CowgirlJane

DesertRat, some interesting ideas, but I have a simpler theory. When I had the band they made me do a liquid diet 30 days post op. That is the time when I lost that initial 30 pounds. That isn't so terribly different then the first 30 days post sleeve. I do think that over time, support and guidance got better, but I really didn't understand how to eat with the band. My surgery was done when I lived overseas and was performed in Germany. Good surgeon, lousy followup. I was told, small portions, but never specifics. i was told no sweets or alcohol, but not told what to eat. I was told to not snack, but was never advised to eat the small 5-6 meals a day so I was really hungry a lot of the time which made it much harder to control my eating at meal time. Honestly, 1/4, 1/2 cup of food is pretty small and that is why I now eat with miniature plate, bowl and use appetizer eating utinsils. I really didn't understand how small was small enough when I was banded. I could have done better with my initial losses with the band had I been better educated on how to really work it, I still don't think it would have made a lot of difference in the overall outcome though, once that reflux hit it was a nightmare. I am not sure about the whole hunger hormone thing. From what I understand, there are multiple hormones at work in the hunger response so I am curious to see how the science/research develops on that front. Like, over the long run, is the hunger reduced that much or is it just satisfied faster with a smaller stomach? What I can say is that my hunger and cravings are nearly completely under control. I know that may change with time, and I do sometimes crave or desire to eat things that are unplanned, but the sleeve gives me the help I need to manage it in a reasonable way. What I do know is that my whole (remaining) stomach is "satisfied" now after eating a small meal and stays satisfied until it is time to eat again. It is just a whole different situation compared to feeling pain/discomfort "stuck feeling" without ever feeling any satiation which was my experience with the band. With the sleeve, I have only overdone it a very small number of times - generally speaking I am able to stop eating well before max capacity because I am not hungry. So, here is my theory about success rates with revision patients. I am basing this on the bariatric doc (not surgeon) who cares for 4 revision patients + me. Basically, the 3 have been wildly successful and the 4th has never lost much even with the sleeve. Her feeling is that the person who didn't lose with the sleeve is one of the people that just can't get over the idea of food (as comfort, as pleasure as central to her life story) and so eats small amounts all day long. Bandsters are notorious for learning how to "eat around" the restriction and I am guessing that SOME apply those same techniques to the sleeve and therefore don't lose as well. It can happen, it is possible to "fail" with ANY weight loss surgery. I just believe your odds are much better with the sleeve (and DS and RNY) over the band. I feel truly grateful and blessed to have found this help that I needed. I meet with a NUT monthly. She told me that my progress is right in line with/or better then a typical sleeve patient - revision or no. I spend a lot of time visualizing my long term success because I know that the real battle for me is the long haul. I have lost 85# before (my total loss as of this morning!!!) but it is the keeping losing and keeping it off that eluded me in the past. I am giving away too big clothes as soon as I "grow" out of them. I am closing the door on letting myself get so big again and am determined to make it stick. My knees thank me and frankly the stakes are higher now. Yesterday, I met with a friend for a horseback ride. I haven't seen her since last summer and she did about a triple take. She knew I had the surgery and lost weight, but 85# makes a big difference!

I know exactly what you mean. I typed out my whole story of my journey from a band to sleeve, post #34 on this thread, http://www.verticalsleevetalk.com/topic/38798-are-we-all-doing-this-too-soon/page__st__20 In summary, sleeve works, band not so much.

woo hoo! The sleeve is alot better!

First month - my weight loss was comparable. I lost 28-30 pounds month one after both procedures. What was different is what has happened month 2 and beyond. With the band, I lost my initial approx 30# and then took about 11 months to lose another 40 - for a grand total of 70# I have been sleeved 5 months and have lost over 80 pounds and so far it has been much easier. I can handle veggies, i can handle meat. Spicy food is a bit of a problem, but other then that i really have no food restrictions. I eat very small quantities and actually feel satisfied afterwards. That was not my experience with the band.

I dont understand the purpose of the 24 hour nasal tube, did they tell you why you needed it?

