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Gastric Sleeve Patients
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Everything posted by KateinMichigan

  1. In recent years I’ve noticed a spike in the “Hiatal Hernia Surprise surgery” stories shared on the forums. That’s when you wake up to your surgeon telling you he fixed a “surprise hernia” while doing your sleeve. What gives? My 15 years of suffering with GERD after VGS, (I never ate a Tums before sleeve) has lead me to extensive research on this topic. I’ve read ever medical paper, report, blog I can get my hands on. I’ve met with and spoken to MANY surgeons on this subject. THEORY ABOUT “THE SURPRISE” I have a sneaking suspicion that the sleeve surgery itself leads to a hernia in many patients. (See stats about De Novo GERD and VGS). The new stomach is lighter and thinner, with more internal pressure and can now easily slide into the esophageal area past the diaphragm to create a HH because the new shape allows it to. I wonder if VSG surgeon don’t want to scare patients with the stats (30-40% chance of GERD without HH repair), so they just throw in the “hernia surgery surprise” to skirt the conversation. if this happened to you, please share the details- so many would benefit from your story. Knowledge is power! For those who haven’t had it yet - have the convo with your surgeon- let’s eliminate the “surprise”. I’m also sharing my journey to find a solution for those currently suffering from GERD after VSG. Not sure why post VLS GERD is still the “Wild West”. So many different opinions on how to fix it - sheesh. What I’ve been told to do by different surgeons over the years, and what I’ve learned: 1) “convert to rny” This was an instant turn off, but I get why so many do it. The pain is that bad for some. A seasoned WL surgeon recently told me the conversion to RNY is problematic long term (yet many still recommend it). He doesn’t do it anymore. He’s fixed hundreds of these HH post sleeve with a basic HH repair, no- and only had to covert 1 stubborn case. He said the conversion often leads to gas, malabsorption, vomiting, exhaustion, nausea, with many converts still ending up with GERD! If you’ve had the conversion and are a few years out - please share your experience. 2) “go with a partial wrap” This particular Doc said he’d “figure out what was best to do once he was in there.” I lost all confidence in him with that last statement, but I didn’t even realize this was a possibility if your fundus has expanded. 3) “get the LINX” I’m allergic to fake metals (I get hives), yet this particular surgeon was ready to slap this metal puppy around my esophagus. Luckily, the maker ( J&J) posted a warning on their site for sensitive skin types: “do NOT, under any circumstances, put this in your body”. I might have considered it if I didn’t have the allergy, although it seems very problematic for some. 4) “get the ligamentum procedure with repair” This is an old surgery for GERD that involves using your internal umbilical cord. Because it’s so new for WLS GERD, I asked the surgeon if one of his success stories could call me. He obliged. A very sweet women called me, and went on and on about how great the surgeon was. But then she told me she was still on PPI’s and now had chronic diarrhea and dumping syndrome…sooo…back to the drawing board. 5) “Get the basic HH repair”. I’ve consulted with 3 seasoned WLS surgeons who are all on the same page (finally). These 3 say that they pull my stomach back into the right spot, tighten the diaphragm, and call it a day. One uses mesh, but the other 2 sited a recent research paper saying there is no advantage to mesh. They all said I’d have a 80-90% chance of being able to go off the PPI’s. Sorta a fantasy promise- but I’m liking those odds. Of course I’ve done my research and discovered the fail rate over the long term is high (30-40%) after 10 years. and I might have minor swallowing problems, and bloating- yea! But I can have it adjusted if it gets bad, so that’s reassuring. So I’m going in with my eyes wide opened and doing the basic repair, I hope it works. The recovery is long and difficult, but my alternative is PPI’s that are cancerous. Wish me luck and thanks for reading my rant:) I hope it helped a few of my Gerdy sisters, and if you’ve had the “surprise”, please share your experience!
  2. Happy Birthday!!! Nachos and a beer without a side of Acid - lol. Sounds glorious.
  3. Hi Lee - just doing my weekly check in - how’d it go this week? Is the pain better? Is it easier to eat?
  4. KateinMichigan

    Have you had the “Hiatal Hernia Surprise” Fix?

