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Weather in Tucker, GA

Short Post: Reflux Follow Up

The apple cider vinegar caps are a NO GO. Just made the acid worse. I’ve read that this will happen because the acid reducers are basically screwing up your stomach’s sensors. Makes sense. Anyway: NO on the ACV. I’d say that the peppermint and caraway oil supplements would probably give the same results. I may try them at some point, but not right now.

I got a 24 hr stomach bug Mon-Tue last week, so I didn’t take any supplements those days. The acid seemed to start to back off. Could’ve been because I was on liquids only for the time I was peeing out mah butt. But in any case, I went back to my standard supplements on Wed without issue. The acid is still somewhat less than it was. Good sign!!

What I take daily now:
1 multi cap (has 100mcg Vit B12, which is over 1600% DV, but I will add an additional B complex soon)
1 turmeric cap
1 vit D tablet
1 selenium cap
1 Kyodophilus cap
2 calcium chews

Some days, the caps are fine, other days they give me indigestion. Just like everything I eat/drink. Sigh.

I’m down to 2 Zantac a day, usually don’t start feeling reflux until the afternoon. But it varies. I always try to take one near bedtime to prevent overnight issues. BUT that, of course may or may not work. Nothing is a given, nothing is reliable.

TMI ALERT!! The last two nights I’ve been plagued with painful gas cramps that wake me up. I’ve not had a BM since Thursday. This, too, is “normal” now. I don’t have regular BMs and they could be water, regular or hard as rocks. NOT PLEASANT. But it makes sense since I cannot eat more than 1/2 cup at a time anyway. ::shrug::

So be ready for reflux and erratic BMs after VSG. I am not unusual in my symptoms. You’ve been warned! I still think it’s worth it, btw, despite all my bitching. I’ve lost another 6#, which brings me to 21# since surgery, 31# overall.

I TOLD YOU I WAS IMPATIENT. So, I am losing, just not as fast as I’d like. Typical. Sigh. :P

Tales from the Land of Reflux

Today, I’m reading about Apple Cider Vinegar as a remedy for reflux. I just got my ACV capsules, which I will be trying out today. One before meals with water. I can’t drink 8oz of water at a time, so I’ll take it with 4oz. The theory is that the ACV assists with digesting food, which will lessen acid production from the stomach’s proton pumps. We shall see.

I love that I’m also reading that high protein meals can cause more reflux, which is exactly what I’m experiencing. AWESOME! All I can get down is 2-3oz of protein which exacerbates the reflux, so I don’t eat… rinse and repeat. I’m living on one protein shake and a couple of small protein snacks per day with some miso soup as a meal. And vitamin water.

At this time, anything solid/protein (chicken, ground meat, lunch meat) I eat causes stomach discomfort and reflux. The only things that do not do this are protein shakes and miso soup. Liquids and non proteins don’t seem to aggravate the reflux as much as solid proteins, which is a big fat bummer. Basically I’m two steps back to soft/liquid foods with little protein. This is not good. Hopefully it’s temporary – it has to be temporary, I can’t live on NOTHING!!

I hope the ACV helps. I’m taking 150mg Zantac every 8 hrs or so. They DO NOT last the advertised 12 hrs.

I will probably have to deal with this for the rest of my life. This makes me sad. It makes me hate food, which is a BIG part of my life. This problem is screwing up a huge part of my life! For me, it’s kinda serious.

A big part of my identity is (WAS) food. Now I can’t eat it or enjoy it. Gee, wonder why I’m so depressed!!

It is estimated that 25% of VSG patients have reflux after surgery. I’m betting the actual number is MUCH higher. Judging by what I’ve seen on the various forums, I think it is pretty damn common. It bothers me that I see SO MANY patients remain on PPIs indefinitely and their Drs consider this A OK. It is NOT OK to be on PPIs forever! ESPECIALLY women! While the PPI drugs do stop the reflux, they open the door to several other big time problems such as osteoporosis, h pylori infections, ulcers and thinning of the lining of the stomach. I had no reflux on PPIs, but the crazy rebound acid I’m experiencing tells me that prolific acid production is a BIG side effect of VSG that is really not being addressed by Drs who perform VSG. They prescribe PPIs and consider it a non-issue.

