Thinking about Gastric Sleeve Surgery

[Brenda L. Robertson 8]

Hello, new to site, have my 1st appt. with the surgeon, nutritionist, financial dept, etc., next week. Question, I'm on Medicare, what are requirements & out of pocket? Also, after initial visit how long until you get date for surgery? I have been struggling with weight for years, my primary physician is for the surgery, I've gone to a nutritionist for 6 months and lost about 15#, then went thru Physicians Weight loss for 6 months lost 34# and have gained all but 2# back. I have several medical conditions that should get better with the surgery, arthritis in every major joint, scoliosis of lower back, high cholesterol , high blood pressure, and acid reflux. I have questions about liquid diet before operation and then liquid diet after operation, as well as how hard it is to adapt to your new stomach, such as throwing up/bowel problems when you eat wrong. Sorry if I'm jumping from one subject to the next just my mind is racing with so many questions. Any insight will be helpful.

[JamieLogical 8,684]

Well, hopefully you can get a lot of your questions answered in detail at your appointment next week. I can't help you with the Medicare and surgery date questions. As for your medical conditions, most of those should definitely improve with the surgery and weight loss. Acid reflux may continue to be an issue, as it is one of the common side effects of VSG. Prior to surgery, I often had heartburn and acid reflux when I was at my heavier weights. Meaning it was definitely triggered by obesity, as is common. However, post-op, even though I'm at a lower weight now, my reflux hasn't resolved itself as it had in the past at lower weights, so I am now taking 20mg of Prilosec daily and that keeps it at bay the cvast majority of the time. I have not, however, had any issues with heart burn post-op.

Your pre-op and post-op diets will be unique to your surgeon and nutritionist. Some surgeons don't require a pre-op diet at all! Some require very strict pre-op diets. That's definitely something only your specific surgeon and nutritionist will be able to help you with.

As for throwing up and bowel problems post-op, again, it's entirely individual. I personally haven't thrown up once since my surgery 19 weeks ago, but some people throw up every single day. I also haven't had any problems with Constipation, but for some people it is a MAJOR problem post-op. No matter what, you will definitely have a steep learning curve when it comes to getting used to how much to eat and how fast to eat. I'm 19 weeks post-op and I still sometimes overdo it to the point where I am in extreme discomfort (I feel like I'm going to burst!). With every single meal you will just have to be conscious of how much you are eating, take your time, and listen to your body.

[BryBro63 410]

First of all, welcome to the site!! I'm sure you'll find a great deal of helpful and useful information here, as well as meeting alot of great people!!

To try to answer some of your questions...it's hard to say what will be out of pocket vs. what your plan will pay, since this is something that is on a plan-by-plan basis. I personally only had to come up with $300 out-of-pocket, nd the rest was covered by Aetna. As far as the start of the process until the actual surgery, it sounds like you've already covered alot of the prelim process (seeing the nutritionist for 6 months, etc.), and also teh USUAL requirements for the surgery is to have a BMI of 40 or higher, or have a BMI of at least 35 with at least one co-morbidity. Most of what you mentioned would be considered valid co-morbidities. The liquid diet is obviously harder prior to surgery than post surgery, but I've found that you're so anxious any excited about the surgery itself that the liquid diet thing becomes easier than you think! As far as bowel problems and vomiting, you just need to try your best to follow instructions carefully!! The sleeve tends to not give too many bowel issues, but for the vomiting, you just need to assure to eat SLOWLY!!! I only had 3 episodes, and every one of them was due to me eating too fast!!! You learn very quickly, and adjust very quickly!!!

Hope my info helps...and I wish you much success!!!

[dropdeadweightdiva 150]

I can speak to the acid reflux question... I never had an issue with it prior to surgery, but the first 4 months post op it was horribly painful and often. When it hit it was all I could think about, and even Water could cause it. A small few post VSG whom had it prior have it go away, a lot more have it increase. I do not regret having had the sleeve as it has since abated to occasionally, but if I had had it prior, knowing what I know now, I would definitely have avoided VSG and gotten RNY.

Edited January 15, 2015 by dropdeadweightdiva

[Bufflehead 6,358]

I have several medical conditions that should get better with the surgery, arthritis in every major joint,

weight loss can help with arthritis but it can't completely cure it - be sure to be realistic about your expectations! I have arthritis in my hips and knees. Things are *much* better since losing almost 200 lbs but I still need to take a couple Ibuprofen before strenuous, high-impact exercise.

scoliosis of lower back,

see above - weight loss will help but it won't cure you

high cholesterol , high blood pressure, and acid reflux.

cholesterol may or may not get better after surgery. It will depend in large part on your diet and exercise. Mine is a little better, not much - though it was never terrible to start with. High blood pressure often resolves immediately after surgery -- mine did! Acid reflux can actually be made worse by the sleeve, depending on the underlying cause of your reflux. If it is caused by a hiatal hernia, often that will be fixed by your surgeon and it will be better. That is what happened to me. But reflux from other causes can be exacerbated by the sleeve, so if you have bad reflux now and it isn't caused by a hernia, your surgeon may recommend bypass for you instead. Bypass is a great surgery to resolve acid reflux. In any event, you definitely want to discuss it with your surgeon.

I have questions about liquid diet before operation and then liquid diet after operation, as well as how hard it is to adapt to your new stomach, such as throwing up/bowel problems when you eat wrong.

I didn't have a liquid diet prior to surgery. Not every surgeon goes that route. I just had to eat high Protein, low carb, low calorie for a couple weeks. I was on four weeks of full liquids after the surgery. It really wasn't a big deal. I didn't throw up or have bowel problems! For starters, I really didn't eat wrong -- that's pretty much a choice that you make. I did get the slimies a couple of times. Once when my mineral supplement didn't agree with me and once when I accidentally ate too much when I was just starting out on purees -- I used the wrong size measuring spoon. Anyway, the slimies were certainly unpleasant but not the end of the world. Adaptation to my new stomach was guided by the strict and conservative regimen of my surgeon, my desire to follow that regimen, and my instinct to avoid eating the wrong foods or eating too much. Honestly it has not been hard or painful.

Good luck to you!