Oregon Rose

Hey Stoongal- Clue the rest of us in on these "seat sales." I paid more than that just going from Portland to SF and back. I wish you and OrchidFan much success with your surgery. Keep us posted. I hope the trip home goes well. Best wishes,

Dear Helen UK- Trail mix is American for CARBOHYDRATES! Cheers,

Hi Hope4me- Being that this is major surgery and irreversible, I think I read about every medical article on VSG published. I did this because I was trying to make an informed decision. I have never run across the name John Feng. Remember, I mentioned that VSG is the first step of the Duodenal Switch procedure. However, for Duodenal Switch they use a larger caliber bougie. Dr. Jossart did a fellowship in laparoscopic surgery at Mount Sinai Medical Center in New York under Dr. Michel Gagner. Dr. Gagner is on the list and is highly respected. Dr. Jossart's fellowship was right about the time the first VSGs were done as a first-stage procedure for Duonenal Switch. So I am sure that he learned the Duodenal Switch and the earliest forms of VSG from Dr. Gagner. Dr. Feng has not published any papers that I have seen. That is a real signpost in this field. Dr. Jossart has dozens of publications to his name. Drs. Jossart and Cirangle are recognized as being among the pioneers in this field. They have been doing stand-alone VSGs for 7 years. This is as long as anyone has been doing stand-alone VSGs. Before I decided to have my surgery with Dr. Jossart, I paid for a medical background report. Dr. Jossart has never had a malpractise claim or an arbitration. With all the medical literature I read, including Dr. Jossart's papers, and the medical background report, I was completely convinced that I wanted Dr. Jossart to do my surgery. My husband told me he was very impressed by Dr. Jossart. I asked him to elaborate. He said he was very intelligent, very experienced, and he really cares that his patients are successful. He is also very accessible to his patients. I am out of state. He gave me his e-mail. I have e-mailed him several times with questions, and he has replied very quickly. So, my advise is - 1. If you have already had the surgery, tell us who your doctor was and your good and bad experiences with that doctor. 2. If you haven't had the surgery, it is worth it to pay for a medical background report. Do a lot of homework on your doctor before the procedure. It is irreversible. If you have no other way to know how many procedures or how long the doctor has been doing the procedure, ask if you could talk to a few of his patients (with their permission, of course) who had the procedure 5 years ago. 3. Celebrate - we're all getting healthier and skinnier!!! :drool5: Best wishes to all,

I don't envy you. I only had to fly from San Francisco to Portland. Getting to the airport, going through security, waiting, flying, and the drive home were enough for me. For me fatigue was a big issue after surgery. I think you might want to make some contingency plans. I can't imagine such a trip a few days after surgery. Also, call you airline and ask if there if someplace you could lie down if you start feeling badly. Be sure to mention that you will be recovering from major surgery. My very best wishes to you.

Sounds good to me. Where do I sign up for a $3400 refund? :blushing: Congratulations on on your amazing progress. Keep up the good work! :drool5:

As a scientist I have read the published papers of those bariatric surgeons who pioneered VSG. About 5 years ago there were only about 15 surgeons who did VSG. Let me pass on some of the history of this operation. Around 2000, some surgeons who were performing the Duodenal Switch Operation began to do VSG as a first-stage for poor-risk patients. They intended to do the rest of the Duodenal Switch Operation about one year later. The thinking was that a two-stage operation would lower mortality and complication rates for the Duodenal Switch procedure. Of the patients operated on in 2000, when the year was up, many of the patients had lost sufficient weight so that the second state was unnecessary. Thus, the first VSGs were performed in 2000. By 2002, a handful of physicians worldwide began to do VSG as a stand-alone procedure. Between 2002 and 2007 surgeons performing this operation gradually revised the VSG procedure to what it is today, publishing their findings as they learned how to improve the operation. In 2007, The First International Consensus Summit for Sleeve Gastrectomy as held in New York City. The first day consisted of live surgery by experts performing VSG for the 250 attendees wishing to learn the procedure. Afterwards, presentations were given by the experts. The presenters (experts) at this conference were: Gagner of New York, NY Dakin of Cornell, NY Parikh of New York Pomp of New York Jossart of San Francisco Crookes of Los Angeles Elariny of Virginia Schauer of the Cleveland Clinic Florida Rosenthal of the Cleveland Clinic Florida Assalia of Israel Langer of Austria Himpens of Belgium Kotidis of Greece Melissas of Greece Basso of Italy Baltasar of Spain Lacy of Spain Mognol of France Krawczykowski of France Weiner of Germany Won Woo Kim of Korea Boza of Chile De Paula of Brazil So, here is your list of those considered "experts" in this field by their peers as of 2007. So, I think the discussion of who has a lot of experience and who does not has already been established by the medical community itself. The list is above. The procedings of the conference were published in Obesity Surgery 18:487-496 2008. See for yourself. Best wishes,

