Author Topic: Gastric sleeve and Sjogren's  (Read 2736 times)

Nancy60

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Gastric sleeve and Sjogren's
« on: September 23, 2012, 03:22:17 PM »
I almost hate to bring this up here because I don't want to get "slammed" for considering this, but my weight has gotten seriously out of control.  I now have a BMI of 42 which is the morbidly obese range.  I have done diet after diet trying to keep things under control but it keeps getting harder, I try to eat healthy and "know" how to eat right, understand healthy nutrition etc...I know about exercise and safe exercise and that I need to burn more calories than I take in in order to lose weight.  I recognize that I eat emotionally at times, but I do try to listen to my body signals and stop when I am full etc...I do think one of my problems is I tend to eat to counter the fatigue I am feeling, and I have tried to lay down and rest instead of eating, but it is hard when you work full time and have responsibilities that aren't going to go away....I think if I got full more quickly, I probably wouldn't eat as much. 

I've been looking into bariatric surgery for the last year or so, the gastric sleeve sounds like a safer option for me with my Sjogren's/AI issues as food goes through the full digestive process (the back part of the stomach is removed, but no bypass or rerouting like in gastric bypass, and no band or foreign object like in gastric banding...the stomack is just made about 1/3 it's size.  no vitamin deficiencies except possibly B12, no dumpin syndrome or other issues associated with the gastric bypass.)  I can't help but think that if I was able to keep my weight under control, some of the health issues I have would improve (like my BP, cholesterol, GERD, arthritis in my knees, ankle, back etc...)  I know it won't solve everything and the Sjogren's and it's issues will still be here.  I don't really have GI issues with my Sjogren's (unless I want to say the GERD is because of it, but I had that before the Sjogren's was diagnosed and it could be due to my weight also). 

Anyone have any thoughts on this, what questions should I be asking when I talk to my doctors about it?

My insurance will cover this if I meet their criteria, I have to do a 6 month physician supervised weight loss program first.  My PCP thinks it would be good for me.  she did say the sleeve would be the best option as I can take NSAIDS and other meds with that and I can't with the band and the bypass.  She said she has had patients who have had all three types and her patients with the band had more issues and didn't always lose or keep the weight offl

Seriously considering this....

Nancy

shevonne

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Re: Gastric sleeve and Sjogren's
« Reply #1 on: September 23, 2012, 04:30:42 PM »
I have not had this surgery but know people who did, my daughter being one of them.  From what I  have seen with these people, they all do pretty good with the sleeve verses the gastric bypass.  My daughter was extremely miserable because she is young and the weight got so bad she was in the 3s.  She looks great now and she doesnt look sick in the face.  She cannot eat much though.  Im glad she chose this procedure verses the bypass surgery.  Basically,her stomach was just made smaller.  My sister was considering the same surgery so I went to a few meetings with her.  The doctor told the group that sometimes when you are extremely obese people dont understand that you cant do the exercise because it may hurt too much, or you are so tired you dont have the strength.  He recommended the bypass for her cause of her size.  She never had the surgery though cause of her husband has cancer and no more insurance, no work.  Dont let anyone make you feel bad for trying to get help.  Everything is a risk, whats better for me may not be better for you but You have to make that decision and live with it.  .

engy

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Re: Gastric sleeve and Sjogren's
« Reply #2 on: September 23, 2012, 06:16:10 PM »
I don't know your answer but I'll pray for you either way!!!
DX:Sjogrens w/mild Lupus overlap,Hashi,Celiac,Raynauds,Sm.Fiber Neuropathy,POTS,Fibro.,CFS,OI & other dysautonomia.
No thyroid

RX:Plaquenil,Synthroid,LCarnitine,CoQ10,ALA,Dribose,Tumeric/Curcumin, Milk Thistle,AdreneVive,Fish Oil,Flaxseed Oil,Magnesium,B12 shots,vit d & c,high salt diet for low BP!

rudytudy

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Re: Gastric sleeve and Sjogren's
« Reply #3 on: September 24, 2012, 09:29:57 AM »
I had gastric bypass surgery seven years ago. 
Every morning before my coffee I take sublingual B-12 B complex. 
The supplements I do take I take with food.  My stomach stretched quite a bit
after about two years and I eat a 'normal' amount of food now but have to be
careful with bread/pasta.   

Weight loss surgery is a serious option.   Your food issues must be dealt with so you
stay away from sugar/alcohol/white flour.  Atleast this is true with gastric by-pass.
I can now after seven years eat some sugar/flour but only a small amount.

