A thread chronicling my journey to DS

[Cthulurscon]

Making a thread to write about my journey to getting a DS (hopefully) -- hopefully that's okay.

I've posted once before about being suggested a long CC length.

So, pre-op meetings for insurance requirements have been going well. I needed a consult, then 3 appointments with the surgeon and 1 with his dietician. 3/4 of those meetings are done now -- just have my last one on March 22.

I need to lose 32 pounds by surgery date, whenever that is (10% of body weight.) I started the program at 321 on December 15, and as of today 2/18/24 I'm at 299. 10 more to go until 289 goal. I'm trying to make it before the March 22nd meeting, but we'll have to see.

All the medical clearances have been a bit of a headache. I'm a medical nightmare for other reasons (genetic disorder), but I honestly thought I was a healthy fat person, owing mostly to being only 26. I thought it hadn't caught up with me yet, especially since I haven't been fat my whole life (basically only since college.)

Well.

Turns out I have:

• NAFLD
• GERD
• Bile reflux
• Acid reflux (this I knew about at least)
• A hiatal hernia

I'm a little bit upset. It was just surprising to hear I had all these issues. I'm listed as "morbidly obese with multiple co-morbidities" on the paperwork, and that's been slightly hard to wrap my head around. I truly thought I was "just" morbidly obese.

The EGD itself was traumatic, which I gather is an uncommon experience. I've been through a lot of medical stuff in my life and wasn't afraid of it at all.

I aspirated very badly during the procedure, apparently. Woke up totally unable to breathe, with my oxygen sat in the low 80s. Nurses on the floor freaked out, which also then naturally freaked me out. Spent the next week coughing up the nastiest tasting lung fluid ever.

All in all it's fine, I'm fine, but once again that experience just surprised me so much. I expected it to be no big deal, and it was actually hell.

Now I'm a bit scared for the upcoming tests. I need an echocardiogram and a cardiac (chemical) stress test. Now, my genetic disorder DOES mess with the heart, so I'm petrified that I'll get yet another surprising diagnosis from that. I'm also just straight up afraid of the chemical stress test in a way I've never been afraid of a procedure before.

Chest X-ray, abdominal X-ray, abdominal ultrasound, and barium swallow all completed already, leading to the above findings. Psych eval passed. Barium swallow was gross but otherwise an ok experience (except that they had me flopping all around the table to 'coat my stomach completely.' Little bit embarrassing when you're out of shape, it's hard to roll over, and the too-small hospital gown is riding up your backside. Oh well.)

I need a DEXA scan for documentation purposes, I guess. That should be no big deal.

And finally (which I should've actually had done first), I need a METRIC TON of labs. It seems like he wants every lab known to man, which is fair. But the horrid part is that no one can ever find a vein on me. Lab draws turn into multiple hour affairs where they have to bring in the King or Queen Phlebotomist and also an ultrasound machine. Absolutely dreading the lab work and also trying to find some place better than the local LabCorps, which all have totally horrific reviews.

Sorry, this actually ended up being more complaining than I thought. I actually feel like this is going fairly well -- I've just had a few surprises along the way, and I'm so very anxious that I won't be able to get the switch for some reason.

I've also had abdominal surgeries before, and I'm afraid they'll find too much scar tissue and have to do only VSG.

AAAAAAAAAAAAAAA

So, yeah. Continuing to try to lose this post-op weight and not get too anxious.

 

[Cthulurscon]

Should have added: yes, I know regular lab work is a commitment for life with DS. Yes, I'm going to stay compliant with that. But I'm also going to dread it! And I do need to find a place that isn't totally horrible to have it done regularly.

I do already have one place in mind, just need to call and ask what days their professional phlebotomist comes in.

 

[southernlady]

Being fat but fit is a fallacy. Even if we are in our younger years, it bites us in the butt later on. I was overweight most of my younger years, only crossing into obesity in my 40’s. But even after 13 years of having the DS, I’m still paying for my years of stupidity.

I’m sorry your endoscopy was so traumatic. With a diagnosis of Bile Reflux, that means the SADI is automatically off the table. That’s good for you.

