VSG - 10 Years on. Weight Gain - Reflux etc

Hi All.

Its been 11 years actually since my procedure which saw me drop from 180 to 80kg. A huge loss, and something i maintained +/- 10 kg for 8 years.

Unfortunately it then changed and ive had a bad gain, im currently up to 110kg ( not horrible for a male, ) but an increase, my reflux is very bad and im on lansoprazole daily ( without it the day isnt great ).

Im trying to find others who are a decent way out of their surgery date, and wanting to know if you may have undergone an RNY revision to address these concerns. My dr is saying that the only way to fix the heartburn is with an RNY ( given we have no stomach to use normally ) and that RNY is now not that big of a deal given the improvements in surgery techniques ( larger pouch, smaller stoma, and other techniques ).. also that laproscopic surgery has come a long way and stapling is much improved and less concerns.

So can you share your experiences?

Need some decide what i do next to help with teh weight and the reflux..

Thanks

I am five years out from my VSG and I've had severe GERD for about two years. I'm having a revision to RNY late next month, which will fix the GERD as well as help with the regain (imaging showed that my pouch has stretched to well over double in size).

I'll be keen to hear how you go

If I understand correctly, you had a VSG and are having a R/Y. Questions: 1) have you gained weight or is GERD the primary reason for the R/Y?, and 2) is your insurance covering the R/Y?

I am so ashamed, I had my VSG Feb 2014, and I'm edging closer to my pre surgery weight. Everything was going well, then I was hospitalized, and my partner had 2 hip surgeries. Back to old habits, it wasn't my hospitalization that started the downward spiral. During my partners' hip surgeries I stayed the nights, and started hitting the vending machines. I chose my old eating habits over the 90 # I had lost.

That's all history, there's so much going on in my life and I don't know how I'm going to lose this weight again. I'm pretty sure my insurance will not pay for a revision of any type, not sure.

I had hoped with the weight loss my knees would improve, not. Unable to take ibuprofen for the arthritic inflammation, I was sedentary. Unable to put up with the knee pain, I had knee replacements in April 2018 and October 2018. Add the post op mobility issues, bam! God, there's only so much I can handle. Feeling like a fat pig again is becoming unbearable.

Babble babble babble. Sorry, very discouraged here.

Getting back to my question, did your insurance pay for the revision? My GERD was never resolved, I've been on 80mg protonix prior to and after my VSG.

Thanks!

To answer your questions:

Yes, I had a VSG 5 years ago, and I am converting to RNY. I have gained quite a bit of weight back, due in part to the fact that my stomach has stretched back to almost its original size (surgeon says it's super rare and not my fault) but GERD is the primary reason for revision.

Insurance is paying for the revision. To revise because of GERD, I need to have acid that has not resolved after eight weeks of medication. My insurance also covers revision due to weight regain, but I don't qualify under that route; because my BMI is between 35 and 40, I would need a comorbidity and I (fortunately) do not have one.

Many people are having to revise their VSG due to GERD. I would suggest calling your insurance company to find out what their coverage guidelines are. Good luck! :)

I also need two knee replacements, how did that go?

First off, do not have a surgeon who is willing to do a bilateral replacement. That's a red flag, high risk for infection, possible amputation if one knee gets infected, increases the risk of complications. I know that wasn't your primary question.

I had my surgeries 6 months apart. Had I known the 2nd would not go like the 1st, I would have waited 9 months.

The first 2 weeks were rough sleeping, thankfully I have a power recliner. It was a good 2 months before I could sleep in the bed due to the pain rolling over.

Make sure you do the post op flex exercises. After the 2nd surgery, the PT orders were geared towards strengthening whereas, the 1st surgery flexibility was stressed. My surgeon apologized because he did not emphasize the flex based on how well the 1st went. What happened? Scar tissue, some people are more prone to develop, moi. The scar tissue was the worst, it hit 4 weeks post op and I stood the risk of his putting me under to remove it. Apparently it's extremely painful. Anyhow I worked so hard, went through stretching exercises that I had to take the hydrocodone prior to.

