KateinMichigan

I have covered this topic and I'm currently on the hunt for a better solution. Read my latest post and follow me for updates. I was recently told that RNY confession was my only option and as someone with Anemia - this isn't an option.

Hi Why are you on a omeprazole or any PPI? (It's a very hard medicine to get off of and has horrible side effects.) There are a ton on PPI lawyers that make a nice living off of that drug. Wondering why your doc would automatically put you on it. Is this a new standard? I had my surgery 14 years ago and am on the hunt a some sort of help with crippling VSG GERD. I've been trying to get of PPI's for years - but wasn't put on them until a few days after surgery and I struggled...

OMG - you are so lucky!!!! The fact that your surgeon is proactively looking for the HH and going to repair it at the same time will save you years of VSG GERD suffering! (see my past posts) Upfront pain during recovery is a small price to pay when you consider the alternative. Your doc knows the consequence and is trying to save you from a future of intense pain.

Hi Wanderingheart. Absolutely reach out to your doctor and schedule a pre-op and ask the questions. If his answers are dismissive, I'd advise that you find someone else. I know that seems harsh. You've been waiting for this day! But believe me, waiting a few extra months for the right surgeon is better than suffering for years.

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.

Me too! I've also spoken with Dr. Jossart in California who has done many hiatal hernia (HH) repairs post sleeve for those with GERD. This sounds perfect for you. He said he's done 125+ repairs with a 90% success rate. Only 1 of these patients out of over 125 needed a conversion to bypass. As someone with no energy, horrible anemia (iron infusions) and low final weight - the bypass conversion sounds like a disaster waiting to happen, so I'm praying for a HH to show up on my latest swallow test. I've had several scopes over the years, and they can never find a HH, but according to Dr. Jossart that isn't uncommon, and he feels there is a very high likelihood that it's small and the doctor's I've seen are missing it. This gives me hope - that's why I wanted to share it. Hope is everything. I also feel I should share that new research on PPI's show that they are now linked to depression (PPI's rank #1 as OTC drug that causes depression) and eye problems (including blindness). This is new research coming out to add to the list of problems it causes. We all need to get off PPI's! Lastly, a few surgeons are now doing the sleeve with HH repair first, and with other GERD preventative measures DURING surgery. These doctors "get it", and are being proactive because they've seen the pain that GERD causes. I would suggest that ALL sleeve pre op patients have this discussion with their surgeon before moving forward, if he downplays it, RUN. If you are in the 30% that suffer, it's severely lowers your quality of life. I've been suffering for 14 years with too many dead end Dr. Appointments to count. Stanford, UofM - I've consulted with the best "experts" over the years and found found many shake their heads with a sort of "you're on your own" attitude. I truly believe that the only hope we have is with a bariatric surgeon who really understands what was done and who has done the surgery - but also does GERD repairs. These doctors are rare and you need to really hunt for them. When most hear "acid reflux" as a potential side effect, they think "so what, I'll have to take a tums once in a while". It's NOT that sort of reflux. It's debilitating. It's vomiting after half a cup of water. It's pain after every single meal. It's instant dependency of horrific drugs with a myriad of side effects - including blindness and cancer. If my doctor had told me I had a 30% chance of this version of GERD, I would have run for the hills. 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 (my doctor just pawned me off to a GERD doctor), minimizing this horrific side effect, or all of the above. Don't settle of a doctor who acts like it's super rare or no big deal. Find one that is proactive and discusses HOW they avoid it. Please share with me all your research. I'm rooting for you!

Hi Sleeved K, I am seeing Dr.Hawasli who wrote the article on the 15th of April 2021. It seems old - so it'll be interesting to see what he says. I'll let you know.https://www.sciencedirect.com/science/article/abs/pii/S000296102030814X#!