I read this the other day, but wanted to think a little before responding. I think the OP and the discussion raises some enormously important points. I am a project manager, I make "risk based" decisions everyday. That means, weighing the possible outcomes, trying to judge the probabilty and impact of those outcomes - and making a decision. I basically did that when I got the sleeve, and it took me a long time. I am not a medical expert, but i listened to them. I read as much pros and cons as I could and threw some grains of salt into the glowing pros because early euphoria is not really what I was looking for - I want long term success at weight management with minimal risk of bad side effects or consequences. I had EXACTLY the same reservations that are expressed here. I was banded in 2001, right before it was FDA approved. I thought I had reseached it, but I was fooled by a group like this one, (it was a yahoo group called Bandsters). At that time, there was a lot of peer pressure - people who weren't having big success simply didn't reveal. There were a couple of dominant personalities in that group and basically, anybody who wasn't successful had "compliance" issues. I did okay at first, but I was never super successful with the band. Worse then that, the reflux was a nightmare. I can go on and on. Anyway, I had the Fluid out about 2003/early 2004 due to uncontrolled reflux and lived with the band until 2011. I didn't feel shame for being fat, I felt shame for FAILING at a WLS that I thought pretty much everybody else succeeded with. It made me very skeptical of all the claims about WLS, it made me skeptical of myself. I was convinced that I had a "compliance issue" and would surely fail with the gastric bypass or anything else too. In hindsight, I realize I was pretty hard on myself. I lost weight on weight watchers - kept that off for quite awhile, but then in recent years tried everything and couldn't keep weight off for more a few monhts... the regain was always so fast. I couldn't figure out what was wrong with me, I saw counselors to find and hopefully cure my "eating disorders". They kept asking me how I felt when I wanted to eat... they didn't think "hungry" was a legitimate answer.. I really didn't make progress on that front either. I was pushed hard by my sleep apnea doctor to get some weight off. The doctor that looked at my arthritic kneed and told me it needs replacing soon, practically begged me to get weight off. They were both compassionate, but very firm. I could always say "I am healthy" but in truth, I at 47 I was starting to have physical issues. They shared with me real stories of patients, and in the case of the surgeon, about his mother. They painted a picture of the road I was on... 300+ at 47; what is life going to be like at 57, 67... if I made it that long. They shook me up. The sleep doctor convinced me to meet with a surgeon that he knew. Great guy, great reputation but he felt strongly I would fail with a restrictive procedure (oh, the non compliance thing again) so steered me toward the gastric bypass. I started the process, but at some point decided that I was just too scared and would rather die young then do that procedure. This may not be rational, but it is where my head was at. I came across another place that advertised "weight management" services that required a two year commitment to their program and as I read about their program and thought... I need to try again. I got lucky and the director/founder of that business is who I talked to. She listened to my story and said... have you considered the gastric sleeve? I told her about me failing at the band etc etc and she said, please, before you do anything - talk to these guys and referred me to the surgeons they work with. (they have a weight management program that is non surgical but she identified that I was not a good candidate for that due to lifelong obesity and high BMI at the time. The stats don't lie - deck is stacked against people in that situation). She said something that stuck with me.... as much as the deck was stacked against me, a lifetime of obesity, one failed surgery she said I had going for me one very important thing - I never gave up. That little comment gave me some hope. I met Dr Billing and he spent the time to really talk to me about obesity and theories, research and surgeries. He spent such a long time with me, I am so grateful for that. He gave a sobering assessment too about risks of revisions - things can happen. He agreed that the revision to the gastric bypass was riskier and stongly recommended the sleeve. One of the docs in their practice has had the sleeve, and another one's wife has had it done - they really believe in this procedure. He also referred me to a bariatric doctor (non surgeon) to work with. She, combined