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3 year down the line, possible complications?

So it's been 3 years since my bypass and all has been perfect.. up until a month or so ago where I began struggling with solids and they would lay in my pouch for lengths of time where my body would either involuntary bring it back up, or I'd have to do it myself.

However this issue doesn't happen all the time, some foods will go down fine whereas, perhaps the very next day... those same foods would get stuck and I'd bring it up. Although (and sorry to be graphic) but foods always come back up as a liquid so it's not a chewing issue. Some days is perfectly fine, some not... it is seemingly random.

My dietician referred me to a surgeon whom I saw today. He said I would require a scope put down to see if there's anything physically wrong. If the port where the pouch connects to the intestine has narrowed (unlikely after 3 years but not impossible he says), he would stretch it there and then. I'm having the scope on Thursday this week.

I asked him if stretching is required, will this increase my hunger or allow food to pass more quickly. I paid a lot of money for my bypass so naturally, I don't want to do anything that will make it any less effective (even if this means regular sickness). He sidelined the question and began asking me about my mental wellbeing, suggesting that he makes me an appointment with a psychologist because of my fear of regaining weight.

He did make a good point about the psychologist. I didn't have any psychological assessments prior to my surgery, whereas NHS patients undergo LOTS to ensure they don't suffer eating disorders after the procedure so I welcome the referral to one. I picked up the phone, arranged my surgery and it was done, quickly. Mentally, nothing really has changed except my wanting to be lower and lower. Hell, even at 70kg, I still look in the mirror and see an overweight person whereas everyone else around me sees a stick thin person.

The surgeon I saw feels 70kg is way too low for me, and even went far as to say I'm underweight. However, I calculated by BMI on the NHS website (the same BMI chart the NHS themselves promote) and it puts me in the middle of the 'Healthy' range.

So I ask the lovely members of the forum. Will a stretch, if required, increase my hunger or allow food to pass more quickly (and thus contribute me to eating more?) and force me to put on weight. I will allow the scope but I need to make a decision on whether I allow a stretch.

Some stats: My bypass was private. I've maintained at 70kg for a length period, except a recent 6 month period when I quit smoking and gained 11kg but have since lost that and back to maintaining.

I received absolutely NO post-op support from my provider so my dietician support now, and this pending scope is from the amazing NHS Scotland.... whom were quite rightfully within their right to refuse however my case apparently went to a panel who decided I was worthy of being funded by the NHS for this post-op support. I would feel a sense of guilt having this scope on the NHS but refusing their help by way of stretching my hole if it's required.

Please give me your advice! Sorry the post is long. :(
 
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Hi

First of all congrats on maintaining over a good period of time.

Second, well done on giving up the ciggies :) 2 and a bit yrs here too.

Thirdly, it stands to reason if they stretch the outlet allowing food to pass more freely then you may be able to eat at least more frequently, it wont make your pouch bigger.. however no procedure will force you go put on weight, that's a matter of how you work with your WL tool. Ultimately, no-one can make that decision but yourself but I do think you should also take into consideration the advice from the surgeon.

Best of luck with getting to the bottom of your problems and hope it all gets resolved to your satisfaction. Can I ask which hospital they referred you to?



Ps you were extremely lucky to get SHS to take you on after a private op. They very very blunt with me, even though they had made me wait 2 years after a referral with a BMI well into the mid forties and deteriorating health.. I heard not a peep in those 2 years, not even an acknoledgement letter. Then when my health forced my hand and I went private they basically said .. "You are on your own now for life" .

Thank heaven my GP supports me. Bariatric services in Scotland are a national shame. Sorry for the rant.. :eek:
 
Hi First of all congrats on maintaining over a good period of time. Second, well done on giving up the ciggies :) 2 and a bit yrs here too. Thirdly, it stands to reason if they stretch the outlet allowing food to pass more freely then you may be able to eat at least more frequently, it wont make your pouch bigger.. however no procedure will force you go put on weight, that's a matter of how you work with your WL tool. Ultimately, no-one can make that decision but yourself but I do think you should also take into consideration the advice from the surgeon. Best of luck with getting to the bottom of your problems and hope it all gets resolved to your satisfaction. Can I ask which hospital they referred you to? Ps you were extremely lucky to get SHS to take you on after a private op. They very very blunt with me, even though they had made me wait 2 years after a refoerral with a BMI well into the mid forties and deteriorating health.. I heard not a peep in those 2 years, not even an acknoledgement letter. Then when my health forced my hand and I went private they basically said .. "You are on your own now that for life" . Thank heaven my GP supports me. Bariatric services in Scotland are a national shame. Sorry for the rant.. :eek:

Many thanks for your reply! It's Ninewells hospital in Dundee. My dietician is based there too, I see one of the specialist dieticians who works solely with NHS surgery patients.