I think we, VSG patients, need to demand better after care. We need to press our Drs to do more research and find a way to stop this acid production that is ruining our post surgical lives. I don’t WANT to suffer with reflux for the rest of my life. But from what I’m reading, it looks like I will, thanks to the shortsightedness of the medical industry. But, hey, why should they care? The sales of PPIs are astronomical and having large swaths of the population dependent on them is a good reason to NOT explore alternatives and prevention.

This is not an indictment of VSG Drs in particular, it is more towards the medical industry that doesn’t do its homework. But I think VSG Drs should be aware that we, their patients, expect a higher quality of life. Our Drs should be actively working to FIX THIS, rather than bandaid it. Perhaps if I’d known that it’s likely I’d have serious reflux after surgery, I might’ve thought harder about doing it. I would have likely gone through with it anyway, but at least I’d have KNOWN about this. Reflux should be listed as a probable side effect in the literature. For those of us who have never had any issues with it, it is a rude awakening to have constant pain.

I will keep you posted about the efficacy of the apple cider vinegar capsules before meals. ::fingers crossed::

VSG and Reflux

Well, aside from not losing much weight, the truly sucky part of my sleeve recovery has begun. As I wrote about the other day, I decided to discontinue taking Prilosec because I didn’t like the long list of issues that can arise with long term use. I was expecting some acid rebound, so I had Pepcid, Tums and Zantac on hand.

I had a couple of days with no acid after I discoed the Prilosec. Then it hit me hard. I beat it back with Zantac and it was mostly OK (pain level 3-4) for a few days. THEN, day before yesterday, the acid started really hurting, like 7-8 with spikes to 9. I took Zantac and Pepcid, but didn’t get much sleep that night. Then yesterday the acid was terrible all day, despite the Zantac. I even took a Prilosec before dinner, to no effect. The pain kept me up most of the night last night. I took a Zantac around midnight when I got up and went to the couch to sit up for a while. I dunno about YOU, but I cannot sleep sitting up. So all together, yesterday I took Zantac, many tums, Prilosec and another Zantac. FINALLY at around 4-5am, the pain eased off and I slept a little. I moved to the bed around 7am and slept until 11am. No pain today, but my stomach feels weird. And I feel like little bitty RAT TURDS.

I took a Zantac this morning and I’ll take another before bed. Hopefully I’ll be able to sleep tonite.

I talked to Amy and she is still having reflux at 7 months. She takes Zantac twice a day and still wakes up with reflux every morning. Which tells me that I’ll probably have reflux for the rest of my life. Great. I never had any issues before VSG.

YES, I have buyers remorse. I have horrible reflux, I can’t eat anything, I can’t drink anything alcoholic (reflux and I can’t get drunk at all) and I’m very depressed that I’ve only lost 17# in TWO MONTHS. Overall, VSG has been mostly negatives for me.

I know intellectually that this is all just the Period Of Suck that everyone goes through, but it just doesn’t matter, I still feel crappy and depressed. Ugh.

I have a theory that the reflux (that is VERY common) with this surgery is partially due to the design of the sleeve itself. Let’s think about this. They make a narrow tube from the esophagus down to a pouch at the bottom. What do tubes do well? THEY SIPHON. I think sleeve patients get reflux because the tube siphons the stomach acid right up to the esophagus and VOILÀ! REFLUX. I hope someone who designs these bariatric surgeries reads this and will rethink the shape of the sleeve. Why not mimic the original shape of the stomach, just smaller?

Anyway, those are my thoughts on the HORRIBLE reflux that I and many other sleeve patients suffer with. Maybe in the future, they can do something about it by changing the shape of the sleeve. All I can say is that Prilosec forever is NOT the answer. Zantac is not much better, but it appears that I’ll have to take something for the foreseeable future. Which makes me SAD.

