ouroborous

Yeah it's little incidents like these that make me VERY ready to be CPAP-free once again!

Absolutely! That was one of the appeals of VSG for me -- the ability to lose weight without having to follow some sort of super-restrictive diet. Not only are those diets almost impossible to maintain in the long term, but they can be harmful to your health.

I think it's important to separate anecdotal evidence (individuals who controvert the study) from the empirical data (the vast majority of individuals who fit under the bell curve). Or, in non-geek-speak, "there is an exception to every rule, but that doesn't mean the rule doesn't apply." Just because you are a large woman or small man who earns a lot of money doesn't mean that, in general, this study doesn't apply -- any more than a single cold winter disproves global warming.

So, I started at 330; 249, for me, is a big deal. I saw my doctor today (routine checkup) and he actually broke down in tears about how "proud" he was of me. Since I feel like I haven't done any real work, it was a bit confusing, but still gratifying. I feel like I'm slowly -- at age 40! -- becoming the man I was "supposed to be." Here's a picture I took tonight of me wearing a bunch of Xmas presents (my new peacoat, my hand-me-down jeans -- 8 inches smaller at the waist than my last pair! and starting to get too big! -- and my new boots, which you can't see... stupid camera!). It's almost like I'm photographing someone else these days. I don't even feel like it's "me" in the pictures. Weird, eh?

So, I'm about five weeks out from surgery -- May 6th. For reference, I'm a 39 y.o. male, BMI 42 (6'1, wt. 330). My cardiac scans were good, I'm going for an EGD on Thursday due to concerns about GERD and some upper right quadrant pain that could be gall bladder, but is more likely due to my enlarged liver. I have been diagnosed with fatty liver (without scarring, thankfully), but my liver enzymes are normal. My surgeon suspects that my upper right quadrant pain (it is very mild and intermittent) is the enlarged liver pushing against the "capsule" that it sits in. Hopefully with weight loss, this problem will resolve itself. I'm in generally good health otherwise -- I have sleep apnea, as you'd expect for someone who is 120 pounds overweight, but no diabetes or cardiopulminary issues. Aside from some recurrent allergies, sinus infections, I think I'm in decent health (for an obese man). So here's my question. I'm a worrier -- I worry (needlessly, most likely) about post-operative and perioperative complications. I know that my anxiety is normal and not the end of the world, but I'd like to know: 1. What is the real complication rate associated with VSG? I know that general anesthesia always carries risks, but these are generally small. What are the chances of leaks and so on? My doctor (Dr. Robert Landerholm in WA state) has performed "hundreds" of VSG's with "one" leak (due, he said, to patient noncompliance), so I'm hoping that surgeon competency isn't an issue. 2. What can I do now, in the month leading up to surgery, and after surgery, to increase my chances of a successful, complication-free operation? I suspect that with an already-diagnosed fatty liver, the pre-op diet is going to be crucial. I'm also going to start doing cardio work every single day to make sure my heart and lungs and immune system are as strong before the operation as I can make them. Is there anything else I can or should be doing?

Quitting smoking is VERY hard. The most important thing is not to be too discouraged by setbacks, and to keep trying. Remember that it's more important to have smoke-free days than it is to be 100% perfect in quitting your addiction. So, even if you smoked 100/365 days last year, that's still 265 days that you DIDN'T smoke, and that all adds up to time for your poor lungs and heart to heal.

Congratulations on the great process, longhorn! I'm going through a lot of the same things you have. I'm a very sedentary guy, so the transition to being more active is nowhere near as smooth as it seems yours has been, but still I move a LOT more than I used to. The confidence thing is a big change, isn't it? I'm nowhere near "confident," but I'm so much *more* confident today -- even 50 lbs above goal, still -- that I'm almost like a different man. Congratulations again. It's good to see my sleeve-brothers doing well!

Large amounts of anabolic (muscle-building) exercise can trigger HGH "dumps," which can lead to vomiting. Bodybuilders have known about this for years (pump till you puke being an operative phrase). I used to have this happen to me quite frequently when I was a bodybuilder in my 20's (these days I'm far too lazy to work hard enough to throw up!) You should definitely talk to your doctor about this, but if there's no other cause found, it may be a simple HGH dump.

This is absolutely correct, and a very good point. The net result of lap sleeve is, for almost all of us, a significant reduction in risk of death and illness. The few specific risk areas -- GERD, B12 deficiency, acid-blocker consequences -- are relatively small compared to the big killers like diabetes, heart disease, and cancer.

If you begin having any problems breathing, or start spiking a high fever or vomiting, run, don't walk to the ER. A staple line leak (which this starts to sound like) is nothing to mess around with.

IIRC, it would take you more than a month for hypoproteinemia (low protein) to significantly harm you. Although you don't want to go with too little protein for too long, at this stage of the game you're still living primarily on fat stores! So take your time to find a protein concoction that you LIKE (or at least, can tolerate), and don't stress out too much. The most important things at this stage for you are doing *everything* the doctor orders, trying to move as much as you safely can, and drinking lots of water. That, and rest!

I had a liver ultrasound to diagnose fatty liver some time back; it really is nothing to be concerned about. It's not even uncomfortable; I almost fell asleep during mine! I have heard that very rapid weight loss can be a strain on the liver, but I don't know if I've ever heard of permanent damage being done from drastic weight loss. I am not a doctor, but I'm a concerned layman who's been tracking his own liver health for some time. The most likely cause of elevated liver enzymes is fatty liver. I'm not sure if the metabolism of the fat capsules on the liver can lead to elevated ALT/AST, but I do know that *healthy* weight loss is one of the best things you can do for your liver; my liver functions were always borderline "abnormal" pre-sleeve, and now they're all perfect. So, I'll echo what others have said: follow your doctor and nutritionist's advice to the letter. If you're always nauseous and that makes it hard to eat, TELL them -- make sure you're heard! -- they may be able to propose a solution (maybe a change of dietary habits, or an antinausea medicine, or something... who knows, maybe they'll prescribe THC!). But the bottom line is that elevated ALT by itself is not something to lose a great deal of sleep over. As the quote below shows, some hepatitis patients have ALT levels of a thousand or higher and yet recover with no liver damage after treatment. http://www.medicinenet.com/liver_blood_tests/page2.htm#4whatdo

Drinking Water is as close to a religion as the granola crowd has! And yet almost all experts agree that most people get most of their water from food and other beverages. As always, you should listen to your doctor/nutritionist. But the idea that you have to be chain-swigging glass after glass of clear water to avoid "dehydration" (and by the way, slightly dark urine or dry mouth or even slightly crepe-paper skin is NOT the same thing as clinical dehydration! -- which exhibits with things like nausea, confusion, and death) is probably more than a little bit silly. It's ironic that we Americans (overgeneralizing here, but I get the impression that most on this board are Americans) worry way too much about things that aren't very likely (dehydration) or aren't -- in the grand scheme of things -- very dangerous, and not enough about things that ARE likely killers (heart disease, diabetes, smoking-related illnesses, cancer).

I most enjoy feeling like a MAN. It's hard to quantify that, but it's definitely the biggest perk.

Erm. A gentleman doesn't kiss and tell.

Yes, and yes. The... mechanics... are... way better. Oh, btw, there are limits. For someone like me with >100 lbs to lose, no... you don't become a porn star (and the women in my life are thanking me). But what you HAVE becomes more... available, and definitely more USEFUL.

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Thank you You too!

Thank you, Davida! It still really hasn't sunk in!

Thank you, thank you

Thank you! The jeans are getting to be too big at the waist!