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Hello, and welcome! I did not work on losing weight prior to consultation. I also had a 6 month supervised diet and nutrition period. I was in the hospital 2 nights but had gastric bypass. Yes, the support group meetings were helpful. Good luck as you embark on this exciting journey! Sent from my SM-N960U using BariatricPal mobile app

It is said to be reversible, however, there has been some doubt about it being reversible over the long term once the anchors and sutures have taken hold/stomach 'melded'. I am no expert but I would say it is possibly reversible in the early stages. For those who have had an ESG and need a revision some surgeons will not do a VGS due to the anchors but will do a bypass.

Mine was high in the hospital from dehydration even though I was on an IV! When they gave me a large volume of liquid my heart rate went down. Now, 6 months post bypass, my heart rate is slow!! Averages 55. Go figure! Sent from my SM-N960U using BariatricPal mobile app

Im the odd one out perhaps since I was hoping for RNY to have some amount of calorie malabsorption due to extremely slow metabolism. Turned out the doctor agreed anyway since I had severe GERD so bad my ears would burn from it. Both have similar surgeries and recovery, the only difference is more initial restriction with RNY. Better to have RNY now than have sleeve and end up needing revision later. RNY is seen as the gold standard.

Wow. What does thiamine deficiency have to do with the topic of this thread? That’s an awful lot of medical jargon mixed with scare tactics of posting it in a thread that has nothing to do with vitamin deficiency. I have complex lifelong chronic illness which includes neuroimmune/immunodeficiency. Basically it effects every aspect of my body. I also have neurological symptoms starting long before surgery. I take a series of gummy vitamins. My last bloodwork by my bariatric surgeon my thiamine aka B1 was within the normal range. Just take the right vitamins that have good bioavailability (whole food based, chewable or liquid form) and have regular bloodwork and there is no need to panic about vitamin levels. Besides an issue with iron and some bloodwork that could indicate anemia (which I’ve had issue with before surgery) my blood vitamin levels have been fine so far. Even my extremely low vitamin D is in normal range now. Low thiamene isn’t going to instantly cause some life threatening neurological disease. If your doctor says it’s low, take the vitamin. Or just take a good food based b complex as prevention. I e studied holistic heath, nutrition and vitamins. Do I remember everything. No my memory sucks but it’s crazy to post a long medical research report and not even on the appropriate topic. Sorry if I’m rather touchy today. Taking a basic multivitamin isn’t enough especially tablets like centrum or any tablet that might not get properly utilized by the body is probably not enough. One of the things about gastric bypass surgery is an investment in our health and making sure to get the right vitamins and nutrition. But I’ll shut up. I got flack because I said I take gummy vitamins and too many. Just do your best and don’t worry about thiamene deficiency unless your doctor says it’s low and it’s easy enough to get a natures way alive b complex vitamin at the grocery store.

Hello everyone I'm new here I'm supposed to be having gastric bypass surgery done soon but I don't know if i should. Because I am a food addict and I fear I will regain. Started looking into wls over a year ago n actually gain about 20lbs!!! Why do something if you're are going to fail right? I don't want to have my intestine rerouted to lose weight then gain it back like people on here. I need to loose a 100 pounds. Im over 230lbs scary I need help. I know I'm a food addict.

No brainer. RNY. I've seen WAY too many revisions from sleeve to RNY because of worsening GERD. Yes of course there's a chance that that wouldn't happen to you, but the risk is real. Go with RNY.

Definitely go for RNY if you have GERD, the sleeve is notorious for worsening symptoms, just do a search on 'sleeve revision GERD' and see how many people have had to change to RNY. I had both ops in a space of 2 weeks and I wasn't any more uncomfortable after the RNY than I was with the sleeve. All the same bits get moved around, bits still get cut stitched etc etc and you still have the same laparoscopic scars