I'm not familiar with the gastric sleeve.   It's definitely life-altering so I wish you
well in your decision.

female, 54
Primary SJS, fibromyalgia, arthritis
SS-A >8.0    SS-B  1.4     ANA positive
punctal eye plugs
no presc. meds

Nancy60

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Re: Gastric sleeve and Sjogren's
« Reply #4 on: September 24, 2012, 07:51:42 PM »
Thankyou Shevone, engy and rudy,

Your responses help.  It helps to hear from others and how they did, what helped them make their decision etc... 

Rudy, if I can ask you, did you have Sjogrens when you had your bypass, do you think the surgery caused you to have more GI issues from the sjogrens?  Are there sjogren's treatments you can't do because of the surgery?  I know the sleeve and the bypass are different approaches, but it helps to get an idea of what to expect.

Thanks again for your responses.

Nancy

Belsey1

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Re: Gastric sleeve and Sjogren's
« Reply #5 on: September 26, 2012, 10:52:53 PM »
I was glad to see this topic.  I have considered having weight loss surgery, just not sure which one I would choose.  I had pretty much made up my mind to take the first step in the process about 2 months before I was diagnosed with Sjogren's.  Of course, I dropped the idea but constantly think about the possibility.  Like you, I wonder about the GI issues.  Have any doctors advised you about the implications of Sjogren's on weight loss surgery patients?  I am curious.
55 year old female, diagnosed with SJS in 2010...Fibro in 1990, sleep apnea with C pap-Restless Leg Syndrome.  Recently added Diabetes and high blood pressure...have anxiety disorder, depression and PTSD.  Chloroquine, Clonazapam, Lexapro, Januvia, Metformin, Losartan, Diclofenac, Gabapentin.

slccom

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Re: Gastric sleeve and Sjogren's
« Reply #6 on: September 27, 2012, 02:50:07 PM »
I would recommend that everyone get the daily short obesity newsletter by Aya Sharma, http://www.drsharma.ca It is free, and he is a strong proponent of surgery and weight maintenance. If you don't gain, it is a victory. He is in Canada, so, can't treat anyone here, but he is great to read and follow. It is 5 days a week, and you can search his

I think that Medicaid is paying for this surgery if you are broke and have medical conditions that would be helped, like diabetes. For some reason, diabetes is sometimes cured immediately after the surgery, at least for bypass surgery.

Sharon, who is struggling with weight, too.



 


Sharon, 57-YO female, Sjogren's, depression, sicca, ataxia, hard of hearing, neuropathy,  high BP, arthritis, more. Restasis, pilocarpine, Wellbutrin, Lexapro, oxygen, arthrotec, HRT, plaquinel.

Nancy60

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Re: Gastric sleeve and Sjogren's
« Reply #7 on: September 27, 2012, 09:19:23 PM »
I am seeing my Rheumatologist in a couple weeks and plan on discussing it with her.  I really want this, but don't want to do something that would make my Sjogren's worse or unable to treat/take needed meds.  We will see.  My Internist seems to feel it would be beneficial and the surgeon I talked to just generally said autoimmunity and Sjogren's in and of themselves are not absolute contraindications, it depends on the individual.

I'll let you know what my Rheumy says.

Nancy

rudytudy

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Re: Gastric sleeve and Sjogren's
« Reply #8 on: September 28, 2012, 09:32:47 AM »
Nancy,
Just a year ago I was diagnosed with Sjogren's.   Had gastric bypass seven years ago.
I was in very good health...great blood pressure, heart, blood sugar, white/red blood count perfect.   I was 45 and had no health issues...just 100 pounds overweight and my feet/ankles were killing me...very hard to excersize ENOUGH to drop weight.  Had tried all the low carb stuff.   Because I didn't have any complications going in to the surgery I did fantastic in recovery.   Re-routing your disgestive tract is a major surgery and I do have malabsorbtion with B vitamins so I take a sublingual (liquid under the tongue) every morning so it goes straight in to my blood stream.   

If you're in good over-all health it helps.   If it was TODAY I would go with a proceedure that was the LEAST invasive.  So that it was easier on your body.   Just my two cents....

P.S. Before gastric bypass I never had any reflux or heartburn...could eat jalepenos by themselves...so I had a great stomach/digestive tract.   I still can eat stuff like that and lay down...so I'm blessed with a good stomach.    If you already have digestive issues I'd be hesitant to mess with your stomach...I'm not a doctor and this is just my thoughts.   : )
« Last Edit: September 28, 2012, 09:37:26 AM by rudytudy »
female, 54
Primary SJS, fibromyalgia, arthritis
SS-A >8.0    SS-B  1.4     ANA positive
punctal eye plugs
no presc. meds

Nancy60

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Re: Gastric sleeve and Sjogren's
« Reply #9 on: September 28, 2012, 02:49:29 PM »
thanks Rudy,

They do the sleeve (and bypass I think now) laproscopically so less invasive.  The sleeve doesn't bypass anything, just decreases stomach size, plus it removes the part of the stomach the secrets ghrelin (a hormone that makes you hungry).  That is the procedure I am considering.  It supposedly doesn't have as much of the nutritional deficiency issues that the traditional bypass does because it doesn't bypass anything. 

