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4MRB4PHOTO

Gastric Sleeve Patients
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Everything posted by 4MRB4PHOTO

  1. 4MRB4PHOTO

    people not educating themselves

    Here is a perfect example of misinformation, everyone knows that 77.956% of the statistics are made up on the spot. I know that is true, someone told me, who heard it from someone else, who overheard two people talking on a train that they read it in an internet post.
  2. 4MRB4PHOTO

    Post Your Silly Rant

    People who make a printout or copy and when they go to retrieve it, find the copier jammed and instead of following the onscreen instructions how to remove the piece of paper (or at the very least tell someone who may be able to clear it) they just walk away. What do they think, that the copier fairies come out at night when everyone goes home and clear out the paper jam?
  3. 4MRB4PHOTO

    Post Your Silly Rant

    Getting stuck behind a person for a few minutes because they do not have their transaction ready when they go to a drive up ATM (or even a walk up), even though they were on line behind 1 or two other people and then instead of pulling up so the next person can use the ATM, be stuck on line longer while they put away their money, bank card, fix their hair, adjust the mirrors, etc. Some people you don't know what the hell they are doing and why it is taking so long. It is as if they are trying to do a hostile bank takeover via the ATM or never saw a keypad or touch screen before. HELLO, they had ATMs for decades now, they still work about the same way! Rant over (microphone drop).
  4. 4MRB4PHOTO

    Alcohol

    I also remember reading and hearing years back that "4 out of 5 doctors prefer Camels". Well at least 1 out of 5 doctors aren't into bestiality!
  5. 4MRB4PHOTO

    A lil scared Spiked M levels

    I hope that it is nothing serious. I am not familiar with what could cause this nor do I have any medical expertise. Don't stress yourself out over it being cancerous, maybe there is another reason such as a medicine you are taking or some other minor, treatable health issue that is causing this? Are you on a pre-surgery weight loss diet? Are you eating extra Protein? I am not saying this could be the reason, but maybe your blood chemistry is being affected with rapid weight loss?
  6. 4MRB4PHOTO

    Translation help - french speakers

    I think it is pronounced (in a French accent) "Le Cottage Cheese". Sorry, I don't speak French. But "fromage" is something I have seen on cheese.
  7. 4MRB4PHOTO

    My Dad's First Compliment

    He called you a "fat a-asterisk-asterisk"? It could be worse, he could have called you a "fat a-exclamation point-exclamation point". You sound like a great son. I will not make excuses for your Father's words or how he has treated you in the past, nor will I say anything negative about him. He is your Father and I want to believe that he loves you very much. You can't change the past, but hopefully through open dialogue you will have a strong, caring relationship going forward. It sounds like you are off to good start. I hope your relationship with him continues to grow stronger.
  8. "Have patience young grasshopper." You need to follow your post op plan. It won'f be that long until you are eating soft Proteins and then onto solids.
  9. Tell that to my sore bum. If it's not the staples, then what is it?? Your move, know it all. In the dark, could your significant other confused the "restroom" with the "snack bar"? Evolution was not always a good architect. OH NO YOU DIDN'T!!! BAAAAHHAHAAAAAAA!! I am totally quoting this little gem so your 120 minutes don't pass without record of this remark!!!! Nope, I "own it" and stand behind it (the remark that is) and wasn't going to delete or change it -except for maybe a spelling error.
  10. 4MRB4PHOTO

    Work, Work, Work, Work, Work

    @@Andrea72 "....Meanwhile in another episode of "As This Dysfunctional World Turns", the mother from Honey Boo Boo is going on a strip club tour. ARE YOU FREAKING KIDDING ME?!?!?" To each their own; some people will enjoy watching her. But me-thinks there might be a little more shouts from the audience of "PUT IT ON!" than "TAKE IT OFF!".
  11. 4MRB4PHOTO

    The great straw debate!

