tracyringo

erosive esophagitis

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I was diagnosed with erosive esophagitis a little over 3 months ago and went back for the 2nd EGD after my PPI being raised to 60 mg.  I didn't get better and am being sent back to my surgeon who performed my VSG.  I go in on the 2nd of Jan.  I was totally out of it after the EGD so of course I don't remember anything they said other then I was still swollen and the meds didn't work.  I guess I am wondering if this has happened to any of you guys and am I being sent to the surgeon for a revision or is there something else they can do?  

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That's the problem with VSG (and also with lap band): reflux. When the meds don't work there is not much you can do, especially if your EGD was still not good.

I fear conversion to bypass is not that uncommon after VSG or lap band.

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5 hours ago, summerset said:

That's the problem with VSG (and also with lap band): reflux. When the meds don't work there is not much you can do, especially if your EGD was still not good.

I fear conversion to bypass is not that uncommon after VSG or lap band.

I see you had a revision was it for something similar and how are you doing now?

 

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Yes, it was of reflux and the band beginning to erode into the stomach already. I was quite happy with my MGB before my hernia got back and part of the reflux. They want to perform another revision, including hiatoplastic and gastropexia. I'm still not sure if I really want to do it since I have some symptoms but I don't even take PPI regularly and the last two EGDs showed no inflammation so there is no need to hurry. Bile reflux or mixed reflux doesn't necessarily cause as much inflammation as the acidic reflux (don't ask me for the reason, I have no idea why that is).

Mind you, usually the classic RNY is the way to go with reflux. There were reasons they went for MGB though, but it's not common.

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Just got back from the surgeons office and am having the By Pass done at the end of February.  Not quite sure how I feel about it.

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1 hour ago, tracyringo said:

Just got back from the surgeons office and am having the By Pass done at the end of February.  Not quite sure how I feel about it.

Sorry you have to have additional surgery, but glad you're going to have a "fix" for your reflux issues.  I have had reflux issues, but symptoms are controlled with a low dose ppi.  I do have a significant hiatal hernia which is new so I need to decide whether to have that fixed or just go ahead with revision while they're in there.  Don't really want a revision if I don't have to.  I will be interested to hear how you do post-op and what your experiences are with bypass vs what they are with your sleeve.  I wish you well as you go through this again.

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3 hours ago, msmarymac said:

Sorry you have to have additional surgery, but glad you're going to have a "fix" for your reflux issues.  I have had reflux issues, but symptoms are controlled with a low dose ppi.  I do have a significant hiatal hernia which is new so I need to decide whether to have that fixed or just go ahead with revision while they're in there.  Don't really want a revision if I don't have to.  I will be interested to hear how you do post-op and what your experiences are with bypass vs what they are with your sleeve.  I wish you well as you go through this again.

I suppose we are close to the same situation.  He said I could wait and its not emergency, but in the end I will need it.  Hoping this will fix the esophagitis.  I don't have to do the liquid diet he said I lost enough weight.  You had mentioned awhile back you may do this too?  Do you have ulcers or the esophagitis?

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That's kind of what my surgeon said as well: one can postpone because EGD was ok but usually most patients are not able to cope endlessly. 

I remember postponing going from lap band to MGB for a whole year. In the end I regretted it but I was so afraid of the whole process, including insurance company issues. Now there is no talk about insurance having to give the ok. So might as well schedule the revision in time instead of waiting a year because of fear and maybe causing some damage during this time. I don't want to know what postposing for a year did to my lower esophagus in the long run...

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3 hours ago, tracyringo said:

I suppose we are close to the same situation.  He said I could wait and its not emergency, but in the end I will need it.  Hoping this will fix the esophagitis.  I don't have to do the liquid diet he said I lost enough weight.  You had mentioned awhile back you may do this too?  Do you have ulcers or the esophagitis?

I think you have had far worse symptoms than I have; it sounds like you have really been suffering!  I don't have ulcers or esophagitis and my symptoms are controlled with 20mg of Nexium daily.  I worry about being on a ppi long-term though.  When I try to go off the Nexium I wake up choking on acid in the night.  So, with the hiatal hernia now my dilemma is do I just fix that and take a chance that the GERD will continue, requiring a revision sometime in the future?  Or should I just do the revision and fix the hernia now and get it over with.  My yearly follow up appointment is in about 3 weeks so I'll have another conversation with my surgeon.  Last year when I discovered the hiatal hernia I had just had shoulder surgery so really wasn't able to do any other surgery.  Now I just don't want to lol.  I think if I had the level of symptoms you have it wouldn't be as difficult to decide though.  I feel bad for you and hope all goes well!

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17 minutes ago, msmarymac said:

I think you have had far worse symptoms than I have; it sounds like you have really been suffering!  I don't have ulcers or esophagitis and my symptoms are controlled with 20mg of Nexium daily.  I worry about being on a ppi long-term though.  When I try to go off the Nexium I wake up choking on acid in the night.  So, with the hiatal hernia now my dilemma is do I just fix that and take a chance that the GERD will continue, requiring a revision sometime in the future?  Or should I just do the revision and fix the hernia now and get it over with.  My yearly follow up appointment is in about 3 weeks so I'll have another conversation with my surgeon.  Last year when I discovered the hiatal hernia I had just had shoulder surgery so really wasn't able to do any other surgery.  Now I just don't want to lol.  I think if I had the level of symptoms you have it wouldn't be as difficult to decide though.  I feel bad for you and hope all goes well!

