Guidance on VSG

Thank you so much for your help/responses.

I think, of course I'm not a doctor, but from what I've read, because I occasionally have to take steroids and anti-inflammatory meds, the VSG is probably the way I have to go... the stomach removal is freaky, but I guess if that's the option I have....

That's a relief about eating out... I was thinking I was going to be stuck for a year or so. Just limiting you know, because we usually take my MIL to breakfast a couple times a month or so. I was thinking I could just go and visit - awkward! LOL Can you add salads back in after a while? I do enjoy salads. It seems like the diet leans a lot on protein and I get that in the beginning for healing etc, but was wondering about later on.

Thank you so much for answering. I appreciate it!

The NSAID aspect is part of why I chose VSG as well. Tylenol doesn't do jack for me.

One thing my doctor told me when I worried about having my stomach removed-- if there's some sort of "catastrophic failure" (my words, he said that's seldom a problem), the surgery can still be revised to an RNY using the stomach remaining after VSG. So you're not completely screwed if you need to have your plumbing re-re-arranged.

You'll be eating a protein-forward diet for the rest of your life. Salad is OK, but you'll only really need a bite or two of veggies after you've had all of your meat. Luckily, eating breakfast out is pretty easy after surgery! You can order one scrambled egg, or some breakfast sausage, and that will be PLENTY!

That's interesting, Julie...my surgeon and my guidelines say absolutely no NSAIDs for me, either. It's even on my med-alert bracelet.

As I understand it, the recommendations used to be no NSAIDs for RNY, but OK for VSG. There has been some newer research suggesting VSG patients should stay away from NSAIDs as well, but not all surgeons make that recommendation.

As far as I've seen, the ASMBS hasn't made any revised guidelines for VSG patients and leaves the recommendations up to individual surgeons.

Ahhh, okay, gotcha. Thanks!

It's also a risk/benefit analysis. So while the overall recommendation is no NSAIDs for any WLS, the risks are lower for VSG than for RNY, so individual medical conditions may guide a team to determine that for an individual patient, the benefits outweigh the risks in a VSG, but wouldn't outweigh them with an RNY. The risks can also be lowered (but not eliminated) using a PPI, so that factors in as well.

No NSAIDS for VSGers actually is in the newer ASMBS guidelines.

Do you have a link to the newer guidelines? This is the most recent I have from ASMBS.

Thanks!

Thank you.... There is so much to think about, but I think I may be thinking too much. I appreciate the reassurance and advice. The autoimmune stuff truly stinks. I keep thinking well maybe if I just cut back to what everyone here says they eat, but I need to see the bigger picture. If it was "that easy", I would've done it a long time ago. I don't know that the eating part is the only issue. So look to mostly protein is what you're saying... Thanks so much!

If in doubt, get your surgeon's opinion on which surgery to have and listen to his/her experience. Most bariatric patients have done thousands of surgeries and have a good feel for what medical cir****tances are best for each type of surgery.

Food restriction is only part of the benefit of WLS. They call it "metabolic surgery" for a reason-- surgery triggers some biological changes in our gut and affects our metabolism as well. But being able to eat very tiny amounts, especially soon after surgery, certainly doesn't hurt.

To get a good idea of what post-op eating is like, I'd suggest checking out the "what's on your menu?" threads each day on the VSG and RNY forums. You can see what people at different stages of loss and maintenance have on a daily basis. As a general guideline, you'll be shooting for 600 - 800 calories, 60 - 80+ g protein, and under 25g carbs each day while losing weight, primarily lean, dense protein. :)