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I went with the sleeve because, fundamentally it does the same thing as an RNY - amount of weight loss, regain resistance, etc., but "costs" less in terms of trade offs and potential problems. The sleeve is predisposed toward GERD problems (that simply means that more people in that population will suffer from that problem than in the genera; population. In contrast, the RNY is predisposed to marginal ulcers, dumping and reactive hypoglycemia.. It is also fussier in supplement need - you can get into more trouble if you are lazy about your supplements with an RNY, while a sleeve can be closer to that ideal of getting all of your nutrition from your food, if one is so inclined (and your natural body cooperates.) Even with all the supplements in line, there is still a greater risk of iron issues or osteoporosis with the RNY as its malabsorption is focused on minerals. And, the marginal ulcer risk makes it more limited with some medications (it is the origin of the "no NSAID" rule in bariatrics - the sleeve based procedures are more tolerant in that area. If I need something stronger than the VSG, then the DS is readily available, as it starts with a sleeve and adds a stronger malabsorbing component than the RNY offers, so there is better weight loss and most importantly, regain resistance provided there if needed. Finally, there is the "Plan B" factor of what if it doesn't work for me and I have/want to revise? The sleeve is readily revisable to either the RNY or the stronger DS, while the RNY is something of a dead end procedure which is very difficult to revise (it can be done, but there are few surgeons around who are qualified to do so.) Overall, that is why I would start with the VSG and move up later if needed (or if I was starting from a very high BMI or otherwise challenging metabolic situation, I would go straight to the DS and avoid the risk of having to revise the bypass if it wasn't strong enough.)

I agree. Start as if you had surgery yesterday with the liquid diet and follow the 5 day pouch reset. That will help get a lot of the sugar toxins out of your system and it will jump start you. Then, focus on the rules: 1. No drinking anything 30 minutes before and 30 minutes after you eat. 2. Limit your beverage calories. Try to stay on Water or sugar free non carbonated beverages. Stay away from alcohol. If you can, even limit caffeine as it really does cause you to feel hunger. 3. Mindful eating, remove distractions so you can pay attention to your pouch. Your tool is still there, you just need to retrain it. 4. Eat your meals slowly chewing well in between eat bite. Put the fork down in between but do not go over 30 minutes for your meal as your pouch begins emptying at that point. 5. Drink a minimum of 64oz of water or SF non carbonated liquids. 6. Ensure you get a minimum of 1 gram of Protein for every inch you are tall. Even a little more is better. Make sure that you get that protein mostly from dense Proteins like fish, seafood, beef, chicken and pork. These foods will keep your pouch fuller longer and provide you with much needed protein grams. 7. If you have not done this recently, you should have a full Bariatric blood panel drawn to ensure you are not lacking any nutritional elements that could cause you problems. 8. Are you still taking lifelong Vitamins like B12, Calcium Citrate or any other vitamins your Bariatric Doctor put you on? If not, you will want that nutritional panel to inform those decisions. 9. No grazing.....this is where most people start to have weight gain. Eat your 3 meals a day and try to avoid snacking. If you are one of those people like me who has reactive hypoglycemia, then have 5 smaller meals. 10. Avoid sugar, potatoes, Pasta, rice and bread. Same thing with any prepackaged processed foods. Get rid of the junk and stick to good quality proteins and veggies and fruits. Once you hit goal again, then you can introduce some whole grains back into your diet slowly until you get to a good maintenance schedule. 11. Try to get some exercise even if it is just walking daily. These are the things that I will do if I ever start to regain my weight. It really is getting back to the basics.

Banded 11/24/2009. Weight loss only 22lbs. Just now (today) have good restriction after 6 fills. I take 75 mcg of Synthroid for Hypo. I believe the restriction has been what held up my weight loss; not the Hypo.

I'm hypo and actually had to have my meds increased since my levels TSH levels were rising instead of falling. It is now under control - but I didn't noticed any particular problems due to the fluctuation. Doc monitored it every 3 months and now every 6 to make sure it is in range.

For post WLS patients the hypoglycemia after booze would be reactive, and it can cause you to pass out. Alcohol is extremely carb-dense, and its liquid so it will be absorbed very quickly, your body will respond in kind by releasing tons of insulin into the bloodstream. The booze will past through your digestive tract extremely quickly and the insulin will lower the glucose in your bloodstream by far more than you can handle. This problem gets compounded if you haven't had much to eat or drink, as in water, not booze, in the prior few hours. At any decent concert one can be there for hours.. even worse if they're burning off energy standing, walking, moshing, etc., and not sitting, out in the heat, it only gets worse. Sometimes people need to learn the hard way that their bodies can't take much post-op.