Thank you.  Don't feel bad, I feel fine a lot of the time.  That is why I am unsure about the whole thing.  I am also scared to have Bypass.  I know most folks do just fine with it but its the stuff that may come later that concerns me.  It wont hurt me to lose another 20 lbs its just that I have gotten use to being able to eat a portion size and now I will be going back to nothing lol. I worry about the stoma or what is going to happen with my teeth ?   Stuff like that

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3 hours ago, summerset said:

That's kind of what my surgeon said as well: one can postpone because EGD was ok but usually most patients are not able to cope endlessly. 

I remember postponing going from lap band to MGB for a whole year. In the end I regretted it but I was so afraid of the whole process, including insurance company issues. Now there is no talk about insurance having to give the ok. So might as well schedule the revision in time instead of waiting a year because of fear and maybe causing some damage during this time. I don't want to know what postposing for a year did to my lower esophagus in the long run...

Ugh, hopefully your esophagus is okay.  I myself am just afraid but I am sure all will be fine.  So you feel better now?

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Better than with the band? Yes, absolutely.

It's this (maybe irrational) fear of "having done unseen damage that can't be undone" - like something to the lower esophagus sphincter or something... who knows? But then again there are so many, many people with reflux and esophagitis and hernia out there who never had WLS...

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15 hours ago, tracyringo said:

Thank you.  Don't feel bad, I feel fine a lot of the time.  That is why I am unsure about the whole thing.  I am also scared to have Bypass.  I know most folks do just fine with it but its the stuff that may come later that concerns me.  It wont hurt me to lose another 20 lbs its just that I have gotten use to being able to eat a portion size and now I will be going back to nothing lol. I worry about the stoma or what is going to happen with my teeth ?   Stuff like that

I completely understand, I am hesitant to have bypass as well.  I don't know that it's a logical fear given all the data and the wonderful first hand reports here.  I just know my sleeve and what I can tolerate and hate to start over I guess.  I am successfully maintaining and can have the occasional treat.  What if I become one of those bypassers who dump on the tiniest bit of simple carb? Or have problems with iron levels.  I suffer with Restless Leg Syndrome when my Ferritin level gets to low normal so even without absorption issues I struggle. However, I don't want to have surgery to fix the hiatal hernia and then a few years down the road determine that I need to have a revision because the GERD continued anyway.  I sure wish my crystal ball was working lol.  I'm sorry, I didn't at all intend to make my reply about me, and here I am whining.  I just wanted to convey how much I relate to your situation; I don't have any answers but I sure do empathize.

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1 hour ago, msmarymac said:

I completely understand, I am hesitant to have bypass as well.  I don't know that it's a logical fear given all the data and the wonderful first hand reports here.  I just know my sleeve and what I can tolerate and hate to start over I guess.  I am successfully maintaining and can have the occasional treat.  What if I become one of those bypassers who dump on the tiniest bit of simple carb? Or have problems with iron levels.  I suffer with Restless Leg Syndrome when my Ferritin level gets to low normal so even without absorption issues I struggle. However, I don't want to have surgery to fix the hiatal hernia and then a few years down the road determine that I need to have a revision because the GERD continued anyway.  I sure wish my crystal ball was working lol.  I'm sorry, I didn't at all intend to make my reply about me, and here I am whining.  I just wanted to convey how much I relate to your situation; I don't have any answers but I sure do empathize.

I don't mind hearing your story and picking out or similarities, it actually helps.  I think I will go see my Dr. and see what she has to say about all of this.

Had I not made my goal or if I was struggling with regain we probably would not be having this conversation and like you I actually like my sleeve.  I have a medical problems with my back and neck and worry if medicine will work if I need them.  I rarely take anything but when I do I really need it.  There is a lot more to consider then just the Gerd and esophagitis especially if I can be comfortable for the most part taking the PPI and I see you have done this for years now.  I also have a hernia and he didn't say if it had gotten any bigger.  I didn't have it when I had the VSG but they found it in an EDG 2 months post op when I was feeling like food was stuck in my throat.

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Same here, I have disc issues in my neck and sometimes just need an NSAID.  I didn't have the hiatal hernia at surgery either, and actually didn't have GERD for the first couple of years or so.  That makes me think the GERD might be from the development of the hiatal hernia so fixing it might fix the GERD.  If not for those studies coming out showing it's really not great for us to be on PPI's forever, it would be a no-brainer for me...I would just fix the HH and stay on the Nexium if needed.  But they did so I want to do what puts my future health in the best shape; that's why I did all this after all.  You're right, lots to think about. 

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3 hours ago, msmarymac said:

I sure wish my crystal ball was working lol. 

Yeah, I wish mine would work, too. LOL.

I'm so scared of the surgery and possible complications. That's maybe the main reason I also didn't have plastics so far.

Edited by summerset

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