LOWCALGAL

Another ? Does anyone know if some recommend wearing a tummy tucking underwear of some kind in order to prevent the navel scar from straining and maybe to hold some of the tummy as the weight goes down and the loose skin flaps (?). I already hate my question lol

Today was my first day off the liquids, I was scheduled to eat only as much as comfortable from a serving of oatmeal topped with a tablespoon of sugar free jam and 1 tablespoon unsweetened yogurt. That was nice and healthy, but I was able to eat it ALL, over about 20 minutes, without any problem at all - WTH ? I was expecting a LOT more restriction that this. Now I am worried !

MrsG thank you for this important detail. I am still using the occasional oxy pain relieving pill, so indeed maybe I am not feeling my sleeve as I should: I would have never thought of that ! I was careful to remain on plan and have not eaten more that the daily menu, all things weighed and measured, so I should be ok, but that is a GREAT point that they SHOULD TELL everyone after surgery. I think this information should be a sticky note on the forum: BEWARE: RIGHT OUT OF SURGERY AND FOR A VARIABLE SHORT PERIOD YOU MAY BE UNABLE TO FEEL YOUR STOMACH AS YOU SHOULD, DUE TO SWELLING AND PAIN MEDICATION. DON'T GAGE YOUR FULLNESS BY THE FULLNESS YOU FEEL, USE INSTEAD THE PORTIONS INDICATED AS YOU MAY OVEREAT AND NOT NOTICE, THEREBY INJURING YOUR SLEEVE. DUHH! ME AND ALL MEDICAL PERSONEL!

Thanks for all the comments. Indeed it is about the feeling of restriction, only 4 days and that oatmeal went down too easy. I mean before surgery I could barely eat a whole cup of oatmeal anyway lol For lunch I had pureed chick peas and cottage cheese along with canned peas and asparagus that I chewed to a pulp. It was funny to look at my "toddler".plate ha! The amount that I was able to eat were absolutely less than before,but still more than I expected.and while everything was noted and measured, I did not expect to be able to eat it all as others have mentioned I had read about people being stuffed after a tablespoon or two of food...that won't be my case. I can see that I will be able to eat at least a cup of food, as I am now and while I did not try to eat more; nothing in my body made me feel awkward or that I should stop before I had it all. So far I am ON PLAN,and lost some weight already but I see that I am not as restricted as some are.

I am having my surgery on monday, or maybe. My blood test revealed low Protein (total and albumine)just under the normal rate, just barely, but now I need to do a urine test and I just know that it will be positive for protein. I have smelled it and I can smell that slight buttery scent that would indicate protein in them. Now I have asked the nurse and she seems to think that if I do have some protein in my urine, the surgery will be cancelled. I am so disheartened. The next slot for an operation will a long time from now. I am wondering if anyone had such a thing happen to them. Is impaired (of it turns out to be that) kidney function a contra indication to this surgery (sleeve)? Thanks

http://journals.lww.com/annalsofsurgery/Abstract/2010/08000/Long_term_Results_of_Laparoscopic_Sleeve.16.aspx Results: Full cooperation was obtained in 41 patients, a response rate of 78%. Although after 3 years a mean EWL of 72.8% was documented, after 6 years EWL had dropped to 57.3%, which according to the Reinhold criteria is still satisfactory. These results included 11 patients who had benefited from an additional malabsorptive procedure (duodenal switch) and 2 patients who underwent a “resleeve” between the third and sixth postoperative year. Analyzing the results of the subgroup of 30 patients receiving only sleeve gastrectomy, we found a 3-year %EWL of 77.5% and 6+ year %EWL of 53.3%. The differences between the third and sixth postoperative year were statistically significant in both groups. Concerning long-term quality of life patient acceptance stayed good after 6 + years despite the fact that late, new gastro-esophageal reflux complaints appeared in 21% of patients. Conclusions: In this long-term report of laparoscopic sleeve gastrectomy, it appears that after 6+ years the mean excess weight loss exceeds 50%. However, weight regain and de novo gastroesophageal reflux symptoms appear between the third and the sixth postoperative year. This unfavorable evolution might have been prevented in some patients by continued follow-up office visits beyond the third year. Patient acceptance remains good after 6+ years.

1- Lots and lots of question pre-op, going on march 25th, 2013... I know why I am fat. 1/3 is my stomach can stretch and I don't feel full, 1/3 is my body's economical ways, 1/3 is my emotional over eating. The sleeve won't fix the emotional eating but it will make it impossible to do for at least 2 years, I plan to learn new coping mechanisms before my honey moon is over. At least with 2/3 of the problem at bay, I will have a fighting chance to finally win this time. Not that I have not before but the cost was so high (under eating and over training is hard to maintain). 2-I was not given a pre op diet, so I am on a last supper mode; trying not get that under control... 3-Preparing for my sleeve on march 25th and for sure I am looking into long term result. Two recent studies seem to indicate that: A- Bigger bougie size (above 40 up tp 60) does not reduce weight loss at 3 years but it reduces leaks and GERD http://www.ncbi.nlm....pubmed/23023201 b- Long term side effects reported after 5 years include GERD and regain http://www.ncbi.nlm.nih.gov/pubmed/20622654 In light of this I am wondering what the best middle ground might be. I am discussing this with my doctor but would like to hear more about real people with actual life experience. Has anyone here had a large bougie 40 and up ? 4- I am thinking of making a youtube series, though I am loathe to do it. I know how much I enjoyed doing it and I am thinking I should give back into the pool that fed me till the wee hours while I decided. Chime in please Danie

Thanks for the inputs. Funny thing is I don't have a pre-op diet at all. I just need to stop eating at midnight before the day of the procedure. SO I do get to eat a few last meals within reason )

Preparing for my sleeve on march 25th and for sure I am looking into long term result. Two recent studies seem to indicate that: A- Bigger bougie size (above 40 up tp 60) does not reduce weight loss at 3 years but it reduces leaks and GERD (acid reflux) http://www.ncbi.nlm....pubmed/23023201[/font][/font] b- Long term side effects reported after 5 years include GERD and regain[/font][/font] http://www.ncbi.nlm.nih.gov/pubmed/20622654[/font][/font] In light of this I am wondering what the best middle ground might be. I am discussing this with my doctor but would like to hear more about real people with actual life experience. Has anyone here had a large bougie size guide of 40 and up ? am wanting to ask my doctor to use a bougie 50 or 48 in light of this does anyone have information about that ?[/font][/font] 2-One question I have is about working out - when can I start again ?

