Confused on what surgery to have

[mrsto 2,925]

I hear what you are saying about, "What if I get stomach cancer?" or something along those lines. I am, by nature, not a risk taker. So, when I posed this question to my PCP, she laughed saying I had a higher chance of being in a severe car accident than I had with developing a cancer or condition where I would need my excised stomach. Something like 1 in 10,000. Now, I do understand that it does happen and I am sorry to hear about your husband. I hope he is doing well. I think cancer has touched or will touch just about everybody's life in one way or another at some time, but with today's medicine, it no longer is the death sentence it once was. However, my obesity and the co-morbidities were. I knew I needed a permanent change with food's role in my life. Also note that due to this surgery, my nutrition has never been better in my life. I choose to eat what I call nutritionally relevant foods, where pre-sleeve, I ate what was in reach. I have had two unrelated surgeries since and recovered marvelously, thanks, in part, to this new lifestyle.

It was quite co-incidental that while I was researching this, 3 people were killed when a bus turned a corner as they were crossing. Literally run over by a bus. I take the bus and train into work in downtown PDX, so it gave me pause ... Which would be the greater risk? Being hit by a bus or having complications from VSG (vertical sleeve gastrectomy) or needing 100% of my stomach? I decided I was not going to live my life afraid of living, so, I got my sleeve and I still take public transit into downtown. Who knew I was such a rebel!! LOL!

BTW, I take the exact same Vitamins you do ... a multi, B12 and Vit D.

If you'd care to wander over to Vertical Sleeve Talk, you can see my before and after pics in my profile, but like here, Alex is also upgrading the site, so gallery pics are currently down.

http://www.verticals...r/11267-pdxman/

BTW, as I mentioned before and as Sharpie points out, each of us has our own journey. I am in no way trying to discount the lap band for everyone. Just like other WLS solutions, each has it's place in our lives. We have to find what works for us and our issues. If you do not want a procedure which is not reversible, then VSG is not for you. I didn't want my intestines re-routed or the possibility that my "pouch" could stretch, so RNY was not for me. Constant office visits, likelihood of slippage and knowing that if/when the band was removed I could consume large portions is why I opted not to be banded. I merely came on here to point out some mis-information and to direct researchers over to the other boards for better information.

Good luck to all of my WLS friends, pre or post surgery!

You look amazing! I know how good you feel

Though the margin was small for serious complications after sleeve surgery, it was a risk that I couldn't afford to take. The worst being, leakage from the staples, which could put me (anyone) in the hospital for 4-6 weeks. I'm self employed, and that type of absence from work would ruin my business. Aside from the health risks, I couldn't put my business in jeopardy. Again, small chance that would happen, but the reality is.....it does happen.

I do like the idea of minimal aftercare.....if any. The band certainly requires a lot of follow up. But it was the choice I could live with. Who knows what will happen down the road. But for today, it's been better than I ever dreamed it would be.

Thank you for your post. Very articulate and informative.....

[PdxMan 4,292]

Congrats on your weight loss with the Sleeve, but to say that the Sleeve WILL NOT eventually stretch out, is misleading people on a surgery that they can't reverse once it's done.

Regardless of which bougie size you have it WILL stretch out eventually, you are only 2 years post op, based on my friends who have Sleeves, AND many medical published cited journals to back this up....

My friends with the Sleeve can't eat as much as pre op and they are 5 + years post Sleeve, but they can eat too much for it to be effective for weight loss without serious dieting, and they have to diet if they want to lose weight at the 5 year mark, also they have dumping syndrome, something that's not openly discussed with the Sleeve.

If your Sleeve is working for you great! But many are just not willing to risk removing their stomach and end up having to diet like crazy in about 3-4 years.

Oh no, believe me ... deciding to have 85% of your stomach removed permanently is no easy decision. I had to do a lot of soul searching about my history and my efforts in the past versus my long-term prognosis.

