letmeeatcake

Hi Tania How are you? I had my plication surgery on Monday 8th of November and I know what you mean about the hunger pangs. I live in the UK and had the surgery done in Prague where they don't give you the proton pump inhibitors (ppi's) that help alleviate acid and gas production and which your body may misinterpret as hunger. As I understand it the hunger you and I are having are a combination of leftover eating habits, the severe reduction in calorific intake, how your body functions in producing the hunger making hormone ghrelin (it may assist to read Dr Watkins posts on this matter) etc. Your stomach needs you to be gentle with it after such major surgery that is why they recommend the liquid and pureed diets, but even then if you're feeling able to chew/masticate your food without any negative symptoms then that can only mean good news on a wonderful recovery. The other thing is that you will lose weight faster on the liquid diet your body is intaking less calories and having to put less energy into the digestive process. With me currently dealing with the hunger pangs is a two fold process, first keeping my goals in mind and reminding myself that the surgery is just a tool the hard work has to be done by me... sort of bite the bullet time. Anyway I think its great that you have lost six pounds, remember everyone is different and loses weight differently, just try to follow the guidelines as best as you can and if not then ensure all your foods are low fat, that you try and take some ppi's and if unlike me you cannot access them then find distractions and slowly incorporate some activity into your schedule. By the way how much are you looking to lose? Warm Regards letmeeatcakenomore

Hey Lisa my surgery will be in Prague, in the Czech Republic and I will be travelling from the W. MIDS UK, the surgery, transport including flights and transfers, two nights accomodation hospital and two nights (pre and post op) in an apartment will cost me ?5,400. If you are interested and need Nick's number I can email this to you? Regards Letme:svengo:

Hey Lisa That sounds gr8 my surgery is on the 8th of November with Professor Martin Fried. How are you feeling? Will you be taking someone with you? Regards Letme

Hey I know what you mean about exercise... tho at one stage I was a gym bunny. Now the only exercise I seem to get involves running around and picking up after the kids and the occasional game on wii fit. Let me know how the weightloss is going and keep me peeled re. any bumps in the road, I think it helps to have support. I'm beginning to feel a little nervous now, still plenty of time to go tho... Letmehavemycakeandeatitaswell letthemeatcake!

HEY CONGRATS on the weight loss that is fantastic news I know what you mean about feeling full on a lot less. How much further do you have to go? Have you adopted any sort of exercise regimen or is the weight loss purely down to lower food intake down to your good food choices and that feeling of satiety with the help of your procedure? Regards LetmeGimmee

Thank you for your offer of help with your own personal journey and I will definitely click on Dr Watkins name, I feel like I am finally getting somewhere. Regards LETME