I do agree I should take their advice and have it stretched if it's required but I'm just scared of the consequences of that. I fear that I won't have the fullness feeling for as long and I may end up eating more.

It's a concern in its own right that I'd much rather put up with this severely diminished food tolerance than have a stretch and possibly eat a little bit more so I'm glad for the psychologist referral if I'm honest.

I was actually surprised myself NHS decided to help. I was told by my own GP I would be turned away immediately with no exceptions unless it was life threatening but he fought my case and managed to get me in to the dietician but he said at the time, that's the best I could hope for and even then the dietician support would only be for a very short time. Unfortunately I wouldn't have been able to afford all of this had I needed to go back to private so would have been in trouble.

I was even more surprised when a surgeon was willing to see me today and arrange this scope and refer me to the psychologist.

I really can't express how grateful I am to the NHS, it's beyond words and that's why I would feel incredibly guilty refusing a stretch if they say that's what I need - even though deep down, I really don't want it. I really don't deserve this support and already feel guilty enough accepting it when I know I shouldn't be getting it.
 
Many thanks for your reply! It's Ninewells hospital in Dundee. My dietician is based there too, I see one of the specialist dieticians who works solely with NHS surgery patients. I do agree I should take their advice and have it stretched if it's required but I'm just scared of the consequences of that. I fear that I won't have the fullness feeling for as long and I may end up eating more. It's a concern in its own right that I'd much rather put up with this severely diminished food tolerance than have a stretch and possibly eat a little bit more so I'm glad for the psychologist referral if I'm honest. I was actually surprised myself NHS decided to help. I was told by my own GP I would be turned away immediately with no exceptions unless it was life threatening but he fought my case and managed to get me in to the dietician but he said at the time, that's the best I could hope for and even then the dietician support would only be for a very short time. Unfortunately I wouldn't have been able to afford all of this had I needed to go back to private so would have been in trouble. I was even more surprised when a surgeon was willing to see me today and arrange this scope and refer me to the psychologist. I really can't express how grateful I am to the NHS, it's beyond words and that's why I would feel incredibly guilty refusing a stretch if they say that's what I need - even though deep down, I really don't want it. I really don't deserve this support and already feel guilty enough accepting it when I know I shouldn't be getting it.

Please don't beat yourself up because they decided to treat you. Of course you deserve it, having a private op you already saved the SHS money and that should not preclude you from treatment.

I hope the psychologist proves helpful. One thing to consider is whatever has caused your recent change in eating may not be a fixed thing so may progress unless dealt with. The gastric band I lived with for years decided to play havoc with my eating, I developed acid reflux which seriously reduced my quality of life, my GP was very helpful and wanted to refer me again to a SHS consultant but again my health was so bad I went private for speed, firstly for diagnostics and ultimately for a revision to a bypass, Take whatever is on offer :).

Your concerns about regain are understandable, your health comes first though.

Good Luck with your gastroscopy.
 
I've had a couple of stretches done, it won't make you gain weight or increase your appetite. It will just allow the food that you do eat to go through like it used to due to the stricture.

My stricture is now so bad I'm needing 20cm surgically removed from the Jejunum to allow me to eat and drink. I haven't eaten for over 2 years and now have a feeding tube. If you leave a stricture it will only get worse and you will need surgical intervention.

Hooray for the NHS where you are, I'm at St George's which couldn't get worse if they tried. I have lost all faith in my team due to repeated lies and letdowns. After battling to get on the wait list for a couple of months, I was then told a week later that I'm being removed as all elective surgery is being cancelled.

