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Today is my sleeve surgery, and I'm surprisingly NOT too nervous. The doctors and whole staff have done a fabulous job informing me of everything, that I feel confident knowing what is about to happen to me. I lost 2.5 lbs yesterday. UGH - the 'clean you out stuff' is not fun. But now I'm down 12 lbs since the start of the liquid diet and 20 lbs since I began this journey in Oct. of 2012. My mom and husband are just wonderful and I feel better about the kids' welfare. Silly mommy needs to step back and take care of herself! I am proud of myself for sticking with the program and making this HUGE change for ME. I feel better about myself already. Now my only concern is my boobs - their race to my waist is quite apparent and I'm thinking losing weight will only fuel their decent! Hmmmmm . . . The stupid song "I'm so excited" won't get out of my head, but I guess that's a good thing. I can't wait for the new me to meet me on the other side!

Don't you just love the douter?? the one who say "it a cheet you would have lost anyways" Gosh pepole to the researcher it not a cheat it hard work. Okay so i was selected form 1000 to the 25 to the Zumba informal I mean after all no one love Zumba more then me. So here i was being interviewed and she tell me to turn of the carama. And said Do you really think it was zumba and not the band that changed you. You would have loosed just sitting on the couch after all you have a band. I wish it were that easy, So here my reprocess se " do you research 80 % of all people who have weight loss surgery gain it back. I can eat around my band if i want to my it might recerct me in some ways but in other it gives me a lot of freedom. The band is a tool you get out of it what you put into it. I put every thing i have into it and right when i done i think i have nothing more to give I give it a little more. I did not and will throw in the towel I just use it to wipe up the sweet and keep going. Right when i think I can't give any more to this I always find just a little bit more some were. This is Hard work Hard Hard work .I need to be strong not only physically but mental too. To do what have done changed my life from sitting on a couch to teaching Zumba, Spin, body pump, cross fit The gym i work at I have a waiting list of people who want me to be there trainer so i can do what i did to my self to them. Some day I wish I did not have to work so hard and could sitt on a in an office some were an a coshie chair must be nice huh ? So the answer is it a not a cheat it is detraction demonstration and given it all i got and Just a little more . So i found my self a good zumba class and let it getaway from me becuse something about the music alway makes me feel better

Hey, Everyone want to hear a "Joke"? What the hell is wrong with people. Seems we can't win for loosing. Based on a true story. I was told a "Joke" involving a gastric bypass surgery patient that was successful in loosing weight. Now let me remind people that I myself have also hade gastric bypass and the person telling the joke knew this.....So I hear the crude "Joke" and I have been told I have a great sense of humor a time or too. And can indeed if you will take a "Joke". This "joke was not funny to me in any way shape or form. I will not repeat this so called "joke" but what I will say is this.... Some people are ignorant and hurt full that is just the way it is. Later I imagine the same joke being told about myself they just need to change two names and this crude joke would be told on anyone that has had WLS. And it is sad. The point I am trying to make is this. Be yourself and if you are just a little over weight or morbidly obese like I once was. Make the change for yourself not what other people think or say. Because in the end you can not stop people from being hurtful to one another. . If you think the dirty looks or crude "jokes" about your weight will stop once you are at a "health" weight it will not. Some people will just find other faults to judge others by and be hurtful. That is just the way it goes But what you can do is distance yourself from those people. Has anyone else run into situations like this? If so how did you handle it?

