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Schizophrenia and the sleeve operation



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So I'm considering getting the gastric sleeve surgery. I'm almost 40 years old and weight almost 440 pounds and have a BMI of 67 and ive tried literally everything to lose weight and nothing has worked. I've never lost more than 20-30 pounds at a time.Bariatric surgery is really the last option for me. So I'm in a bariatric program right now and we've decided that the gastric sleeve would be the safest operation for me. The problem my team including my surgeon is trying to address? I'm schizophrenic and Bipolar and take Antipsychotics. I've maybe gained 100 lbs over the course of trying meds since 2011 to find the right medicine combination. Right now I'm taking Latuda and Seroquel for antipsychotics.

My GP has stated over and over again that Latuda might not be the greatest medicine for me to be on because it requires me to consume 350 calories in order for it to work properly. But reallym the medication does wonders with me. When/if I get bariatric surgery that's going to be a challenge for my bariatric team finding a meal or snack that I can fit those calories in. Not to mention my surgeon has mentioned that it will be an extra challenge for him to try to work around my anti psychotics. He didn't say it was impossible but he did call it a great challenge. I guess why I'm posting here is to ask is, is the gastric sleeve an option for me? Or should I consider the switch instead? My bariatric team pretty much flat out said that the bypass would be too risky of a surgery to do with me and they don't do the lap band anymore and my bmi is too risky for the lap band anyway.

But before I go and permanently change my stomach I'd like to know what my options are. My team hasn't really been forthcoming and just seem to want to do the surgery as soon as possible. But, I'd like it to be a success as well. Especially when the sleeve is a permanent change to my body.

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I’d be careful and talk to the provider you see for your mental health meds as well. When you have gastric sleeve and or bypass medication absorption is impaired. It’s a huge adjustment and one you should really research thoroughly and with your provider input, not just the bariatric team. It’s a life long commitment and all things should be considered for success. I know I had to be evaluated by a mental health provider and cleared by him for surgery. I hope it goes well for you!

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WLS patients can easily increase daily calories by drinking them. That may be an option for you instead of trying to consume additional solid food. liquids just go down easier and pass thru the stomach quicker without making you too full.

For example.... a Protein Shake of milk, Protein Powder, fruit and no sugar added yogurt could get you there.

GL

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8 hours ago, TRAVELRN said:

I’d be careful and talk to the provider you see for your mental health meds as well. When you have gastric sleeve and or bypass medication absorption is impaired. It’s a huge adjustment and one you should really research thoroughly and with your provider input, not just the bariatric team. It’s a life long commitment and all things should be considered for success. I know I had to be evaluated by a mental health provider and cleared by him for surgery. I hope it goes well for you!

Yup I've got to have a mental health evaluation as well. And my wife and I have had those concerns (latuda needing food to be absorbed to work) the lead nurse practitioner seemed to be not too concerned about it or is working on it behind the scenes. Right now I have to wait for medical tests they're doing a stress test, ekg,, blood work, and all that jazz all in June and then when we go through those results I will rebring up my Psych meds and how I can take them after surgery.

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8 hours ago, BabySpoons said:

WLS patients can easily increase daily calories by drinking them. That may be an option for you instead of trying to consume additional solid food. liquids just go down easier and pass thru the stomach quicker without making you too full.

For example.... a Protein Shake of milk, Protein Powder, fruit and no sugar added yogurt could get you there.

GL

I wasn't aware of that. I thought that the stomach was compressed to not be able to hold as many liquids as well. Must be I'm wrong. That's good then and doesn't concern me anymore.

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I don't think there's any malabsorption issues with the sleeve, just the bypass and the switch. I would say talk to your mental health provider, do a lot of research on meds with a sleeve, and then take all of that to whoever you need to see to get you going on the safest surgery for you.

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1 hour ago, SleeveToBypass2023 said:

I don't think there's any malabsorption issues with the sleeve, just the bypass and the switch. I would say talk to your mental health provider, do a lot of research on meds with a sleeve, and then take all of that to whoever you need to see to get you going on the safest surgery for you.

I see my psychiatrist again after the bariatric nurse goes over the test results in late June. I told my psychiatrist I was getting the sleeve and he didn't say much but I can ask him how it will affect my meds the next time I see him.