I can't actually form a coherent sentence of just what my reply to that is just yet.

I am in pain every waking moment, I can only eat/drink hot milk. I can't even drink water. I have no hope of any kind in the horizon. I quite simple have such a low quality of life now that I have simply had enough of this. This is not a life worth living.
 
I've had a couple of stretches done, it won't make you gain weight or increase your appetite. It will just allow the food that you do eat to go through like it used to due to the stricture. My stricture is now so bad I'm needing 20cm surgically removed from the Jejunum to allow me to eat and drink. I haven't eaten for over 2 years and now have a feeding tube. If you leave a stricture it will only get worse and you will need surgical intervention. Hooray for the NHS where you are, I'm at St George's which couldn't get worse if they tried. I have lost all faith in my team due to repeated lies and letdowns. After battling to get on the wait list for a couple of months, I was then told a week later that I'm being removed as all elective surgery is being cancelled. I can't actually form a coherent sentence of just what my reply to that is just yet. I am in pain every waking moment, I can only eat/drink hot milk. I can't even drink water. I have no hope of any kind in the horizon. I quite simple have such a low quality of life now that I have simply had enough of this. This is not a life worth living.

Oh Jemima, it beyond belief that the surgery you need is classed as elective. Something terribly wrong has happened here, what are PALS saying?

Hugx
 
Tried all of the team, PALS, secretary etc. I even emailed my surgeon on his private email yesterday! He forwarded to someone else and I've not heard back.

I haven't been feeding for 19 days now, and malnutrition does mess with your mind eventually but I've had the usual suspects infused into me and I'm safe for a while.

I give up. I didn't sign up for this.
 
Tried all of the team, PALS, secretary etc. I even emailed my surgeon on his private email yesterday! He forwarded to someone else and I've not heard back. I haven't been feeding for 19 days now, and malnutrition does mess with your mind eventually but I've had the usual suspects infused into me and I'm safe for a while. I give up. I didn't sign up for this.

You really have had a terrible time of it...I would have hoped you may have improved by now for you.
My issues are nothing compared to what your going through...but I wish at times I'd not had my bypass either.
 
I've had a couple of stretches done, it won't make you gain weight or increase your appetite. It will just allow the food that you do eat to go through like it used to due to the stricture.

My stricture is now so bad I'm needing 20cm surgically removed from the Jejunum to allow me to eat and drink. I haven't eaten for over 2 years and now have a feeding tube. If you leave a stricture it will only get worse and you will need surgical intervention.

Hooray for the NHS where you are, I'm at St George's which couldn't get worse if they tried. I have lost all faith in my team due to repeated lies and letdowns. After battling to get on the wait list for a couple of months, I was then told a week later that I'm being removed as all elective surgery is being cancelled.

I can't actually form a coherent sentence of just what my reply to that is just yet.

I am in pain every waking moment, I can only eat/drink hot milk. I can't even drink water. I have no hope of any kind in the horizon. I quite simple have such a low quality of life now that I have simply had enough of this. This is not a life worth living.

I am sorry to read this. This really does sound like a horrific situation to be in and if I could give you my NHS support instead, I would in a heartbeat.

Reading this has made me change my perspective on my situation. My issue is not even 10% as bad as yours, heck I don't even know until tomorrow if there is a stricture but there is definitely something causing my frequent sickness. Sickness that is either voluntary or involuntary.

Given how little support you and Weegie have received from the NHS where you both are (any everyone else who is turned away by the NHS), I guess I would be stark raving mad and selfish to refuse permission tomorrow for a stretch given how bad it could potentially get like you are currently faced with.
 
I forgot to mention that I have daily nausea and vomiting. Some days it's still so bad I can't get out of bed. These are all symptoms of a stricture.

Good luck tomorrow. I can't recommend enough being sedated for the procedure. Let us know how you get on.
 
Thanks Emma-Louise. I can't just yet say I regret my bypass as my reason for having it was to claw back some time on ignoring diabetes. But i don't have a quality of life. Everything I value and enjoyed is gone. I quite literally have nothing to live for now.
 
Thanks Emma-Louise. I can't just yet say I regret my bypass as my reason for having it was to claw back some time on ignoring diabetes. But i don't have a quality of life. Everything I value and enjoyed is gone. I quite literally have nothing to live for now.