Well it’s been a while hasn’t it?! I believe an insanely long blog entry is in order!! I want to first say that due to you, my dear VST people, nothing that has happened has been a surprise, and that has been really, really nice I had my sleeve surgery on Wed., May 22nd. My “call time” was 1 pm, and my surgery was scheduled for 2:45. I believe I was #3 on my surgeon’s docket for the day. My parents, my husband and I arrived and were all ushered into pre-op, where I was asked to go behind a curtain and put on a hospital gown. I was so interested in the conversation my parents and husband were having that I rushed, and when I popped out from behind the curtain, the nurse said “No honey, you’ve got it on backward”. Lol. I was wearing it like a robe. So I had to switch it. Then I climbed into bed and my family sat in front of me in chairs – felt like I had an audience. The nurse was extremely nice – she got me all covered up and warm under the blankets and this special inflatable thing that blew warm air on me. I also got the leg-squeezy things and some fab socks with nonskid rubber on the bottom. Another nurse came by and started an IV – I asked what was in it and she said it was basically Gatorade without sugar. I’m guessing there was no color or flavor either. Then I heard some commotion and found out that my surgeon was running ahead of schedule so they’d be taking me early (!) The anesthesiologist came over. This was the first time I’d met him, and let me tell you, he was so adorable I would have gone anywhere with him! But alas, he only wanted to take me to the OR…. lol. Before we left, he put something in my IV that made me goofy – I remember looking at my family and saying “ooh that was fast” and then someone putting the shower cap type thing on my head & I had to help because I have long hair. I remember being wheeled into the OR, and once in there they had me scooch onto a different table. I think. That could well have been after – it’s one of those weird disconnected memories. Anyways, I do know that my surgeon was there and they started introducing all the support team “this is John, and you know Dr. Z, and here’s Vern “ and I was chuckling to myself like you guys really think I care at this point who’s who? I think they were chuckling too – I just remember that there was happy banter and/or joking as they went about prepping me, and it was a good feeling all around to have happy people around me. Next thing I knew someone was calling my name, and I surfaced VERY reluctantly from a deep sleep. Once I let them know I was awake they left me alone, and I could drift in and out all I wanted. At times I had pain in my upper belly and felt a little nauseous. What’s interesting is that it is such a distant memory now it hardly seemed like anything as far as the pain goes. I was aware of another patient in the recovery room – a large man who was moaning a lot. In my drugged out mind, this made me feel the need to do some moaning of my own just so I wouldn’t be forgotten. LOL. No logic there, just instinct. Someone was apparently standing behind me monitoring my machines, because pretty soon they said it was time to go and my bed started moving. We went in the elevator and pretty soon I saw my family come into view as I was wheeled past them to my room. I felt very concerned with making sure they knew I was just fine, so I was saying hi and trying to smile. But boy I was still pretty high! Once in my room, I began to experience some more pain. I must say it is nearly impossible to assign a number to pain. I think I’m a people pleaser, and I was like “oh it’s not so bad, a 4? Maybe?” But it was a bit worse than that. My mom said she could tell I was in pain because she could see my blood pressure going up. The nurse gave me morphine in my IV, and within a few minutes I felt no pain, but I did feel the nausea. I salivated a lot, but I breathed through it without heaving, thank goodness. In retrospect, the pain must have been gas and the nausea was from the morphine. I drifted in and out for a few hours, then in the evening I got the nurse to disconnect me from everything but the IV, so I could walk and go to the restroom. From that time on, I honestly had no real pain. I used gas x strips every 3 hours, burped a little, didn’t toot at all I felt the tiniest bit of the gas in my neck, but even that came and went quickly. They never had to put the oxygen thing back in my nose because my oxygen levels stayed good (yay for me for quitting smoking!!!) My hospital stay was uneventful. The tray they brought the next day was silly – I asked if there was any protein in any of it, and when I was told no, I thought why waste the time & tummy space? I ate some to prove no problems, and then was released to go so I could start working on protein My surgeon came by and said everything went really well. I have one incision in my belly button and two more "punctures" high up on my left side. These are smaller than a grain of rice and I'm sure will be undetectable once healed. I'm still completely amazed at this surgeon's skill -- to think that 85% of my stomach was removed and no one will ever be able to see a scar -- blows my mind. He said I was good to go if I wanted. Once unhooked from the IV, I admit I didn’t feel nearly as perky as I had when I was hooked up to it. But they let me walk out on my own and I did not have to do the wheel chair ride. The next 2-3 days were all about