Hi all,

I'm new around here and I have a bunch of questions. For starters, I am currently taking a low-dose BC pill to help ease my PMS symptoms. I have nausea, killer cramps, bloating--just a bunch of ugly stuff. The pills are helping but will I have to stop taking them after I get the sleeve?

Also can I take Motrin after the operation? I know the stomach will be sensitive, and I don't want to risk getting an ulcer. If I can't take painkillers I am going to be in a lot of pain monthly.

As for your BC pills, talk to your surgeon. My surgeon recommends going off them pre-op, and then using a backup method because of the crazy hormone flux during the rapid weight loss phase.

On the NSAIDS (motrin/advil/aleve), check with your surgeon. But, with VSG there are no medication restrictions. I've taken Aleve since 2 months out, and have never had any issues. We don't have a pouch for the pills to sit in like with RNY. Many appeals have been won for patients wanting VSG vs. RNY because they have to take NSAIDS. I always took NSAIDS with something on my stomach pre-op, and I do the same now. Either I pop the pill and eat some cheese or yogurt, or I eat something light, pop the Aleve with a tiny sip of Water.

I don't know about the BC pills since I am way beyond that. . .LOL! But my surgeon said no Motrin. I have to deal with my pain with Extra Strength Tylenol. I am just 8 weeks out so maybe that will change as time goes on.

As for your BC pills, talk to your surgeon. My surgeon recommends going off them pre-op, and then using a backup method because of the crazy hormone flux during the rapid weight loss phase.

On the NSAIDS (motrin/advil/aleve), check with your surgeon. But, with VSG there are no medication restrictions. I've taken Aleve since 2 months out, and have never had any issues. We don't have a pouch for the pills to sit in like with RNY. Many appeals have been won for patients wanting VSG vs. RNY because they have to take NSAIDS. I always took NSAIDS with something on my stomach pre-op, and I do the same now. Either I pop the pill and eat some cheese or yogurt, or I eat something light, pop the Aleve with a tiny sip of Water.

I wanted to add that I do not take the BC for prevention (had a Tubal Ligation yrs ago).

Its just to make my cycle more tolerable.

I don't know about the BC pills since I am way beyond that. . .LOL! But my surgeon said no Motrin. I have to deal with my pain with Extra Strength Tylenol. I am just 8 weeks out so maybe that will change as time goes on.

You are so lucky to have the monthly blahs behind you!. My cramps are simply terrible. I was crying in my sleep back in August and immediately went to the Dr for relief. I think until then my hubby thought it wasn't that bad.

My surgeon said I didn't have to stop taking my BC at any time; I even took them the morning of and the morning after surgery.

As far as Motrin, I was told it was off limits. My center gave me a list of medications that were a no-go after surgery and basically all I can take is Tylenol.

I wanted to add that I do not take the BC for prevention (had a Tubal Ligation yrs ago).

Its just to make my cycle more tolerable.

I think his concern is bleeding since anti-coagulants are given for general surgery. Not all surgeons require this one, but several do recommend going off BC for their own comfort level with their patients.

Here's some information from Dr. Cirangle and Dr. Jossart regarding VSG. I know every surgeon has a different protocol, but considering the number of sleeves these 2 surgeons have performed between RNY and VSG, plus their recognized as pioneers of VSG as a stand alone procedure. This is their information on NSAIDS.

Alternative to a Roux-en-Y Gastric Bypass

The Vertical Gastrectomy is a reasonable alternative to a Roux en Y Gastric Bypass for a number of reasons

1. Because there is no intestinal bypass, the risk of malabsorptive complications such as Vitamin deficiency and Protein deficiency is minimal.
2. There is no risk of marginal ulcer which occurs in over 2% of Roux en Y Gastric Bypass patients.
3. The pylorus is preserved so dumping syndrome does not occur or is minimal.
4. There is no intestinal obstruction since there is no intestinal bypass.
5. It is relatively easy to modify to an alternative procedure should weight loss be inadequate or weight regain occur.
6. The limited two year and 6 year weight loss data available to date is superior to current Banding and comparable to Gastric Bypass weight loss data(see Lee, Jossart, Cirangle Surgical Endoscopy 2007).

First stage of a Duodenal Switch

In 2001, Dr. Gagner performed the VSG laparoscopically in a group of very high BMI patients to try to reduce the overall risk of weight loss surgery. This was considered the ‘first stage’ of the Duodenal Switch procedure. Once a patient’s BMI goes above 60kg/m², it is increasingly difficult to safely perform a Roux-en-Y gastric bypass or a Duodenal Switch using the laparoscopic approach. Morbidly obese patients who undergo the laparoscopic approach do better overall in their recovery, while minimizing pain and wound complications, when compared to patients who undergo large, open incisions for surgery (Annals of Surgery, 234 (3): pp 279-291, 2001). In addition, the Roux-en-Y gastric bypass tends to yield inadequate weight loss for patients with a BMI greater than 55kg/m² (Annals of Surgery, 231(4): pp 524-528. The Duodenal Switch is very effective for high BMI patients but unfortunately it can also be quite risky and may be safer if done open in these patients. The solution was to ‘stage’ the procedure for the high BMI patients.

The VSG is a reasonable solution to this problem. It can usually be done laparoscopically even in patients weighing over 500 pounds. The stomach restriction that occurs allows these patients to lose more than 100 pounds. This dramatic weight loss allows significant improvement in health and resolution of associated medical problems such as diabetes and sleep apnea, and therefore effectively “downstages” a patient to a lower risk group. Once the patients BMI is lower (35-40) they can return to the operating room for the “second stage” of the procedure, which can either be the Duodenal Switch, Roux–en-Y gastric bypass or even a Lap-Band®. Current, but limited, data for this ‘two stage’ approach indicate adequate weight loss and fewer complications.