Jemima...I'm lost for words and truly feel quite sad reading this xxx
Please don't give up hope,you are a very brave lady you can get through this.
Reason I don't post much now as I don't want to sound all doom and gloom...the first 2 years was great and now....i get on my own nerves,and feel I've made my bed so I have to lie in it.
 
Jemmima this cannot be right. Someone needs to intervene on your behalf. Your situation is now life threatening. I am going to PM you if that is ok?

TBx
 
So it's been 3 years since my bypass and all has been perfect.. up until a month or so ago where I began struggling with solids and they would lay in my pouch for lengths of time where my body would either involuntary bring it back up, or I'd have to do it myself. However this issue doesn't happen all the time, some foods will go down fine whereas, perhaps the very next day... those same foods would get stuck and I'd bring it up. Although (and sorry to be graphic) but foods always come back up as a liquid so it's not a chewing issue. Some days is perfectly fine, some not... it is seemingly random. My dietician referred me to a surgeon whom I saw today. He said I would require a scope put down to see if there's anything physically wrong. If the port where the pouch connects to the intestine has narrowed (unlikely after 3 years but not impossible he says), he would stretch it there and then. I'm having the scope on Thursday this week. I asked him if stretching is required, will this increase my hunger or allow food to pass more quickly. I paid a lot of money for my bypass so naturally, I don't want to do anything that will make it any less effective (even if this means regular sickness). He sidelined the question and began asking me about my mental wellbeing, suggesting that he makes me an appointment with a psychologist because of my fear of regaining weight. He did make a good point about the psychologist. I didn't have any psychological assessments prior to my surgery, whereas NHS patients undergo LOTS to ensure they don't suffer eating disorders after the procedure so I welcome the referral to one. I picked up the phone, arranged my surgery and it was done, quickly. Mentally, nothing really has changed except my wanting to be lower and lower. Hell, even at 70kg, I still look in the mirror and see an overweight person whereas everyone else around me sees a stick thin person. The surgeon I saw feels 70kg is way too low for me, and even went far as to say I'm underweight. However, I calculated by BMI on the NHS website (the same BMI chart the NHS themselves promote) and it puts me in the middle of the 'Healthy' range. So I ask the lovely members of the forum. Will a stretch, if required, increase my hunger or allow food to pass more quickly (and thus contribute me to eating more?) and force me to put on weight. I will allow the scope but I need to make a decision on whether I allow a stretch. Some stats: My bypass was private. I've maintained at 70kg for a length period, except a recent 6 month period when I quit smoking and gained 11kg but have since lost that and back to maintaining. I received absolutely NO post-op support from my provider so my dietician support now, and this pending scope is from the amazing NHS Scotland.... whom were quite rightfully within their right to refuse however my case apparently went to a panel who decided I was worthy of being funded by the NHS for this post-op support. I would feel a sense of guilt having this scope on the NHS but refusing their help by way of stretching my hole if it's required. Please give me your advice! Sorry the post is long. :(

Hi there..

Did I read a bit ago on one of your older posts you don't like the feeling of fullness?
And sometimes your sick to relieve the feeling?....maybe psychological help might be a good start.
On saying this being 5 years post op...everyday is completely different regarding foods now for me.
One day food can agree the next is doesn't and I'm sick,and I really struggle with bread,pasta,rice,meats so I do have limited foods I can eat.
I can still eat very little at one sitting,and I hate the feeling of fullness...due to my restriction grazing is creeping in..and my crisp habit is too(as crisps is one food that is safe for me,I mean doesn't get stuck!)
I've mentioned to my dietican about struggling with lots of foods as they get stuck,but I was told to chew well....i do this but it still gets stuck and can sit till the next day then I'm sick when I try to drink or eat something new.
With all the tests I've had done nothing has been spotted in relation to my eating...only for trying to fix my tummy issues.
If I'm honest I know I have developed a bit of fear of food...just wish my weight would show this!
Crisps are the devil x
 
I forgot to mention that I have daily nausea and vomiting. Some days it's still so bad I can't get out of bed. These are all symptoms of a stricture.

