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It has been a while since I was posting regularly here. I had vsg in May 2013, reached my goal weight and a healthy BMI in about 16 months, and have had no trouble maintaining. I've been very happy with the sleeve overall.

But I have had some trouble the whole time. Basically I dump (severe diarrhea and sometimes severe hypoglycemia too) after almost every meal. We are talking agonizing, clear-the-ladies-room, stuff. I actually experienced it right after surgery in the hospital and they said it was normal and would go away. It never has. I've worked with my surgeon, dietitians, other gastroenterologists, I've had all kinds of tests including numerous endoscopes and colonoscopies. I tried going dairy free, gluten free, low carb, low fat. I had my gall bladder removed after a severe attack and hoped it might help. I took Questran at 4x the normal dose. I tried Calcium. I tried eating g things that tend to block other people up. I ate 120+ grams of low fat Protein a day. Nothing helped.

Now I have another problem too. Despite being on nexium since surgery, I have severe acid reflux and bile reflux that have caused my stomach and upper bowel to develop severe ulcers. The acid reflux is a relatively common long term complication of the sleeve. The bike reflux is often genetic and doesn't cause a lot of trouble with a full size stomach apparently. My current gastroenterologist is going to revise my sleeve to a bypass, which will eliminate both types of reflux because it will be impossible for the acid and bile to reach the pouch from the blind stomach. He also thinks that the bile reflux is causing the dumping because it is impeding the break-down of food, which is passing through me only partially digested.

So I will be having the revision Monday morning and I get to re-experience the joy of the 6 week post-op diet. My surgeon is confident that any weight I lose will only be temporary, since I really don't need to lose more. I may actually gain a bit because I will be absorbing more nutrients.

I don't know how many sleeve to bypass revisions there are, so I wasn't sure where to post this. Hopefully it is helpful to someone.

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Thank you for trying to help others through all that you are going through.

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I surely hope this will correct the problems. I hope the surgery goes well and you heal quickly. Thank you so much for sharing this since you never know who will be helped with the information.

Blessings,

Kathleen

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Thanks for sharing, and best of luck to you...

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I think there is a dedicated section for sleeve to bypass revisions-- hope you connect with those knowledgeable folks! The most recently-active person with sleeve to bypass that I'm aware of is Band07. Best wishes & kudos for your tenacity in dealing with all that!

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I saw a section for band to sleeve and one from band to bypass but not one for sleeve to bypass. I will look again. Note that this is also different from sleeve to duodenal switch. Thanks!

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Thanks for that info! My biggest concern is what my pouch capacity will be compared to the sleeve now. My surgeon thinks I will not have any trouble but it is in the back of my mind as I have never really noticed a loss of restriction. I still don't eat more than 50 grams of dense Protein at a time for instance.

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Thanks for that info! My biggest concern is what my pouch capacity will be compared to the sleeve now. My surgeon thinks I will not have any trouble but it is in the back of my mind as I have never really noticed a loss of restriction. I still don't eat more than 50 grams of dense Protein at a time for instance.

Misty it is so good that you are back on the site. Although I feel for you in regards to the issues you are experiencing. I often wondered how you were doing. Please keep us updated on your progress

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Thanks for the welcome back. :) I have to say I can't get used to all the ads though.

Surgery went fine yesterday morning. It took two hours including a massive hiatus hernia repair (had it repaired as part of the sleeve surgery too but it came back). This morning I had clear fluids for Breakfast with no trouble (about 6 ounces total I would guess). The expected amount of pain. Everything seems easier this time around even though the sleeve was very easy too.

I'll be out of the hospital tomorrow and on full fluids for two weeks, mushy for two weeks, then gently back to normal. I expect to be back at work (desk job, work from home) next week.

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I'm home now. Tolerating free fluids fine. My capacity is better than with the sleeve. I'm nursing a Protein Shake now. It's funny not to be so worried about the calories as I was the first time. To maintain I probably have about 1600 and I don't really count anything. So during the liquid phase it will be nearly impossible for me not to have a deficit. It's also weird to realize that this time my goal is to maintain, maybe losing a couple of kg but it's not a priority at all.

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Sounds like you are doing well! The couple of cases of revising from sleeve to bypass that I have been aware of were inspire by lack of weight loss (or troubling re-gain), so your journey will be interesting to watch since you're not trying to lose a great deal.

Truly hope this is the beginning of a great new era for you – you have sure been through a lot!

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Still doing pretty well. Bring on week 2 of liquids. Back to pre-op weight now. Not really trying to lose anything which is weird in a way!

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@@mistysj glad you are doing well. How is the reflux?

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It's tricky to say as it was "silent" reflux. I didn't really ever have proper heartburn. So I'll find out at my 4-week appointment. Because of the way the bypass works I was told it would be almost impossible for me to have reflux afterward.

It's hard to tell with the diarrhea as well. It seems like it might be a smidge better but I am still on liquids so it's still not expected to be "normal" yet I suppose. So just waiting a bit longer to see.