I only get heartburn on occasion so am not sure I really have true GERD,  I guess all the GI testing they will do beforehand will tell for sure.  I have the BP and high cholesterol issues but am well controled on meds.  otherwise I am pretty healthy other than joint issues and some skin/rash issues (all sjogren's related).  I am hoping the sjogren's will be a NON issue. 

It will be 6-8 months before I can actually have the surgery just because of all the hoops you have to jump through to be approved for it.  But I am starting the process now, have contacted my insurance and am working with a case manager now.

Keep your fingers crossed for me!

Nancy

Nancy60

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Re: Gastric sleeve and Sjogren's
« Reply #10 on: September 28, 2012, 02:58:23 PM »
Sharon,

Thanks for the link, I went to look at it and it has a lot of interesting info.

Besley - I will let you know what the doctors say as I go through this process.  I do think it all depends on what your health issues are with Sjogren's and your overall health, but there are some pretty unhealthy people who have had this done, so I think they are able to manage alot of issues if necessary.  I figures it can't hurt to ask and investigate.  I want as much info first though, before making a final decision.  Like I said before, I don't want to do something that will cause lots of problems in the future, the benefits of the surgery have to outweigh the risks of being overweight long term.  As I said I will post on here as I find out more.

Nancy

slccom

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  • Sharon,
Re: Gastric sleeve and Sjogren's
« Reply #11 on: September 28, 2012, 03:32:43 PM »
And there is a lot of question as to just how much being overweight is the cause of diabetes, etc., etc., etc.

That is a lot of why I send people to Aya Sharma's blog.

Sharon
Sharon, 57-YO female, Sjogren's, depression, sicca, ataxia, hard of hearing, neuropathy,  high BP, arthritis, more. Restasis, pilocarpine, Wellbutrin, Lexapro, oxygen, arthrotec, HRT, plaquinel.

Nancy60

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Re: Gastric sleeve and Sjogren's
« Reply #12 on: October 05, 2012, 10:49:56 AM »
I just got done talking to the RN/Case Manager from my insurance company about bariatric surgery and she was very helpful and informative. 

Talked about what was required by my insurance for approval, discussed the different surgery options, outcomes, requirements, complications etc...I am now OK'd to talk to and choose a surgeon to start the whole process.  I have to complete a 6 month weight loss program documented by my doctor. 

I am getting kind of excited that I may finally have the help to get my weight down and how that will help my health and help me feel better!  I feel kind of bad that I haven't been able to do this and keep it off without the surgery, but am hopeful that this might be the extra boost I need to be successful and keep it off. 

I will keep updating this thread as I progress toward doing this and let you know about obstacles I might run into related to Sjogren's.  I hope this can be helpful to others here struggling with obesity and Sjogren's. 

Nancy


Tivia

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Re: Gastric sleeve and Sjogren's
« Reply #13 on: October 05, 2012, 11:16:31 AM »
I wish you the best of luck, make sure you research everything you can. I know you understand the concept of exercise and proper diet, have they checked you for a hormonal or brain issues for the weight problems to rule that out?  My cousin was morbidly obese her whole life. It took 39 years for them to figure out it was a combination of her female hormones, and something misfiring in her brain that was causing the problem. She had to have a total hyster and adapted to changing her thought process when it comes to food.   But she lost all the weight. She functions normally and works has a boyfriend, and said if only they had figured it out earlier in her life...all that wasted time.

Not saying that is your issue at all, just hope they have looked into all the possibilities. Hormones are the devil I tell ya ;D But I hope all goes well for you
Sjogrens, UCTD with Lupus and Scleroderma symptoms, Ulcerative Colitis, Graves Disease, Severe Gerd and failing pancreas/biliary system . Poss ANA 1:640 speckled , nerve damage in legs feet and hands, fibro, Restasis, evoxac, creon, prilosec, plaquenil, apriso, canassa, prednisione

lynnmarie219

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Re: Gastric sleeve and Sjogren's
« Reply #14 on: October 06, 2012, 01:15:08 AM »
Good luck to you Nancy on your new journey! It seems like you are thinking everything through carefully and weighing the pros and cons of each procedure to see what is best for you!

Please keep us posted...I am interested to see how it goes for you. I have always struggled with my weight and understand how difficult it is to lose it...people who don't have a weight problem sometimes don't always get it...it's a difficult process.

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