MacMadame

My surgeon has been doing sleeves for 7 years. Most surgeons have been doing them for about 3-4 or even less. In their 5 year study, they only had 3 years of data with the 32f. However, data falls behind reality and I think the practice has more like 5 years of experience with that size. With most WLS, regain happens around the 2-3 year mark. That's when the hunger comes back for everyone (though usually not like before), when everything is at its max stretched out, when the patient is most likely to ease up with the rules, etc. With some of the older surgeries, regain would happen farther down due to failure of the procedure -- at about 5 years out. But the VSG is the stomach portion of the DS and that procedure has been done for around 20 years with no failures like that. Plus partial gastrectomies (of which the VSG is a subset) have been done for decades. So we know what happens with this kind of operation long term and we know there is nothing that is going to fail. For some people, the lack of data is a sticking point with this procedure. They want a surgery that's been around for 20 years too. I can understand that, but it wasn't for me because I believe the operation is sound from a engineering point of view. There is no stoma or pouch to enlarge like with bypass. There is nothing to grow back together like with VBG or bypass. There is nothing mechanical in there that can fail like with a band. Plus my aunt battles stomach cancer and has lived most of the time I have known her with a partial gastrectomy so I have personal knowledge that people can have good lives with part of their stomach missing.

With EVERY wls, there are some people who don't lose much or who gain every drop back. Just like there are people who get to goal and beat their surgery type's average EWL. But the average EWL for the sleeve is about the same as the bypass, which is better than the band. There are a number of reasons for this, but I think the main one is hunger control. Hunger control with the band works by giving you proper restriction. If you don't have enough restriction, you will be hungry and if you are hungry, you won't stay on your diet. Some people have found getting to the "sweet spot" to be elusive inspite of their best efforts. They get restriction and then lose some weight and lose that restriction. Or they never get true restriction and are doing it all by willpower -- the same method that we've all tried before and failed. Hunger control with the sleeve, OTOH, comes from removing the part of the stomach that produces ghrelin, the hormone that stimulates the appetite. While some people still experience hunger, it's nothing like before (and often not real hunger). So it's a more sure thing. As for complications, the sleeve is a more serious operation upfront. There is the possibility of a leak which can be very serious as people die from them if not detected in time. But once you pass the 1 month mark, you are pretty much home-free. So the long-term complication rate is very low, much lower than with a band. With a band, the short-term complication rate is excellent. It's pretty rare to die from a band -- and usually going to a butcher is involved, though of course there are also freak accidents. But the long-term complication rate is not good. The longer you have the band, the more likely it is that something will go wrong that will lead to a re-operation including slippage, erosion, port flips, band leaking, esophegal spasms, uncontrollable acid reflux, etc. One hospital reported a 40% complication rate by 10 years out. My surgeon says it's more like 25% in his experience. Yeah, 25% is a lot less than 40% but it's still ASTRONOMICALLY high. It was too high for me and that's at least one reason why I got the sleeve.

I have a confession. Last week when when I weighed in, my weight was 159.5. I was pissed because two days earlier it was 159. So I put 159 in my ticker figuring it would go back down to 159 the next day and then I'd lose some more and no one would ever know. This breaks two of my rules. First, I was weighing more than once a week. Second, I *always* round up. So today I paid the piper. I only weigh 159 and now it looks like I didn't lose anything this week even though I did. That's what I get for cheating, I guess.

I don't think ordering club soda is weird. I do think it's weird to order two different drinks every time you go out. Sometimes I switch drinks in the middle because I'm sorry for my first choice, but not very often and not every time. (And not since my surgery, obviously.)

Um, this is Rants and Raves. You are supposed to post CONTROVERSIAL topics. That Oprah is an idiot is more like a universal truth! J/K, I'm sure her fans will be out to defend her soon and then the fur will fly, baby! :frown:

A mini-bypass (aka as the "loop" bypass) is a dangerous operation that isn't recognized by the American Society of Metabolic and Bariatric Surgeons. IMO you should RUN from any surgeon who thinks it's a good idea. Anyway, if you want some hard data, the LapSF guys have recently published their 5 year data which includes results for over 750 patients. What they have found is that when they first started doing the procedure, initial weight loss was excellent. However, at around the 2-3 year point, regain became a problem. So now they do the sleeves with a 32f boughie and regain is not an issue. Average EWL is around what you get with a bypass and regain stats are actually better ... around 20-25% of bypass patients regain a significant amount of weight. But only about 10% of their sleeve patients have this problems and their average regain is not as significant. The LapBand has the lowest average EWL stats of any of the four WLS recognized by the ASMBS. Duodenal Switch has the best average EWL. Bypass and sleeve are in the middle. However, the lower your starting BMI, the better you are going to do with any surgery. Plus averages are just averages. You need to match the surgery type with your food issues to get the best results. If you do that, you'll be one of the above average people instead of the below average people.

I think a VBG to VSG is a pretty natural operation. You would just be taking out the band and finishing the transection of the stomach. I'd think you could probably revise to a bypass as well, but I'm not sure about the band. That might be trickier because your stomach has a hole in it now. Both of the surgeons at LapSF (where I went) have done VBG to sleeve revisions including at least one I know about that was VERY HAIRY because the band was so embedded into the stomach. But this person was on a liquid diet for over a year beforehand due to problems with her VBG. So it was totally worth it for her. In fact, it probably saved her life. But if you aren't having big problems, I would guess your operation wouldn't be as hairy as hers was. You would still want to go to someone very experienced with revisions, even if you have to travel to find them. Revisions have higher risks so experience is even more important than it is when your stomach is a "virgin." If you do get a VBG to sleeve revision, the aftercare can be handled by your PCP so that shouldn't be an issue.