My intent is not to discourage you, rather prepare yourself for the emotional piece and down days. Have a spinal and a block. I was so scared of the spinal, I didn't even feel it. When the block wears off 24 hours later, the pain sets in.

I want to stress, no 2 people have the same experience. Nor are our knees the same. The 1st was a better recovery than the 2nd.

While I have clicks, totally normal. I have no arthritic knee pain! No cartilage crunching!

My surgeon was very strict with the BMI, he started out that I had to lose 15 # in 6 weeks. No way, I'm on a med that messes with my metabolism plus sedentary due to pain. He gave me a break, I lost 8#, he knew I was doing my best.

Finally, research, research, research surgeons. I doubt you live in MN, my surgeon was awesome, part of the Allina System. When you go to your preop appointments strike up a conversation with a post op patient. If they have a negative story find out why, if it's the doctor run. Easier said than done.

Summary, of sorts:

1) Find a reputable surgeon; 2) do pre op knee / buttock / lower back strengthening exercises, the more strength you have going into surgery the easier the post op PT/ endurance. 3) One knee at a time, if you're able space them out, at least 6 months apart. I had little choice due to my work. 4) Take your pain meds, if you're at a 8-9 it's out of control, you will be miserable, and unable to do your PT. Use caution of course if you've been through treatment, could be an an issue. It wasn't for me because I'd go to hell before treatment again. However you can balance the pain, the meds, and PT is the key to success.

Sorry for the book, hopefully this is helpful. Like I tell people, take what you need, and leave the rest.

All the best to you. And no, I do not regret having replacements. I don't want to do it again, but I would if something were to happen.

I has surgery in 2011. Hiatla hernia was repaired in the surgery and reflux resolved. A few years later it was back with a vengence and my gallbladder gave out, both repaired. Surgeon warned no more repairs on the hernia and I nearly revised to rny at that time. Reflux is back again and images show a small hiatel hernia again. Not bad enough to do anything about it, but if it comes to that I will have to revise to Rny.

Doc has me on Pantoprozole and my situation is complicated due to having esophogeal dysmotility. This just means the muscles in the esophogus do not contract properly and things come back up the esophogus. He prescribed baclofen (spelling?) and that helps- when I remember to take it.

Lastly, once I realized I was far more lactose intolerant than I realized that helped substantially. The really gerd resolved just from eliminating dairy or a little dairy combined with lactaid.

Interestingly, the only time maintaining my loss is when my acid is an issue. I am up out of my range at the moment by 10 pounds and the heaviest since making my goal. I have some work to do as well. Good luck!

I had VSG 5 years ago, a HH repair during it, and lost about 85+ lbs. Did great, but some horrible life events lead to some regain. My GERD resurfaced with the regain. I went full on Keto about 20 months ago and lost the regain, but the GERD persists. EGD about 20 months ago found a new HH.

Surgeon also offered me RNY for the GERD, although I'm going to try and lose another 10# on my own and see if it makes the difference.

If not, I'll likely opt for the revision, since I don't want to be on a PPI my entire life. I've been on a PPI for about 17 years already.

I'm sure everyone's hiatal hernia issues (and other issues, too) that result in GERD are peculiar to each of us, since (just like the outsides of our bodies) our internal organs are also arranged a little differently sometimes.

I just want to say that when I don't eat or drink late at night and stay upright at least 2 hours or longer before going to sleep, my GERD issues are pretty nonexistent.

I've also learned to no longer eat GERD-inducing foods for supper, e.g., tomato sauces, chocolate, red wine, citrus fruits, etc. And I am a big consumer of high-fiber veggies, healthy fats (e.g., avocados), lean meats, etc. -- the kinds of foods that reduce GERD symptoms. Here's a good link re some foods to avoid and eat if you suffer from GERD.

FTR, a LOT of folks have GERD. "Up to 60 percent of the [American] population at some time during the year, and 20 to 30 percent weekly, experience symptoms of gastroesophageal reflux disease (GERD), such as heartburn and acid regurgitation." See this study report from the Agency for Healthcare Research and Quality. It's a rapidly growing problem, associated with obesity, fast-food, overeating, and late-night eating, among other conditions and behaviors.

Best wishes to you!