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I am ONE step closer to finally having a surgery date like everyone else. The insurance coordinator called me this afternoon and told me that she had spoken to the director of my insurance (Cal Optima) and he told her to follow up with him by the end of this week to see if I will be approved or not. She just told me to hang in there and hopefully she will be calling me next week. Initially, she said at the latest of two weeks and 1/2 that I will be hearing from her. But I guess it's another week or so of waiting for me. I suppose it's not as bad as I'm making it out to be. I've waited 21 years to make this decision, so another week wouldn't hurt! I just needed to vent. I have been feeling so heavy and it's harder for me to walk as I am reaching 265lbs. Good luck to everyone on your journey.

I had to do liquids for two weeks to reduce my liver and to get me used to diet changes. No lb. Requirement but I lost twenty no problem.

The following is some info I found re: bougies. It is not the ultimate source, I would prefer JAMA articles over this, but it's something to refer to. 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 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 would have to agree. Get it in writing. I was told 1 palm size portion of protein (or two eggs) with one of the meals, loads of the allowed veggies and 2 Optifast shakes. That’s what I did - strict, VLCD for 2 weeks prior to surgery. I was only hungry some of the time but actually ended up enjoying the structure. Miss it now being 3 days Post Op and would give anything for a shake and to not feel like I’ve just entered a pie eating contest and feel so full and bloated I could puke (just from small sips of water).

I was starving the entire pre-op diet. You're lucky you only have to do it 1 week. I had to do it 2 weeks with the same restrictions! Not gonna lie, it was awful. The only thing that got me through was why I was doing it. Does your nutritionist respond to emails? If so I would send her an email asking if it is okay to consume 100 grams of protein a day. Then you will have it in writing to refer to.

I would strongly suggest watching YouTube videos on WLS and go through this website with a fine tooth comb, read everything you can, research, ask questions, watch more videos 😇 I have been researching WLS, specifically VSG, over the last few weeks, and have not only learnt a lot but am super confident on what I want to do and what steps I need to get there.... and currently I'm 60 days out from starting my pre-op diet. Not saying I'm a pro and know-it-all, just saying that it sounds like more research/understanding/knowledge on your end will help you clear up your confusion. 🤗

Hi Amy, Welcome! You are probably one of the first to have the surgery of the people who participate in this board. I'm three years behind you (had my surgery in May 2011). I'm so glad you have joined us. I love having other vets to chat with. There is such a steep drop off as the years go by, but there are quite a few of us who are more than two years out here. I'm interested to hear how you do with the pouch test. I've heard several people say it's too harsh when you are further out. You will find other vets who have dropped their regain here. I originally had a bounce range of 5 lbs., but found that was too much and encouraged some junky eating on my part, so I cut my bounce range to 2 lbs. over goal. I still weigh and track my food on most days. Lynda

I. Can not take credit for any of these recipes they just sound good The web is full of recipes No-Noodle Lasagna This recipe is suitable for the pureed food stage. Ingredients: Low fat ricotta cheese Spaghetti sauce (look for sugar free sauce) Grated parmesan cheese Directions: Put two tablespoons of ricotta cheese in a bowl. Top with one tablespoon of spaghetti sauce and one tablespoon of grated parmesan cheese. Microwave for three minutes. Variation: One you progress to the soft stage, you can add cooked ground beef to the lasagna if you like. Refried Bean Delight This recipe is suitable for both the pureed stage and the soft stage. Ingredients: Fat free refried Beans Salsa Shredded cheddar cheese Directions: Put two tablespoons of refried beans in a bowl. Top with one teaspoon of salsa and one tablespoon of shredded cheddar cheese. Microwave for three minutes. Cheese and Veggie Casserole This is suitable for the soft stage, but not for the pureed stage. Ingredients: Two cups of cottage cheese Half cup of shredded cheese (whichever type of cheese you prefer - I like it with grated parmesan) wo eggs (or the equivalent of Egg Beaters) One bag of frozen vegetables (broccoli is good, or broccoli, cauliflower, and carrots) Directions: Mix all ingredients in a casserole dish. Bake at 350 degrees for 45 minutes. One cup equals one serving, although you may need to eat less than that, depending on how much food fills you up at this stage. Tomato Crab Soup Ingredients * 3 cups tomato juice * 12 ounces evaporated milk * 1-2 small onions * ½ teaspoon basil * 1/8 teaspoon red pepper flakes * 3 tablespoons flour * ¼ teaspoon old bay seasoning * 3 tablespoons olive oil * ¼ teaspoon Worcestershire sauce * 1 teaspoon Splenda sweetener * 10 ounces lump crab meat * ¼ teaspoon thyme * 1 clove garlic * Salt and pepper - as per taste Directions Chop onion and garlic into fine pieces. Heat olive oil in a deep bottomed cooking pan and fry the onion and garlic for 8-10 minutes. When they become transparent, put in the flour and stir for a minute or two. Pour in the milk, tomato juice, red pepper flakes, sweetener, thyme, basil, salt, pepper and old bay seasoning and continue to stir. Cook in a high to medium flame. When the mixture starts boiling, turn the flame to low. Simmer for at least 15 minutes, but do not forget to stir in between. Stir in the crab meat and switch off the flame. Surgery Anniversary 7/30/12