sleeping. I tried my darndest to get fluid & protein in, but I felt pretty nauseas. Had the super-saliva production thing going on a couple of times where I thought I would start heaving, but I never did, thank goodness. My sweet husband would run to bring me a paper towel to spit the saliva into (I mean I was producing tremendous amounts of saliva when I got nauseas! sorry if TMI) and then he would rub my back and say sweet things to me while I took deep breaths and let it pass. Nausea sucks. But! By day 3 it was ALL gone. Ever since then all I can say is that the vague soreness in my tummy has gotten MUCH better every day, and the tiredness is slowly getting better. Day 4 after surgery I went on a very short trip to Target and was amazed to stop and think about the surgery I’d just had and that I was out walking around. After about 10 minutes though, I was headed to the lawn furniture department for a lil break I have a desk job, and I took just short of 2 weeks off work – I honestly can’t imagine taking more than that with how normal I feel. Yes, I am pretty damn tired right now, but c’mon, I was tired all the time before surgery! It’s just going to get better and better. Today is the last day of ‘full liquids’. Tomorrow I get pureed! Hooraaaaay! Been daydreaming about cottage cheese lol. The liquid diet has begun to go literally right through me. Yes I get hungry but nothing like presurgery. Once I drink a few sips off a protein drink, I am satisfied. However, within half an hour, it is coming out tha other end if you know what I mean. TMI I know, but I’m here to tell it like it is So I’m hoping that pureed foods will be just what I need to set things right in that department. I had my first poo maybe 3 or 4 days post op and it was normal, if a bit small. I was very happy not to have the severe constipation some folks have immediately post op. I know it could still happen, but at least I’ll be a little further out from surgery. Last I checked, I had lost 20 lbs since the start of pre-op, and about 10 lbs since surgery (about a lb per day). HOWEVER – and here’s something really fun --- my husband accidentally kicked my scale into the wall in the dark and it shattered into a million pieces. I had left it out in the middle of the floor – my bad So... I haven’t weighed in days! I’ve ordered a new fancy scale on Amazon, and I think it will be kinda neat to just wait until it arrives. I know I’m losing weight. But for some reason, my immediate focus is not the weight loss, it’s just about doing what I should be doing. I really feel like I made the right decision for me, and honestly, it has been a good experience so far. looking forward to feeling better and better and better! ONWARD!

It is to true that old habits die hard. It doesn't seem to matter how long ago you put them away, you thought for good, they will still on occassion rear their ugly head. If we are not on the look out for them, it is very easy to fall prey. This weekend, the hubs and I hosted my mom's 65 birthday party. I had about 35 people at my house. While it was an awesome night and every one had fun, I realized that I screwed up. Our menu was hot dogs and hamburgers on the grill, sides were: chips, tater salad, cole slaw, baked beans, mac and cheese. I thought ahead enough to know I couldn't do the bread, so that was fine, I bought skinless hot dogs so I could have one with a little slaw on the side. I did good in the fact that I avoid the chips, mac and cheese, and tater salad. I had a small spoon of baked beans. I was having a great time. I ate slowly- no stuck problems. Then it was dessert time. I had made a homemade apple cobbler and peach cobbler and had purchased a beautiful cake from BJ's. I also had ice cream to go with these. I ate a peice of cake and a spoon of ice cream on the side. Granted in days past I would have eaten double, maybe triple what I ate that night. But, I still over did it. My band is really loose right now and that makes it really easy to slip up. (My appointment is Thursday- yeah) But, I can't blame my band, it is me, my choice. But, honestly I wasn't even thinking. We had a ton of cake left and chips and burgers. I sent left overs home with my brothers being that one has 5 kids at home and the other has 3 at home. I did keep one small square of cake for me and my hubs to share- shouldn't have done that. Yesterday, I woke up with the mother of all migraines. I managed to stay up right long enough to feed the dogs and tell the hubs I was going back to bed. I stayed their till noon. I got up cleaned my house up from the party the night before and the head ache returned, I hit the couch. I hardly moved yesterday. Felt like crap. This morning I felt better- got up and hit the scale before heading out to work. 191.3- well the weekend certainly showing it's self. 3 lbs up for the lowest. I keep bouncing between 188 and 191 for the past 3 weeks. I know I can do better, I should do better, I want to do better- but I keep slipping up. At the moment I am like screw it I want this- then I feel aweful. Granted I don't slip to bad, but a slip is a slip and bad either way. I worry that I will never drop below this weight. Is this where I am destined to stay? Will I self-sabatage myself more? How do I get back on track and stay there? You may say, well you have to do it, you have to want it. I do want it and I know I have to do it- but it is not easy, WLS is NOT the easy way out.