They discovered I have 1 biggish nodule in the left lobe and multiple littler in the right, still at the "Watchfully Waiting" stage, Lefty is just a little under operation level, haven't gone Hyper yet, but I am still losing,weight , so I'm not that much Hypo either, although more. there than "normal" , but then most facets ofv me didn't fit that description so Why would,i expect my Thyroid to be Any different?

I just go back to basics when I need to lose weight. Protein first, then non-starchy vegetables. If I have room after that, maybe a small serving of fruit or whole grains. I don't think I could go all the way back to shakes only at this point. I also have reactive hypoglycemia. Eating something every 3-4 hours helps with that. Either a protein or, if I do a carb, then I pair it with a protein - for example, some apple slices with peanut butter.

Hello, I am from OR and had a vsg in Mexico as a self-pay patient in May 2014. I am still doing very well. The sleeve still prevents me from overeating and magically controls hunger as well as limits my sweet intake (i get reactive low blood sugar when I eat anything too sweet now and it is bad enough to avoid most times). I do not regret my surgery and in fact wish I had done it sooner. I run now, can do yoga poses easily and am enjoying the freedom of life-long portion control. I am still 12 pounds from my original goal, mainly because I stopped low-carb dieting and can eat more than when I first had surgery, but I love my figure and my energy level and am taking my time reaching my goal. I wear between size 4-6 dress/tops/pants and may just maintain here as I feel really good. Research the right doctor for you. I am sorry to say the brilliant surgeon I went to tragically died in a plane crash about a month after I left his hospital. His team was fantastic, so I imagine they are still working and operating at Almater Hospital. Check into them. There was another surgeon I considered in Texas, named Dr. Guillermo Alvarez, I only ended up going with the one I did based on timing. Be prepared to pay at least $12,000 for the procedure, stay and aftercare, but it is worth it. It's still more reasonable than self-pay in the US. I would make sure you are in a clean hospital NOT A CLINIC for the procedure and that there is an actual medical team and nurses there for aftercare. I had mandatory counseling before the surgery in Mexico, which was important for maintaining, I had solid pre-op tests run as well as solid post-op tests. My only complaint was my doctor refused to give opiates so my pain was not well managed and I ended up in the ER when I got home for pain control. The US ER docs were shocked that a doctor in Mexico didn't provide pain meds. I was shocked as well. So, be sure to have someone with you to advocate for pain management. Other than that, I healed quickly and now it is a distant memory. Good luck, you will do well, just be prepared to pay over $10K for a good surgeon, do your research, reach out to people who used the surgeon you are selecting and make sure it is in a clean hospital. There are no short cuts or dollar savings worth your health and life.

Well I'm up late for a terrible reason. But I thought I should leave record of this because you don't see it on the boards often. I had VSG but I have the unfortunate side effects of dumping and late dumping possibly even reactive hypoglycemia. I need to confirm the later with my doctor the next episode. The very first time it happened or that I can remember, I was 4 months post of in Naples. I was taking a coffee and felt a wave of flush wash over me but it disappeared immediately. Thought nothing of it. The next time I was in Paris, Nothing out of the ordinary lol. I had a pettit croissant and then a spoonful of panna cotta and I thought I was dying. Not exaggerating. Room spinning, heart racing, sight failing all in french subtitles. Took an hour to pass in a highly ornate turn of the (17th) century bathroom. The next few times I was on home soil eating (safely/properly cooked) homemade curried chicken breast. Then roasted lamb, next a tossed salad , then means and even once Greek yogurt! But not dessert/pastries again? Whatever...I'm sure it will happen again Absolutely no rhyme or reason. Every time it happens now I can't predict why, when or what foods will cause it. Just tonight peanuts and salmon pate. My usual suspects. I nearly went to The ER, it was that bad but I passed out in bed. Well now I'm awake to tell the tale. So I maybe a unicorn, who knows, but if you are banking on VSG not causing dumping syndrome, you may be surprised...

If it truly is reactive hypoglycemia, eating small meals and snacks more frequently will help. Eat a little something every three hours you're awake. Fasting would be contraindicated. A gall bladder issue would be an extremely common reason for the symptoms you are describing. Reactive hypoglycemia is possible, but is very rare and would surprise me. 25-30% of weight loss surgery patients who have their gallbladders develop issues requiring treatment. Gallbladder attacks are often set off by high fat, high protein foods. Sensitivity to eggs is often reported. Nuts, too. Spicy foods and fatty processed carbs can set off attacks as well. Talk to your doc. If it's gallbladder....it's a horse in a field of horses. If it's reactive hypoglycemia it's a unicorn.