As far as scar tissue, request they convert to open instead of lap if they run into too much scar tissue. That should allow them to complete the DS. It will mean a different recovery but you would still have the surgery you want and recovery from an open is doable. I’ve had an open abdominal surgery, it wasn’t a DS but it was a partial hysterectomy. If you do end up with open, give me a shout and I’ll give you some tips on healing.

 

[JackieOnLine]

I'm a little bit upset. It was just surprising to hear I had all these issues. I'm listed as "morbidly obese with multiple co-morbidities" on the paperwork, and that's been slightly hard to wrap my head around. I truly thought I was "just" morbidly obese.

it's so hard!

Sorry, this actually ended up being more complaining than I thought. I actually feel like this is going fairly well -- I've just had a few surprises along the way, and I'm so very anxious that I won't be able to get the switch for some reason.

vent here all you want, that's one of the reasons we are here! Anxiety is normal.

 

[aaa]

Making a thread to write about my journey to getting a DS (hopefully) -- hopefully that's okay.

I've posted once before about being suggested a long CC length.

So, pre-op meetings for insurance requirements have been going well. I needed a consult, then 3 appointments with the surgeon and 1 with his dietician. 3/4 of those meetings are done now -- just have my last one on March 22.

I need to lose 32 pounds by surgery date, whenever that is (10% of body weight.) I started the program at 321 on December 15, and as of today 2/18/24 I'm at 299. 10 more to go until 289 goal. I'm trying to make it before the March 22nd meeting, but we'll have to see.

All the medical clearances have been a bit of a headache. I'm a medical nightmare for other reasons (genetic disorder), but I honestly thought I was a healthy fat person, owing mostly to being only 26. I thought it hadn't caught up with me yet, especially since I haven't been fat my whole life (basically only since college.)

Well.

Turns out I have:

• NAFLD
• GERD
• Bile reflux
• Acid reflux (this I knew about at least)
• A hiatal hernia

I'm a little bit upset. It was just surprising to hear I had all these issues. I'm listed as "morbidly obese with multiple co-morbidities" on the paperwork, and that's been slightly hard to wrap my head around. I truly thought I was "just" morbidly obese.

The EGD itself was traumatic, which I gather is an uncommon experience. I've been through a lot of medical stuff in my life and wasn't afraid of it at all.

I aspirated very badly during the procedure, apparently. Woke up totally unable to breathe, with my oxygen sat in the low 80s. Nurses on the floor freaked out, which also then naturally freaked me out. Spent the next week coughing up the nastiest tasting lung fluid ever.

All in all it's fine, I'm fine, but once again that experience just surprised me so much. I expected it to be no big deal, and it was actually hell.

Now I'm a bit scared for the upcoming tests. I need an echocardiogram and a cardiac (chemical) stress test. Now, my genetic disorder DOES mess with the heart, so I'm petrified that I'll get yet another surprising diagnosis from that. I'm also just straight up afraid of the chemical stress test in a way I've never been afraid of a procedure before.

Chest X-ray, abdominal X-ray, abdominal ultrasound, and barium swallow all completed already, leading to the above findings. Psych eval passed. Barium swallow was gross but otherwise an ok experience (except that they had me flopping all around the table to 'coat my stomach completely.' Little bit embarrassing when you're out of shape, it's hard to roll over, and the too-small hospital gown is riding up your backside. Oh well.)

I need a DEXA scan for documentation purposes, I guess. That should be no big deal.

And finally (which I should've actually had done first), I need a METRIC TON of labs. It seems like he wants every lab known to man, which is fair. But the horrid part is that no one can ever find a vein on me. Lab draws turn into multiple hour affairs where they have to bring in the King or Queen Phlebotomist and also an ultrasound machine. Absolutely dreading the lab work and also trying to find some place better than the local LabCorps, which all have totally horrific reviews.

Sorry, this actually ended up being more complaining than I thought. I actually feel like this is going fairly well -- I've just had a few surprises along the way, and I'm so very anxious that I won't be able to get the switch for some reason.

I've also had abdominal surgeries before, and I'm afraid they'll find too much scar tissue and have to do only VSG.

AAAAAAAAAAAAAAA

So, yeah. Continuing to try to lose this post-op weight and not get too anxious.

The Dexa is a good idea. So you have a preop baseline.

Next time ask for 2 gowns. One opening in the front and one in the back. That stops your butt from hanging out.