I have hit many stumbling blocks of late and admit to falling a few times. I regret this and do not blame my band at all, I blame myself for becoming complacent and just plain out not caring enough. When I get down and out I tend to get into the "I just don't care" mode- not a good place to be. I haven't had a fill since Feb and am really feeling it now. I get hungry pretty quick, this lets me know the band does work, which properly used. I go in Thursday to see my surgeron and get a fill- pretty excited. I will be happy to drink protein shakes for a day and have them fill me up. Last night I did a fridge purge of all the bad stuff that I was falling prey to. I know this is my own fault- not the foods or the bands. I am not as strong as I would like to be when it comes to certain things. I must work on that. Work is killing me - long hours and a lot of hurry up and wait. Right now I am waiting on several teachers to do their part so I can finish mine. There slowness, makes my days long and irritating. I woke up this morning and told myself that today was a new day- fresh with no mistakes (A line in Anne of Green Gables- love that movie _) I am going to make this a good day- I have that power. I can do it and I will. I have said this several times of the last month and still manage to stumble in a few days. However, this time I have taken a few steps to help myself. I am back to my journal and I have made meal plans. I will not gain this weight back, I will not fail. I will move forward. I will not fall!! It is imbarrishing to faulter as much as I have, but I am not pefect and I have my issues. There are some bandsteres on here that are the "perfect" patient and don't seem to ever have a problem or struggle with this process, but that isn't me and I have to accept that I am not them. I have to stand up, shake it off and get back on the horse. I hope that others who read this and have stumbled will join me in getting back on it. I hope that those who stumble find courage and support that they are not alone in the fight. We can do this if we continue fighting, but if we throw our hands up in defeat the fat will win. My rump is dusty and sore from all the "throws", but I am jumping back on!

With so many things to think about on this lap band journey, I feel like I've forgotten some of the rules that could be leading me to more weight loss. One commenter on my last post brought it to my attention that I need to make sure I get my daily protein amount in ... a rule I forgot about. And it makes me wonder, what other rules am I neglecting? 1. eat only 1 cup of food 2. eat all of your protein first, then veggies, then carbs 3. don't drink with your meals 4. get in your required XX grams of protein per day 5. take your multi vitamin supplments 6. dont eat within 2 hours of laying down All of these rules Ive totally disregarded at one point or another, on multiple occasions and with some frequency. Well for the past 3 days I've met my protein requirement. I got a fill on Thursday and I'm down 3 lbs ... I guess they really do tell us all of this stuff for a reason.

So here's my first blog post on the site. I just had my surgery on Friday, May 24, 2013 at OHSU in Portland, Oregon. The surgeon told my boyfriend, Will, that the surgery was textbook, and everything went very well. I woke up with a foley catheter and no drains, which I was very happy about. My pain has been manageable as long as I take my pain meds on a regular basis. I'm on liquid Tylenol and oxycodone for my pain. I was lucky in that my surgeon was able to call in a prescription for the tylenol to my local pharmacy so that I didn't have to buy a bunch of the smaller bottles over the counter. A little background on what I went through leading up to surgery. I made the decision to get WLS in November 2013 after a second endoscopy showed that while my ulcers in my stomach and esophagus were healing, I had a hiatal hernia and needed surgery to fix it. Oh and I needed to lose weight, which would help with the acid reflux. I was at the point where I would wake up in the middle of the night choking on stomach acid that I was aspirating into my lungs. By December I was at OHSU going through their WLS orientation. It didn't take long for me to get all the testing done. I needed a pap and a parathyroid hormone test, and I had already had all the other tests completed in the last 3 months, my PCP just needed to send over the results to OHSU. I also completed a psych review. One of the requirements from my insurance company before they would approve surgery is that I needed 3 consecutive months of visits to a dietician. I was travelling for work and ended up missing out on my February appointment and had to start over in March, April and May. My last appointment was on May 1st which is when OHSU