Hosting Company Reviews

Since we have so many sites (about a dozen), we need Virtual Private Server (VPS) hosting. We’ve had reseller accounts which make every site a separate account and we’ve had standard VPS. I tend to prefer just standard VPS because you can admin all the sites from one control panel. I’ve written about our experiences with these hosts, but I decided to condense our experiences into one post for Google and for my reference.

We’ve had VPS type hosting for a decade+ and we’ve had several hosts. First, let me give you my opinion on the hosts we’ve had; their pricing, their uptime and their support. Those are the three main factors that everyone looks at when trying to find a decent host. Nowadays, things like SSL certificates and ddos attack prevention also factors in. I’m just going to review the last three hosts we’ve had: InMotion Hosting, Wiredtree Hosting and our current Zweeko Hosting. I am not linking to these hosts, because I don’t want to hear any whining from them about my negative reviews.

InMotion Hosting (inmotionhosting.com)
We were with this host about 4-5 years ago. They were fairly new at the time and things started off great, as they always do when a host is new and hustling for clients. We had a reseller VPS account that was around $50/mo. The first coupla years was good, when I called I got the owners on the phone and they helped me with lots of technical stuff. As they grew, they had a handful of support people who were trained and did a good job. But somewhere around the 3-4yr mark, they started buying other companies and expanding, but they didn’t expand the tech support team. Then they started hiring support staff that wasn’t trained. The support degenerated into the usual bullshit excuses when our sites were down: it’s WordPress, it’s not enough RAM, it’s Bigfoot, etc. What was happening was our sites were getting ddos attacks and it was killing the server. Things kept escalating until our sites were hacked and the support people had NO IDEA what to do. They actually blamed us for the attacks and tried to tell us that there was nothing they could do to fix the SERVER HACKS. Uh, isn’t that the definition of a host’s JOB? I don’t recommend IMH if you need good support. We started looking for a new host and ended up with the next one.

WiredTree Hosting (wiredtree.com)
We were with WiredTree for about three years. They were very solicitous and moved all our sites from InMotion for free – even tho they usually charge for that many sites. We had about 15 sites at the time. We had a reseller account with these guys and it was about $60/mo. The biggest issue with WiredTree support is that they really loved to use geekspeak when answering tickets, which is annoying when a) you are not a server geek and b) you just want a straight answer in ENGLISH. Their service was actually pretty good, it was the support that was annoying. They also had a habit of fixing things, but never telling me what the problem was in the first place. I want to know what is going on, but I don’t need to know how to build a watch when I ask for the time. They did not have the ability to tell me what an issue was in non-geek terms. They also charged out the ass for an SSL Certificate, which I was interested in putting on our sites, but did not due to their exorbitant fees.

Towards the end of our tenure there, our sites were again suffering with ddos attacks that would bring down the server. They did nothing about these attacks. They didn’t even offer or use Cloudflare, which is pretty standard these days. They blamed us for the attacks, with the usual excuses: it was WordPress, it was not enough RAM, it was Bigfoot, etc. They talked me into an upgrade to SSD ($65/mo) and they SWORE that would do the trick, but alas, it was just their lack of giving a shit that was the issue. Much arguing ensued and they didn’t even refund the last month that I paid for and didn’t use. I felt swindled by WiredTree and I don’t recommend them. I was bitching about WT on Twitter, looking for a new host and that’s when the owner of Zweeko offered to move all my sites for free to his center in London. He was a sweet talker and convinced me that he’d take care of us. Yeah, not so much, turns out.

Zweeko Hosting (zweeko.com)
So last year, we moved to the brand new company Zweeko in London. They moved all the sites and put me on a standard VPS (not reseller, which is what I prefer) and all was good. They are $70/mo. They have us on SSD servers, nicely tricked out, and they use Cloudflare for all sites at the enterprise level. They also offer SSL Certificates for $18/yr, which is a very good price. Unfortunately, despite the nice hardware, it wasn’t long before the outages began. As early as two months after we moved to Zweeko, we had server issues. At this early time, the owner was always on Twitter and he’d get things up again right away. But that, of course didn’t last. He got some tech people to run the place and he was off to travel around the world hustling big businesses to host. When he left the asylum to the inmates, support became nonexistent.