I’ve been taking things in stride as best I can but am rather miffed at doctors and events today so I am just going to rant even though I need to be trying to sleep. Prior to my gastric bypass surgery and gallbladder removal My gastroenterologist insisted I have a colonoscopy due to the fact that previous ct scan had shown severe narrowing of my colon and a recent ct showed possible colitis. But the colonoscopy had to wait until after my surgery. I went through three days of clear liquids and hellish prep trying to swallow the required liquids. While the nurse was great I was literally the last patient and they were already starting to close down the facility before my procedure started. I had an unusually hard time waking up from the sedation and just wanted to close my eyes but they were in a hurry to get me out, I was barely awake and told to get dressed and get in the car to go even though I was stumbling and could hardly walk. I didn’t get answers from the colonoscopy. I don’t know if endometriosis can be confused for colitis. But why would a ct scan show something but not a colonoscopy. It showed melanosis in the colon usually caused by chronic laxative use which I refuse to use laxatives on a regular basis so rarely take it. Also diverticulosis of the sigmoid colon which has been there some years now and the last doctor just said well you have to wait until you end up in the Er with an emergency to even do anything. Like ok. But no biopsy was taken of the darkened spots of my colon. And no explanation of my symptoms. My bariatric surgeon said My gastroenterologist could do the endoscopy since he is closer to where I live, and he got all my information and everything. I had previously had a balloon dilation of a very narrow stricture. They saw the stricture during this procedure (so I guess the previous dilation didn’t do anything) but my endoscopy report reads: “ge junction with mucosal tear from hiccup during dilation” I didn’t speak to the doctor, I wasn’t alert enough. He made it out like nothing to my mom. They didn’t take any biopsy from either tests. And I have a mucosal tear but not what to do about all the pain? Im just tired and frustrated. I can only manage so much when I don’t have clear answers. I have to have another procedure this time a surgery in two weeks to do with the endometriosis. Not even sure the doctor will be able to find where it is since it can be anywhere and the main reason is my ovary has to come out. All my long rambling, sorry. Has anyone had a tear happen during a balloon dilation? From what I see dilation isn’t a cure just a treatment or temporary fix. I know you don’t want the stoma too big but too small is not good either. I’ve been having spasms in my left side, crushing chest pain, nausea and difficulty with purée and other symptoms. I’m the end I just shut up and deal with it. Im not regretting RNY because with my nonexistent metabolism I would not have lost nearly 63lbs. And I knew it would take its toll on my chronic illness but so much at once has me exhausted. end of rant.

