to take 4 tums throughout last night - kept waking up with GERD. The mug has homemade chowder - 3 tablespoons. The greens are avo and cucumber. Gotta avoid hot Tea at night...Have not been diagnosed with Barrett’s yet.

I hear you sister. No one tells you it's 30%, and no one tells you this isn't garden variety GERD. I call it VSG GERD - very different.

Found this too: https://pubmed.ncbi.nlm.nih.gov/33483233/