But to talk about the sleeve stretching, I believe this is a misnomer. People tend to think their sleeve is stretched when, in fact, they have learned to "eat around" the sleeve's restriction. I have had discussions with folks further out than myself who, like myself at over 2 years, when they follow the guidelines of not drinking just prior, during or right after eating and begin their meal with lean Protein, have excellent restriction. I have no diet, per se. It was tough at first not to drink when eating, but now it is easy and preferred. Have you guys seen

video? It is from a RNY patient, but applies to all WLS procedures. People who feel their sleeve is stretched are most likely not following the guidelines, which, allows them to consume more calories. I don't think it is that difficult to not drink with meals and eating my chicken first before I eat my potatoes and veggies ... not a big deal and certainly not what I would refer to being on a diet. And when I say stretch, we have to define that a bit. Say your stomach starts, when distended, has a capacity of 70 oz. Post-sleeve and after the swelling has gone down, it would be around 10 oz. As my surgeon said, it is going to stretch like a man's wallet. Tight at first and then loosen a bit. Most likely, that person will stretch out to 12-15 oz. WOW! THAT IS ALMOST HALF AGAIN IN SIZE!! Well ... yes ... but you are still left with 15 oz which, compared to 70 oz is dramatically smaller. (This is by volume, not weight, so no ... you won't be able to eat 15 oz of a 16 oz porterhouse steak) It is then up to the individual to have dealt with their own personal demons as to why they abused food. I know I have had to. And, of course, follow the guidelines.

But I do also think some of the surgeons early out may have been using larger bougie sizes which may have included more of the fundus. This would definitely be a topic for the surgeon for anyone contemplating WLS. Leave more fundus, it will stretch more. My surgeon used a 34fr. Last night's dinner was chicken Tikka Masala. Had 3 oz of chicken, two teaspoons peas/carrots and two tablespoons of rice with sauce. So tasty with leftovers for lunch. So, it is working for me, so far. But sure, I can go to Baskin Robbins with the family and eat a single scoop ice cream, no problem. That slips right on through ... no problem, but I do not do this regularly, by any means. I love enjoying portions which feed my body to the levels it needs instead of feeding what my minds thinks it needs. Being freed from the constant cravings (with the gherlin production reduced) I used to be demonized by is such a relief, too, which I didn't fully appreciate the impact of pre-surgery. I used to be such a snack fiend, but now it doesn't even cross my mind. I sit at restaurants and watch people with huge plates of food cleaning the whole thing and I smile because I am so happy I don't have to do that anymore.

Another thing to note, of course, is that I do exercise two to three times a week. Losing the initial weight put me into a position where I could begin moving comfortably, so I began an exercise regimen which works for me. I can easily see where a person not following the basic guidelines, not exercising and eating around the sleeve would easily gain weight. There are several threads over at VST you will find where people are struggling and this universal constant is true. The theme of the threads are constantly, "I'm xx months post-op and have some re-gain. I don't exercise and I eat a lot of foods I shouldn't." Well ... yes. These folks will struggle if they are not able to address some of the basic issues which perhaps got us into trouble in the first place. This is a surgery on our stomach, not our heads.

As for surgical risks and leaks, yes, it was a concern for me, too. But, I think I mentioned earlier I have a previous history of doing well recovering from surgeries. Leaks are a component of the skill of the surgeon, your ability to heal, your ability to follow the guidelines early out and a wee bit of luck. My nutritionist told me a story of someone (not from their clinic) who ate a 8 oz steak 10 days post op. Had problems and didn't go to the hospital. Long story short ... they died. I do believe there should be a strict psychological screening prior to any WLS as some folks just aren't mentally ready to be compliant.

Aren't some of these issues also true with the band? If an emotional eater decides they are going to hit a tub of ice cream hard or are determined to be comforted by food as they had been in the past, aren't there ways to "eat around" the band with slider foods? Do banders who exercise and follow the guidelines have better success than those who don't?