Obesity Surgery Springer Preventing Wernicke Encephalopathy After Bariatric Surgery Erik Oudman, Jan W. Wijnia, [...], and Albert Postma Additional article information Abstract Half a million bariatric procedures are performed annually worldwide. Our aim was to review the signs and symptoms of Wernicke’s encephalopathy (WE) after bariatric surgery. We included 118 WE cases. Descriptions involved gastric bypass (52%), but also newer procedures like the gastric sleeve. Bariatric WE patients were younger (median = 33 years) than those in a recent meta-analysis of medical procedures (mean = 39.5 years), and often presented with vomiting (87.3%), ataxia (84.7%), altered mental status (76.3%), and eye movement disorder (73.7%). Younger age seemed to protect against mental alterations and higher BMI against eye movement disorders. The WE treatment was often insufficient, specifically ignoring low parenteral thiamine levels (77.2%). In case of suspicion, thiamine levels should be tested and treated adequately with parenteral thiamine supplementation. Keywords: Clinical nutrition, Dietary, Bariatric, Gastric, Obesity, Wernicke’s encephalopathy, Thiamine Introduction The prevalence of morbid obesity has risen to global epidemic proportions and bariatric surgery has been shown to be the most effective treatment to achieve substantial and long-lasting weight loss for morbid obesity [1–3]. In the past decades, the number of bariatric procedures performed has increased exponentially. Currently, laparoscopic Roux-en-Y gastric bypass and laparoscopic sleeve gastrectomy are the most commonly performed bariatric procedures with more than 500,000 interventions worldwide per year [4–6]. Wernicke’s encephalopathy (WE) is an acute neuropsychiatric syndrome resulting from malnutrition and a possible adverse complication from bariatric operations. WE is characterized by the classic triad of ataxia, eye movement disorders, and mental status change. The prevalence rate of WE is 0.6–2% of the population, but the condition is often only discovered at autopsy [7]. Current guidelines for bariatric surgery suggest preventive thiamine suppletion (12 mg) in multivitamin treatment for all patients undergoing surgery, but higher doses for patients with suspicion for deficiency [8]. The aim of this paper is to review the clinical characteristics of WE after bariatric surgery, also referred to as “bariatric beriberi” [9] and to raise the clinician’s index of suspicion about this neuropsychiatric diagnosis and its preventability. Methods We searched MEDLINE, EMBASE, and Google Scholar, using MeSH terms (WE, Korsakoff syndrome, beriberi, restrictive weight loss surgery, gastrectomy). There were no language restrictions. Studies published from 1985 to 2017 on bariatric surgery with a diagnosis of WE were included. We reviewed the title and abstract of these articles, and indexed the data for year of publication, age, sex, BMI, onset duration and progression of symptoms, radiographic findings, treatment, and follow-up. All included studies were either case reports or case series, since information on the course of illness and symptomatology was often lacking in all group studies. The maximum number of represented case descriptions in one study was five [10]. One study reviewed four cases [11], three studies reviewed three cases [12–14], and eight cases reviewed two cases [15–23]. Cases were excluded if too little information was available to confirm a diagnosis of WE or no clinical characteristics regarding the patient or course of illness were available. Since the collected data is not a random sample of cases, and not likely to be normally distributed, nonparametric statistical procedures were applied (Mann-Whitney U test for comparison of two independent means, chi-square test for multiple means). The recorded data are either number of patients (percentage) or median (range) as appropriate. Results General Overview We identified 118 case descriptions in the published literature [9–101]. The most common bariatric procedure was Roux-en-Y gastric bypass [9–13, 15–18, 24–63], followed by sleeve gastrectomy [19, 64–85] (see Fig. 1 for an overview on the characteristics of the identified bariatric cases that subsequently developed WE). [https://www] Fig. 1 Bariatric procedure case descriptions (n = 118) leading to Wernicke’s encephalopathy (left), gender and age distribution of case descriptions on Wernicke’s encephalopathy after bariatric surgery (right, n = 113) ... Importantly, new cases of WE have continuously been published since the early beginning of weight loss surgery, and the total number of reported bariatric WE cases is growing per 2-year period (Fig. 2), suggesting that it is still relevant to review this differential diagnosis. Also, the total number of bariatric interventions (NHDS and NSAS databases (1993–2006) [102] and ASMBS database (2011–2016) [103]) has been rising each year [5], resulting in a relative decrease of WE cases per intervention (Fig. ​(Fig.22). [https://www] Fig. 2 Reported bariatric WE cases by 2-year period (left) and relative reported WE cases by 2-year period compared to general reference information from NHDS and NSAS databases (1993–2006) [23] and ASMBS (2011–2016) [102]. The red dotted line ... Descriptions of sleeve gastrectomy [19, 64–85] had a more recent publishing date (median 2014) than papers on Roux-en-Y gastric bypass [9–13, 15–18, 24–63] (median 2006) (U (85) = 301.5, p  [https://www] Fig. 3 Months after bariatric procedure, Wernicke’s encephalopathy was diagnosed per surgical procedure (n = 115) Vomiting We further analyzed the symptomatology in all case descriptions. Vomiting was the most frequently described presenting symptom (103 cases, 87.3%) and could be seen as the most relevant precursor of WE. From the literature, it is known that vomiting can also be a major complication in bariatric surgery and is one of the most frequent causes of postoperative readmissions [104]. Severe vomiting is not a normal situation after bariatric surgery and therefore further investigation in cases with frequent vomiting is indicated. In the present sample, non-vomiting cases were distributed throughout all onsets post-surgery, but only 5 out of 15 case descriptions were after the first year, suggesting that other causes than vomiting are likely to cause WE later post-surgery. Alcohol abuse (2 cases), a malabsorptive bariatric procedure (2 cases), and a new operation for hernia (1 case) could explain the late onset in non-vomiting WE presentations, suggesting other factors that negatively affected vitamin B1 storage. Importantly, severe infections, such as postoperative intra-abdominal abscesses leading to thiamine deficiency [78], are also a common presenting feature of WE and are likely to relate to an adverse outcome of WE [105]. Wernicke Encephalopathy: Presenting Characteristics The most profound characteristic of WE in the