Congradulations on your surgery. lapsf.com has a hair loss kit. You can go to the web site and see what's in it. I bought it but don't know if it will work yet. They say to start it within 3 months of surgery. Best wishes for weight loss success and hair! :smile:

Hi- Well I keep losing weight. Now down 23 pounds. I still have diarrhea. (Sorry to mention something unpleasant.) I am able to eat 4 oz of Dannon light yoghurt and 1/4C of Non-Fat Cottage cheese (with Dairy Aid.) I made some thick chicken vegetable soup. Then I pureed it. It had the consistency of baby food. I ate 1/4C and my stomach hurt for 2 hours. It felt like my stomach was way too full. The feeling eventually passed, but I don't want any repeat performances. Now I am mixing 1/4C of the puree with 1/4 cup of Swansons Chicken broth. It is much thinner and I can comsume 1/2C. Its very tasty! I appreciate all of your comments. I think I will try some kind of mild white fish in a broth/sauce over the next week. I also have a good recipe for egg salad where I use NF yoghurt and cottage cheese instead of mayonaise. Finally, I may get brave and try a poached egg. Slowly, slowly. But most of all, I'm really watching my calories, Protein, and Water. I want to keep the weight loss going. :smile:

Hi- Tomorrow is the day I am supposed to start transitioning to soft food. I'm a little afraid of choking or getting the "soft food" stuck in my stomach. :cursing: My stomach is tiny, tiny. I can only take a few sips before I have to wait a while. Are there any foods you think I should try first?

Shanda- We're all praying for you. I think your pre-op diet just messed up your biochemistry. I BELIEVE YOU ARE GOING TO GET YOUR VERTICAL SLEEVE GASTRECTOMY AND YOU ARE GOING TO BE VERY HAPPY WITH IT!!! Tiffy - Woo Hoo your hubby is going to go wild when he sees you! :001_tt2:

Thanks for all of the replies. I did talk to Amy - MacMadam's and my dietician. She suggested scrambled eggs, homemade pureed chicken Soup, Danon Light Yoghurt, and Trader Joe's Greek Yoghurt. She said its okay to stay on liquids for a while longer too. Besides not knowing if soft food might get stuck, I am also having diarrhea. (Sorry to mention something unpleasant.) I was partially lactose intolerant before surgery. Amy said this is not uncommon even if you aren't lactose intolerant for the first month after surgery. About half of the stuff I bought has "milk Protein concentrate" in it which is only 80% milk protein. The rest is lactose, fat, and other milk stuff. Oh Boy! "whey protein isolate" is 90% whey protein. In getting to the isolate step they purposely try to remove the lactose and fat. So even though they can't call it lactose free, it has very little. The "whey protein isolate" products would be the Syntrax nectar. Not my favorite, but a couple of flavors are palatable. I prefer not to go to soy protein because soy protein has a nasty taste to me. I guess I will try some yoghurt tonight :001_tt2: since the Lactobacillus have taken care of the lactose for me. I can't complain too much: I've lost 19 pounds in 2 weeks! Best wishes,

I tried everything in the Syntrax nectar sample pack from Syntrax. The only sample I liked as Capuccino. The rest were either grossly too sweet :tongue_smilie: or tasted like cheap drink syrup without the alcohol. :crying: I heard Fuzzy Navel was good so I bought some of that. Its their best flavor. I do like the Health Wise Lemonade and Health Wise pineapple Orange.

I had my sleeve done in San Francisco, and I stayed overnight. Surgery was at 7:30 A.M. Was discharged about 1 P.M. the next day. Do you have any friends who are nurses, parametics? If you do go home same day, you might want to ask them to watch you for about 24 hours. You can also hire a nurse from a home care agency if you don't know anyone. It would make me very nervous to go home so soon after VSG. My very best.:cursing:

Hi Kromrider- Sorry to hear you had so much pain. I had less pain initially than you. However, I am 2 weeks out and still cannot lie on either side without pain meds. My largest/lowest incision is still very sore. I also had some slight cramping in my stomach. I noticed it more frequently when I was drinking something cold. Hot seemed better. I also noticed it more when I tried to drink too much at once. I'm supposed to end my liquid diet and start my soft food diet tomorrow. I'm a little nervous about that. I figure why rush. Congratulations on you surgery! Here's to a healthier tomorrow.:cursing:

Hi- I am sorry I haven't been on the message board to answer questions several people asked me. I have been busy traveling home and sleeping. A few days ago I mentioned I had pain at my lowest incision. Dr. Jossart said this is very common to have pain at this incision site. He said the incision was not straight back, but somewhat sideways. This incision is at the bottom of the stomach. He said there were reinforcing stitches there and a lot of the work is done from this incision. This is also the incision from which he pulled the excess stomach. Anyway, it is gradually feeling better little by little. Someone asked me what medication I was on and if Lortab is the same as Vicodin. I think it is. In the hospital I had a morphine pump. I have to admit that the liquid vicodin instructions said to take 15-30 mls by mouth every 8 hours. I never took more than 15 mls because it makes me groggy. Several people wondered why my doctor only kept me in the hospital 1 night. Its quite simple - economics. I was a self-pay patient. The cost for the Operating Room, one night in the hospital, the surgeon, and the anthesiologist was $17,300. Each additional night in the hospital was $2000. This is a HUGE sum of money. Dr. Jossart is sensitive the fact the VSG surgery is coming out of the patient's pocket. Few insurance companies will cover VSG. He sends you home (or to your hotel) as soon as you are doing well in the care of a "support person." We had a list of what symptoms to watch for and a 24 hour phone number. My husband called the number one time because I was sleeping almost non-stop the first two days after being discharged. Dr. Jossart called back right away. In my case I had to stay in San Francisco until after my pre-op appointment 4 days after surgery. On the 5th day after surgery I was allowed to fly home. (You should read my horror story with TSA at the San Francisco airport on another thread.) You might ask me why I went to San Francisco for surgery. Why not have it in Oregon? Why not have it in Mexico? I did talk to the surgeon's office in Oregon. Like most bariatric surgeons, she only started doing VSG a year ago. She can't have done more than a handful because it is all self-pay. The quoted self-pay cost was $35,000. Yes, you read that correctly - $35,000. I am a scientist and came to the decision to have VSG after reading the medical journals on the Band, Roux-en-Y, VSG, etc. There are a handful of surgeons in Spain, Belgium, and the U.S. who have done the pioneering work on this procedure and have presented their work to the international medical community. In the U.S. those surgeons are Jossart & Cirangle. No one has more experience doing VSGs in the U.S. Now a lot of surgeons in various states are starting to do VSGs. There is a learning curve. I did not want to be part of some surgeon's learning curve. Just about every surgeon who has done VSGs for at least 5 years has been busy publishing their VSG data in the medical literature and presenting on their VSG experience at medical conferences. As far as I know, no Mexican surgeon has ever published study results on VSG. This does not mean that there aren't good Mexican surgeons. Just that they do not have the experience or reputation of Jossart & Cirrangle. Well, there is no place like home. I seem to be in less pain and feeling less tired. I got on the scale this morning and I was down 8 pounds. SUCCESS!!!:glare:

The only study on "sleeve stretching" I've read is "Evaluation of the Radiological Gastric Capacity and Evolution of the BMI 2-3 Years After Sleeve Gastrecotmy," Obesity Surgery, May 2009, Braghetto, et. al. This study comes from the University of Chile. Operative procedure was the same as that of Drs. Jossart and Cirangle and most physicians in Spain. A 32 French bougie was used as a calibration tube and division of the stomach began 2cm from the pylorus. Measurements were taken on 15 patients at three different intervals for this study. After the the sleeve had been formed and the bougie had been pulled out mean gastric volume was 70 ml. (Volume determined using methylene blue.) Gastric capacity was measured on the third postoperative day by both Barium Swallow and CAT scan. The mean was 108 ml by Barium Swallow and 116 ml by CAT scan. (The difference between the intraoperative measurement and this measurement is probably due to decreased swelling as the stomach healed.) The same 15 patients were measured again 24-36 months after VSG. Mean stomach volume was 250 ml by Barium Swallow and 254 ml by CAT scan. During the study period, BMI decreased progressively and then remained stable at BMI=25 in 12 of the 15 patients. The other 3 patients had a slight increase in BMI (of worst of which was BMI=30 per their chart.) So, this study indicates some normal stretching of the stomach will occur. What are the lessons to take away from this article: 1. Work really hard to lose weight while your stomach is as small as possible because it will be harder later. 2. We've all been told to avoid carbonated beverages and to only eat until full - not until stuffed. This is because carbonation and overeating can stretch your stomach more than will naturally occur. 3. Even with the natural stretching that will occur, we can still maintain a healthy BMI. Think about it - 250 ml is about 1 cup. Before surgery your stomach held about 7 cups. If you restrict the number of meals you have and don't graze you won't be able to eat the same number of calories you ate before surgery. The key is DON'T GRAZE. When doctors say the sleeve won't stretch, you have to ask them how many Barium Swallows and or CAT Scans have they done over the sleeve life of their patients. There is a difference between what a doctor has observed with one patient (who may have needed a Barium Swallow several years after surgery due to some problem) and a controlled study such as that done at the University of Chile. Doctors have very strong opinions about things and they don't always have the same opinion. I'll stick to what has been scientifically demonstrated. Well, hopefully this info should stimulate some lively discussion.

