biopsy results, changing plans, many questions

unavidanueva

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So, I haven't posted in a few days because everything is going a little topsy turvy and I've been trying to sort it all out.

The biopsy results came back from my colonoscopy. The gastro had biopsied three shiny spots, and they showed mild to moderate colitis.

The DS surgeon's office had flagged the results, then called to ask me to describe my bowel symptoms. I told them the truth. I'd had a hard time getting back to normal after the colonoscopy, so I started taking probiotics. Everything got better, and a normal day for me was 3-4 formed BMs, no urgency. But before the colonoscopy, I'd been having unpleasant symptoms for a while. I'd go 6-8 times a day, progressively looser as the day went on, ending up as diarrhea with urgency. This was going on pretty much daily since at least mid April.

After that conversation, I did a lot of thinking, and realized, oh my, I was feeling so much better -- so WELL. When I was symptomatic before the procedure, I would feel sick every afternoon, had no energy, ended up lying on the bed, wiped out and in pain.

The gastro office called, I have an appointment to see them this week to talk about the test results.

The surgeon's office called back. Dr. Prachand is concerned about the severity of the colitis symptoms, that the combination of a colitis flare with the loose stools that can come with the DS, especially early on, could dehydrate me so severely that I might end up in the ER and possibly in a situation so serious that they could need to take down my surgery. He does not want to do the DS at this point, thinks the sleeve would be better for my overall health, given the colitis symptoms.

Two days later, the colitis flared again for two days. I was miserable, no energy, feeling awful, back to lying in bed, sick, all afternoon. Point taken.

Flare seems resolved, back to feeling ok for two days now.

So. I obviously need Thursday's gastro appointment. This tendency toward loose stools and urgency seems to run in my family, and I've had it off and on for years. I guess I accepted it as just my family's version of normal. But my 2-3 weeks of freedom from those symptoms were so liberating.

I have the pre-op prep day at the hospital next week (@hilary1617, is this the mindful blueberry meeting?), and a surgery date of September 4.

I've been mentally working toward the DS since the end of May. Now I'm trying to wrap my brain around this change. It's not necessarily a bad thing. I need to be healthy, in all aspects, and need to see what causes this colitis and how to control it. Eating for the sleeve, while perhaps more challenging than eating for the DS, may be a good thing because it will be an across the board, mom-and-kids-together thing that should also help my currently-too-chunky 11-year-old son. But I need to re-train my brain, because I've spent 2+ months anticipating eating for the DS.

I'd love to hear from any of you who are "just" sleeved. I checked out a few sleeve support pages on fb, and ... this sounds like a terrible thing to say even as I type it, but the people posting on those pages just weren't very bright. I much prefer the level of thinking/writing around here, even though I won't quite fit in with the majority of you who already have the DS.

Also, I have been approved by my insurance for the entire DS, so this surgery will go on the books as the first part of a staged DS. If I need the second stage later, and we have figured out the colitis by then, it will still be an option.

Thanks for listening.
 
I'm 100% in agreement with your decision Unavidanueva. I applaud you for not simply trying to ram through the procedure in your desperation to be thin. Absorption can be markedly reduced in patients with severe colitis, Chrones disease, ulcerations,etc. The last thing you need is life threatening dehydration! I also have a friend who lost 18 inches of his colon from severe colitis and complications related to it. You MUST be cautious here. If you figure things out later and the DS is an acceptable course for you...great! It it can't happen because of your medical condition....won't you be soooo glad you didn't have it now?! The sleeve is going to be awesome for you and you CAN lose very well with it. If you continue to listen to the sage advice offered by these angelic vets here, your prognosis is excellent I'd say to lose most if not all of your excess weight. My prayers are with you going forward! I know it's all gonna work out just great for you. :)
 
@unavidanueva I am sorry for your diagnosis but I suspect your surgeon is correct. With these issues in place your best bet is the VSG. And while it doesn't have the malabsorption to help you later on, it also doesn't have the malabsorption that could HURT you later on...