reviewed case descriptions was ataxia (84.7%, 100 cases), presenting itself as gait abnormalities up to the full inability to walk or move. The second characteristic was an altered mental status (76.3%, 90 cases), presenting itself as delirium, confusion, and problems in alertness or cognition. The third characteristic was eye movement disorders (73.7%, 87 cases), such as nystagmus and ophthalmoplegia, resulting from extraocular muscle weakness. The full triad was present in 54.2% (64 cases), a percentage much higher than the originally reported 16% of patients that present themselves with the full triad in literature in post-mortem case descriptions of WE in alcoholics [105]. Post hoc analysis in the reviewed sample shows that patients presenting themselves with mental status change were older (median 36 years) than patients without mental status change (median 25.5 years) (U (66) = 262, p Moreover, patients with eye movement disorders had a lower BMI (median 45.6 kg/m2) than patients without eye movement disorders (median 52.1 kg/m2), suggesting that a higher BMI can protect against this symptom of WE in bariatric cases. Male patients that did not present themselves with eye movement disorders had a later onset of symptoms (median 24.0) than male patients that did have eye movement disorders (median 3.5) (U (33) = 49, p  Imaging CT scans of the brain did not reveal any significant radiological finding in all cases undergoing this procedure (13 cases), suggesting that CT imaging is not the most suitable imaging technique to detect WE. In 65.6% of the case descriptions where an MRI was performed (40 cases) the procedure revealed radiological alterations. This percentage is somewhat higher than the reported sensitivity of 53% in an earlier study on WE [106]. Of interest, positive MRI results were more frequently associated with mental status change (χ2 (1) = 3.9, p  Treatment: Too Little Too Late According to the European Federation of Neurological Societies and the Royal College of Physicians, 500 mg of parenteral thiamine should be given three times daily until symptoms of acute WE resolute. The treatment is lifesaving and has the potential to reverse this acute neuropsychiatric syndrome [107]. A total of 57 (47.5%) case descriptions were reported in detail on the treatment of WE symptoms. Suboptimal treatment, with relatively low doses of parenteral thiamine (Importantly, a progressive clinical course was visible in 31.6% of the patients (37 cases), resulting in post-acute deterioration of neuropsychiatric and neurological symptoms. This suggests that the diagnosis was easily missed, resulting in a lower likelihood of full recovery. Moreover, the detrimental effect of not treating WE promptly is visible in Fig. 4 showing that many of the patients who developed more than one acute symptom later progressed into chronic Korsakoff’s syndrome. This neuropsychiatric disorder is characterized by severe amnesia, executive problems, and confabulations, leading to lifelong impairment [108]. Patients that developed Korsakoff’s syndrome had significantly more acute symptoms (median 3 symptoms) than patients that did not develop Korsakoff’s syndrome (median 2 symptoms) (U (99) = 703.5, p  [https://www] Fig. 4 Long-term cognitive outcome related to number of acute symptoms (left), MRI outcome (middle, n = 55), and too low levels of thiamine treatment (right, n = 52) Although this finding was not significant, in the group that presented themselves with acute MRI abnormalities, more cases later developed Korsakoff’s syndrome (Fig. ​(Fig.4).4). Also, too low dose of a dose of thiamine suppletion therapy resulted in more cases of KS despite the lack of significance. Non-compliance Of interest, in 10.3% of the case descriptions (12 cases), non-compliance to the medication and follow-up medical regimen was reported. A lack of insight into a given situation is a relatively common sign of the acute and chronic phase of WE [105]. The patients did not follow their follow-up, did not take prescribed drugs, or discharged themselves from the hospital against advice, leading to adverse outcomes. Because of the severity of the syndrome, this aspect requires specific attention in the treatment of WE patients, and at risk bariatric patients. Discussion Persistent vomiting is a common symptom suggesting a complication after bariatric surgery [109]. Nausea, vomiting, and a loss of appetite are also common, non-specific symptoms of thiamine deficiency [8]. Ultimately, vomiting and a loss of appetite are also a preventable cause of thiamine deficiency [110], leading to Wernicke’s encephalopathy (WE) in the majority of bariatric case reports. Adequate, timely, prophylactic, and substantial thiamine treatment in all patients undergoing bariatric surgery is required to prevent the development of WE, which is a rare but severe complication. The present review highlights that current treatment was neither prophylactic, adequate, timely, nor substantial in the majority of cases, leading to worsening of WE symptoms, the development of additional WE symptoms, and ultimately chronic Korsakoff’s syndrome. One of the most remarkable findings in the present review is that the initial symptoms of WE are often not recognized as such, leading to a prolonged state of emergent WE. In 31.6% of the cases, the initial symptoms progressed into more severe symptoms, ultimately leading to chronic Korsakoff’s syndrome. Prompt treatment of the first symptoms suggestive of WE with high doses of parenteral thiamine replacement therapy is necessary to prevent further damage [110]. According to the European Federation of Neurological Societies and the Royal College of Physicians, 500 mg of parenteral thiamine should be given three times daily until symptoms of acute WE resolve [107]. Interestingly, guidelines for treating WE suggest that patients suspected of WE should already be treated as such [107, 111]. Additionally, prophylaxis of WE following early signs and symptoms is only achieved by use of parenteral vitamin supplements, since oral supplements are not absorbed in significant amounts [111]. Moreover, in bariatric surgery, it is always relevant to give prophylactic vitamin therapy, according to international guidelines, to prevent patients from WE. Of interest, newer methods for bariatric surgery such as sleeve gastrectomy and intragastric ballooning still can lead to WE, despite their relative benefits for the patient. Recently, Armstrong–Javors (2016) pointed out that new techniques lead to the primary risk factor of WE, namely vomiting, despite a theoretical advantage by reducing the stomach volume without bypassing the duodenum [112]. Suspicion for WE should therefore be equally high in more traditional surgical procedures and newer procedures. Also, the risk of developing WE due to vitamin B1 deficiency is not restricted to the first half year after surgery but appears to be