I am dealing with tjis too. My dr dx it as RHG its called Reactive Hypoglycemia. It comes on from losing weight and malabsorption. Whenever eating a carb i have to have protein to balance it out. An by carbs i mean even in fruits veggies an such. If you gpogle RHG it gives tons of info HTH

If its happening after eating it could be the reactive hypoglycemia, one lady who had it was put on a zero carb diet and that helped her. I recommend getting a referral to an endocrinologist from you primary doctor. Let them run the labs they are specialized in it and will know better than anyone here. 😬

Congrats to you! I have Hypo Thyroid disease too. You will do fine. Just take your meds and vitamins everyday.

I had a very bad insulin problem: I went for my walk (as I always did) when i got home I decided that I needed to rake the leaves. I became so dizzy and weak I almost didn't make it in the house. I checked my blood sugar, it was 294. Before this (I was diabetic before I lost my weight) I was confused because my BS had been in the 120's. I drank a protein drink and headed to lie down. When I finally went to see my DR he looked at my ledger and seen what had happened. He told me that I had REACTIVE BLOOD SUGAR. My blood sugar had dropped so low that my Pancreas kicked out lots of insulin, that is why I had the super high BS. Strange but true. I hope you figure it all out. Good Luck

PCOS Links! Centre for PCOS PCOS Association SoulCysters Living With PCOS INCIID Hey there: Kick up your feet and stay a while, as you read my PCOS story. Hello, I'm Tracy... I was first diagnosed with PCOS while undergoing infertility treatment during my early 20's. (Mid 30's now) ..... Period at age 9, Birth Control pills at age 16-18, Married at 18 no birth control, no babies... finally at age 22 I sought treatment. I was told that I had the thyroid of an 80 year old man, and that I had PCOS.. he put me on synthroid for my HYPO-thyroid, and told me that it was just my body type that caused me to have PCOS... no offer of help or anything... just to accept it. Since I had PCOS, I wasn't able to ovulate.. my periods had NEVER been regular except when on birth control pills...... Treatment didn't work: charting, pills, shots... nothing could budge my follicles to pop out any mature eggs..... so I went on with my life, childless.... then fast forward to 1999... I was surfing the net and came accross an article "Losing Weight With an underactive Thyroid" Well, this peaked my interest, and from this article they mentioned Low Carbing and Dr. Atkins..... I was like "What the HECK" is low carbing???? Well anyway, on my lunch break I went to the book store and bought Dr. A's book, I started to read, and read, and read.. and that night I threw away the nasty slim fast, and made myself a bunless cheeseburger.... I had been starving myself on Low Fat Slimfast shakes and GAINING weight....... I would cry because I was hungry and then to get on the scale and actualy GAIN weight... life just wasn't fair..... ok.... so I took dr. A's advice and decided to devote 2 weeks of my life to the diet.... I did... meat, cheese, eggs, and Water.... I started dropping weight like crazy.. 14 lbs during induction.. my husband was shocked... but as the pounds came off and the sizes went down... everyone soon became a believer. OK...... so, I was about 3-4 months into the program when I realized by looking at my weight chart that my period was starting a pattern of every 28 days... I couldn't believe it.... from the first month my cycles had reset themselves to be just like a regular person!!!! THIS WAS A MIRACLE... my cycles were SO regular that I could set a clock by them... so I suspected that I was ovulating too.... my hopes of being a mom returned.... and BAMM, a few well timed whoopee sessions and I ended up preggo... unfortunately I suffered 3 miscarriages right in a row. So here I was down 80 lbs, PCOS symptoms were non-existant, and I FINALLY saw the little pink link on a home pregnancy test all with out meds or dr's... but life was unfair and I lost 3 precious babies.... all at about 7-9 weeks... one after I even saw the Heart Beat... that one killed me, and I went into a deep depression.. and I started feeding my sadness with High Carb things... I really feel that I was sabbotaging myself..... Lots of other Life events followed... got caught up in a corporate meger/layoff... so my job of 12 years went bye, bye.. and so did my husband my best friend since age 15.... had replaced me with someone who he said was "just like me" just 10 years younger...... so ok..... divorce, heartbreak, money issues... yada, yada, yada..... life goes on! Get your butt up and live life!...... ok so time passed... I hooked up with a new guy... technically my "rebound" guy from hell.... we both started LC'ng, the wieght had returned and my periods were slipping to sporadic bursts at no particular time.... PCOS had taken it's hold again.... anyway I told him, If I start LC'ng I might end up preggo........ he didn't believe me.... but ONE month after starting to eat right again.... I ended up preggo... and now I have a son who is the light of my life! April, 2004 I rededicated my eat life to Low Carb.... it may not be for everyone.. but it is what keeps my PCOS in check and I lose weight as a side effect! Edited August 11, 2005....... my little Low Carb miracle has now turned two years old. It was funny, that during my first Low Carb journey where I had 3 misscarriages.. no one wanted to believe that a formerly infertile woman could get preggers, simply by changing her diet. I had started seeing articles in the Atkins Center magazines for open calls for women with PCOS that had noticed changes in their cycles or had gotten pregnant because of this WOE... I called and told them of my experience.. as so many had done... NOW, in 2005... every PCOS website will lead you to a Low Carb way of eating, also they've developed drugs to help with the symptoms... .I feel proud to have been "IN" on the discovery of this phenom...... you will see LOTS of women popping up pregnant all over the Low Carb Friends website, and many threads where the gals are pregnant and doing a maintenance level of LC'ng to help control the amount of weight they gain during pregnancy.... IT IS AWESOME! I feel like broadcasting to the world.... I AM FINALLY A MOM!!!!!!!!! All thanks to the Low Carb way of eating. 2/22/07 A final edit to my LBT friends.... my son is now 3.5 and once again I find myself needing to lose the weight... the band AND LowCarb is my choice.. Low Carb because IT WORKS, and the Band to HELP ME and to MAINTAIN, :clap2:

Hello Mdawncooper, I am sorry for my delayed response! So, I almost didn't go through with the surgery because I was afraid the PMR flare pain would be too much on top of the sleeve recovery pain... The surgeon convinced me to go through with it and said that a week post op I could resume prednisone if needed. Well here's the miracle: severe bi-lateral leg pain is gone! It could have just been the prednisone withdrawal symptoms rather than a flare; but I am so happy to be on the other side of this surgery and OFF prednisone! The Doc told me they give all patients a dose of steroids in the O.R., so that could have helped as well. The tell-tale symptoms are bi-lateral pain (rather than one side only). The only way diagnosis can be confirmed is to try Prednisone. If the pain resolves within three days or less after beginning prednisone, then you know you have PMR. My pain was in my legs and lower back ; rather than in the shoulders and neck where it is more common. The prednisone worked and I felt great (but also gained weight). I am am hopeful that my symptoms will not return and when I have my C-reactive Protein levels tested that they are lower. It is so nice to be certain that I will lose weight and feel better as a result! Down 34 lbs. since I began this process in late November!

My friend, I would be concerned about adding a weight suppressant right now. Didn't you just recently start another new med? I think I would ask if THAT med might be revving up your appetite. It's weird how meds reactive so differently within individuals. Until you can find out about the med and its possibilities pertaining to you new appetite, I wouldn't be adding anything new. I'll always side on "changing the existing recipe" before "adding another ingredient". Decisions, decisions. Why do we always have to be making them? Prayers going up for you---and me.

You may have already done considerable research about RnY. But there are some very significant medical complications and side effects with the RnY that the sleeve doesn't (usually) trigger. For instance, * significant malabsorption and anemia issues requiring very serious Vitamin, mineral and other supplements for the rest of your life (more than with the sleeve) * reactive hypoglycemia -- as many as 72% of RnY (bypass) patients have it; it ain't a minor thing at all. "Reactive hypoglycemia is a late complication affecting up to 72% of RYGB patients although it seems to occur also after SG, in about 3% of the cases." See http://clinicaltrials.gov/show/NCT01581801 * more complicated surgery and more surgical complications with RnY than with gastric sleeve That's not to say that there aren't some diagnoses / patients for whom gastric bypass is the better choice. But IMHO you should choose bypass ONLY if you have those diagnoses. The choice between bypass and sleeve is not a simple 6 of one, half-dozen of the other proposition.

i have had hypothyroidism for almost 15 years...I had my surgery 13 months ago and I am down 148 pounds. My low acting thyroid has not slowed my weightloss down so far. I have 32 left to lose to reach my goal. I hope that it doesn't decide to kick in now! Have faith...I am one success story of someone with hypo!

Go Shirley, you are doing great with your weight loss! Hang in there hypo bandsters!