with Dr Billing changed my view of the whole thing. There are physical reasons I am hungry all the freaking time!!!! I am not denying personal responsibility, i realize it is lifestyle and choices, but, I was swimming upstream trying to overcome the obesity cycle I had been deeply caught up in my whole life! He told me that it is possible to break free without surgery, but the odds aren't good. He also told me my band needed to come OUT as it had slipped, I had pouch dialiation - it needed to go. I was not mentally ready for it, but I went ahead with the band removal surgery... still deciding about the sleeve. About 2 days after the band came out, I was hungry hungry hungry even more! I couldn't believe it, even my failed band had been helping somewhat. My gosh, wonder if I would have weighed 400# if I hadn't had that crapband in there - maybe I should give it some credit. I went to the bariatric doc (not the surgeon) and followed her program which kept me from gaining 50# but I was becoming frantic and even depressed over what was happening. The drive to eat was out of control. I am not sure what clicked, but at some point, I could no longer deny that I needed a tool to help me. I could not deny that my life was being negatively impacted by my obesity. I could not deny that I was starting to not be able to do the things I love and that everything was such an effort. (I could still wipe my butt, but I know what she meant, everything just gets so hard when you are that heavy). And I was miserable always feeling like food was the most important thing in my life since I just had a drive to eat. I am reminded of the quote "I was going downhill faster then I could lower my standards" So, because i had one foot in the door on this whole deal, I had some of the presurgery things taken care of including insurance approval. Then, in November 2011, I found out my insurance was changing. The new insurance specifically excluded the Gastric Sleeve, but still covered the gastric bypass. I did some soul searching and then booked it for December before the new insurance kicked in. At the time, I didn't like that pressure, but in hindsight, it was the kick in the butt I needed after dallying with this whole subject for a year. I wound up with a different surgeon (who is also amazing) in the same practice because my doc was on vacation in December. It was a huge leap of faith. I still don't really know what problems, or weight regain I might have in 5 years, 10 years. I have risked being "fooled again" by the hype - I know that. For me, the risk was worth taking because I just could not keep gaining weight. I could not remain in that high BMI catagory - that wasn't me and wasn't the life I want. Anyway, I am only 5 months out, but my success has already surpassed anything I achieved with the band. It has also been easier so far, and so far, I don't experience hunger all the time. My whole relationship with food is changing. I am not claiming the war is over, but I have been winning many battles. I have heard it said on this forum "the sleeve is everything the band promised but didn't deliver" - I agree with that statement. My blood work is the envy of the medical and nutritionalist staff (like wow, fasting blood sugar of 77 for example and I was pre-diabetic, triglicerides all that are in the outstanding excellent catagory). I feel like a million bucks. I am doing stuff with my horses again and loving on it. I am so active, I have so many choices of what to do, where to go, where to shop - all that. I no longer feel like the morbidly obese person who has no business doing horse things. I no longer feel the constant drive to EAT. I feel more like ME. I still have lots of weight to lose (I am still obese even, but in a whole different weight class now), but I am so happy with how this is going I can't even express it adequately. My life is becoming a life I want to live. So, back to the original point. Yeah, I am skeptical. I still wonder sometimes when the shoe will drop and I suddenly have "mental issues" with food. There is a part of me that still believes this whole situation is a character flaw on my part, even though I fight that. Seems to me that my issues with food have pretty much gone away since I am not starving 24/7, but time will tell. My docs openly disclosed the limited data on long term results of this exact procedure, based on the stomach size they are currently using. I just couldn't wait another 10 years to see how the studies turned out, so for me the risks as I understand them now, are totally worth the benefits, as I understand them now. Here's to a great next 10 years - I am determined to be one of the good statistics! (my signature shows I still have 66# to lose, but I have lost over 80# in the 5 months and am much closer to normal sized person now)