lifelong, given other factors such as new infections, insufficient meals, or alcohol consumption [110, 113, 114]. Preventive education on the necessity of sufficient vitamin intake should be given before bariatric surgery is performed and is relevant in long-term follow-up. Bariatric patients in their teens or twenties are likely to be more protected for mental status change in the course of WE than patients in their thirties or older, as reflected in a younger age of non-mental status change patients. This finding is in line with earlier reports showing that age is the strongest predictor for postoperative delirium [115, 116]. Importantly, pediatric patients and young adults undergoing bariatric surgery therefore require more attention for sensorimotor problems, such as ataxia and eye movement disorders, besides prophylactic parenteral thiamine treatment. In this specific group, more attention to lifestyle training should be an essential element of treatment, since non-compliance is relatively higher [50]. Relatively more cognitive reserve in combination with non-compliance can leave symptoms of WE unnoticed for a longer period. Although eye movement disorders such as nystagmus and ophthalmoplegia were much more common in bariatric cases than those in the general WE population [113], a higher preoperational BMI was predictive for fewer eye movement disorders. Additionally, male subjects with longer post-bariatric onsets often had no eye movement disorders as a presenting characteristic of WE. It is likely that eye movement disorders represent the most severe form of thiamine deficiency, since it is also the least common phenomenon of the WE triad. Moreover, females are at greater risk for full thiamine depletion than males [8]. A possible mechanism of action explaining the protective effect of higher weight is a greater storing reserve of thiamine in severely obese patients in comparison with less severely obese patients. This mechanism of action has been referred to as “preferential intracellular thiamine recycling” [116], leading to relatively less thiamine depletion in patients with higher body weight. Often, cases with WE following anorexia nervosa present themselves first with eye movement disorders [117], suggesting that this symptom is likely to be the result of full thiamine depletion. This suggests that both patients with lower body weight, and female patients are at greater risk for developing WE, and should guide clinicians in preventive thiamine therapy [1–4, 118]. Radiologic imaging can be employed to support the diagnosis of WE, but is not always sensitive to WE symptomatology. Often, hyperintensities were visible in the thalamic region, the mammillary bodies, and the region around the third and fourth ventricle, in line with previous research on WE [7]. Our results show that MRI alterations are frequently associated with mental status change, but not the motoric aspects of WE. This finding is relevant, because it suggests that specifically in bariatric patients with motoric problems, such as ataxia or eye movement disorders, WE should be treated despite the outcome of an MRI. Non-compliance is common in WE patients following bariatric surgery (10.3%) and could be viewed as a more discrete symptom of the disorder. Patients with WE lack insight into their situation, due to the severity of the neurological problems [108, 110]. Education on the direct adverse consequences of malnourishment should be incorporated into the provision of information before surgery. After surgery, more automated checks on vomiting are relevant. A limitation of the present review is that we only reviewed case descriptions. Therefore, predictive information regarding prevalence rates and incidence rates is limited. Despite this limitation, the level of detail in the reviewed case studies leads to new insights into WE following bariatric surgery. Recently published studies on treatment perspectives of WE in general and psychiatric hospitals are alarming: European as well as American studies demonstrated that most patients did not receive thiamine at all or only received it orally in low doses [119, 120]. Both types of treatment lead to unnecessary cases of chronic Korsakoff’s syndrome characterized by severe amnesia, executive problems, and confabulations, leading to lifelong impairment [108]. It is therefore important to highlight the clinical signs of symptoms in this specific condition. In conclusion, there is a growing number of bariatric patients worldwide. Malnourishment-related WE is a rare but severe and preventable consequence of bariatric surgery that warrants attention given its rapid onset and detrimental course. All bariatric procedures can lead to deficiencies and therefore to WE. WE can be fully prevented by supplying prophylactic thiamine given either parenterally in vomiting patients or orally in non-vomiting patients. Mental confusion, eye movement disorders, and ataxia are often missed as crucial symptoms of WE. After the initial onset of symptoms, rapid treatment with high doses of thiamine is still a life-saving measure, directly ameliorating the core symptoms of WE. The large distribution of WE onsets suggests that bariatric patients remain more vulnerable to vitamin B1 deficiency for life, and therefore require lifelong routine follow-up on their B1 status. Acknowledgements We thank Topcare for supporting excellence of long-term care. We also thank Misha Oey for her advice, and textual suggestions. Compliance with Ethical Standards This review was conducted in compliance with the ethical standards. Conflict of Interest The authors declare that they have no conflict of interest. Ethical Approval Statement This article does not contain any studies with human participants or animals performed by the authors. Informed Consent Statement Informed Consent statement does not apply. Article information Obes Surg. 2018; 28(7): 2060–2068. Published online 2018 Apr 24. doi: 10.1007/s11695-018-3262-4 PMCID: PMC6018594 PMID: 29693218 Erik Oudman,[https://www]1,2 Jan W. Wijnia,1,2 Mirjam van Dam,1,2 Laser Ulas Biter,3 and Albert Postma1,2 1Experimental Psychology, Helmholtz Institute, Utrecht University, Heidelberglaan 1, 3584 CS Utrecht, The Netherlands 2Korsakoff Center Slingedael, Lelie Care Group, Rotterdam, The Netherlands 3Department of Bariatric Surgery, Franciscus Gasthuis, Rotterdam, The Netherlands Erik Oudman, Email: ln.uu@namduo.a.f. [https://www]Corresponding author. 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My EGD showed damage from reflux and my surgeon urged me to do the bypass because he said the sleeve can make reflux worse. I ended up doing the bypass because I also have mild Barrett's esophagus (pre-cancerous changes in the esophagus) from the reflux so by doing the bypass we eliminated the risk of further damage from the reflux. I'd definitely do the bypass over the sleeve if that's an issue for you.

