60 Days post-op, just getting to know the sleeve ..

[dudeman 0]

I got sleeved on February 8th in Taipei, Taiwan, by one of four physicians who handle VSG there. My doctor was a young gun at it. He wasn't the most experienced but he was the most progressive possibly and my family knew his boss well, so he came highly recommended. I work and live in Hong Kong, so Dr. Wang Wei of the Taipei Medical University Hospital got my business. The total cost was also a great bargain at NTD $ 180,000 or USD 6k+/-. My Taiwanese citizen's insurance covered another USD2k aside from the cash paid. Interestingly, pain medication post-op was optional at around USD200 for the morphine drip, which post-op had I not paid -- it would have made the experience 10 times worst. Overall, the pain was tolerable and short lasting, especially with the morphine drip covering about 24 hours. I had my follow-up in office check on February 15th. It was noted that the weight dropped from 98.6kgs to 91.4kgs in 7 days, mostly due to awful pure liquid diet averaging under 1,000 KCal per day. By 16th February, I was back in Hong Kong and back at the daily grind. I haven't had any contact with the physician, except for 2 phone calls I placed to the office about 2 weeks post-op to ask about issues with vomiting after eating.

That's mainly the subject of this thread, my wishing to share my experience with eating post-op and what I learned about VSG on my own after 60 days.

The best event I can describe my experience with my sleeve is by an afternoon snack I had after picking up my teenage daughter from school at a local food court in Hong Kong. Now, as you all know -- there are lots of restrictions post-op with VSG. So, it is quite useless to discuss the restricted diet, although there were lots of trials and tribulations there for me personally as well. So, I will describe this afternoon snack which was the very first public eating experience post-op for me, after I was by schedule allowed to eat solid foods.

Anyways, before my VSG my daughter and I always enjoy an afternoon snack together. My child is a very picky eater, and most of the time -- she probably didn't eat her full lunch due whatever reason. Pre-VSG -- I would order whatever she was having -- either a cheeseburger and fries set or even sushi, pending our mood and location. So on the first day I was allowed to eat solid foods besides the semi-liquid diet I had been drinking 3 meals a day. And I ordered: 1 set of 6 Japanese Gyoza (similar to Chinese pot stickers) and a frozen smoothie of fresh Mangos. I ate just 2 pieces and left the remaining 4 pieces along with about 80% of the smoothie for my daughter when she arrived from school at the food court. Within 10 minutes of eating those 2 Goyzas and part of that smoothie, which I would estimate at no more than the recommended 100 grams overall weight/volume of food, I was in major discomfort. The feeling is similar to having two lead balls rolling around in a gym sock, except the sock .. is my sleeve/new stomach. Promptly, I walked to the closest toilet and offered up what I ate. I walked back to the food court to find my kid was still working on the remaining of my order. After 20 minutes, she took the smoothie to the car to drink on the drive home.

Skipping forward about 5 weeks to current day, which I find myself 65 days post-op. Yesterday, was the first opportunity after that last visit to the same food court. So, just to test out any progress I had made with the new sleeve/stomach .. I ordered the same exact 6 pieces of Goyza and a 8 ounce smoothie. This time, my daughter had her snack of ice cream already, so I set out to eat the whole order on my own. Now, when I started eating, to be honest -- I was expecting to run off to the toilet at any time. Surprisingly, when I took down 2 pieces, then the next 2, and the last 2 .. the pressure from the sleeve I was expecting -- never materialized. I drank about the same 20% of the smoothie and ate slowly. But after about 20 minutes -- I finished the order, and proceeded to walk to the car with my child for the drive home .. still expecting to have to stop on the way at a toilet in case the urge to vomit takes over .. and behold .. made it all the way to the parking level, and along with the walking .. the need to throw all that food out .. never came.

So, the moral of the story -- you just need to give your sleeve sometime to adjust. Although the doctor never told me and I figured things out on my own. When you have your stomach reduced by 75%, the post-op sleeve is not only just smaller volume-wise .. the stomach lining not only needs time to heal .. the lining itself by my own experience .. is the part of the original pre-op stomach lining that more than likely had not made contact with much food. It is sort of a "virgin" lining. In addition, the pressure after food enters this narrow sleeve is many many times PSI post-op compared to pre-op when there was ample space in the stomach. Things not only fill up fast, the pressure is incredible and thus it quickly becomes painful when you eat near its 100% capacity.

From the above "experimentation" I ended up performing through a period of about 5 weeks .. food and liquid that could not be tolerated roughly 1 months post-op, was easily tolerated 2 months post-op. No doubts about it. The food and drink and patient were all the same.