Vertical Gastrectomy as an only stage procedure for Low BMI patients(alternative to Lap-Band®and Gastric Bypass)

The Vertical Gastrectomy has proven to be quite safe and quite effective for individuals with a BMI in lower ranges. The following points are based on review of existing reports:

Dr. Johnston in England, 10% of his patients did fail to achieve a BMI below 35 at 5 years and these tended to be the heavier individuals. The same ones we would expect to go through a second stage as noted above. The lower BMI patients had good weight loss (Obesity Surgery 2003).

In San Francisco, Dr Lee, Jossart and Cirangle initiated this procedure for high risk and high BMI patients in 2002. The results have been very impressive. In more than 700 patients, there were no deaths, no conversions to open and a leak rate of less than 1%. The two year weight loss results are similar to the Roux en Y Gastric Bypass and the Duodenal Switch (81-86% Excess Weight Loss). Results comparing the first 216 patients are published in Surgical Endoscopy.. Earlier results were also presented at the American College of Surgeons National Meeting at a Plenary Session in October 2004 and can be found here: www.facs.org/education/gs2004/gs33lee.pdf.

Dr Himpens and colleagues in Brussels have published 3 year results comparing 40 Lap-Band® patients to 40 Laparoscopic VSG patients. The VSG patients had a superior excess weight loss of 57% compared to 41% for the Lap-Band® group (Obesity Surgery, 16, 1450-1456, 2006).

Low BMI individuals who should consider this procedure include:

1. Those who are concerned about the potential long term side effects of an intestinal bypass such as intestinal obstruction, ulcers, anemia, osteoporosis, protein deficiency and vitamin deficiency.
2. Those who are considering a Lap-Band® but are concerned about a foreign body or worried about frequent adjustments or finding a band adjustment physician.
3. Those who have other medical problems that prevent them from having weight loss surgery such as anemia, Crohn’s disease, extensive prior surgery, severe asthma requiring frequent steroid use, and other complex medical conditions.
4. People who need to take anti-inflammatory medications may also want to consider the Vertical Gastrectomy. Unlike the gastric bypass where these medications are associated with a very high incidence of ulcer, the VSG does not seem to have the same issues. Also, Lap-Band ® patients are at higher risks for complications from NSAID use.

All surgical weight loss procedures have certain risks, complications and benefits. The ultimate result from weight loss surgery is dependent on the patients risk, how much education they receive from their surgeon, commitment to diet, establishing an exercise routine and the surgeons experience. As Dr. Jamieson summarized in 1993, “Given good motivation, a good operation technique and good education, patients can achieve weight loss comparable to that from more invasive procedures.”

Next: Advantages and Disadvantages of Vertical Sleeve Gastrectomy >>

This information has been provided courtesy of Laparoscopic Associates of San Francisco (LAPSF). Please visit the Laparoscopic Associates of San Francisco.

I think his concern is bleeding since anti-coagulants are given for general surgery. Not all surgeons require this one, but several do recommend going off BC for their own comfort level with their patients.

Here's some information from Dr. Cirangle and Dr. Jossart regarding VSG. I know every surgeon has a different protocol, but considering the number of sleeves these 2 surgeons have performed between RNY and VSG, plus their recognized as pioneers of VSG as a stand alone procedure. This is their information on NSAIDS.

Thanks for the information!

I have taken ibuprofen for my menstrual issues since having the sleeve. I however can not take Aleve it does weird things to my period. It always has, it makes me stop bleeding mid cycle then suddenly two weeks later my period would start again (though it worked awesome on the cramps lol). I brough it up to my doctor years ago and he said that Aleve is actually prescribed to women who experience episodes of heavy menstrual bleeding for days on end. It will in a lot of women stop their bleeding. It also has been linked to possibly messing with fertility in women. I found this article about it on a fertility website:

Fertility Plus

Also this:

Precautions related to fertility

The use of naproxen, as with any drug known to inhibit cyclooxygenase/prostaglandin synthesis, may impair fertility and is not recommended in women attempting to conceive. In women who have difficulty conceiving or are undergoing investigation of infertility, withdrawal of naproxen should be considered.

I have taken ibuprofen for my menstrual issues since having the sleeve. I however can not take Aleve it does weird things to my period. It always has, it makes me stop bleeding mid cycle then suddenly two weeks later my period would start again (though it worked awesome on the cramps lol). I brough it up to my doctor years ago and he said that Aleve is actually prescribed to women who experience episodes of heavy menstrual bleeding for days on end. It will in a lot of women stop their bleeding. It also has been linked to possibly messing with fertility in women. I found this article about it on a fertility website:

Fertility Plus

Also this:

Precautions related to fertility

The use of naproxen, as with any drug known to inhibit cyclooxygenase/prostaglandin synthesis, may impair fertility and is not recommended in women attempting to conceive. In women who have difficulty conceiving or are undergoing investigation of infertility, withdrawal of naproxen should be considered.

Thanks for sharing this information since we've been TTC for months now. I'll be eliminating Aleve. I have 800mg Ibuprofen for cramps, and rarely take Aleve but now it'll be removed from my medicine cabinet.

Thanks for sharing this information since we've been TTC for months now. I'll be eliminating Aleve. I have 800mg Ibuprofen for cramps, and rarely take Aleve but now it'll be removed from my medicine cabinet.

Well I am glad I shared it! It couldn't hurt to get the cards stacked on your side. Best wishes on conceiving.