Here is just some information that is probably already out there. Please let me have your thoughts/opinions on this. Apologies if there are any errors, again just give me a heads up. My surgery is with Prof Fried he comes well recommended and certainly seems to be an expert in the gastrointestinal/gastroentrological field. Though I am a little concerned that there is no specific suturing device being used! I checked out the doctors in Mexico, USA AND INDIA and most are well versed/good at the procedure, they tend to use the correct number and size of incisions to go in laproscopically i.e. 1, 10mm and the others 5mm; they also look at the individuals stomach to determine the narrowness of the tube/bougie size, ranging from 32f through to 42f, possibly there are larger bougies out there; though some stick with one tried and tested bougie size usually 34f to prevent stomach twisting, slippage into chest cavity, reflux etc. Prices vary with the USA being the most expensive around $9,000-$13,000 dollars unfortunately that is also where some of the better surgeons are, I suppose you the old adage "you get what you pay for," is true; through to Mexico and Europe being mid range around $ 8-9000 dollars and approx ? 6,500 if you consider the higher end of the exchange rate, this would include price of flights and accomodation and finally India being the cheapest, around $ 5- 7000 approx ?4000- ?5000 British pounds again depending on Rs/currency fluctuations and which clinic you attend including flights and accomodation. Most take a full medical profile but not all and follow the NIH (National Institute of Health) or British equivalent (NICE )guidelines re. BMI and Co-morbidities. Many good surgeons also perform an thorough OGD endoscopical check to ensure that there are no nasty surprises lurking within your abdomen that could cause future discomfort or pain, i.e. ulcers and hiatal hernias. I understand patients are advised accordingly and any size of hernia is fizxed/sutured up accordingly to prevent further heartburn/reflux. I understand that by and large sutures are made of varying non absorbable materials i.e. PDS and that the surgeons tend to apply at least two layers of Prolene running sutures using the Endoflip device by Crospon, again not every imbrication surgeon is authorised to use this device as it isn't being marketed everywhere yet and you will need to check, i.e some clinics in India and Europe are using the old needle thread holder and grasper. The stomach retains viability and therefore the procedure is reversible, the few that have had a reversal have been due to early complications such as prolonged nausea that has affected the individual and may have had an impact on the stitches? There does not appear to have been any dihension, loosening away or give in the stitches thus far. Furthermore though there have been some concerns about the stomachs elasticity it is thought that as the greater curvature, the elastic part, is being reduced and folded into itself and that the remaining inner sleeve is both smaller/narrow and generally considered to be the firm part of the stomach, that stretching of the stomach or dihension of stitches, shouldn't really be an issue as long as you try to stick to the dietary guidelines and stop eating just before you feel full. Pre op guidelines tend to be similar to other weight loss surgeries and are both dependent upon your surgeon/clinic and BMI. Though I always think it is is a good idea to try and shrink your liver. Post op dietary guidelines are as follows: 1st and 2nd Week after TGVP Clear broth or Soup without vegetables or meat and not too creamy. Low fat, sugar free yogurt. Skimmed milk. Natural fruit juice or pureed soft fruit (apple, banana, pear, etc). Vegetable juices. Low calorie drinks. Sugar free Protein supplements, with skimmed milk. Water ( 6-8 cups / 2.0- 3.0 liter a day). In between meals we recommend that you drink vegetable juice, milk, fruit juices, and water, to ingest sufficient liquids and prevent dehydration 3rd and 4th Week More liquid/pureed diet included in your meals during week 3 and 4 after the TGVP, to assist in adapting to smaller stomach How can I prepare a pureed diet? This may be a challenge for you. You will need a blender or food processor. The food has to be blended until reaching a Gerber or applesauce consistency. Avoid spicy flavours; they may irritate your stomach. Use the following list to give you an idea of what you can eat on weeks 3 and 4: Liquids or beverages, and milk. Good options: Tea, non-carbonated drinks, natural fruit juices, Crystal Light, coffee, water, skimmed milk, low fat and sugar free yogurt. Limit or try to avoid: Artificial fruit juices, soda, alcohol, all carbonated beverages, iced tea with sugar, milk or yogurt products with nuts or seeds, chocolate milk, sweetened condensed milk, whole milk. Fruits. Good options: Applesauce, pureed pears, and bananas. Limit or try to avoid: Canned fruits or fruits with syrup. Vegetables. Good options: Pureed vegetables, vegetable juice. Limit or try to avoid: Raw vegetables, canned vegetables, vegetables that cause discomfort (gas forming). Soups. Good options: Broth, cream soups make with skimmed milk, egg drop soup, low sodium bouillion or consomm?. Limit or try to avoid: All others. Starches. Good options: Mashed potatoes. Limit or try to avoid: Bread, Pasta, rice and all other starches. meats or protein supplements. Good options: Pureed chicken, fish, tuna, veal, beef, low fat cottage cheese, baby food meats, mashed or pureed tofu, pureed egg or egg substitute, sugar-free Protein shakes like Designer’s Protein, Boost Breeze, no sugar added Carnation Instant Breakfast. Limit or try to avoid: Peanut Butter, others. Fats, sugars and others Good options: Sugar free gelatine, sugar free popsicles, pudding. Therafter general recommendations are as follows: Eat three small meals a day and limit snacking in between meals. Eat slowly and chew food until it reaches a mushy consistency (15 to 20 times per bite). Stop eating or drinking right before you feel full. Eat only good quality foods. Drink low calorie liquids. Drink enough liquids /about 2.0 – 3.0 litres per day . Drink after eating. Exercise moderately, however not sooner than 2 weeks after TGVP procedure. Limit: Others. Note foods high in fat, acid, sugar and stodgy foods are to be avoided due to calorific content and problems with bloating and digestion, as well as their potential for heartburn and reflux. Carbonated drinks are to be avoided because they contain too much fizz and cause an explosion type effect in your stomach causing problems with gas and of course they are also corrosive and there may be some concerns that their explosive effects may have an impact on stretching the stomach?!! Though if you do desire these they appear to have been known to be consumed in small quantities or after the drink had been left to breathe for a couple of hours thereby disposing of some of the bubbles. Most hospital keep patients for approx two days to monitor them. I think there are some really good surgeons and these are as include, Dr Daniel Cottam, Dr Sunil Sharma, Dr Mahinder Narwaria, Dr Brad Watkins, Dr Lopez Corvala, Dr Jose Rodriguez etc apologies to anyone I may have missed off my list. Anyway I could chunter on forever, however my little ones are demanding my attention. I hope this information helps, please do not take it all as read and set in stone this is just my own research, the whole point of this site is to get better equipped by talking to experts who are willing to give up their valuable time and assist with putting this procedure out there and others intending to or that have already undergone the procedure. Finally the procedure remains in its infancy and like the sleeve we have no longer term data or comparisons of longer term weight loss, or health issues or reduction in ghrelin levels to go on, though it seems to be working. Warm Regards Cake is my favourite food

None that I am aware of. aNYONE KNOW OF tgvp surgeons in or around the UK. Good to know you have had yours repaired. HOW are you doing with the weight loss and in general, i always think a large part of the journey is as psychological as it is physical. Best Wishes:biggrin0::scared0:

Thank you all so much, especially Dr Watkins for the informative medical advice. They always say the best surgeons are the ones who assist in answering all your questions. I am booked in with Dr Fried and wlll endeavour to discuss this further with Dr Martin Fried at our consultation and come back to you all with the advice he gives. I did some research and found several places, including India, Mexico, and the USA, offered the plication but chose Europe due to the ease of travel and locale, especially as I have four young children and wish to get back to them asap. Warm Regards

Hi It's November 8th, thanks for the welcome. I was hoping someone would point me in the right direction re. reflux and hiatal hernias. It appears the surgeonwho is operating is prefers not to carry out the TGVP if the hernia is larger than 2cm and due to my reflux? I thought that weight loss would help with hernia's? Anyway he is going to do an endoscopy but if I insist on proceeding will have me sign some sort of liability waiver re. potential for hernia/reflux problems continuing or worsening. I'd love appreciate any insight upon this, then at least I can go ahead and decide better informed. Thanks Again Regards

I thought that I would post a thread for all members that had or is considering the TGVP procedure. I thought it would be a great idea for us to share our thoughts and experiences. I know of only one person so far. If you all know of any others please tell them to respond. Thanks VSG family!!

i'm awaiting plication surgery in PRAGUE