    Thank you for the detailed reply! You are such a success story and it’s so helpful for people to be able to read different experiences. I’m really curious about your fall. My surgeon told me today that “the bigger the hernia, the less weight loss success”, which made me wonder if hernia and weight gain go hand in hand. Did you have weight issues before your accident?
  5. Hi Lee, I thought after a month it was supposed to get a lot better. The weight loss is a bonus, but the pain when eating sucks! Has the pain stayed constant - or is it slowly getting better? Is it really tight when you eat meats? Does it feel like it’ll get stuck? When does your surgeon say it’ll get better? What are some of your favorite foods/go to’s during this time? I’m guessing a lot of shakes - but do mash potatoes hurt too? Thanks!
  6. Hi K- My surgery (and surgeon) has changed to August. (original Surgery clinic told me last minute that my insurance was “out of network and I’d be on the hook for the bulk of the cost). Found a surgeon locally and just saw him this morning. He does it robotically. He was a straight shooter. Said my success rate is more like 70% - not 90. Why? Because over time scar tissue causes the HH bubble that formed above the diaphragm to become less amicable to reshaping back into a natural shape once pulled below the diaphragm. a lot depend on how much scar tissue and how I heal. This misshape could still cause gerd. I’m just hoping that the surgery doesn’t make it worse. My new surgeon doesn’t feel it’ll make it worse. Gosh - such a hard decision.
  7. KateinMichigan

    Have you had the “Hiatal Hernia Surprise” Fix?

    Be glad that it was addressed! Wow - you’re on day 3! How are you feeling? I hear the HH repair is the bulk of the pain…don’t worry, it’s gets way better. If you get a chance to share your recovery steps, I’d appreciate it. I’m going into the HH repair soon and would love to hear what that’s like.
  8. KateinMichigan

    Have you had the “Hiatal Hernia Surprise” Fix?

    Hi Creekimp, I noticed you had the HH repair with your sleeve - brilliant. I also noticed you had no reflux. The reason you might have skirted reflux is because your surgeon addressed this. (Many still don’t). Do you know how big your hernia was? Did you have any signs the you had a HH before surgery such as reflux? How was the recovery? I’m Going in for a post HH repair because of de novo GERD, but hardly anyone in here talks about the actual HH part of it. Did you feel any tightness around you esophagus? Swallowing issues? Any feedback would be greatly appreciated!
  9. KateinMichigan

    Have you had the “Hiatal Hernia Surprise” Fix?

    So glad to hear many are being told upfront about the HH surgery with sleeve. Did you all know this in advance? (Already had gerd), or did they find it pre op? Recently read a new study that found a 50% increase in HH repair during Sleeve vs. bypass…so it’s obvious docs understand sleeve carries higher risk of GERD from HH than bypass.
  10. Cont.. the new stomach is lighter and thinner, slides into the esophageal area because the new shape allows it to. The seasoned docs now realize that the sleeve surgery actually causes this, so after they create the sleeve, they tighten the diaphragm so a hernia can’t slide up right away. (HH repair has a large fail rate). why not be upfront about this? Why are so many waking up to the “hiatal hernia surprise!”
  11. Observations. I’ve noticed a ton of people on this site who get VGS are waking up to a HH repair from a “surprise” HH. I had all the tests, and it didn’t show pre-op. It wasn’t until I experienced excruciating acid for the very first time when I awoke from surgery that I was sent to a specialist who found it. in my life I’m guessing that when they remove the stomach, the newly reduced and lighter banana stomach
  12. This is such great news! I'm so excited to see this!!!!! Thank you for sharing... it's given me such hope.
  13. I forgot to ask - did your doc use mesh? Did she tell you how many stitches?
  14. Wow! I’m so glad it’s getting better. Are you off all PPI’s? I can’t even image what that would be like. I can’t even have a few sips of water without gerd. I’m surprised to hear it’s like the first few weeks of sleeve - did they do any resleeve/reshape touch up? I’m going under in 2 weeks. How’s the brick on chest feeling? How’s the pain? Any tips/advice or surprises would be super helpful.
  15. Hi Lee, just checking in. How are you doing?
  16. OMG - that kind of heat without air conditioning while recovering is a big challenge! The weather is just crazy everywhere. I'm in Michigan and our town flooded. Everyone's basements completely ruined because the sewer backed up into the homes. Everyone has spent the weekend emptying out their basements onto the sidewalk - it looks like a tornado hit. When we bought our house the previous owner had cemented the basement sewer drains and put in a sump pump, and we couldn't understand why. Now we know. They lived here for 80 years. Apparently, this sewer backup happens every 10-15 years - and they had had enough - lol. We were one of the only houses not flooded. I'm so glad to hear you're not getting any acid. I was wondering if you'd have the rebound effect from the PPI medication. How bad was your acid reflux? Was it at night, after meals, etc?
  17. 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:)
  18. KateinMichigan

    5 years post op and have huge REGRET!

    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.
  19. KateinMichigan

    5 years post op and have huge REGRET!

    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....
  20. 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.
  21. 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?
  22. 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?
  23. 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.
  24. KateinMichigan

    Any Regrets?

    Everything SleevedK said is true! Same here.

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