    Thank you for these images. I will never be able to enjoy a 7-Eleven sugar free Slurpee again.
  12. Tell that to my sore bum. If it's not the staples, then what is it?? Your move, know it all. In the dark, could your significant other confused the "restroom" with the "snack bar"? Evolution was not always a good architect.
  13. 4MRB4PHOTO

    Getting Called Fat After WLS

    Talk about the "down under"!
  14. Dub, that is absolutely preposterous! Everyone knows that only a sting from a box jellyfish with toenail fungus can do that! (I have 119 minutes to verify this information and make a correction).
  15. 4MRB4PHOTO

    NEW POLICY: Editing Posts

    I agree or disagree with this decision. I guess I have another 119 minutes to make up my mind.
  16. 4MRB4PHOTO

    The great straw debate!

  17. 4MRB4PHOTO

    The great straw debate!

    "Bubbles" is a very lucky man.
  18. Here is an article I posted before and a spreadsheet I created for bougie sizes: Sleeve Gastrectomy – Does Size Matter? by Kimberly Taylor on August 21, 2013 · Comments | Weight Loss Surgery The gastric sleeve procedure has quickly become one of the most common types of weight loss surgery, jumping from obscurity to importance in only a few years. Despite it’s newfound popularity among patients and surgeons, there are many technical aspects of the procedure including bougie size that remain controversial. What is a Bougie? The bougie (prounounced BOO-zhee) is a measuring tool in the form of a long, thin, flexible tube. The surgeon uses it as a guide when dividing the stomach. During surgery, the bougie is put into the mouth and pushed down through the esophagus and stomach to the pylorus. The tube creates a bulge inside the stomach that the surgeon uses to guide the stapler when dividing the stomach. After the sleeve is formed, the bougie is removed from the body. Bougies comes in a range of sizes that are identified by a unit of measurement called a French. 1 French is equal to 0.333mm (1/3 mm) and is abbreviated as F, Fr or FR. For reference, a 40F bougie measures about 1/2 inch (40F x 0.333mm = 13.32mm, converted to inches is 1/2″). Standard bougie sizes in the United States range from 32-50F. The bougie size is not the same as stomach size, although it does influence the size of the sleeve. Generally, the smaller the bougie, the smaller the new stomach size, but the same size bougie does not always create the same size stomach. The finished sleeve size is determined by how close the stapler gets to the guide and whether the surgeon oversews the staple line and if so, by how much. While the gastric sleeve is now widely accepted as a primary bariatric procedure, there is not yet unanimous agreement on an ideal bougie size. The decision is trying to find the size that will provide the safest results with the most amount of weight loss. With a smaller bougie size, the smaller the sleeve and greater the restriction, but greater the risk of leak and stricture rate. A stricture is an excessively narrow section that develops when scar tissue grows and interferes with the normal movement of food and liquids into the stomach. It can cause upper abdominal pain after eating and chronic vomiting or regurgitation of undigested food. Symptoms usually start in the first 6 weeks after surgery. Strictures are very uncommon, but surgery is required to remedy the situation. If a larger bougie size is used, the sleeve will be larger and the operation safer, but the concern is that it may not produce enough weight loss. 2008 Study A study in 2008 found that a bougie size of 40F compared with 60F did not result in significantly greater weight loss in the short term. Comparing 40F versus 60F: At 6 months, the excess weight loss was 38.8% versus 40.6%. At 12 months, the excess weight loss was 51.9% versus 45.4%. (Study: Laparoscopic sleeve gastrectomy: does bougie size affect mean %EWL? Short-term outcomes. Surg Obes Relat Dis. 2008 Jul-Aug;4(4):528-33. doi: 10.1016/j.soard.2008.03.245.) 2013 Study In a 2013 study, researchers wanted to find out if there is an ideal bougie size. To do this, they did a search of medical literature published in the last 5 years and analyzed 32 publications involving 4,999 patients. What they found: The use of bougies 40F and larger had a leak rate of 0.92% and excess weight loss of 69.2%. The use of bougies smaller than 40F had a leak rate of 2.67% and excess weight loss of 60.7%. The results show that larger sizing bougies had a lower incidence of leaks with no change in weight loss. The researchers call for further studies before a decision is made on optimal bougies size, but recommend caution in using the smallest bougie possible because the risks may outweigh the benefits. (Study: The Effects of Bougie Caliber on Leaks and Excess Weight Loss Following Laparoscopic Sleeve Gastrectomy. Is There an Ideal Bougie Size? Obes Surg. 2013 Aug 3. [Epub ahead of print]) 2012 Surgeon Survey According to a 2012 survey of surgeons experienced in sleeve gastrectomy, the bougie size used ranged from 32F to 50F, with the most common size being 36F (used by 32% of surgeons surveyed). Studies show that the procedure is relatively safe, but there are still many variations in bougie size. (Study: Survey on laparoscopic sleeve gastrectomy (LSG) at the Fourth International Consensus Summit on Sleeve Gastrectomy. Obes Surg. 2013 Aug 4. [Epub ahead of print]) Bougie Size Bougie size is based on patient input, height, weight, and surgeon technique. The bougie size is typically smaller when the procedure is performed as a stand-alone procedure (32-50F) rather than part of the duodenal switch (50-60F). Depending on the bougie size used by the surgeon, the new stomach size will be about 60-80% smaller after surgery. The average stomach holds 30-40 ounces, or roughly 4-6 cups per meal. After surgery, a small meal of 1/2 cup to 1-1/2 cups will fill the new stomach pouch. The sleeve will stretch somewhat from the surgery size, but will get no where near the size of the original stomach. If you are planning to undergo the sleeve gastrectomy procedure, make sure you discuss the bougie size with your surgeon during the pre-op process. It is important that you understand the rationale for your surgeon’s recommendation and to feel comfortable with the size of your post-op stomach. While bougie size is a consideration, healthy weight loss will ultimately depend on following a reduced-calorie, nutrient-rich diet. The sleeve will help reduce hunger and limit food intake, but it is up to you to choose the foods and liquids that you put into your body. I made a quick EXCEL spreadsheet converting the size to mm and inches based upon the formula. Note: Per this article, the surgeon's techniques contribute to the overall size ("...how close the stapler is to the guide...", "...whether they oversew"..., etc.) Bougie Size mm Inches 32 10.66 0.42 33 10.99 0.43 34 11.32 0.45 35 11.66 0.46 36 11.99 0.47 37 12.32 0.49 38 12.65 0.50 39 12.99 0.51 40 13.32 0.52 41 13.65 0.54 42 13.99 0.55 43 14.32 0.56 44 14.65 0.58 45 14.99 0.59 46 15.32 0.60 47 15.65 0.62 48 15.98 0.63 49 16.32 0.64 50 16.65 0.66
  19. 4MRB4PHOTO