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    • Prdgrdma

      So I guess after gastric bypass surgery, I cant eat flock chips because they are fried???  They sell them on here so I thought I could have them. So high in protein and no carbs.  They don't bother me at all.  Help. 
      · 1 reply
      1. NickelChip

        It's possible for a very high fat meal to cause dumping in some (30% or so) gastric bypass patients, although it's more likely to be triggered by high sugar, or by the high fat/high sugar combo (think ice cream, donuts). Dietitians will tell you to never do anything that isn't 100% healthy ever again. Realistically, you should aim for a good balance of protein, carbs, and fat each day. Should you eat fried foods every day? No. Is it possible they will make you sick? Maybe. Is it okay to eat some to see what happens and have them for a treat every now and again? Yes.

    • NovelTee

      I'm not at all hungry on this liquid pre-op diet, but I miss the sensation of chewing. It's been about two weeks––surgery is in two days––and I can't imagine how I'll feel a couple of weeks post-op. Tonight, I randomly stumbled upon a mukbang channel on YouTube, and it was strangely soothing... is it just me, or is this a thing? 
      · 1 reply
      1. NickelChip

        I actually watched cooking shows during my pre-op, like Great British Baking Show. It was a little bizarre, but didn't make me hungry. I think it was also soothing in a way.

    • Clueless_girl

      How do you figure out what your ideal weight should be? I've had a figure in my head for years, but after 3 mths of recovery I'm already almost there. So maybe my goal should be lower?
      · 3 replies
      1. NickelChip

        Well, there is actually a formula for "Ideal Body Weight" and you can use a calculator to figure it out for you. This one also does an adjusted weight for a person who starts out overweight or obese. https://www.mdcalc.com/calc/68/ideal-body-weight-adjusted-body-weight

        I would use that as a starting point, and then just see how you feel as you lose. How you look and feel is more important than a number.

      2. Clueless_girl

        I did find different calculators but I couldn't find any that accounted for body frame. But you're right, it is just a number. It was just disheartening to see that although I lost 60% of my excess weight, it's still not in the "normal/healthy" range..

      3. NickelChip

        I think it's important to remember that the weight charts and BMI ranges were developed a very long time ago and only intended to be applied to people who have never been overweight or obese. Those numbers aren't for us. When you are larger, especially for a long time, your body develops extra bone to support the weight. Your organs get a little bigger to handle the extra mass. Your entire infrastructure increases so you can support and function with the extra weight. That doesn't all go away just because you burn off the excess fat. If you still had a pair of jeans from your skinniest point in life and then lost weight to get to the exact number on the scale you were when those jeans fit you, chances are they would be a little baggy now because you would actually be thinner than you were, even though the scale and the BMI chart disagree. When in doubt, listen to the jeans, not the scale!

    • Aunty Mamo

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      I'm in day three of the "puree" stage of eating and despite the strange textures, all of the savory flavors seem decadent. 
      I timed this surgery so that I'd be recovering during my spring break. That was a good plan. Today is a state holiday and the final day of break. I feel really strong to return to school tomorrow. 
      · 0 replies
      1. This update has no replies.
    • BeanitoDiego

      Now that I'm in maintenance mode, I'm getting a into a routine for my meals. Every day, I start out with 8-16 ounces of water, and then a proffee, which I have come to look forward to even the night before. My proffees are simply a black coffee with a protein powder added. There are three products that I cycle through: Premier Vanilla, Orgain Vanilla, and Dymatize Vanilla.
      For second breakfast on workdays, I will have a low-fat yogurt with two tablespoons of PBFit and two teaspoons of no sugar added dried cherries. I will have ingested 35-45 grams of protein at this point between the two breakfasts, with 250-285 calories, and about 20 carbs.
      For second breakfast on non-workdays, I will prepare two servings of plain, instant oatmeal with a tablespoon of an olive oil-based spread. This means I will have had 34 grams of protein, 365 calories, and 38 carbs. Non-workdays are when I am being very active with training sessions, so I allow myself more carbohydrate fuel.
      Snacks on any day are always mixed nuts, even when I am travelling. I will have 0.2 cups of a blend that I make myself. It consists of dry roasted peanuts, cashews, pumpkin seeds, sunflower seeds, pistachios, and Brazil nuts. This is 5 grams of protein, 163 calories, and 7 carbs.
      Breakfast and snacks have been the easiest to nail down. Lunch and dinner have more variables, and I prepare enough for leftovers. I concentrate on protein first, and then add vegetables. Typically tempeh, tofu, or Field Roast products with roasted or sautéed vegetables. Today, I will be eating leftovers from last night. Two ounces of tempeh with four ounces of roasted vegetables that consist of red and yellow sweet peppers, sweet potatoes, small purple potatoes, zucchini, and carrots. I will add a tablespoon of olive oil-based spread, break up 3 walnuts to sprinkle of top, and garnish with two tablespoons of grated Parmesan cheese. This particular meal will be 19 grams of protein, 377 calories, and 28 grams of carbs. Bear in mind that I do eat more carbs when I am not working, and I focus on ingesting healthy carbs instead of breads/crackers/chips/crisps.
      It's a helluva journey and I'm thankful to be on it!
       
      · 0 replies
      1. This update has no replies.
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