I personally felt a little blah at the 6 week mark. some people get downright depressed... losing 40# is great, I wonder if you are just feeling kind of blue due to the system shock. Alot of us go through that.

I joined the YMCA back in February and have been going regularly. I also walk, including my very hilly neighborhood. Most recently, i have been training my pony and have been doing alot of walking with him, he walks fast and we are doing alot of hillwork. As I get fitter, i keep upping the intensity at the gym, and felt like I was progressing well. So, most weeks I do: high intensity Water aerobics 2x elliptical cardio for 30-45 minutes, 2x strength train 2x plus walking and stuff around my property - sometimes high intensity. Sunday i was out for 3 hours, walking hills and fast pace (for me anyway). Okay, over the last two weeks, I have noticed just feeling like it is harder and harder to "push" myself into higher intensity. At first, i thought maybe I was overtraining/going to fast with the progression so I cut back a bit. Then I thought, maybe I am eating too low carb, so I started tracking carbs again and no, that is about right. Protein is really good. The only thing I can think of is mild dehydration. i feel like I drink alot of water and noncaf fluids, but I am sweating more. One of the water aerobics instructors suggested I keep water by the pool since I am really working it hard, I am sweating I just can't tell due to the pool. anyway, I am really pushing the fluids, but I still feel... just like I don't have the energy to keep the intensity going. I have cut back a little, but wondering what else to try/think of? I hope this is just a temporary setback because i only have so many hours a week to dedicate to exercise so I want to incrase intensity as I get fitter.

Ok, I don't track everyday, but I would say I am normally in the 50-80 total carbs a day, but some days more. Protein, well, I was struggling with getting enough so I have added back shakes and have about 60-80g a day, sometimes more. Calories are variable, but I would say 700-1000 would be typical. Women do need less then men, but with the good weather I am just overall doing more and maybe i just need to increase something. Yesterday, I spent about 4 hours with a friend doing horse stuff, including about half that time training from the ground, where we walked all over the place. I then came home and mowed lawn etc. I held up pretty well, finishing my chores etc after getting home, but then once i hit the couch I was done in. Anyway, I am still having this issue of running out of steam. I do alternate activities and sometimes it is lower intensity/longer duration. I am still suspecting it is the Fluid or carb/calorie combo that isn't quite right. I see the nutritionalist in a week, maybe she will have more ideas.

I don't remember when I first tried beef, but yesterday I shared a steak grill platter from a favorite restaurant and the steak settled great. I didn't eat much, I paid attention to make sure I chewed properly, but nothing crazy/extreme. I am 5 months out.

I don't understand the use of the band with the bypass so I guess I shouldn't comment on whether it works. However, as a 10 year band veteran, I think they suck and would not recommend it. You may know this already, but on obesity help they have a list of "DS" docs that the veterans maintain. DS is a very complex surgery and your odds are so much better with the preapproved doctors. Vickie, I am so glad you got resleeved and are doing well! Yea!!! It does shock me though that the choice of surgery was made by whether there was a second surgeon there at the time. DS has a longer recovery and is a riskier surgery - I would not be comfortable with it being a "maybe" until the last minute! Sounds like it all worked out for the best in the end though.

Blood work was done about 6 weeks ago and everything was perfect. Wonder if it could change that fast?

I do about 30-45 minutes on an elliptical, but I sweat like you would not believe. I also don't have the resistance too high, I mix it up on the resistance. It is hard, but I think a good workout.

No problems. I was told the main risk is not during surgery, but the first 24 hours after surgery when your respiration is depressed due to the sleepy drugs. Be sure to have your cpap with you.

Thanks for the encouragement. I have been doing a good job of keeping "unhealthy" food out of the house, but my adult son recently moved back in. I stupidly bought these little packs of Cookies for his lunches and of course they are calling my name - I gave in once and was a bit disappointed that they weren't that great anyway. That surprised me because i really haven't had food cravings or anything so far. I guess it sort of startled me that I felt the urge to eat food not on my plan - it was a reminder of how those old habits are still looking over my shoulder looking for a way in. And yes, I am so thrilled with Dr Landerholm and everyone at Pacific surgical - i got great care and am getting great follow up. At this point, I feel like it is up to me, to just keep "working the sleeve" to get to my goal.

I am almost 5 months out and while I am super thrilled with my weight loss, it is definately slowing down. I know that is normal, but i still have a long ways to go so I would really appreciate tips from those of you that managed to keep the momentum going. I started with a total of 150# to lose to get to my personal goal and although I am more then half way there, the remaining is still daunting. I have been cranking up the exercise intensity and frequency. I am doing pretty well with food, but i notice that I am more likely now to get hungry (appropriately, when I haven't eaten) rather then forgetting to eat. This seems a normal progression to me, and I am still eating under 1,000 calories a day but it feels like a warning sign that old habits could creep back - extra diligence is in order! I would love to stay rolling along as best I can and I know there are a bunch of you out there that have done this! I may not lose 150 in my first year, but I want to get as close as I can. Thanks!