Now, having share this little bit of success -- what I can tell you all is that I still experience urges to vomit. It comes at all times with all kinds of different foods and drinks. There are certain food items that my sleeve still protests to .. to include -- steamed white rice. Now, that's a serious problem for an Asian person in Asia. Although for today's snack -- I had 2 sushi hand rolls along with 2 regular sushi's -- all had rice in them. They all held after eating with no much of an urge to relieve them from the sleeve. Unfortunately, I had more vomiting at dinner after some pan fried beef, chili, and Soup. So, there is still quite a lot of volatility with the sleeve for me and I must watch what I eat. I would estimate that between the first food court experience and the one yesterday -- I must have had to vomit up over 60% or more of everything I ate -- the problem with the pressure and pain from the sleeve sometimes there is just no action left to take except to go to the toilet and let the food out to relieve the discomfort.

Hopefully, at 90 days post-op -- I will have better experiences to share.

Cheers to all~!

Steve in Hong Kong.

[tntransplant06 20]

Thanks for this post, Steve! It sounds very much like my experiences. More often than not, my issue is eating too fast and within 10 min of eating, I have to go visit the toilet, too. It's hard trying to change all these years of bad habits. I don't want to continue to be visiting the toilet, so I'm working on this. Good luck to you.

[dudeman 0]

Yes, eating too fast will cause pain and urges to vomit. Case in point -- at a French Cafe in the Chinese city of Guanzhou 10 days ago, I order the same pan fried salmon with egg plants and colored peppers 2 days apart for lunch. First lunch it ate beautifully. But it took me about 30 minutes to get done with a huge plate and little food, the salmon strip was only 180 grams. Second day came back for the same. Ate it in 20 minutes. Had to go vomit. Go figure ..

The sleeve is very nice as I have lowered my BMI from an all time high last year at this time of 41 to 29 currently. But the sleeve is very volatile, at this stage anyways. I compare my old stomach as a Ford F-150 pick-up tuck. The VSG is .. a Ferrari .. sleek and small and picky as all hell can be. It will vomit and breakdown on the side of the road, making you go to toilets at a very personal altitude that makes vomiting a lot easier, if you know what I mean. LOL!

[Loooou 30]

Thank you so much Dudeman! this is a great walkthrough to what I should expect after my surgery, I am glad you mentioned sushi as I am a daily sushi eater !! but I am wonder when u said 2 hand rolls.. is the roll made of eight piece?! cause thats what we call a roll of sushi here. with my band now I can eat 1 to 1 and half roll .. so after the sleeve do u still can manage to eat that much quantity?

thanks again for this great manual!! I am saving it to my favorite on my browser:)

[QueenBee 0]

Just wondering... Are you eating and drinking at the same time? This could be the reason for the frequent vomiting.?.? I am to wait 30 minutes between drinking and eating, and then 30 minutes after eating before drinking again. Just a thought. CONGRATS on being a sleever!!

[dudeman 0]

@ Looou -- well, the hand rolls or handroll I referred to are always made cone shape with the seaweed wrapped much like a ice cream cone. So to me hand rolls are one per order. So, that's 2 x handrolls (salmon and uni), and 2 x the regular sushi's. That's hardly 100 grams of food. There have been times past post-op and now -- that I ate sushi and had to vomit it up, due mainly the way cooked rice feels within the sleeve. Rice is just too irritating to the sleeve's lining even at this point, such that I can't eat rice as a staple ever since VSG. As said -- that's kinda like people can't eating bread in the States. You miss it. You wish you could eat it. But every time I do. It goes down, but it must come back out. LOL!

@QueenBee -- I typically do drink something when I eat. Even Soup. But those two calls I put into the doctor's office in Taipei was to discuss this exactly. I leave the liquids until the end. Because the idea is when you put liquids in .. it takes up all the volume already and there's no more room for solids. Whereas if you take in solids first, wait a bit -- then the liquids can follow. BUT .. to answer your question and your theory as to the frequency of vomiting .. it is definitely NOT due to my drinking AND eating at the same time. Why >? Becuz I vomit when I just eat solids and haven't had any liquids at all to wash it down.

There is a very strange occurrence for me now which always precedes vomiting, and that is -- I get a gagging feeling, followed by a sensation in the sleeve that the food is just not sitting well, then I sneeze .. yeah, I suffer from chronic post-nasal drip allergy, and the food puts pressure on the eusophegus (?) then I sneeze due to some kind of irritation to the nasal cavity to due with the act of swallowing food. Very strange. Never used to happen. You know they say earthquakes can't be predicted, but I can predict my vomiting by my allergic sneeze just prior to .. all thanks to VSG. LOL!

