Ken C.

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Hard to believe how smoothly things have gone. I've lost 31 lbs and have few regrets about having WLS My only discomfort has been eating pork and beef, but only in excess of 4 ounces. No soda pop, I thought that would be the hardest thing to give up and yet I seemed to do fine with lemonade (zero calories) or tea. When I drink milk it seems to best when ice cold. Seems like I am able to tolerate most anything now. A couple times I've had pain and slight nausea when over eating, that keeps me motivated to stop that behavior! It usually subsides in about an hour. Eating out is when I eat too quickly and feel the most pressured to over indulge. Also giving up fluids is altogether impossible with meals, I usually drink about 1 ounces over the course of 30 minutes. I know drinking fluids is a no no with meals though.

My 34 inch jeans are starting to get loose around the waist! People have commented on my weight loss, but actually I don't think much about it anymore. Appearance is not as important as health, my cholesterol is down and I am feeling good! I try to stay active and exercise about 40 minutes a day. 

Hope whoever reads this doesn't think it is easy, but weight loss has been a struggle for the last 15 years. Now I am off CPAP and doing well.

There is a gradual return to the new normal of 2-3 ounces stomach volume for me at 3 weeks, much better than the first week of surgery. I've been doing some research on the Pyloric valve and advanced to a soft diet now. No drinking fluids with meals has been hard for me and I wanted to understand why, so here we go!

Now for the anatomy and physiology lesson: the Pyloric Valve and how it pertains to my revised stomach after the VSG. Not sure, but if you did not have the sleeve surgery, what follows may need some further discussion with your surgeon.

The function of your Pyloric valve is part of understanding how and when you should eat and drink following gastric sleeve surgery: it is a valve that is located at the bottom of your stomach/sleeve. This valve is in between your sleeve and the lower intestine. When open this valve it is about the diameter of a dime, when closed it’s about the diameter of the head of a ballpoint pen. Dense proteins and harder to digest foods will cause the Pyloric valve to close to hold the food in your stomach for pre-digestion...... stomach acids breaking down food. That’s why we are told to eat dense proteins first.....In order to close the Pyloric Valve so food stays in your stomach/sleeve longer and we get a sense of hunger relief and satisfaction. It takes about 30-60 minutes for the food to clear the Pyloric Valve. After that it’s OK to drink.

That is also where the term slider food comes into play. A slider food does not close the Pyloric Valve and as the term is intended.....food slides right past an open Pyloric Valve. IF you eat apple sauce and drink water on top of the apple sauce to dilute it... the diluted apple sauce runs through faster.

Now for the top of the stomach. The esophageal sphincter (valve) is at the entry into the stomach and works like a flapper valve. The function of these two valves is to hold food, bile and stomach acids in your stomach and the esophageal sphincter keeps food from not backing up into your esophagus (source of esophageal reflux pain or burning for some people when not working) or into the air way (aspiration pneumonia). This is a very high pressure system. Burning pain at night is usually caused by esophageal reflux and can be relieved by elevating the head of the bed.

A gastric sleeve empties faster than a unaltered full size stomach so sometimes it’s beneficial for you to learn what foods stay in your sleeve longer to extend satisfaction. Dense proteins are #1 in closing the Pyloric Valve. Chicken, steak, pork, fish.... other foods that are hard to digest and help close the Pyloric Valve are foods like: Broccoli Stalk Asparagus Celery Cucumber with Skin Radish Cabbage (I’m not testing this right now).

Went to my first postoperative appointment and was a little dehydrated. We ran 1000 ml NS over a couple hours and feel a little better. I think this will really help me feel better, I just wasn't getting enough oral fluids down. I came off Zofran yesterday, not much nausea today. I am on my own now, don't return for 3 weeks.

I called in the nausea issue yesterday and was placed on a regular schedule of oral Zorfran. It is better. It is really difficult to keep up with fluid intake tho. I feel distended after a couple sips. Everything has a different taste to it, even water. So I tried sugarless popsickle - too strong tasting - also jello (same). Boring protein shakes, but I try and keep up.

Anyway, I followed preop diet for 2 weeks (puréed type) and was told the actual surgery time was only 45-50 minutes and my stomach and liver were easily manipulated to complete the procedure! I only wish recovery was easier. Some of you hardly reported any issues and even went back to work after a few days! Definitely not my situation. I have good blood pressure (112/74), but fatigue easily on walking.

i can't wait to heal up and get over this period. I long for naps and escape this discomfort whenever I can. Clinic visit is in 2 days.

A little nausea still. More like a sour stomach all the time. No energy, barely can consume 3 oz skim milk. I stopped dilaudid tabs, now just take Tylenol. I'll go for a walk outside today.

I've been home 2 days now. Nausea still there. Tried Zofran, Compazine and Phenegran. Nothing seems to help. Currently on Prilosec 2014 and that does nothing. Very discouraged. 

Still in the hospital,  but yesterday had unenthusiastic response to anesthetic medications. Nausea that wouldn't respond to Zofran.  Pain was fine though. Hope to go home this afternoon.  JP drain will need to come out. 

It is 4am so in about 90 minutes we leave for the surgery center. My preop weight is 217 lbs, down from 232 when I started out. I have been following a preop diet for 2 weeks. This isn't as scary as I thought it would be. 

Can't believe it has been nearly 7 months since starting this whole process of looking into the surgery. I knew little about the different types of procedures and all of the insurance caveats. This is despite three siblings and a parent who underwent some sort of surgical treatment of obesity. 

It is scary thinking about walking into the hospital and having the IV started and stretching out in a gurney. I've never had surgery of any kind before.  I worry about how hard it will be to keep hydrated and the postoperative pain. I sure don't want nausea.

What am I doing to prepare? The last 12 days I have been on a puréed diet. Most days using the blender, but often eating higher protein soups. We bought an expensive elliptical about 2 years ago, to be honest haven't used it much until the preop plan called for exercise everyday. While not using religiously, took off about 12 lbs and I couldn't take much more off as I barely qualified for the surgery. 

Pre-approval didn't really take too long, about 10 days (submitted after 6 months of nutrition support with daily diaries). I originally went to the bariatric center in Sept '13, not really sure of what I wanted. My family is all obese, with siblings having surgery at some point in their lives. My weight was normal up to about age 42, where I gained about 4 lbs a year that never came off. Currently I am 57 years old, my start date BMI was 37, but I was eligible because of obstructive sleep apnea. My major motivation for the surgery is to come off a CPAP machine.

My past attempts at losing weight have included weight watchers and self medication with OTC diet pills and fad diets. At one time I lost 40 lbs, but gained it back! The problem was mostly evening time hunger and snacking. Basically I work at a office so not much daily activity.

As of the time of this posting, I am day 3 of a 14 day preop diet that consists of mostly blended foods capped at 1200 cal per day. My VSG surgery is scheduled for Mar 11, 2014 so that is coming up soon. My weight loss during the last 6 months has been about 12 lbs and my BMI is 35.1 which is the bare minimum to qualify for surgery for our health insurance.

My biggest challenge to date has been exercise as we live in a cold climate in a rural area, temps below zero the last 4 months. No motivation to walk in that weather. I've been using an elliptical exercise machine for about 30 minutes a day. I've developed a routine of using the elliptical in the AM followed by a protein shake. Occasionally I will have oatmeal. 

A bit scared about upcoming surgery, but my wife is supportive.