submitted for approval. We heard back on the approval in a week and I was scheduled for surgery for May 24th. I think my journey from when I made the decision to have the surgery to my surgery date was a relatively short period of time with few hassles. I had to make a lot of changes in a short amount of time including quitting smoking, soft drinks, and becoming more mindful of what I ate. I think the hardest thing for me was to slow down my eating. I am used to quickly eating and moving on to something else. I didn't like the idea of chewing for long periods of time and really didn't enjoy what the texture of food in my mouth after chewing it for a long time. I have two kids, Brieanna is 15 -- she turns 16 in another month and Sylar, who is 11. I was lucky to have my children when I did because right after I had Sylar in 2001, I went menopausal. Brie is a typical teenage girl who has ups and downs almost hourly. It's a roller coaster ride with her at times. She's finally figured out that her grades in high school are very important and has turned herself around academically. Sylar is very different from her sister, but just as smart and enjoys being athletic. I'm sure I'll mention the girls a lot if I continue blogging. Let's see, I also have two cats. Mr. Mushy face is a lynx point himi and Zim is a black domestic short hair. I love my cats so much. I never thought of myself as a cat person yet four years ago my best friend suggested that I get a cat as a pet since I live in an apartment. I got both cats at the same time and they were such a welcome addition to my family. I have a boyfriend, Will. We've been dating for a little over a year. We've had a lot of drama since we started dating. Brie really doesn't like the fact that I am dating again. I chose to stop dating in 2008 and focus on my children. Before that I was in serial relationships from the time I was a teenager. It was a good period of time for my family. Just me and the girls. When I decided to start dating again after 4 years of being single, Brie took it very hard. Every day we still are having to work through her passive aggressive tendencies with regards to Will. Though she's improved greatly over the year we've been dating. I'm just taking it one day at a time right now with the relationship. I don't know if it will last, but I'm going to give it my all while I have the chance. I got home from the hospital around 11 am yesterday morning. I was really looking forward to being able to sleep through the night in my own bed. Yet here I am writing my first blog entry. Since it's Memorial Day weekend, I'm going to have to wait until Tuesday to call my PCP and get a follow-up appointment made for after the surgery. If I'm still having trouble sleeping, I'll bring it up with my PCP. My anxiety level has dropped significantly since the surgery. Most of the things I was worried about were the unknown aspects of the surgery. What was my pain level going to be? Would I be able to tolerate anything in my pouch after the surgery? What about drains? Luckily I didn't have any drains when I woke up and I'm tolerating everything I've tried so far. I haven't had any nausea to date. Though I did get a little spell of it after I had some liquid colace (a stool softener) at the hospital. The surgeon was quick to change out the stool softener to senna after that. I'm going to give blogging a try for a bit to see if it helps me organize my thoughts for the day in addition to chronicling my post-op experiences.

As some may know, I have been trying for WLS since August of 2005. Finally my time came and I was sleeved. I was a very active member on ObesityHelp until I found this site. Enjoy the info and videos... The word bougie means "candle" in French. "F or FR/Fr" following a bougie size=French Its just a guide that the surgeon uses to butt the stapler up against, when forming your VSG. The closer s/he gets to the guide the 'tighter' /truer to guide the sleeve is. During surgery the bougie is inserted into your mouth down your throat, towards the end of yer stomach where it meets the pylorus via an esophageal dilator. After the new stomach is formed, the bougie/guide is removed out of your mouth, possibly why some VSGrs complain of a sore throat post op. Some surgeons will use an endoscope or other "guide" to size ones new stomach. I read an OH post of a VSGr who's surgeon explained an endoscope is the same size as a 32F bougie...Im not sure. Bougie size determination is between YOU and YOUR surgeon. Discuss size, rationale for size chosen, type bougie and technique used when sizing your new stomach........ PRE-OP!! Some surgeons may "oversew" the staple line giving one a 'tighter' than bougie sized sleeve. In order for an "oversewn" staple line to affect stomach size it MUST be running or continuous oversewn suture line across majority of staple line not intermittent oversewn nor merely at intersected "junctures" where the surgeon has reloaded the staple gun as majority of "oversewn" techniques (to prevent leaks) are done today. Make sure your surgeon explains what his/her "oversewn" technique is. Do not assume because a surgeon "oversews" you have a tighter than bougie sized sleeve. A bougie is 1/3 mm PER french. i.e to calculate ~ inches 40F bougie 1/3 x 40 = 13.33mm convert to inches = ~.52 inches or ~1/2 inch in diameter. Below are diameters of bougie/ "guides" in inches 32F = .40" 34F = .425" 36F = .45" 38F = .476" 40F = .5" 46F = .576" 60F = .75" Video 1 This VSG surgery video shows a 'red' 34F bougie, one technique in sizing stomach, exised stomach, testing for leaks etc .http://www.orlive.co...eight-loss-surg ery-gastric-sleeve Red bougies are older mercury filled ones. FDA is tryin to ban em because of disposal issues (mercury). More surgeons will use SINGLE USE disposable sized bougies Video 2 In this surgical video Dr. Alvarez shows a disposable 32F bougie and use/technique ~9-2012 In another Forum, this member's bougie pix is from hospital she works at 1st: 36F, 2nd: 38F on left, 32F on right General/ crude comparison chart created by another Forum member Standard sized bougies in the US and Mexico are 32F. 32F is the smallest guide a bariatric surgeon in the US may safely use in forming your sleeve. Your surgeon may prefer any size bougie from 32-50F, based on YOU, your height, weight, or perhaps the need for a malabsorptive procedure in the future, inc. 1st step of 2 part DS. Discuss what to expect, rationale for size chosen with your surgeon if this is a concern. LapSF/Dr. Criangle on their routine use of 32F bougies in VSG "Optimal weight loss may require the smallest possible pouch, which may yield the highest leak rate" . Some surgeons will welcome discussion and your input on bougie sizes. After reading a published journal on the higher incidence of VSG surgically induced GERD (acid reflux/heartburn) in use of 28-32F bougies, it may be wise to request a higher bougie size. However, like all surgeries, we will need years of data to support whether or not this claim is actually true. The History of using Bougies In 2000 the use of 50-60F bougies were standard for VSG when it became a stand alone WLS, as they were the standard sizes of DS bougies, which VSG was modeled after. As the years went by, bariatric surgeons thought..smaller bougie, better restriction, less regain. So in ~2005 an adopted 32F bougie became the VSG standard. Rarely, if ever are 28-30F or 50F and over bougies used in the US for VSG as stand alone anymore. Many many VSGrs do EXTREMELY well with 40F-48F bougies as the guide to sizing their new stomach, losing all the weight they need to. In 2008 study (small poll 135 pts) on Bougie Sizes in VSG seems to indicate at 6 mos and 12 mos post VSG .... 40F and 60F bougies with no significant difference in EWL (eventual weight loss) 2008 Bougie Size Comparison In 2009 study (a large poll) on Bougie Sizes in VSG seems to indicate at 5 years post VSG ... 32F and 44F bougies show exactly the same EWL (eventual weight loss) 2009 Bougie Size Comparison In 2012/13 study (a very large poll) on Bougie Sizes in VSG seems to indicate at 3 years post VSG, a LESS than 40F bougie and GREATER than 40F bougie show no difference whatsoever in EWL (excess weight loss) 2012/13 Bougie Size Comparisons VOLUME/GASTRIC CAPACITY in VSG: PRE VSG: Average stomach holds 32-48 oz or 4 to 6 cups per meal POST VSG (~6-8 months out FOR LIFE) ..new stomach holds 8-12 ozs or 1 to 1.5 cups per meal (depending on weight/density of foods you eat! can be much less or much more) The length of an adult stomach is 10-12 inches. DNA affects the length of our stomachs, as well as variations in shape. Tall people, for instance are known to have longer stomachs..so makes sense they have a bit more capacity, short people have shorter stomachs therefore less capacity.... so volume/capacity can be influenced by the length and physical anatomical variations of an individual's stomach. Dr. Alvarez explains in this You Tube video about length of an individual's VSG stomach and how it relates to volume. This limited 2009 study is interesting in looking at gastric capacity in VSG, just 3 days post op (120 ml=~1/2 cup) compared to 2 years post VSG (250 ml=~1 cup) http://www.ncbi.nlm.nih.gov/pubmed/19533260 At the end (8:28 mark) of this LapSF VSG surgical video shows 1 DAY old (pod) sleeve Xray and a sleeve Xray at 4 years out. It is not clear to me if same pt. or solely to impress the new "normal" sleeve size. Note the "new normal" 32F tightly formed sleeve has dilated/stretched naturally to perhaps triple in size...The video also shows one technique of sizing