The one guy that was really good left – which was a bad omen, but I am still friends with him. He confirmed my suspicion that Zweeko was abandoned by the owner and the support staff was running the show. The outages started to become regular, about once a month the sites would be down for a couple of hours. Apparently they have no monitoring software at Zweeko, since they never knew when our server was down. Rather than fix the issues which were ALL on their side, all they could figure out to do was restart the server. Nothing was getting fixed, they would just restart.

One time, they insisted it was my WordPress configuration (WP is the whipping boy for hosts across the land!) and they went into my WP and fiddled with the plugins to make my site work. This is NO BUENO. They also could not tell me what they did, I had to go in and ferret out their stupid plugins and shit, which I removed immediately with no discernible detriment, proving that they had no business in my WP install in the first place.

The latest incident was a couple of months ago. Our sites were down for NINE HOURS on a Sunday and they did NOTHING about it. Absolutely NOTHING. I put in a ticket and the B team support people apparently didn’t know what to do, so they just left our server down for the A team to fix on Monday. THEY JUST LEFT IT DOWN. I was apoplectic with rage and demanded to know why our sites were left down despite a ticket. Of course, they had nothing to say. Fortunately, my buddy who used to work there can still access their servers (wow, not much security!) and he found the problem and fixed it. It was a setting, of course. Apparently the support people at Zweeko are not trained well enough to THINK and actually solve problems. All they know to do is what is written on their support software screen. Which is why I’ll be moving again (fuck) in a few months.

They also promised me a credit for the down time, which I did not get until I bitched at them about it. Again, inmates are running the asylum and they have no power to really DO anything for clients, so they just put us off with excuses.

For these reasons, I do NOT recommend Zweeko. They are pricey and they have no real support.

Other Hosts To Avoid
One of my clients was using Bluehost for their WP site. They’ve been there about a year. The database blew up and WP was unusable, so I contacted support. After much back and forth, they finally admitted that the server was having issues and it would be fixed. But of course, they would not tell me WHEN. So this went on for a few days and they continued to lie, blame WP and put me off, meanwhile the site was up, but WP was hammered. Bluehost is a flaming piece of shit. DO NOT USE THEM. At this point, I started doing research for a new host, both for my client and for myself.

I asked the hive mind of Twitter to give me host recommendations and I got a couple of lame ones. Then this company Webhosting Ninja (www.webhosting.ninja and @ninja_hosting) said I should check them out, so I did. I did not like their plans, so I said “thanks, but no”. Then they started attacking me, assuming that *I* used Bluehost (my CLIENT does) and told me I was an idiot for not switching to them. Ninja Hosting is clearly run by a bunch of misogynistic nerd hey-bras and I DO NOT RECOMMEND THEM.

Sources for Host Reviews
But I found @HostReviewHell (www.reviewhell.com) during this, so it was worth it. This site has tons of useful info! I especially like the list of EIG hosts to AVOID (Bluehost is one). I found Siteground (https://www.siteground.com/) on this site and I decided to try them out with my client’s WP site. So far, so good. Siteground is out of Eastern Europe (you can choose your server location, I chose Chicago), but they seem to have their shit together. They offer chat, email and phone support (I love chat support!) and it’s always manned from what I can tell. They moved my client’s site with no issues and we were up and running the next day. (Proving that it WAS Bluehost’s fucked up server that hammered WP, NOT US.) We’ve been with Siteground for a few weeks and I’ve no complaints. They offer Cloudflare with all packages and they use CPanel (a MUST).

I am fairly sure we’ll move to Siteground once I’m good and sick of Zweeko. We’ll have to switch back to a reseller set up, which is cumbersome, but whatever. We are going to pare down our sites, so that should help a lot. I’ve only got one client that I host, so moving is not a big deal. I’ll update this post as things progress.

Week 6.5 Daily Foods Snapshot

So, I hope to do a video for you tomorrow, but I wanted to give you an idea of the kinds of things I’m eating on a daily basis for an idea of what it’s like after you’ve healed. Also: the videos will now be ONCE A MONTH, starting with July. The next video (besides tomorrow) will be at the END of July/beginning of August. This is to retain my sanity about the weight loss numbers.