 

[aaa]

Being fat but fit is a fallacy. Even if we are in our younger years, it bites us in the butt later on. I was overweight most of my younger years, only crossing into obesity in my 40’s. But even after 13 years of having the DS, I’m still paying for my years of stupidity.

I’m sorry your endoscopy was so traumatic. With a diagnosis of Bile Reflux, that means the SADI is automatically off the table. That’s good for you.

As far as scar tissue, request they convert to open instead of lap if they run into too much scar tissue. That should allow them to complete the DS. It will mean a different recovery but you would still have the surgery you want and recovery from an open is doable. I’ve had an open abdominal surgery, it wasn’t a DS but it was a partial hysterectomy. If you do end up with open, give me a shout and I’ll give you some tips on healing.

If she has GERD, wouldn’t anything with a sleeve component become more difficult? Or does it mean PPIs for assistanc?

 

[southernlady]

If she has GERD, wouldn’t anything with a sleeve component become more difficult? Or does it mean PPIs for assistanc?

Yes, but it also depends on how tight her sleeve is made.

 

[Cthulurscon]

Yes, but it also depends on how tight her sleeve is made.

Srikanth said 36 French bougie. I understand that's pretty small. I asked if he thought that would make the gerd/reflux worse (I had no idea I had gerd actually) and he said given that they were going to also do hiatal hernia repair, probably not. Idk

He did also tell me to start taking Omeprazole so insurance will cover any future treatments for gerd/reflux (idk what that would be.) Apparently my insurance won't cover anything related unless I'm on PPIs.

 

[Cthulurscon]

If she has GERD, wouldn’t anything with a sleeve component become more difficult? Or does it mean PPIs for assistance?

He said DS was the best procedure to fix bile reflux. I take it I have several issues that contraindicate each other. DS seems like the best option even if the sleeve might be a bit of an issue... I'm hoping not. I'm not interested in bypass.

 

[southernlady]

He said DS was the best procedure to fix bile reflux. I take it I have several issues that contraindicate each other. DS seems like the best option even if the sleeve might be a bit of an issue... I'm hoping not. I'm not interested in bypass.

It is, for those who got the SADI and developed bile reflux the only cure us a revision to the DS.

I had GERD preop, was already on Prevacid. Omeprazole did nothing for me. The first surgeon I saw was an asshat, tried to “force” me into a RNY because of the GERD issue. I asked, well, what about my requirement for an NSAID (for life), his response was, well just take opioids. I fired him.

 

[Cthulurscon]

It is, for those who got the SADI and developed bile reflux the only cure us a revision to the DS.

I had GERD preop, was already on Prevacid. Omeprazole did nothing for me. The first surgeon I saw was an asshat, tried to “force” me into a RNY because of the GERD issue. I asked, well, what about my requirement for an NSAID (for life), his response was, well just take opioids. I fired him.

Yeah... I can be off NSAIDS for a while but not forever. Like I mentioned, I have a genetic issue which requires lifelong management. Medication restrictions forever are not an option.

So bypass is out. (I also think it's not very effective, but anyway...)

I would settle for sleeve if they got in there and truly couldn't do anything else. But like you said, I think I'd probably prefer they just go open at that point. I want the obese part of my life to be over forever.

 

[galaxygrrl]

The DS is the best decision I ever made! I did not need any of these tests and I don't even know what some of them.

Here is what I know,

(1) you will be much healthier
(2) you willl feel physically better.
(3) People will treat you better
(4) you will be able to be much more physical.
(5) you will have more dates.
(6) you will be happier
(7) you will live longer

Just think about the outcome as you slog through the pre-ops stuff.

We are here to be supportive.

 

[southernlady]

I would settle for sleeve if they got in there and truly couldn't do anything else. But like you said, I think I'd probably prefer they just go open at that point. I want the obese part of my life to be over forever.

Make sure that’s in your surgical clearance and witnessed by someone of your choosing (not in their office but an outsider) and get a copy before leaving the office. That way you have a copy of what you signed. And let your family that will be at the hospital with you Have a copy and know your exact wishes.

 

[navygrrl]

My husband had horrible GERD and getting his hiatal hernia fixed solved that issue for him. If that info helps any.

 

[southernlady]

I had a hiatal hernia repair a year ago and while it’s helped greatly, I still have mild GERD.