the sleeve, as well as reinforcement of the staple line (to prevent leaks) This VSG video shows the speed with which LIQUIDS/FLUIDS empty from the sleeve. In normal stomachs fluid empty rate is 5 minutes or less due to space creating a reservoir for large volumes of fluids. In VSG stomachs: fluid empty rate looks MUCH faster than that... youdecide! The COTTAGE CHEESE TEST /CCT (link following) may be helpful to VSGrs that are curious about their new stomachs capacity. It was developed for RNY but an effective tool in VSG as well! I'd suggest waiting until you are on a regular diet before checking. When doing this test PLEASE eat to sensation of satiety - no longer hungry, and absolutely not full. A simpler method, following the basic guidelines and time frame in the link provided... is to place 1 level cup (8oz) of small curd cottage cheese in a bowl and eat from that. Using a measured tablespoon to eat any remaining cottage cheese from the original container. Add or subtract any cottage cheese eaten or not finished using the measured tablespoon. 2 TBS=1oz. Total...the amount consumed = your sleeve's capacity. http://www.bsciresourcecenter.com/proddetail.php?prod=A4 STRETCHING in VSG: YOU CANNOT STRETCH/DILATE out your sleeve to anything remotely close to its original size. From LapSF/Dr. Criangle: The removed section of the stomach is actually the portion that stretches the most. The long vertical tube shaped stomach that remains is the portion least likely to expand over time and it creates significant resistance to volumes of food. The fundus (inc. majority of stomachs 'body' up to pyloric canal) of the stomach is ALL but removed with VSG. The fundus is the upper most part of the stomach's greater curvature. The fundus is: 1) the stomach's stretchy/expandable tissue, capable of expanding 2-3xs its resting 'unfilled' size 2) the pre-op 'mass quantities' of food, waiting to be digested, storage section 3) where 70% of the body's grehlin a "hunger hormone" is produced. Stretching, due to overeating is most common in RNY because more of the stretchy fundus part of the stomach is retained to make the 'pouch', and is usually NOT covered by insurance to correct. Re-sleeving or a need for a malabsorptive surgery post VSG may or may NOT be covered by your insurance plan. Anecdotally, Ive read from select OH VSG members, or according to a/their particular surgeon..overeating will cause your sleeve to stretch out. Ive read/found no scientific data, published or otherwise, to date that says this is a TRUE statement. Since food stays in our stomach less than ~ 3 hours after a meal..common sense tells me food doesn't stay in our stomachs long enough to create 'stretching'. Food once ingested, immediately begins to be churned into a liquidy sludge called chyme through peristalsis in the stomach. This liquidy sludge must be small enough to pass through our very small pyloric valve and into the small intestine for further digestion /breakdown and absorption of 'micronutritents' ...so there cannot be enough pressure for long sustained periods of time in our stomachs to cause it to stretch. Post op VSG ... depending upon the amount of swelling/inflammation you have..even a little 'thick/er' dense liquids or pureed foods/mushies may or may not feel restrictive, as you pass through the progression of texture dietary phases ( to promote healing) and onto your regular diet ~2mos post op. ... swelling/inflammation has naturally reduced. Density of meals becomes a key player in restriction. By 1 year out you'll find you can eat more than you could at 2 days post op, at 2 weeks post op, 2 months post op, and 6 months post op. Your sleeve has naturally and fully matured. Depending on the food..you can eat more or less than the 8-12 oz capacity of a fully matured sleeve.......at any particular meal. Toleration of a food, does NOT make it a good choice! "just because I CAN...doesn't mean I DO" --------------------------------------------------------------------------- The bougie size controversy/wars are ridiculous imo.. 'get a smaller one, you can stretch it out, you're not going to have any restriction, that bigger one is all wrong, you'll re-gain easily years out, my surgeon made mine smaller and I got to goal in 6 months' ...all nonsense DO NOT PAY EM NO MIND!! This is YOUR story! YOUR journey! ALWAYS REMEMBER THIS TRUTH: YOUR WEIGHT HAS NOTHING TO DO WITH THE SIZE OF YOUR STOMACH, altered or not! Most important is the quantity and quality of the food choices you ingest post-op