And I just talked to my wife. Apparently both the surgeon and the nurse practitioner that we saw gave the ok on the sleeve operation and said that there was no malabsorbtion with it unlike the other two operations so as long as I'm given a clean bill of health and pass my Psych eval I should be good to go to start physical therapy and start seeing a bariatric nutritionist.

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Posted (edited)

I took Latuda for bipolar when I had my sleeve three years ago and my prescribing doctor was concerned about me not getting enough calories in the beginning for it to absorb properly as well. (For those who don’t know about this particular medication it’s not about it not absorbing due to the surgery itself like many controlled release meds. This med needs the 350 calories in order to absorb fully for anyone, not just people who had surgery).

Anyways, My doctor switched me to vraylar for a couple of months prior to surgery just to make sure I was stable on it and then a short time after until I was back to being able to consume 350 calories at one time. The vraylar is quite expensive but luckily they were able to get enough samples for me. The plan was to switch me back once I was eating enough. What was weird and unexpected was post surgery when he tried to switch me back to the Latuda all of a sudden it caused me a great deal of anxiety and I couldn’t tolerate it anymore (even though I was on it for three years before surgery) so he kept me on the vraylar a little longer until things got back more normal for me and then made another change.

I am now on a completely different medication. Neither the surgeon or prescribing dr could explain that anxiety except that when you alter the anatomy things just happen sometimes but I just worked with my prescribing dr and he sorted it out. The most important thing is that your prescribing dr and your loved ones are very aware that you may encounter some issues and that everyone is on top of it. If you feel the slightest bit off, you may need to be the one to contact your Dr.

You mentioned “the switch” as an option. Not sure if you are speaking if the SADI switch or the Duodenal switch but both of those are restrictive and malabsorbing surgeries. The reason they suggested the sleeve for me was because they were concerned about my other meds not absorbing fully just because of the malabsorbing component of the other surgery.

Fast forward three years and I gained my weight back and we are now considering conversion to the SADI or bypass because I gained my weight back. I gained it back because I ate the wrong things though so don’t let that scare you. I only mention it because I’m guessing you can see my current weight and may wonder why I didn’t lose. I did lose quite a bit and maintained it for a while but I was discouraged I didn’t lose it all and I let that get to me. Which is something you should be aware of, you may not lose as much as someone who is not on all these meds. Just don’t get too caught up in comparing your journey to others. I am 5’8” and I got down to 168. I would be so much happier and healthy now if I had just accepted that win instead of getting it in my head that I failed by not making it to where others did.

Edited by ShoppGirl

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7 minutes ago, ShoppGirl said:

I took Latuda for bipolar when I had my sleeve three years ago and my prescribing doctor was concerned about me not getting enough calories in the beginning for it to absorb properly as well. (For those who don’t know about this particular medication it’s not about it not absorbing due to the surgery itself like many controlled release meds. This med needs the 350 calories in order to absorb fully for anyone, not just people who had surgery).

Anyways, My doctor switched me to vraylar for a couple of months prior to surgery just to make sure I was stable on it and then a short time after until I was back to being able to consume 350 calories. The vraylar is quite expensive but luckily they were able to get enough samples for me. The plan was to switch me back once I was eating enough but What was weird and unexpected was post surgery when he tried to switch me back to the Latuda all of a sudden it caused me a great deal of anxiety and I couldn’t tolerate it anymore (even though I was on it for three years before surgery) so he kept me on the vraylar a little longer until things got back more normal for me and then made another change.

I am now on a completely different medication. Neither the surgeon or prescribing dr could explain that anxiety except that when you alter the anatomy things just happen sometimes but I just worked with my prescribing dr and he sorted it out. The most important thing is that your prescribing dr and your loved ones are very aware that you may encounter some issues and that everyone is on top of it. If you feel the slightest bit off, you may need to be the one to contact your Dr.

You mentioned “the switch” as an option. Not sure if you are speaking if the SADI switch or the Duodenal switch but both of those are restrictive and malabsorbing surgeries. The reason they suggested the sleeve for me was because they were concerned about my other meds not absorbing fully just because of the malabsorbing component of the other surgery.