I had just the opposite. I was set on the sleeve and had to do the bypass because I had severe reflux I wasn't aware of and the sleeve would make that worse. Trust your surgeon, they're experts in this field and they would never guide you the wrong way.

Thank you! So far so good. He fixed my hiatal hernia at the same time. Thats giving me more pain than my bypass Sent from my SM-N960U using BariatricPal mobile app

I had my bypass Weds. I can only sleep in a recliner my husband ran out and picked up Sent from my SM-N960U using BariatricPal mobile app

Both are major surgeries! It blows my mind that people still think the sleeve is the “easier” surgery. if you have any problems with Gerd then Bypass is your best option, otherwise you’ll most likely need a revision anyway

I'm having the revision from the sleeve to the bypass due to serious reflux and a hiatal hernia. I had the sleeve 3 years ago and I still have restrictions on how much I can eat so it's still working very well but the bypass does help you lose a little more weight so if I lose another 20 pounds I'll be happy. My surgery date is on Oct 15th. Sent from my SM-J337P using BariatricPal mobile app

I consulted two surgeons for my revision and they both advised bypass for people with reflux. It is a pretty common story that people get the sleeve and their GERD gets so bad that they then revise to a bypass. I am sure there are stories on both side of the spectrum where GERD gets better or worse, but just from the outside looking in, it appears it gets worse more often than not. I think your doctor is trying to just give you the best option he can to avoid two surgeries. 😃 Ultimately it is your decision and your surgeon is there to serve you! I'm hope by the end of six months you'll have a clear decision!