Ok, so, daily eating. There is a learning curve, I won’t lie. My serving size is that of a toddler for the most part. I eat protein first, which means that is about all I eat. I ate shrimp ragout the other night which was full of veg and tonite I’m making gyro sausage w/ sauteed greens, but mostly I’m eating just the protein. We typically have baked fish and I can get in about 4oz of that. I find that different foods fill me up in different ways, which has been interesting. I’m also eating salad again, which makes me VERY happy. I’ll have a wee salad for a snack in the afternoon sometimes. Vitamins are SO important, folks. Get a good multivitamin, take tons of B12, take calcium + D and take iron if you run anemic. (I’ve written about vitamins in depth here.)

Alright, here is a typical day for me. I’ll include the protein count and variations just FYI.

8:30-9am
1 cup of coffee w/ creamer and cream (may or may not finish; about 10oz)
2 eggs, either whole scrambled or beaters w/ salsa (10-12 gm) OR 1/2 cup cottage cheese 12 gm
take vitamins and supplements (SEE Prilosec info below.)
1 20 oz Vitamin water that I sip all day (yes, there’s sugar, but there’s also a TON of vitamins)
noonish
4-5 slices of deli meat (usu ham or turkey) 8gm
4 crackers either triscuit (sriracha!!) or Ritz
1 cheese stick, string or cheddar 6gm
afternoon snack 3-4pm
small salad OR
more meat + cheese 14gm
fizzy water zero cals 12 oz
dinner 7ish
Baked fish filet (cod, tilapia, salmon, about 4 oz) 17gm
OR protein with sauteed veg, various protein, I aim for 15gm+
8ish
protein shake 30 gm (sometimes I have this in the afternoon instead; trying to move it to the afternoon)
another fizzy water if I can manage it 12 oz
For a grand total of around 85 grams IF I have the meaty snack; without the afternoon meat, it’s 71gms, which is within spec. Liquid intake is 65oz IF I get in the second fizzy water, 53oz if not (I count ALL liquid, including coffee and shake). These are under spec, but for me, this is better than I was before VSG. I’ll take it.

I am happy with these numbers. However, every day can’t be a winner, so sometimes it’s barely 60gms. Eh, what can you do?

Now I know you’re looking at the water intake and gasping in disbelief. Well, I’ve never been much for drinking allll day, so 44oz of drink is good for me (one vit water and 2 fizzy waters). I’m doing well at getting in the second fizzy water.

Another thing I’m messing with is Prilosec. When you leave the hospital, you are told to take a double dose of TWO per day, in order to assist your stomach in healing and to prevent the reflux/heartburn you’ll get from your stomach acid going crazy. I switched from the Mexican omeprazole caps to US Prilosec tablets when the first ran out. According to the US package, it is supposed to be ONCE a day. I’ve been trying once a day with varied success. If I don’t take it at night, I’m DEFINITELY refluxy. Today I did not take the morning dose to see how that goes – so far, so good. I’m VERY concerned about acid rebound, which is the effect that Prilosec has when you take it for months, then stop taking it. The whole point is to get your stomach to STOP making too much acid on its own; I fear that taking too much Prilosec for too long will cause me more pain in the long run. Here is a compelling study about the dangers of Prilosec. Here is another. Interesting to note that the long term effects is another area that the Drs don’t seem to have much info about. Long term effects COUNT, people!

I will keep you posted on the stepping down from Prilosec. I’m going to ONE per day before bed and getting some Zantac to use if I feel refluxy during the day. I really don’t want to deal with a stomach that makes too much or too little acid. The body is a marvel of self regulation if you allow it to do its job. I feel that too much Prilosec is interfering with my body’s attempt to self regulate. I feel that my stomach will regulate the acid production if given the chance. I’m giving it that chance. (This is why Drs can’t STAND me and call me “noncompliant”. Whatever. I know what’s best for MY BODY. Deal with it.)