But you can join @JackieOnLine, @Jo777, and @more2adore on their journey. There are others but I can't remember all off hand.
 
@unavidanueva, yes, I think you may be eating dried cranberries "mindfully" at that session... I'm sorry for the colitis diagnosis - that doesn't sound like fun at all. Do they have a handle on the underlying cause in your case? If it is an infection, maybe you could get that resolved and then go for full DS afterwards?

Wishing you the best!
 
Hey @unavidanueva! Really sorry about your colitis diagnosis, but at least you know what's happening. :( I'm also sorry you can't get the DS - I know how that feels! But I've done very well so far with the VSG - more than 80 pounds lost since my sleeve surgery at the end of March (so just over 4 months ago). It is possible to do well with the sleeve, especially initially - it's regain that can be a LOT more challenging without a DS to help with malabsorption during maintenance. Let me know if you have any questions - always happy to chat with you!
 
I think the big question is what is your actual diagnosis. Colitis is a catch-all term. On the one hand, if you have ulcerative colitis, the DS may truly be a bad idea, and the sleeve the best possible alternative. On the other hand, if this is IBS (irritable bowel syndrome, which is also somewhat of a catch-all diagnosis when nothing more specific can be found) the DS might work out just fine.
I agree completely that this is something if great importance to discuss with the gastro. I suspect they will urge caution, but I hope they can also pin down for you what is causing the colitis and how best to treat it, and not just that you should or shouldn't have the DS. You have a problem that is clearly not caused by bariatric surgery (since you are pre-op) and just telling what surgery to have or not have isn't enough. You need treatment. I would be somewhat concerned about this being ulcerative colitis since that can run in families (as can Crohn's disease, which is related) but that's not a diagnosis. They need to pin this down for you no matter what surgery you have.
 
I think the big question is what is your actual diagnosis. Colitis is a catch-all term. On the one hand, if you have ulcerative colitis, the DS may truly be a bad idea, and the sleeve the best possible alternative. On the other hand, if this is IBS (irritable bowel syndrome, which is also somewhat of a catch-all diagnosis when nothing more specific can be found) the DS might work out just fine.
I agree completely that this is something if great importance to discuss with the gastro. I suspect they will urge caution, but I hope they can also pin down for you what is causing the colitis and how best to treat it, and not just that you should or shouldn't have the DS. You have a problem that is clearly not caused by bariatric surgery (since you are pre-op) and just telling what surgery to have or not have isn't enough. You need treatment. I would be somewhat concerned about this being ulcerative colitis since that can run in families (as can Crohn's disease, which is related) but that's not a diagnosis. They need to pin this down for you no matter what surgery you have.
That is such a great post Larra. GI's are not my favorite Docs in the world, at least not the ones I have come in contact with because they are ultra conservative with diagnosing GI disease/issues. I tend to believe it is because they don't know, but they need to do testing to at a minimum rule out everything possible when people present with IBS type symptoms and not simply tell people to adjust their diet or worse yet in Diva's case, don't have the DS because we think it might be this........accurately and definitively diagnose the problem...that is what you were trained to do.

Sorry, this stuff ticks me off because both my sons have GI issues that the GI Docs didn't do squat to definitively diagnose. My youngest Collin is still having issues that we have so far been unable to get any help with.
 
So, I haven't posted in a few days because everything is going a little topsy turvy and I've been trying to sort it all out.

The biopsy results came back from my colonoscopy. The gastro had biopsied three shiny spots, and they showed mild to moderate colitis.

The DS surgeon's office had flagged the results, then called to ask me to describe my bowel symptoms. I told them the truth. I'd had a hard time getting back to normal after the colonoscopy, so I started taking probiotics. Everything got better, and a normal day for me was 3-4 formed BMs, no urgency. But before the colonoscopy, I'd been having unpleasant symptoms for a while. I'd go 6-8 times a day, progressively looser as the day went on, ending up as diarrhea with urgency. This was going on pretty much daily since at least mid April.

