Saw Dr. C. today-update on my surgery

I'm so happy to hear everything has gone so well for you!  You have been an inspiration for me, since way before my surgery and that hasn't changed!

I missed you this month? Damn work getting in the way!

I'm so happy to hear you are off the PPIs though. Come back to SJ in May!

Hello Lizanne.  I haven't popped in here for a while - glad to hear that your hernia's fixed!  Dr. C repaired mine at the time of surgery, but I'm going in for a test to see if it has recurred.  If it has, the insurance company wants me to use a local general surgeon!  I said "NO WAY!  No one knows my upper abdomen like Dr. C!"  (They were a bit surprised at the intensity of my approval, but I'm not taking any chances.  They'll just have to approve me going out of network.

So good to hear of your positive outcome!

Ev

So nice to see you! I agree--there is NO way I would let a general surgeon try to fix this, especially since they have to work inside our little stomachs! Fortunately, Dr. C is in my network, so that wasn't a problem. Are you having a lot of GERD symptoms?

Lizanne

Hi Lizanne,
How did you know that you had a hernia and that hernia was causing the GERD symptoms? I had heartburn twice before I had my sleeve, literally 2 times. Now I take a PPI every day. The heartburn didn't start until about 3 weeks post-op I took it for a solid 6 months after that. Then i weaned myself off of it and I was okay without the PPI for about 3 months...Don't know what happened but it's back and with a vengance. I thought I might have a hernia--with no insurance coverage at the moment, I have no way to find out..and then I don't know if that hernia would cause my GERD or if it's just a symptom of having a tubular tummy...any help would be great. Glad you got all fixed up- I HATE taking this Omeprazole

Unfortunately, it's pretty common to have long term acid problems with the sleeve, and many people do have to stay on acid reducers or proton pump inhibitors. The only way to know if you have a hernia is to do an upper GI test (once you get your insurance back) which is easy and non-invasive. That's how I found out, about a year post surgery. I kept expecting the GERD to improve, as it always had in the past as I lost weight, but it didn't happen. My surgeon, Dr. Jossart, operated to fix it then but he wasn't aggressive enough, and it actually got worse over the next few years, until I was taking a double dose of pantoprazole (Protonix) daily and still had symptoms and gastritis. I repeated the upper GI before this surgery to confirm. I hope it gets better for you!

Lizanne

So, your originall sleeve was not done by Dr. C.? 

I am impressed by what he did for you.  It's as if you are a new sleever!  I'll bet you are glad that he fixed that herna!  It sure makes me wonder if I need mine repaired.  My surgeon told me I had a small hernia after he sleeved me, but that it didn't need repairing. That was 19 months ago and my GERD has gotten really bad in the past year.  I'm going to ask about it when I go in for my 2 year follow up.  I wouldn't have even remembered or thought about it if you had not posted.  Thank you.

No, I was sleeved by Dr. Jossart at LapSF. Until recently, he and Dr. Cirangle were partners, so they developed the surgical and diet protocols together.

It was like being newly sleeved for a few weeks since everything was swollen, I think. Now I really can't tell much difference in capacity. Dr. Cirangle and Dr. Jossart started trimming the sleeves a little tighter at the top in the years after I had mine in order to prevent dilation, so what Dr. C did was suture the top a little. What he told me, and I can tell now, is that it didn't change the capacity of my sleeve at rest, but it prevents overeating and stretching. But I've never really pushed my sleeve too much, so I feel like I'm eating pretty much how I was before this operation. For a while it seemed like my capacity was much smaller, but I think things were just swollen.

I DEFINITELY can tell a difference in the GERD. Huge difference and it's wonderful! I know Dr. Cirangle is extremely aggressive about fixing hernias at the time of surgery because they do get worse and they are much , much harder to repair after the bulk of the stomach is removed. I hope your symptoms improve!

Lizanne

The tighter sleeve at the top of the stomach is very interesting!  He sure is a smart doc!  Like you, I cannot eat fast.  It takes me 20-30 minutes to drink a shake.  If I accidental get to big of a mouthful, and swallow it, it will hurt.... 

No, I don't think so. I think the hypoglycemia comes at the other end when food enters the intestine abruptly. That's controlled by the pyloric valve (which we have and RNYers don't). However, one of the reason he DID tweak it was to make sure that food didn't go up there and push against the esophageal valve. I think the wider-at-the-top can contribute to the GERD.

I've never heard of swallowing and pain being a symptom of a hiatal hernia. I could gulp water before this surgery without a problem, and now that I'm healed, I still can. I'm also (unfortunately) pretty much back to eating almost as quickly as before. I think things were still not completely healed when I posted before, but I haven't had any of those esophageal spasming for over a week and I think that was because of the mesh he used...

Lizanne