Fast forward three years and I gained my weight back and we are now considering conversion to the SADI or bypass because I gained my weight back. I gained it back because I ate the wrong things though so don’t let that scare you. I only mention it because I’m guessing you can see my current weight and may wonder why I didn’t lose. I did lose quite a bit and maintained it for a while but I was discouraged I didn’t lose it all and I let that get to me. Which is something you should be aware of, you may not lose as much as someone who is not on all these meds. Just don’t get too caught up in comparing your journey to others. I am 5’8” and I got down to 168. I would be so much happier now if I had just accepted that win instead of getting it in my head that I failed by not making it to where others did.

Funny you should mention Vraylar. I learned the hard way before I was put on Latuda that I couldn't take that. Why? It caused a 7 month long manic episode that was just terrible. It was one of the worst episodes I had ever had I nearly died from the experience and had I actually passed away from it my wife would have been able to sue the pants off of my psychiatrist for malpractice because she definitely was in the wrong. I was on Saphris beforehand and she took me off of Saphris cold turkey and then immediately stuck me on Vraylar. She later said she shouldn't have done that. Anyway, we're supposed to be talking about bariatric surgery not Psychiatric meds. I just figured I'd share my own personal story since we seem to have similar med history.

The only reason I'm concerned about Latuda and getting bariatric surgery is you're right, it needs 350 calories to be absorbed properly and if im on a 1k calorie diet that's going to be problematic because thats almost half of my daily calories. But I do so well on Latuda (it really, really helps stabilize my moods and my psychotic symptoms) that it's really stupid to take me off of it and stick me on something else. So my surgeon and nurse practitioner/psychiatrist have to all work together and figure out how it's going to work.

I'm not discouraged by your weight in fact, I wish I was your weight I weight almost 440 pounds lol. But I get what you mean you gained 4 pounds. But that's what happens when you don't follow the diet. I've heard lf many people regaining the weight because they got discouraged. I really hope that once I lose the 200-250 pounds I want to lose I'm able to keep it off!

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22 minutes ago, Neostarwcc said:

Funny you should mention Vraylar. I learned the hard way before I was put on Latuda that I couldn't take that. Why? It caused a 7 month long manic episode that was just terrible. It was one of the worst episodes I had ever had I nearly died from the experience and had I actually passed away from it my wife would have been able to sue the pants off of my psychiatrist for malpractice because she definitely was in the wrong. I was on Saphris beforehand and she took me off of Saphris cold turkey and then immediately stuck me on Vraylar. She later said she shouldn't have done that. Anyway, we're supposed to be talking about bariatric surgery not Psychiatric meds. I just figured I'd share my own personal story since we seem to have similar med history.

The only reason I'm concerned about Latuda and getting bariatric surgery is you're right, it needs 350 calories to be absorbed properly and if im on a 1k calorie diet that's going to be problematic because thats almost half of my daily calories. But I do so well on Latuda (it really, really helps stabilize my moods and my psychotic symptoms) that it's really stupid to take me off of it and stick me on something else. So my surgeon and nurse practitioner/psychiatrist have to all work together and figure out how it's going to work.

I'm not discouraged by your weight in fact, I wish I was your weight I weight almost 440 pounds lol. But I get what you mean you gained 4 pounds. But that's what happens when you don't follow the diet. I've heard lf many people regaining the weight because they got discouraged. I really hope that once I lose the 200-250 pounds I want to lose I'm able to keep it off!

Sorry to hear about your experience on vraylar. That’s why they make so many meds I guess because we are all different. I think you will be just fine so long as you stay in touch with your prescribing dr. My Dr had me come in more often right after surgery and my therapist called to check on me to make sure I was doing okay in between appointments. Best of luck with your journey.

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3 minutes ago, ShoppGirl said:

Sorry to hear about your experience on vraylar. That’s why they make so many meds I guess because we are all different. I think you will be just fine so long as you stay in touch with your prescribing dr. My Dr had me come in more often right after surgery and my therapist called to check on me to make sure I was doing okay in between appointments. Best of luck with your journey.

Yeah I've been on almost every antipsychotic under the sun. It took doctors a long time to find one that worked for all of my symptoms since I'm both schizophrenic and Bipolar. Vraylar had the worst side effects out of all the ones doctors have tried over the years. I was actually going to give up hope because I had been on so many different meds. So I'm under as much control as possible now. It's enough to keep me out of the hospital anyway.

Good luck with your weight loss journey too I hope you reach your weight loss goals. I know for women it's extra hard to lose weight.

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