This is all new, but I was wondering what is the point of the 2 week pre-op diet? Is it to lose some weight before the surgery? Or to clean out your stomach?

i am jealous I was banded april 2 also at BI tell me how did u get thru the three weeks any ideas I am getting tired of slimfast and Protein drinks I am happy for you MAry

Hi! My name is Mariah and I am new to LapBandTalk. I am planning on having the lapband surgery. I am waiting for my insurance approval and surgery date. My surgeon is Dr. Cirangle. I am so excited. I have been reading so many posts. This is a great site! I' ve been having a huge problem controlling my eating since my final decision. I did well for about a week, but as my as usual, when I get nervous or emmotional I overeat. I can't wait until that is no longer an option. I am hoping for a surgery date in April(hopefully mid). I've been contemplating this for two years now. I wish I had decided to follow through two years ago, but I guess I just wasn't ready. Any way I'd love to make some friends that have or will be going through some of the same issues I am.

How long ago did you have this done? I'm not excited about the liquid diet for a week, but it's a sacrifice to get to where I'm going! I'm traveling from Japan, so I have a long flight (there and back!).

I only vomited a handful of times - and I would say it wasn't until I was a couple of months out, on solid foods and perhaps feeling a little cocky... well really I was eating too fast. I apparently had not sufficiently broken that bad habit. I was so paranoid - in the early weeks and was very very careful. Be aware that you can;t really feel everything in those first 3-6 weeks so I ate "by the book" measuring everything and watching the clock to know when to eat. I felt that was the best way to avoid accidental overeating in those initial weeks. I am 2.5 years out and never vomit (I did constantly with the band) so I guess I have learned something finally!

Hi, I have a bmi of 32,off on holiday next week so it is bound to rise over the two weeks away, my question is this,is there any way I can get a sleeve with this bmi, Ive been offered the band but really don't want it as there seems so many complications and horror stories Would it help my case if my mum and two sisters have developed type 2 diabetes and my dad has had to have a quadruple heart bypass? Anyone had the sleeve in uk with lower bmi and who did you go with? Any advice greatly welcomed x

I use to love water but now every time I drink it I get sick to my stomach! Anybody else have that reaction? I'm 6 weeks post op and doing well.. Just can't drink plain water!!

Oh weird, I just posted that today I could finally drink water again. I'm also 6 weeks post op. I had just tried a few days ago and couldn't. Hopefully you'll be able to very soon!

Yeah, last night I succumbed to eating about 5 bites of ice cream. I'm 5 weeks out and on soft foods. Regretting it this morning with an upset tummy. This surgery isn't for the faint of heart!

I had one a couple of years ago unrelated to WLS. They actually stopped the treadmill test after a short time as my heart rate went up too fast. Ended up having a Lexiscan about a week later as a subsitute where they take pics (MRI-like) then inject you with something that replicates walking on a treadmill (speeds up your heart) and then take more pics. Hope you can just do the treadmill test!

I had severe nausea the first two days after surgery. After that, none. In fact, I only take my nausea meds to help me sleep at night. I'm one week post op, so next Monday 12/9 I'll transition to puréed and see how I do! Katy W- Louisburg, NC Lapband revision to VSG with DS HW- 297 Weight at Surgery-279 CW- will update at two week appt

That is what I felt (I'm only 2 weeks out so I still remember it vividly). I have had anxiety/panic disorder for the last 20 years give or take, so I kind of knew what to expect. In my case, I asked the anesthesiologist beforehand if I could take Xanax before I arrived at the facility, to which they told me I could, so long as I took it 2 hours before my arrival time. Doing so made the pre-knocked-out part 1 million times better than normal for me. Otherwise, I would try to distract yourself and do some fun things that you won't be able to do for the first couple of weeks. Take a walk, country drive, go boating, go to the movies... basically anything that you enjoy that will not cause you to get "hurt" (Allergies, etc.) before the surgery. I'm sure everything will go fine, but I will pray for you tonight!