[dudeman 0]

You know QueenBee brought up an interesting idea -- and that is that some seem to experience more vomiting than others. Whereas certain others have experienced no vomiting or need to fight the sensation to at all post-op. I have noticed these comments from other VSG members as well ... here's my theory about that. First -- it might have to do with sensitivity. Firstly, my personal thing is that I don't do well with internal organ sensitivity. I have never accepted a colonoscopy and where the scope goes down your throat that I had to go through pre-op to examine signs of reflux .. my internal organs are extra sensitive to ,these instruments. This could be a correlation to vomiting that are caused by food sensitivity post-op. But .. that's just my guess. The second possibility -- and this one you all can attest to yourself -- is the actual volume of the sleeve you end up with. I know that my sleeve post-op -- can fit roughly 100 grams or 100 cc's (that's 1/10 of 1 liter) volume worth of foods/liquids. Could it be .. that some surgeons, particularly Stateside .. are creating post-op sleeve volume that are larger than mine ? Theory being -- if there is more room -- there can be more expansion, and the pressure within the sleeve is lesser due to being more volumeous. Who knows why some are more prone to vomiting. I just know that I .. am a daily vomit-er post-op at 65 days. I dunno in reality whether to expect the vomiting to decrease, as my sleeve is used more and stretched more and becomes more volumeous thereby reducing pressure and sensitivity. But that's kind the purpose of my thread --- which is to discuss pressure within the sleeve after swallowing, irritations of grains and non-greasy dry meats and high Fiber veggies to the sleeve lining, and the increase stretchability of the sleeve as time progresses, and the ability of swallowing food, holding to food within the sleeve before it moves on to the intestines. I mean -- these issues -- "they" don't tell you about at any point pre-op or post-op. To be honest -- I dunno why they don't discuss these issues more.

[Loooou 30]

Oh that cone!! we call it Temaki here:)) Its one of my favorite too!! and yes it too little portion I guess less that 100 grms u mentioned!! I love that I have someone here who is addicted to such kind of food Which i consider healthy! Thanks for clearing that thing up! it seems so little portion! I can rarely get satisfied with 2 hand rolls of those! and rice is an issue for me too so I let them do it with less rice as a special request! seems like u are not handling the rice too well as u mentioned so I think my first step toward solid food will be only Sashimi ( sushi w/o rice ) I am talking to someone whose living at the birth country of this food but may be the names are different or something thats why I am clarifying sashimi here lol

Did u try sashimi yet? how many OZ can u handle ? what about the shrimp? I find salmon easy with my band but Shrimp is hard!

Thanks a lot for ur reply:)))

[swizzly 901]

I'm 47 days post-op and my experience is so different. I am sometimes concerned by this...but pleased that I am not having a rough time. I vomited violently while I was still in hospital, but have not vomited once since three days post-op. I've been on full foods since day four post-op, so I've been eating solid foods all along and don't use shakes at all. I don't weigh my food, so I'm not sure what my capacity is, but I can't eat that much. Tonight for dinner I had two small pieces of chicken (like finger sized, but flat, each), about three tablespoons of cream spinach, and two very small pieces of potato. I was full and I knew I was full, I really try to never go past that point. Maybe if I did, I would vomit again, I don't know. But I find most foods sit well in my sleeve, I am not sensitive to smells, I still like the same things I did pre-op, I am still feeling hungry (but only when I'm actually hungry, which is pretty similar to pre-op), I can eat bread, rice still bugs me as it did before, etc. It's just odd how different the surgery impacts people so differently.

Glad you've done so well, dudeman. Despite the vomiting, your sleeve is clearly helping you rapidly lose weight! Cheers.

[dudeman 0]

Thanks, Swizzy. I've really lost dramatically. So dramatically that the ex-wife couldn't stop staring at me when I went to China 10 days ago to sign papers for the home we had to sell ... that sounds like a joke and is funny. But really happened!

Did u try sashimi yet? how many OZ can u handle ? what about the shrimp? I find salmon easy with my band but Shrimp is hard!

Temaki is Te (hand) maki (rolled) in Japanese, but can't count on every Hong Kee waiter to know his/her Japanese so we got to call them hand-rolls here.