I too like Quest bars. You can order them on netrition.com - one at a time to try different flavors.

My surgeon also uses a 38 - I am told that is where they think the whole risk of stricture and issues versus benefit of smaller size balances. It is often said that the bougie size is just one factor on the actual stomach size. surgical technique and how long your stomach is may have an important impact on end size.

It is just a yardstick and if you are heavily muscled it will show you as too high BMI over someone who is lighter but out of shape. I have never in my adult life been below 24 BMI. When I was down at that weight, I looked slim and trim. I do pay attention to it as guidance, but just like the scale, it is just a measuring stick and not the end all. What I do know is that people who stay under 28 BMI appear to have some statistical health benefits. Again, another guideline, not rule.

I wonder if your baby sleeve has woken up fully and is sending all the signals back to your brain. I suggest you follow the guidelines given, for both types and quantities of food even if you "can" eat more you should stay with very small portions as you are still healing.

I guess it is more art then science... My surgeon's office says that their guidelines are based on the best available data from their own practice and other surgeons. There are some things they used to routinely do that they don't anymore and vice versa, based on actual outcomes. They are experts, but they are not all knowing. My strategy was to pick a surgeon that has a good reputation, good stats, good results and TRUST him and follow his guidelines as best I can rather then being concerned with what others are doing.

Other then sharing on the sleeve support boards, i don't tell people how much i have lost or my absolute starting weight. If i did, I would include my 8# preop loss,

Imagine my dissapointment when I went in to the doc for my one week follow up and he said, since you are a band to sleeve revision, stay on liquid an extra week (compared to the plan they gave me) and push out the whole progression another week. The nutritionist forgot to mention that to me and I was literally counting the days... only to have it ripped out from under me...lol At the time, I was sorta disappointed, I wanted to eat, i was feeling some hunger etc etc. Well, I stuck with it and am glad I did. In hindsight, it was such a short window to do without solid food, it really wasn't THAT bad. I am happy to have not had a leak - not to say that everyone who cheats has a leak, but why tempt fate? Another thing that somebody mentioned is that certain kind of foods can get caught in the still healing staple lines. Stuff like nuts and other small hard bits like that. EVen if you chew carefully, you might swallow something that could get caught in the healing tissue... and eeeewww, you can imagine what that might result in.

The other thing that pushed me over the edge was finding out that my insurance changed as of Jan 1st and the sleeve was not covered (but they did cover gastric bypass and lapband). I was preapproved for the sleeve on my old insurance so I decided to go for it. I went to the same surgical practice for the two operations but actually had different surgeons. My original one went on vacation for the month of December so I was promoted to the chief surgeon! They were both awesome and I am very happy with them. One thing I considered is that these guys do a fairly high number of sleeves and a decent number of revisions. Nothing like the higher volume Mexican docs, but pretty good by local standards. The sleeve is now the main weight loss procedure they perform so they have worked the kinks out. i feel like they have seen it all before and my chances were better of having low complications. The sleeve isn't that complex of a surgery, but the scar tissue and all that can make the stapling an issue. Especially if you are a revision, seek out an experienced surgeon with as good of a history as you can find. Did you really join this forum in 2006? That is a long time - they weren't doing many sleeves then, were they? I was under the impression that it has been more like the last 3-5 years that the sleeve surgeries became so popular.

Mine were two seperate surgeries almost 3 months apart. The reason is that it is thought (not sure of the evidence!) that this is lower risk. Most importantly, I wasn't ready to be sleeved - mentally - but that band needed to come out as they feared i could have a critical problem if it slipped further. It was a bummer to do 2 surgeries, but the advantage is they removed alot of scar tissue from the stomach (the band was encrusted in scar tissue, the photos are gross) which theoritically helped with having more good tissue to staple the sleeve shut. The other advantage is that I knew beyond a doubt that I needed a replacement tool because i was just so hungry starting about 5 days after the band was removed. Oddly, the band removal surgery kinda depressed me/made me feel icky. I happened to catch a virus right after, but I also think the anesthesia kinda messes with me.