    Am i in trouble?

    Yes, you are starving yourself at 200 calories/day. Your body is going to get Protein one way or another. If you don't provide it enough protein, it will obtain it from your muscles. You need to also drink enough liquids every day too. I'll let someone with medical experience chime in, but IMHO you are heading down the path for some serious health issues at this rate. If you were provided any nutritional counseling or information on the post-surgery diet phases, search for them online from reputable sources. Maybe you can meet with a nutritionist? You need to act on this promptly! I wish you well.
  20. 4MRB4PHOTO

    Drinking With Straws

    The use of/not of a straw when drinking liquids has been discussed, sometimes passionately, many times before. I found "scientific" images of circumstances where they should not be utilized.
  21. 4MRB4PHOTO

    Drinking With Straws

    I'm going to walk out before I say something y'all will regret. Let me guess..............Does it involve never giving a bull a giant straw?
  22. 4MRB4PHOTO

    Funny Weight Related Pictures

    If you have a funny (or even serious) weight related picture, post it for everyone to enjoy. I was always told that vertical stripes makes you look thinner; here's the proof: (I wish it was that easy)
  23. 4MRB4PHOTO

    Just For Laughs or Inspiration

    Post a cartoon, joke, quote or picture for laughs or inspiration.
  24. Oh God, why did you give me that image! I wish I could use bleach with a brush and scrub it out of my brain. I'll probably have night terrors while sleeping tonight. Thanks.
  25. These "straws with girth" that you speak of to drink your beverages with, do you place one hand behind the back of your head pushing you downwards when you are using them? Inquiring minds would like to know. Any person who dared push my head downwards under any circumstances is likely to draw back a nub. My first black belt included knife training. My second came with bo staff, nun chucks and sword. I am one year away from earning my third. You don't even want to know what I am practicing now. That said, beginner self defense teaches you to scratch, claw and bite down hard if you feel threatened. They already got me with a knife down there when I was born.

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