I have tried sashimi. In fact I tried it at 4 days post-op to some pretty horrifying results. Fastest way to waste fresh raw salmon. LOL! But that was 4 days ppost-op and I ate it against recommendation and diet restriction. Nowadays, I am free to eat sashimi, and I have eaten salmon sashimi and tuna sashimi without problems. The problem came when I ordered some Wagyu steak. That came up 10+ days ago for dinner in Guangzhou. Reason I remembered it was that it was an expensive dinner and it was all thrown-up by me, as it just wouldn't sit well in the sleeve.

You've got to remember that the stomach .. is just a holding area for food. Digestion is done further on. So, if food doesn't sit well in the sleeve, it's not going to move down the plumbing. That's the problem and the function of vomiting. It gets rid of the un-pleasant feeling. Again, best I can describe it .. like steel ball barings in a tight tube of gym socks, just sitting there and not moving. But you can feel the weight and expansion caused by the food. Then comes the sliming, and the gagging. Then you just hang on until you get to a toilet bowl. It's mighty unpleasant, and I been having to eat more food afterwards each time eventually.

By the evidence of what I had been able to hold down in the past week: 2 slices of garlic bread (French bagget type). Chewed it up. Swallowed it. Held them. Never happened before since the VSG. So, the sleeve IS showing signs of being more tolerant to different solids previously it rejected.

[Loooou 30]

Aww!! thanks for the Temaki Tip! never knew it! I am glad I have had the chance to speak to u!! u are an info guru when it comes to my favorite food!! which I become addictive to after my band!! I was glad I found it too! it was my only way out! with the band "No chicken, meat or veggies can pass through!" so yeah I am glad to have great news about the sleeve and sashimi!! It is a great deal of losing weight! when u stay away from the fried stuff ofcourse:)

Thanks again for ur detailed explaination!! it is a great insights to what I should expect in less than 4 days!! my surgery is on the 16th .. BEST OF LUCK on ur journey and glad ur ex wife saw u! and stared!! )

I cant wait for someone who called me a "cow" after he broke up with me years ago to see me after my sleeve! one of the NSV I am looking forward too!

have a great week!! and one last question.. is the hunger really fading?

[dudeman 0]

Just to let you all know .. went back and got the same sushi snack again. On on the drive home, I was fighting the urge to vomit, as the sleeve was trying to eject it. But since the drive was 30 minutes non-stop, but the time we approached home, the urge to vomit went away. So, it is possible to fight it. It's a bit like holding a bar of wet soap -- it could go either way up or down. I prefer down. LOL!

[Eureka-C 20]

I have a lot of problems with vomiting. I am 4 1/2 months out and have noticed some patterns. bread, tortillas and rice are the worst. It's like they gum up un a ball and just stick, even if they are the first bite. I have to take these in smaller bits than other food, baby size bites, even when chewed thoroughly. I also eat too fast. It's like it takes a while to move from the top of my stomach to the bottom, so a traffic jam occurs and it feels like it's sitting there at the bottom of my esophagus. I still get a painful gagging sensation if I drink too much too fast. These things usually occur when I go too long without eating or drinking. I do better if I wait between bites to see how it feels, measure my food, take small bite, and swallow a drink, not a gulp of liquid. When I do vomit, it's not the whole meal, usually one gag and the last bite. Reminds me of a mommy bird regurgitating. I don't feel bad like being sick (or drunk) and vomiting.

[former_vbg 198]

Just to let you all know .. went back and got the same sushi snack again. On on the drive home, I was fighting the urge to vomit, as the sleeve was trying to eject it. But since the drive was 30 minutes non-stop, but the time we approached home, the urge to vomit went away. So, it is possible to fight it. It's a bit like holding a bar of wet soap -- it could go either way up or down. I prefer down. LOL!

First, congratulations!! It's neat to hear about people in other parts of the world who have had this procedure. Do you worry about stretching your sleeve too much if you eat beyond feeling full? Do you know what size bouge your Dr. used? That might be one way to tell the size of your new stomach compared to others.

Last, I have to say you seem so Americanized with your comparisons. I had to laugh when you made the comparison to an F-150 truck. Are those commonly sold there? Anyways, great to see you on the boards! Keep us posted on your journey!

[Oregondaisy 2,021]

I would say that anyone who is still throwing up 2 or 3 months post op is

A) taking too big of bites

Not chewing well enough to mush

C) Not waiting in between bites. Let it sit for a minute before you decide you need another bite.

I used to make a game of it to see how tiny of a bite I could take and just exactly how long I could chew it.

I did throw up the other day and I haven't for at least a year. It was because I

ate too much. It takes awhile for my brain to catch up and 20 min later, I am more full than I was at the table. It would have stayed down, but it would have been very uncomfortable waiting it out.