I consider myself an expert when it comes to autoimmune rheumatic diseases. First- let's talk your prednisone: See an endocrinologist. Pronto. I was taking 60 mg of pred a day for years. There was no weaning off, because any time I got down to 20-25mg, I literally could not function. In any capacity. Enter the endocrinologist. Because the prednisone does just as much (if not more!) damage than good, my adrenal function was gone, I had prednisone induced glaucoma as well as prednisone induced diabetes. I needed off the meds ASAP. She prescribed me ORAL hydrocortisone. It mimics- and tricks- your body into believing it is prednisone, and is MUCH easier to wean off of than the prednisone. It took a total of 2.5 months vs over a year or longer if it were the prednisone. Do this. Again, ASAP. Ask for it. Second- methotrexate, either by pill or injection: pills made me sick, puking, typical chemo side effects. The shots did not, and they actually work much more effectively than the pills, so if given a choice, it is a once a week teeny tiny needle. Side effects- don't bother paying attention to them. The benefits far outweigh any possible adverse effects. You will need regular blood work to monitor your liver enzymes. Again, I have been on a very high dosage, so mine were often screwy. Third: I can't imagine any surgeon doing WLS or ANY elective surgery while you are on either of these meds. I had to "wash out" before I could have my surgery, meaning get all traces of the meds out of my blood system and stored reserves. Both drugs make you more susceptible to infection and the prednisone especially makes healing hard. And keeps weight on. Again- seeing an endocrinologist will get you off the pred by using oral hydrocortisone pills. Usually PMR goes away after a year or so. I wonder if you don't have true rheumatoid arthritis? The tests- a sed rate and C-reactive Protein screen are used for PMR as well as other autoimmune arthritis diagnosis. Just a thought. So- don't worry about side effects of the methotrexate and get off the pred!!! Sent from my iPhone using the BariatricPal App

I keep away from most carbs. Definitely proactive in getting mt Protein in (love turkey dishes! lol) I did run out of my meds for hypo but at the time I was overdosed. I did gey a full panel done last year and my levels came back normal. I have been taking kelp since. Aside from slow # weightloss...taking my Vitamins and minerals keeps me straight. But I am not sure if it may be reverting back to hypo. I use myfitnesspal as a tracker. It reminds me alot my caloric intake ia too low lol

Haven't posted in awhile, but I am not finding anything really on GOOGLE to address the issues I am having. My one year post-op coverage ended last March (had surgery 3/29/12 - goal is 60lbs). The first year out I did pretty well, and the second year was weight wise a bust for me. I seemed to have lost/gain the same 5lbs all year...first year I had a net loss of over 34lbs...second year only 14lbs. Now here's the thing..I'm not necessarily concerned about my number weight because I workout alot, and it's pretty intense. I lost inches for sure and have put on muscle..continue to do so at this point. But the scale hasn't budged past 209...I was 258 when I started the journey. My goal for surgery to be a success is 198...so being THAT close and it hasn't happened yet is frustrating me. This will be my third year, 2nd year post op, and I am considering having the Fluid removed from my band if I get a decent tax return, just to see if that would help me get the net calories I need, which is about 1700 for my activity level. I'm on the fence about it..I was hypothryoid, and didn't actually have a eating issue. But because I am so active at this point, I don't take in enough calories, so my weight isn't moving. I can easily burn and exceed my daily intake in one workout session. So I need to eat more, but with my band being filled I am having issues with it. I have had some increase in vomitting the last few months, but my band hasn't been increased in almost a year. So it's hit or miss. I am also wondering if my thyroid is reverting back to being hypo. When my panels were checked last year, I read normal, but I wonder if that might be causing issues too. So I guess my question is for those that are pretty active...did you have to do anything with your band to be able to get more good calories in? I eat every 3-4 hours, and I don't eat crappy foods the majority of the time. My liquid consists of 95% Water, and I make an effort to drink enough. I feel really stuck. I went from the "fat person" to the "fit person" and I really feel like at this point I should be at least in the 190s! LOL Any input would be appreciated, thank you Manda

Our surgeon doesn't perform the DS, but maybe I will have my wife talk to him about it nonetheless. I am so sorry to hear about your RA, my grandmother-in-law has it, and I know first hand how much it affects her quality of life. For a while, she found relief with remicade, if that helps at all. It is extremely expensive and I think is delivered with an IV. Hopefully, the weight loss might help relieve the stress on some of the joints. I've also been reading up on C-Reactive Protein (Mine is quite high) and it's effects (Inflammation). I remember reading elsewhere that white adipose tissue markedly increases inflammation, so hopefully that will help as well. I have Eczema which is also an inflammation/immune system issue, and I am really hoping the weight loss will reduce or eliminate it.

I have to say I am surprised your dietitian would recommend regular rice. Like bread, rice is used as a "filler" in past years when families had a lot less money and food, adding a cheap filler like rice and bread to meal made the meat and other items go further. I also have found that to much rice can affect my RH (reactive hypoglycemia). I know at 4 months I was still eating about 3 oz at a meal, so I went for stuff that I knew would keep me sated longer.