[NaNa 878]

Oh no, believe me ... deciding to have 85% of your stomach removed permanently is no easy decision. I had to do a lot of soul searching about my history and my efforts in the past versus my long-term prognosis.

But to talk about the sleeve stretching, I believe this is a misnomer. People tend to think their sleeve is stretched when, in fact, they have learned to "eat around" the sleeve's restriction. I have had discussions with folks further out than myself who, like myself at over 2 years, when they follow the guidelines of not drinking just prior, during or right after eating and begin their meal with lean Protein, have excellent restriction. I have no diet, per se. It was tough at first not to drink when eating, but now it is easy and preferred. Have you guys seen

video? It is from a RNY patient, but applies to all WLS procedures. People who feel their sleeve is stretched are most likely not following the guidelines, which, allows them to consume more calories. I don't think it is that difficult to not drink with meals and eating my chicken first before I eat my potatoes and veggies ... not a big deal and certainly not what I would refer to being on a diet. And when I say stretch, we have to define that a bit. Say your stomach starts, when distended, has a capacity of 70 oz. Post-sleeve and after the swelling has gone down, it would be around 10 oz. As my surgeon said, it is going to stretch like a man's wallet. Tight at first and then loosen a bit. Most likely, that person will stretch out to 12-15 oz. WOW! THAT IS ALMOST HALF AGAIN IN SIZE!! Well ... yes ... but you are still left with 15 oz which, compared to 70 oz is dramatically smaller. (This is by volume, not weight, so no ... you won't be able to eat 15 oz of a 16 oz porterhouse steak) It is then up to the individual to have dealt with their own personal demons as to why they abused food. I know I have had to. And, of course, follow the guidelines.

But I do also think some of the surgeons early out may have been using larger bougie sizes which may have included more of the fundus. This would definitely be a topic for the surgeon for anyone contemplating WLS. Leave more fundus, it will stretch more. My surgeon used a 34fr. Last night's dinner was chicken Tikka Masala. Had 3 oz of chicken, two teaspoons peas/carrots and two tablespoons of rice with sauce. So tasty with leftovers for lunch. So, it is working for me, so far. But sure, I can go to Baskin Robbins with the family and eat a single scoop ice cream, no problem. That slips right on through ... no problem, but I do not do this regularly, by any means. I love enjoying portions which feed my body to the levels it needs instead of feeding what my minds thinks it needs. Being freed from the constant cravings (with the gherlin production reduced) I used to be demonized by is such a relief, too, which I didn't fully appreciate the impact of pre-surgery. I used to be such a snack fiend, but now it doesn't even cross my mind. I sit at restaurants and watch people with huge plates of food cleaning the whole thing and I smile because I am so happy I don't have to do that anymore.

Another thing to note, of course, is that I do exercise two to three times a week. Losing the initial weight put me into a position where I could begin moving comfortably, so I began an exercise regimen which works for me. I can easily see where a person not following the basic guidelines, not exercising and eating around the sleeve would easily gain weight. There are several threads over at VST you will find where people are struggling and this universal constant is true. The theme of the threads are constantly, "I'm xx months post-op and have some re-gain. I don't exercise and I eat a lot of foods I shouldn't." Well ... yes. These folks will struggle if they are not able to address some of the basic issues which perhaps got us into trouble in the first place. This is a surgery on our stomach, not our heads.

As for surgical risks and leaks, yes, it was a concern for me, too. But, I think I mentioned earlier I have a previous history of doing well recovering from surgeries. Leaks are a component of the skill of the surgeon, your ability to heal, your ability to follow the guidelines early out and a wee bit of luck. My nutritionist told me a story of someone (not from their clinic) who ate a 8 oz steak 10 days post op. Had problems and didn't go to the hospital. Long story short ... they died. I do believe there should be a strict psychological screening prior to any WLS as some folks just aren't mentally ready to be compliant.