I am 7 days away from an 8 mile hike up to LeConte Lodge in Great Smoky Mountains National Park, 8 days away from hiking 5.5 miles down from that mountain, 9 days away from a 7 day vacation in Hawaii, and 32 days away from being sleeved. It is going to be an exciting month. However, I have really struggled with the "food funeral". I have had binge like behavior for the past couple of weeks, and have basically let my "inner fat girl" have everything she wants, and the result of that...the added weight, the bloat, the heart burn, the sluggish "I just want to be lazy" feelings, etc have taken enough of a toll on me, and I have finally decided that enough is enough. It's time to start preparing my brain for what my body is about to go through. Today I kind of gave the following talk to myself... Dear Food, You have always been there for me. You were there for me when I was alone in the evenings after school, you were there for me when people hurt my feelings, you were there when I was alone, you were there when I was rejected, when I was awarded, when I was celebrated. You were there through the loneliness of my teens when I didn't have any "real" friends..during the long hour and a half drive from my mom's to my dad's house when I started driving alone. You were there through my college years when boys rejected me, when the school work got hard and continued on into the night. You were there in my lonely apartment in my early 20's, and there when I went through the financial crisis which landed me back in my parent's house feeling defeated. You were there when I moved to a new state at 28 with my fiance' and I was stressed about leaving everything I knew and loved behind other than this one man. And you were there when my dad died of a heart attack at 57 (obesity related) one week after that move, and through the months that followed trying to get his estate finalized while living 500 miles away. You were there in the nervousness of my wedding, and of being a new bride. You were there through the stresses of every long day of every tax season, and then when I went out on my own as a bookkeeper. You have been there every evening to help me alleviate stress lately. You have been what I've looked forward to at the end of the day. You have comforted me, you have praised me, you have distracted me, you have brought me pleasure. But you have also brought me pain. You have brought me "weight", literally. My bones hurt, my body aches, my feet are killing me, my back feels like it's in knots. My heart races these days with the slightest hill or stair case. You have made me depressed which caused me to ponder that death might be better than life when I feel I can't overcome your power. You are holding me back from my passions of the outdoors. I can hardly hike up hills these days without feeling like I'm going to die. My heel pain is just getting worse with every pound you add to my body. I don't feel sexy anymore... You are tearing apart my life and I'm only 32. I thank you for having been there for me, but I think in order to have the best life I can, I'm going to have to part with you, or atleast part of you. God has brought other things into my life to take over the work you were doing all alone. I have a husband who can comfort me and celebrate me. I have friends who can help me to not be lonely and a bible study group to strengthen me when I'm feeling bad. I have a bike, a kayak, hiking boots and a backpack that will keep me entertained. I have a fantastic gym membership and a mini home gym that can keep me distracted from work when need be. I have kitties who can sooth me on lonely days when I need "love" (okay, my husband can do that too if he's not working late) I will be okay with out large quantities of you. Our relationship is changing, and while I'll still partake of you, I need the best you, you have to give.... things that will make me strong and healthy instead of weak and lazy. The sugary things that I let sooth me have to go...perhaps one day I'll be able to enjoy a bite or two, but since you've turned me into a sugar addict, that day will be far away when I'm at goal and am finally in control. Here's to change! Tomorrow, I will start a low carb, 2 protein shakes a day (I have plenty of sample packets to choose from), and one protein + complex carb + either 1/2 a sweet potato or 1/2 cup cooked quinoa meal a day, food plan. I will get out of this sugar fog, and back into "the light". And I'll flush out the funk with lots of water and green tea. I'm ready to start my new life even though I am 32 days before surgery and am only required to do a 7 day low carb pre-op diet. I'm just ready! With my hike before Hawaii, and lots of hiking/walking planned in Hawaii (and fresh pineapple!!) I can stay on track until my surgery. Wish me luck fellow pre op and post op sleevers! I appreciate you and your stories and questions more than you know!! Edit: No need to suggest counseling...I've already been doing it for 5 months and will probably continue after surgery. I wish I could say it's helping with the mental stuff...but I don't see it.