The sleeve that is left is around the size of the pouch that is created with the band so if you have a sleeve, there is nothing to put the band around. They do put bands around RnY pouches when the stoma stretches out. But sleeves don't have a stoma so that's not an issue.

I haven't had a bullet in over a month. Don't you remember ... they started making me nauseous! Anyway, I have four tubs of Chike. It's a combination of whey and soy that seems to sit better in my tummy than the 100% whey. I don't really like the chocolate shakes though. I think it's hard to fake chocolate. I also do the Protein hot chocolate -- that one is okay for fake chocolate, probably because it's hot. With the amount of real food I'm eating these days, it takes two shakes and 1 protein cocoa to top up to over 100 g. some days. Today I only had 1 shake so that's good. I hate getting all my protein from the same source.

The Intro section can move fast and posts get buried down on the page. Plus it's mostly newbies here. The other areas of the site have more old timers and are better for asking questions.

Hey, if you have any unexpired Vitamin D or omega fatty acids, send them to me!

Welcome to LapBandTalk!

Welcome to LapBandTalk! Be sure to check out the Mens Forum, if you haven't already.

It started out that way, but my surgeon (and others) have found that doing it with VSG-sized sleeve with a longer common channel gives just as good weight loss but minimizes the problems with diarrhea and malnutrition. I'm not sure if he does every DS this new way, btw, or if he lets the patient decide which they want. Plus he still puts his patients on quite the supplement regime and says about 10% have malnutrition issues. I currently take way more supplements than you guys because I screwed up in the early days, causing some malnutrition issues, and also I base my supplements on my labs and I work each number so it's in the middle or high end of the normal range. But, even so, I frequently forget and have to double up the next day to make up for it. If I *had* to take all these Vitamins to stave off malnutrition, I'd be in big trouble. It's hard enough getting in the 100 g of Protein I need to get my protein levels back up.

I don't have a band but my average calories is about 700 a day and I'm training for a triathlon. I didn't start out in wonderful shape ... I was in okay shape though ... so I am seeing dramatic improvements in my cardio workouts. I'm sure that will level off as I get to a more fit level. Anyway, make sure you get lots of Protein so you have the energy you need throughout the day and then time any carbs you ingest so they are right before and/or after your workout. Plus take your vitamins! That's the advice I'm following and it works for me. ETA I was on 500 calories at day at first and I would do cardio at the gym just fine. I was only doing 30 min about 3x a week back then though. Now I do 45 min. and 4-5 times a week.

IME, people who make loose plans like that are rarely put out if you want them to change them. They'll just make some new plans.

Welcome to LapBandTalk! Have you looked into a medical loan with a place like Care First? They usually don't require the same sort of credit score as, say, buying a house. But of course the interest rate is more like a credit card than a mortgage.

Welcome to LapBandTalk! I'm from CA so I can't help you. Have you checked out the IL section yet? I'm sure someone there would know.

Welcome to LapBandTalk! Did you know there are more surgery types than Bypass and Band? Be sure to check them all out before you make your final decision. I chose the "sleeve" which has a low long-term complication rate but the excess weight loss is more like bypass. There is also the DS, but if you are scared of bypass, the DS is even more heavy-duty.

Welcome to LapBandTalk! I think internet support is a wonderful thing. My surgical group has monthly support meetings, but sometimes I need support in between and I can get it here.

Welcome to LapBandTalk! I hear you about wanting a successful surgery. I also picked a surgeon that other people think is "mean". It was a concern because bariatric surgery requires a lot of follow-up and after-care to be successful and I didn't want someone who would piss me off so much that I would stop doing the after-care program. But after I met him, I knew we'd get along great and it's all worked out.

Welcome to LapBandTalk! For my initial weight goal, I picked a number that was right on the cusp between an Overweight and a Normal BMI. I figure I can adjust it as I go but so far that seems to be realistic.

I have determined through actual experience that I hate it more when people don't notice my weight loss than when they do.

Except you do... You don't have to limit fat -- which we've all been conditioned to think of as evil, but isn't necessarily -- but you have to limit white carbs and get in lots of protein. You can't be sucking down donuts all day, for example. You need to eat primarily meat and veggies just like most of us do. I know a few DSers who are not insane. They freely admit that, if they eat white carbs, their farts can clear the room. They admit that the supplementing regime is heavy. They love their surgery, just as we all love our surgeries, but they understand why other people would want other surgeries. It's only a subset of DSers on OH who are whack jobs and will not admit ANYTHING negative about the DS. They insist there are no poop or fart issues, that the supplementing is "easy", that their surgery is "the best" because it has the highest average EWL (because that's the only measure that matters, apparently). They also go on about how the DS "cures" diabetes but the other surgeries only put it into "remission" and claim it has a 98% cure rate when studies show it's more like 90% and the cure vs. remission I feel bad for the people they suck into their little world who get a DS and then have issues with the lifestyle or with malnutrition, but I figure, for the most part, people are adults and can see through their BS. I think they actually turn off more people than they convert... I know I never seriously considered the DS until I met some reasonable people who had it. Even then, the only thing I like about it over my surgery is that you can eat and drink at the same time and, the way my surgeon does the DS, you can't because the DSers get the same size sleeve as the VSGers. So there goes that advantage!

Ooh, I want a Nike+!