agree with "Fluffychix" "you have to your health a priority." I was pushing and fighting for revision "due to GERD, gastritis, a hernia and weight gain." I fought for revision. Lost some battles and now on the road to winning. I can possibly get revised. However, when I achieved my goals over the mandatory next 6 months waiting period? I will no longer need revision. Well, I hope with medical support my weight loss and health goals will be achieved. Sent from my SAMSUNG-SM-G935A using BariatricPal mobile app

Let me tell you a tale. lol. 9/21/19 - I wake up and immediately experience sharp, stabbing pain in my abdomen. It extends from my stomach down in a straight line. Soon after, I develop severe muscle soreness in my back. The pain is superficial; clearly muscular. It is tender to the touch. I decide MAYBE it is related to the gastric so I spend a few hours trying to go about my day. By 3PM I decide I need to go to the ER. I go to the closest ER to where I am. After 5 hours, they tell me they can't treat me because I complained of abdominal pain and they "don't treat bariatric patients". They have me transferred to the hospital that did my gastric bypass. - Cue $150 copay for no reason. 9/21/19 - Different ER. I get several doses of Dilaudid, to no effect. They do a CT scan and see my pouch and organs all look fine. Again, I express I have severe BACK pain and superficial abdominal pain. They call the bariatric surgeon on-call (not my surgeon) who says it's an ulcer. They do no diagnostics to confirm it's an ulcer. They discharge me with $100 in ulcer medicine and "a shot of Dilaudid to get me to my bed, at least". Cue 100$ in meds and $150 copay. 9/23/19 - I call my bariatric office and they fit me in as an emergency visit. The NP says it's definitely not an ulcer. DUH. He orders a back xray and abdominal xray. He prescribes me prescription NSAIDs and says to keep taking the ulcer medicine "anyways". Cue $50 copay. 9/24/19 - The bariatric office says no one is around to read my xrays. I have to sick my mother on them. LOL. They call me back immediately and say "they don't know what's wrong" and I could schedule an endoscopy to rule out bariatric issues. I tell them that is idiotic because I already have all the ulcer medicine. They agree. 9/25/19 - I attempt to go to work. I end up bursting into tears from the back pain. My PCP fits me in in the afternoon. She looks at my xrays and says I have degenerative disc disease from osteoarthritis and a thoracic hairline fracture, which may be more noticeable in an xray performed a week out from the injury. I do not need ulcer medicine. She sends me for a back brace, prescribes a strong muscle relaxer, and prednisone. 9/27/19 - I am back at work with no abdominal pain, but still excruciating back pain. I notice I have a gigantic red bruise straight down my spine and numerous purple bruises. No one has even looked at my back until I did this morning, so no doctor has even seen this. I call my PCP just to give her a status update. She is, of course, out of the office today. I continue to be in pain. BACK. PAIN. It is concluded that I likely injured myself with weight lifting at the gym on the 20th. None of this is bariatric-related, and I was pigeon-holed into a diagnosis without ANY diagnostics being completed because I happened to mention associated abdominal pain which was MUSCULAR but since I said "abdomen" no one wanted to touch me with a 10 foot pole because I am a bypass patient. I spent $500 for literally no reason, and had multiple hospitals and practitioners insist this was somehow bariatric related despite nothing lining up with any bariatric issue. Completely absurd. I should have insisted other diagnostics but I was in SO much pain for this past week, I wasn't even in the mindframe to argue. At first I thought MAYBE this was some freak ulcer thing, despite having ulcers before and knowing this ain't it. Anyways, I guess this is something to look out for in the future - that any remote mention of abdominal pain will trigger a complete shutdown of all common sense from medical providers that, hey, this isn't necessarily because this patient had gastric bypass and COULD be a f**king SPINAL FRACTURE.