I saw my surgeon Monday, and he said I could go home on the airplane. So we headed off for the San Francisco Airport. Airport security pounced on me because I didn't take off my sandals before going through the metal detector. (I admit I was had taken my prescription vicodin, and therefore it didn't occur to me to take off my shoes.) The TSA agent made a sarcastic remark about it being too much trouble to take off my shoes. I asked him if he would help me. (It does hurt to bend over.) He refused and told me to stand in the glass enclosed area. After a few minutes, I said "Excuse me, I've just had major surgery and can't stand here for very long." He called a woman to escort me to another area. She barked at me to take off my shoes. I asked her to help me, but she just kept barking at me. I tried to sit down but she barked even louder. My husband saw what was happening and came over to try to help. She was actually swinging something at him and came close to hitting him and told him to get out. Once I managed to get my shoes off, she made me stand there like an obedient dog and put one arm up or leg forward at a time while I was wanded. After that - and in spite of the fact that I told her several times I has just had major surgery and begged her to be careful - she patted me down - including several not very soft touches in the area of my incisions. When she was done, she just walked off. I was shocked by this callous behavior. I was chosen for this experience simply because I forgot to take off my sandals before going through the metal detector. I was a total power trip on the part of the San Francisco TSA. Shame, shame, on them for the way they treated me after major surgery. In case you are wondering, I was born in America, have blond hair and blue eyes, have always paid my taxes, had never had anything worse than a speeding ticket, and have no radical political or religious beliefs. I have always had pleasant experiences with the TSA in the past. There are a couple of REALLY BAD APPLES at the San Francisco Airport. I'm going to call my congressman's office and find out how to complain. If this has happened to me it is happening to other vulnerable people. :glare: Thank God the flight home was just a little over an hour.

I was discharged from the hostipal Friday afternoon. I sure am sore. Particularly the incision to the right of my waist. It hurts to move or walk. I have been taking the liquid vicodin I was given. I guess it isn't as strong as the stuff I had in the hospital. In the hospital I was able to get up and walk up and down the halls. Now walking hurts because of the incisions. How long does this take to settle down? I know walking is important so I don;t get blood clots.:cursing:

Thanks Bob for you comment about it being the most sore around the largest port. My largest cut seems to be to the right of my navel. It is not sore right at the cut, but the whole area around it is very,very sore. In addition, my surgeon told me he bruised my liver. Maybe that is contributing to my pain. I am sorry to disappoint you all, but I did not get to go home - just to a nearby hotel. (There is no place like home!) I get to go home on Tuesday, after my post-op check.

Hi Vegas Angel. How do you post the date of surgery and the name of your surgeon?

Unless there are electrodes attached to your skin, I don't believe any "scale" can actually measure you body composition. If you are going to buy such a scale, ask how the water and fat are determined. My guess is the numbers are guess guestamates and not a real body composition measurement.

Dear Blue Skidoo- Well, your stomach can die if your surgeon cuts the gastric artery. That's the reason to use a surgeon who is highly experienced in sleeve gastrectomy and who has an excellent reputation. The good news is that your surgeon apparently did not cut your gastric artery. If he did you would know it by now! Anyone can have nutritional deficiencies. You don't have to have had bariatric surgery to develop a deficiency. As long as you eat properly and take the Vitamins your surgeon recommended you should be fine. In the event you do develop a deficiency, your PCP will be drawing blood once a year and should catch anything in plenty of time to correct it. As for the rest of the stuff you heard, it sounds like urban legand. Stop worrying. Just see you PCP once or twice a year for blood tests. Best wishes,

Hi- I am wondering if the incisions will be sore? Will a bra, waist level panties, or elastic-waisted pajamas irritate the incisions or make my stomach sore? Advise is appreciated regarding what kind of clothes to bring. :confused: I will be staying in a hotel for a week after surgery. Any advise about what to bring beside a good book? Best wishes :smile1:

Regular exercise will improve your sex drive no matter what your weight. We should all be doing regular exercise to reduce the risk of loosing too much muscle mass during weight loss and to improve our hearts.

Wishing you the a very easy surgery and a quick recovery. Best wishes,