Thanks for your information on sleeve size. For sure any given surgeon has a style, but none can really cut too close to the guide, as there is a rather standard distance range that they are adhere to in the profession. It is clear that stomach lenght is part of the equation, I hope only to not be too small as I want to be sure to avoid Gastric Reflux and leakage. Thanks again!

Thanks for the link, an interesting read for sure. Here is the info I was looking at: Abstract OBJECTIVE: To conduct a systematic review to identify surgical strategies that may decrease leak after laparoscopic sleeve gastrectomy (LSG). BACKGROUND: LSG is growing in popularity as a primary bariatric procedure. Technical aspects of LSG including bougie size remain controversial. METHODS: Our systematic review yielded 112 studies encompassing 9991 LSG patients. A general estimating equation (GEE) model was used to calculate the odds ratio (OR) for leak based on bougie size, distance from the pylorus, and use of buttressing on the staple line. Baseline characteristics, including age and body mass index (BMI), were included. A linear repeated measures regression model compared excess weight loss (%EWL) between bougie sizes. RESULTS: A total of 198 leaks in 8922 patients (2.2%) were identified. The GEE model revealed that the risk of leak decreased with bougie ≥40 Fr (OR = 0.53, 95% CI = [0.37-0.77]; P = 0.0009). Buttressing did not impact leak. There was no difference in %EWL between bougie <40 Fr and bougie ≥40 Fr up to 36 months (mean: 70.1% EWL; P = 0.273). Distance from the pylorus did not affect leak or %EWL. CONCLUSIONS: Utilizing bougie ≥40 Fr may decrease leak without impacting %EWL up to 3 years. Distance from the pylorus does not impact leak or weight loss. Buttressing does not seem to impact leak; however, if surgeons desire to buttress, bioabsorbable material is the most common type used. Longer-term studies are needed to definitively determine the effect of bougie size on weight loss after LSG. It states that above 40 is safer and doe not affect weight loss...also the scientist named in both studies is my doctor - so it's annoying as it makes discussion difficult hahaha !

In the most recent study (2012) they showed no weight loss change from a bougie 32 or 48. But more side effects from the smallest (gerd and leak) that is the first link. Thanks for the kind words and kuddos to you !

I need coffee and booze too ! Only 1 coffee a day and only 3 drinks a week - but I need them lol

I think I posted my intro on the wrong topic area. I am 48, female, from Canada. Weight is 225 and I am 5 foot 4 inches. Getting sleeved on the 25th and yikes ! 1- Lots and lots of question pre-op, going on march 25th, 2013... I know why I am fat. 1/3 is my stomach can stretch and I don't feel full, 1/3 is my body's economical ways, 1/3 is my emotional over eating. The sleeve won't fix the emotional eating but it will make it impossible to do for at least 2 years, I plan to learn new coping mechanisms before my honey moon is over. At least with 2/3 of the problem at bay, I will have a fighting chance to finally win this time. Not that I have not before but the cost was so high (under eating and over training is hard to maintain). 2-I was not given a pre op diet, so I am on a last supper mode; trying not get that under control... 3-Preparing for my sleeve on march 25th and for sure I am looking into long term result. Two recent studies seem to indicate that: A- Bigger bougie size (above 40 up tp 60) does not reduce weight loss at 3 years but it reduces leaks and GERD http://www.ncbi.nlm.nih.gov/pubmed/23023201 b- Long term side effects reported after 5 years include GERD and regain http://www.ncbi.nlm.nih.gov/pubmed/20622654 In light of this I am wondering what the best middle ground might be. I am discussing this with my doctor but would like to hear more about real people with actual life experience. Has anyone here had a large bougie 40 and up ? 4- I am thinking of making a youtube series, though I am loathe to do it. I know how much I enjoyed doing it and I am thinking I should give back into the pool that fed me till the wee hours while I decided. Chime in please

Thanks Sarsar, I hope others chime in about bougie size 40 seems small... thanks a lot for the information you brought.

Hello everyone. this is my first time here. I hope to find some answers...not that I haven't researched lol I am getting sleeved on march 25th...and yes I am nervous. I had my gastroscopy last Wednesday - no seds - that was unreal....felt like what I think Water boarding must be like hahaha... I hope all goes well. I am discussin bougie size and other stuff with the doc and getting all prepared for the big day - bites nails !

They vary from about 28 to 60 or more but the 32-40 range is mostly used

Nancy thanks for sharing

I just had my tests all done except the blood ones - getting those on tuesday. I did the chest x-ray and the EKG. That was the easy part lol My doc said he wants to use a 38-40 bougie. I want as big as possible since outcome seems to be the same and less complications with bigger sizes. I have mailed him about using bigger yet, I<d like 48 as it was the top range in a study that showed no difference in weight loos

best of luck to you all 3/11thers...wishing you the best

I am going on march 25 but no prep diet for me, just not to eat a day before surgery is all !

Yes the one when they make you swallow a snake lol. Are you pre-op too ^

I am scheduled for the 25th....yikes !