Pre-Op Concerns for Gastric Sleeve Patient

Question Below Submitted By:  

Nancy (a patient from Maryland)

I am scheduled to have gastric sleeve surgery. I have great confidence in my surgeon and that he will make the procedure as safe as he can. However, I am afraid of it due to the following…

I am 64.5 years old.

I have managed to lose 165 pounds of the original 425 I began with on my own, and within one year, and now everyone is telling me that I am 80-90 pounds from where I want to be so why do it now? That includes my SO of 34 years who fears I will never be the same but in a bad way.

I am a diabetic (CURRENTLY controlled, last A1C was 4.9, the one before, 5.0). However, I fear that if I do not have the surgery, I will not be able to permanently control my condition. No one has been able to clarify whether the surgery puts diabetics in remission because of weight loss alone or is there something else that gets altered by the sleeve gastrectomy that will do this in about 72% of patients. If it is only the weight loss alone that does it, why have the surgery?

Also, I fear being unable to eat the foods I like that are healthy such as hard, crunchy salad veggies, and shellfish (one person I met said that she could never again eat shellfish after her sleeve), or small amounts of steak which I enjoy once a week now.

I fear constant dehydration, and the permanent change to my body.

I have written down the pros and cons a dozen times, they always balance out except the surgery gets a slight edge due to my going back to how it may help my diabetes.

I am too old now to delay further, I have to do it now or never.

Can anyone calm my fears down a bit? I want to believe that after the surgery, the only difference will be the amount I can eat of HEALTHY foods and that otherwise, I will be OK.

I am about to begin my all liquid diet on Monday.

By the way, the surgeon is also going to repair a hiatal hernia, will that make the surgery more painful and give me a more difficult recovery? I am essentially asymptomatic on that hernia, it was discovered during the routine pre-op endoscopy.



Expert Responses to the Question Above

Surgeon Response to "Pre-Op Concerns for Gastric Sleeve Patient"

by: John Rabkin, M.D., Pacific Laparoscopy


Most of the benefit on your diabetes from undergoing a vertical sleeve gastrectomy (VSG) will be from the resulting caloric restriction and additional weight loss achieved.

Unlike with the bypass procedures, there is less of a hormonal change following a VSG that will directly/additionally improve your diabetes.

Nevertheless, the statistics regarding the improvement in diabetes are very good after the VSG, just not as impressive as with one of the bypass weight loss surgery (WLS) procedures such as the Duodenal Switch or the Roux-en-Y gastric bypass.

As far as your decision to proceed with surgery with this in mind, the VSG should have a beneficial impact on your diabetes beyond what you have been able to achieve with dieting thus far.

"Constant dehydration" and inability to eat certain foods are not hallmarks of the vertical sleeve gastrectomy, although you may experience these problems transiently right after the procedure. Over time, these symptoms should resolve (if you experience them at all).

You should be able to resume eating "crunchy foods" and seafood as well as steak as you get farther out from the procedure.

Repair of the hiatal hernia should only help you avoid developing any reflux symptoms after having your stomach capacity decreased and shouldn't increase any discomfort that you experience from the surgery.

John Rabkin,
M.D. Pacific Laparoscopy

(click here for Dr. Rabkin's full bio & contact info)

DISCLAIMER: This educational advice is based on the depth of your question and the details provided. The above should never replace the advice of your local physicians as they have the ability to evaluate you in person.

Related Pages:
- Bariatric Diet (What you eat)
- Bariatric Eating (How you eat)
- Life After Weight Loss Surgery

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