Headlines: Last Updated: Jun 12, 2009 - 3:53:09 PM Obesity surgery can lead to memory loss, other problems American Academy of Neurology Mar 14, 2007 - 7:41:20 AM Email this article Printer friendly page ST. PAUL, Minn -- Weight loss surgery, such as gastric bypass surgery, can lead to a vitamin deficiency that can cause memory loss and confusion, inability to coordinate movement, and other problems, according to a study published in the March 13, 2007, issue of Neurology, the scientific journal of the American Academy of Neurology. The syndrome, called Wernicke encephalopathy, affects the brain and nervous system when the body doesn’t get enough vitamin B1, or thiamine. It can also cause vision problems, such as rapid eye movements. The study found that the syndrome occurs most often in people who have frequent vomiting after the surgery. It usually occurs within one to three months after the surgery, although one case occurred 18 months after surgery. The study reviewed the scientific literature for all reported cases of the syndrome occurring after obesity surgery. A total of 32 cases had been reported. Many of the people also had neurological symptoms that are not typical of Wernicke encephalopathy, such as seizures, deafness, psychosis, muscle weakness, and pain or numbness in the feet or hands. "When people who have had weight loss surgery start experiencing any of these symptoms, they need to see a doctor right away," said study author Sonal Singh, MD, of Wake Forest University School of Medicine in Winston-Salem, North Carolina. "Doctors should consider vitamin B1 deficiency and Wernicke encephalopathy when they see patients with these types of neurological complications after weight loss surgery. If treated promptly, the outlook is usually good." For treatment, patients are given vitamin B1 through an IV or injection. Of the 32 people, 13 made a full recovery. Many people continued to have problems, such as memory problems, weakness, or difficulty coordinating movement. Singh said more studies are needed to determine how often the syndrome occurs after weight loss surgery. He said some doctors prescribe thiamine supplementation for their patients after weight loss surgery, but recommends that national standards be set for all doctors to follow.

Hi @Bastian.thx for checking in.....I've been faithful on the diet....I think I'm getting more nervous now. There was an all day pre-surgery meeting for my program that I brought my husband to. He even said, it's okay if you want to cancel. I am just nervous now, not at the actual surgery part...but all of the mindfulness that will come after..... I hope I choose the right procedure...I initally wanted sleeve now I'm getting bypass which involves so many more vitamins. I hope I can be diligent enough to stay healthy.

Okay so I definitely was not a novice drinker before WLS, and I’ve indulged a few times since. I’ve had VGS, not bypass. First drink: hits hard and fast. Will usually be pretty tipsy after 4oz wine, but the effects wear off fairly fast. For some reason, a second drink doesn’t phase me more than the first and I’ve only ever had >3 drinks once (NOLA in July). I had a night where I had a glass of wine with dinner (took over 90 mins to eat and drink together) then I had 3 old fashions at a jazz club. I kinda-sorta remember the walk home, but it would’ve been a lot more hazardous had hubs not been with me.

Please DO NOT stop taking reflux meds without speaking to your doctor. The damage that can be done in stopping FAR OUTWEIGHS any potential (and the link is definitely not proven yet) harm. I’m the person who had been a life-long GERD sufferer. My surgeon did an endoscopy and luckily I didn’t have damage so I was sleeved almost 8 months ago. I still take a PPI a couple times weekly because if I stop altogether my reflux hits. Take them every day for the first 6 months, then discuss the next step with your surgical team. For me, the risk of still having the GERD was worth the sleeve vs bypass because I really didn’t want to have to deal with all of the malabsorption issues. That being said, everyone has to choose their type of surgery based off of many factors and each kind has its pros and cons. There just might be a day when my body decides it doesn’t need to produce an insane amount of acid anymore, but there could just as easily be a day when the PPIs don’t work anymore and I have to be revised. Either way I’m willing to roll with it and do what needs to be done to maintain as healthy status for myself as I possibly can

Severe pain, 3 days. Pain free at a week with occasional soreness. I had gastric bypass and it was by far the easiest surgery I've had.

I had lap band in 2008. It was a disaster we never found my sweet spot. I lost 40 lbs but it was all me. At the gym eating better not eating out, my tool just had my healthy food get stuck and then vomit. Had all fluid removed in 2009 due to pregnancy at my OBGYNs request and haven't had a fill since. Please don't judge... here comes my question. I haven't even had a physical since I had my daughter a decade ago 😳 I did have some blood work in 2018 during a visit to ER. Not diabetic, no high blood pressure, slightly anemic, like my labs came back good i want to have gastric bypass. The surgeon I'm looking at, the website says the first visit they schedule you for a " thorough medical evaluation will be performed and any appropriate tests will be ordered so the doctor can determine which procedure might be right for you " do I just schedule with surgeon or do I get a PCP first? My insurance does not cover surgery so I will be out of pocket for it thanks 💖