Good luck tomorrow. I can't recommend enough being sedated for the procedure. Let us know how you get on.

Thank you. I can confidently say I will need sedation, the thought of tomorrow gives me goosebumps. Will I find out immediately how it went? I'll update the thread tomorrow anyhow!
 
Hi there..

Did I read a bit ago on one of your older posts you don't like the feeling of fullness?
And sometimes your sick to relieve the feeling?....maybe psychological help might be a good start.
On saying this being 5 years post op...everyday is completely different regarding foods now for me.
One day food can agree the next is doesn't and I'm sick,and I really struggle with bread,pasta,rice,meats so I do have limited foods I can eat.
I can still eat very little at one sitting,and I hate the feeling of fullness...due to my restriction grazing is creeping in..and my crisp habit is too(as crisps is one food that is safe for me,I mean doesn't get stuck!)
I've mentioned to my dietican about struggling with lots of foods as they get stuck,but I was told to chew well....i do this but it still gets stuck and can sit till the next day then I'm sick when I try to drink or eat something new.
With all the tests I've had done nothing has been spotted in relation to my eating...only for trying to fix my tummy issues.
If I'm honest I know I have developed a bit of fear of food...just wish my weight would show this!
Crisps are the devil x

I used to get intense feelings of fullness and in a sense, it would be just as much a discomfort as something getting stuck in the pouch but that has pretty much subsided now. I get full, but not so unbearably intense. Although one of my biggest complaints pre-op was that I never felt full so to go from that to intense fullness... it did require re-adjusting.

Pouch has definitely expanded a little since then too, which has helped considerably!
 
My surgeon came to see me after two of them to tell me, I was still quite off with the fairies on both occasions, and he did have to repeat some of the conversation the next time I saw him. But I could feel it. On the second stretch I drank in the way home a litre of orange juice and a litre of flavoured milk, seems unbelievable now, and I didn't dump on them which is the most unbelievable. The last endoscopy I had was abroad.... other than they stopped the bleeding, broke my bridge, was covered in bruises I was glad to get out alive!!
 
Good luck with it hope all goes well. Popadopolous you have been doing great I hope they get you sorted out.

Jemima- what can I say, dig deep on reserves you have try and keep fighting you have come too far and fought for so long to give up now. Are you telling us you want to die? If you do then you need medical help in that are also asap. I work with lot sof people everyday with these thoughts and you do need some immediate help.

Emma Louise - you to endure so much daily. Keep fighting.

I have had a few issues but none quite as severe. I have gained weight. I do like to graze when at work. I eat small and often. I have tried to make lots of changes in my diet so if I want a biscuit I have low calorific type crisps I eta pom bears or something similar. I still eat fruit n veg each day, I also suffer still from bouts of stomach cramps n toilet issues but do find that what suits one day doesn't the next, I am rarely sick at all have made myself on a few occasions when I could feel something was stuck.

Wishing you all the best fro the future each and everyone of you for the future we are all worth so much more. We have to keep fighting, I know that is easier for me to say I don't suffer as much as you all have and juggling work these issues and a family and life as well is just a lot to cope with but I do believe we are never given more than we can cope with. These issues we endure we can use to help others to give them 1st hand information and offer advice we aren't and won't be the 1st and last to suffer like this due to or wls ops. We need to take these episodes and use them to help others.


Thinking of you all.
 
Hi everyone.

So I'm home. Opted for the sedation although it was a complete waste of time as I felt absolutely no effect from it and remember every detail and it wasn't pleasant! They gave me 3mg midazolam but clearly wasn't enough, I wasn't even drowsy.

So, there is a severe anastomosis and the surgeon says it would have closed completely if I left it. He dilated it with a balloon but couldn't dilate it enough to allow his scope to pass through... but the tiny dilation he was able to do should help in the meantime. He says my pouch is quite large, likely because food had been sitting in it for long periods and became stretched.

He wants to admit me so he can dilate it more under a general but will hear from him soon about that.

Pretty gutted my pouch is 'quite large' as he put it but what can you do!
 
HI Well that is good and bad, good you know what they are dealing with and bad that you need further corrective surgery. Would they be able to reduce your pouch size do you think?
 
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