After that conversation, I did a lot of thinking, and realized, oh my, I was feeling so much better -- so WELL. When I was symptomatic before the procedure, I would feel sick every afternoon, had no energy, ended up lying on the bed, wiped out and in pain.

The gastro office called, I have an appointment to see them this week to talk about the test results.

The surgeon's office called back. Dr. Prachand is concerned about the severity of the colitis symptoms, that the combination of a colitis flare with the loose stools that can come with the DS, especially early on, could dehydrate me so severely that I might end up in the ER and possibly in a situation so serious that they could need to take down my surgery. He does not want to do the DS at this point, thinks the sleeve would be better for my overall health, given the colitis symptoms.

Two days later, the colitis flared again for two days. I was miserable, no energy, feeling awful, back to lying in bed, sick, all afternoon. Point taken.

Flare seems resolved, back to feeling ok for two days now.

So. I obviously need Thursday's gastro appointment. This tendency toward loose stools and urgency seems to run in my family, and I've had it off and on for years. I guess I accepted it as just my family's version of normal. But my 2-3 weeks of freedom from those symptoms were so liberating.

I have the pre-op prep day at the hospital next week (@hilary1617, is this the mindful blueberry meeting?), and a surgery date of September 4.

I've been mentally working toward the DS since the end of May. Now I'm trying to wrap my brain around this change. It's not necessarily a bad thing. I need to be healthy, in all aspects, and need to see what causes this colitis and how to control it. Eating for the sleeve, while perhaps more challenging than eating for the DS, may be a good thing because it will be an across the board, mom-and-kids-together thing that should also help my currently-too-chunky 11-year-old son. But I need to re-train my brain, because I've spent 2+ months anticipating eating for the DS.

I'd love to hear from any of you who are "just" sleeved. I checked out a few sleeve support pages on fb, and ... this sounds like a terrible thing to say even as I type it, but the people posting on those pages just weren't very bright. I much prefer the level of thinking/writing around here, even though I won't quite fit in with the majority of you who already have the DS.

Also, I have been approved by my insurance for the entire DS, so this surgery will go on the books as the first part of a staged DS. If I need the second stage later, and we have figured out the colitis by then, it will still be an option.

Thanks for listening.
You say you had 2-3 weeks of freedom from symptoms. Were you given a med that gave you relief? If so are you still on it?

IBS symptoms suck so I hope the GI gets a diagnosis and solid plan of treatment for you quickly.

Best of luck
 
You say you had 2-3 weeks of freedom from symptoms. Were you given a med that gave you relief? If so are you still on it?

IBS symptoms suck so I hope the GI gets a diagnosis and solid plan of treatment for you quickly.

Best of luck

I wasn't given any meds. After my colonoscopy, my body didn't want to let go of the colonoscopy-prep-style diarrhea. I was googling that, and read that some people were helped in getting back to normal by taking probiotics, so that's what I did.

As I've been reading about colitis this week, I came across something I had never learned before. I had never learned the difference between IBS and all these other possible bowel issues. It seems IBS is when the bowel suffers spasms. The other issues -- colitis, Crohn's, IBD -- involve inflammation inside the bowels.
 
I just saw the gastro doc. My colitis path report shows that my symptoms do not clearly match any one category. He thinks the closest match is to microscopic colitis, but again, I don't show everything that should be there if that were the correct diagnosis. Next steps: a blood test to see if I show genetic markers for Crohn's or IBD; and twice daily doses of Pepto for two months to try to get the inflammation (and diarrhea) under control.

I asked him, could this be caused by something I'm eating, could it be a food allergy? Nope. Apparently not with what they found in the biopsy. It more closely resembles an auto-immune disorder.

He said it should not stand in the way of my scheduled sleeve on Sept 4, and he agrees with the surgeon that with this going on, I should not have the DS at this point.
 
Hi @unavidanueva, I'm one of the other sleevers active here from time to time!

Sorry to hear about the last min need to change directions, but having a very, very heavy family history of GI problems myself, I applaud you for accepting the change, and understanding that it may only be a delay of the DS if everything goes well.
 

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