Hi, as you might have read, my name is Carmen. I am a mother of two, a 13 year old daughter, and a 9 year old son. Currently after 15 years working I am taking a break to continue my education. I am an EMT, and I am going to school for cosmetology. I been in the retail industry all my life. When I became and EMT, it was one if my great accomplishments, I was very happy. I started to work for a busy system in the City of Syracuse, and I was doing OK. At the end of my 15 hour days, I was in serious pain, but i got up every morning at 4am to go to work and do it all over again. But the pain got worst, i was barely able to stand on my feet less carry a heavy bag with an oxygen tank. I took a medical leave to address my condition. Resulting that I have arthritis on my back and my knees are deteriorating and I have tendinitis on my wrist. Anyone with arthritis now that pain only gets worst and it never gets better, I started taking medications for the pain that wouldn't allow me to drive the ambulance in the state. So I had to extend my leave indefinitely. My neck started to hurt, along with my ankles, and even so I decided to start going to school for cosmetology more standing up and more wrist work, What was I thinking? I figure I need to continue working on something I like doing but I want to make more for my work, and I want to work when I want to ( when not in pain). Anyways Its been a journey I am half way my journey (http://bbgbeauty.blogspot.com). My brother ended up in the hospital, also my mother. My brother had developed sleepanea, a sleeping disorder mostly on obese people. He weight at almost 600 pounds. He had let himself go. He was in the hospital for many months until he was able to get out he now weights around 550. He can barely walk, or breathe he ended up with a tracheal tube for life or until he gets his weight under control. Now my mother is battling her foot to diabetes in the hospital and they ha to amputate all her toes. I go trough a lot with them and finally get them into my home and they doing a little better. But its far from over, my mom goes again more times to the hospital and still struggling to keep her leg now in top of everything my boyfriend ends up in the emergency room because of his diabetes. I said to my self no more... I decided I am not going to end up like them, to this date I don't have diabetes, I might be in the border of Sleepanea, I might already have it. I don't have high cholesterol but my blood pressure is very high and I take medications for these. I talk to them about loosing weight and that we could do it together, they seem reluctant to the idea of eating less and healthier. I guess I am on my own right now. Each person's health is their own decision. My mom is somewhat supportive, she "tried to keep me under control with sweats" and by trying i mean she waves them in front of me and says resist the temptations! lol . My boyfriend has gone so far to the info group and support groups in the area for me and have allow me to expend a little extra on healthy foods. We all know that healthy food is more expensive... but thats another topic. So I went to the information group to gather information about the Gastric Bypass Surgery, and I have learn a lot. I also went online to research, and I been to support groups in the area. I filled my paperwork and submitted to the surgeons. I am awaiting a date to start the process. It should be this week. They called me last week but I was missing my doctors referral, which hopefully they faxed today. I been on a diet on my own so i can gradually start my transition to better eating. Its been hard. I am limited to 1,400 calories a day, witch is not much compared to what I was eating before. its like torture, to the point that I don't want to leave my room into the world because everything is food, advertised, in commercials, int he internet, on games, in my kitchen, my family and kids, across the street next door, its everywhere, the temptations are all there, its worst than drugs. And for someone that has been big since a child, and never been restricted on what I can eat because my motto was, "I am going to die anyways might as well die happy" Well, i rather die happy but not suffering restricted to a bed or not able to enjoy life. I want to be able to fit in the roller coaster so when my daughter goes in a date I can follow her and get in the same rides as her and her boyfriend. I want to be able to fit on normal clothes and spend $20 less on a shirt. I want to be able to run after my future grand kids, I want to be able to have a snore free sleep, and wake up energized, I don't want to be afraid of a stroke or diabetes. I want to keep all my limbs, I want to be able to work and make money! I want to be able to wash the dishes with less pain on my back and knees, and I want to be able to go back to being a great EMT and live a long healthy life. And more than anything I want to go to my birth country and shove it on their faces that I was able to loose weight and I ams till beautiful as I was before. So this is why I decided to do the gastric bypass. Even thou a lot of people say you can do it without the surgery, I might... but YES i am opting for the easier way, where I will have less chance of failure. Once my stomach is smaller, I will able to be full with less food thus being different from now, that I eat less but i am still hungry. And I don't care if people don't agree with me on doing this surgery, it my decision, and if I am weak for doing it, so be it. Pre-Operation: Currently I weight 280 pounds I lost 3 pounds in 2 weeks. Here are some of my current pics, They are gross, but I want you to have an idea of the real situation and have a visual concept of my progress.

from what I've been told......... plan to take 2 weeks off work for a desk job and 4 if you have to do a lot of manual labor.

I took 2 weeks and I am a Secretary.

Concentrate more on your weekly loss than daily loss. I can hover the same for days, then all the sudden drop 2 in a single day. It's crazy. Once I moved to solid foods I felt the same way, but week after week I am still losing, and most importantly dropping inches. Have you been measuring and taking photos? I find the photos to be the best motivation. I have the same outfit I wear week to week, then take a series of facing each direction with only my underwear on (not publishing those). I also have the mandatory shot in a pair of jeans and a t-shirt, and I have already been able to do the obligatory both legs on one side of my jeans photo. Crazy! I am only 2.5 months post-op.