Aren't some of these issues also true with the band? If an emotional eater decides they are going to hit a tub of ice cream hard or are determined to be comforted by food as they had been in the past, aren't there ways to "eat around" the band with slider foods? Do banders who exercise and follow the guidelines have better success than those who don't?

That's great you are doing so well with your Sleeve, do you have any reflux? Can you tolerate carbs and sugar without getting sick? I know we are not supposed to eat sugar, but my friends told me the further they got out with the Sleeve, they are now experiencing more reflux and food intolerance issues. It's more like hypoglycemia than real dumping syndrome.

[PdxMan 4,292]

That's great you are doing so well with your Sleeve, do you have any reflux? Can you tolerate carbs and sugar without getting sick? I know we are not supposed to eat sugar, but my friends told me the further they got out with the Sleeve, they are now experiencing more reflux and food intolerance issues. It's more like hypoglycemia than real dumping syndrome.

It's funny, my tolerance for sugar is lower, for sure. After finding a Protein powder which I LOVED pre-sleeve, I bought a 15 pound bag of it. Wouldn't you know it, post-surgery, it was SOOOO sweet. UGH! Gave it away on Craigslist. I did find another (Premier Protein RTD) which were not as sweet. I had my surgery in July ... Halloween right around the corner (I have two young kids), TIME FOR SOME CHOCOLATE! Oy! Too sweet!

This was a big surprise to me. But, of course, with Christmas right around the corner I was able to raise my tolerance for sweets , but by no means can I eat it like before. I would agree, it is more of a hypoglycemic feeling than what I understand (from my cousin) dumping syndrome to be. I had severe reflux prior to surgery and unknown to me, I had a hiatal hernia. The surgeon corrected it when he did my sleeve. I have taken a PPI once since my surgery and that was after I worked late one night and ate dinner and went straight to bed. So, for me, it has been another unexpected blessing. But again, I do follow the guidelines, so that may have something to do with it.

As far as other food intolerances, I have heard of people with some lactose intolerance post, but it often resolves after a bit. For me, there is nothing I cannot eat. I understand raw coconut is a no, no for sleevers, (see bezoar) but I never liked it, anyway, so not a big deal. I probably consume about 120g of carbs a day, so, as you can see, I don't really avoid them, but it isn't crazy like it was pre-sleeve.

Without asking them directly (by observation) how compliant with the guidelines are your friends? Do they drink when eating? Do they still inhale their food? That is something I used to do and still struggle with at times when I am out with friends, laughing, talking ... I slip into old habits of shoveling one spoonful after another. The sleeve reminds me to slow down, though.

[NaNa 878]

It's funny, my tolerance for sugar is lower, for sure. After finding a Protein powder which I LOVED pre-sleeve, I bought a 15 pound bag of it. Wouldn't you know it, post-surgery, it was SOOOO sweet. UGH! Gave it away on Craigslist. I did find another (Premier Protein RTD) which were not as sweet. I had my surgery in July ... Halloween right around the corner (I have two young kids), TIME FOR SOME CHOCOLATE! Oy! Too sweet!

This was a big surprise to me. But, of course, with Christmas right around the corner I was able to raise my tolerance for sweets , but by no means can I eat it like before. I would agree, it is more of a hypoglycemic feeling than what I understand (from my cousin) dumping syndrome to be. I had severe reflux prior to surgery and unknown to me, I had a hiatal hernia. The surgeon corrected it when he did my sleeve. I have taken a PPI once since my surgery and that was after I worked late one night and ate dinner and went straight to bed. So, for me, it has been another unexpected blessing. But again, I do follow the guidelines, so that may have something to do with it.

As far as other food intolerances, I have heard of people with some lactose intolerance post, but it often resolves after a bit. For me, there is nothing I cannot eat. I understand raw coconut is a no, no for sleevers, (see bezoar) but I never liked it, anyway, so not a big deal. I probably consume about 120g of carbs a day, so, as you can see, I don't really avoid them, but it isn't crazy like it was pre-sleeve.

Without asking them directly (by observation) how compliant with the guidelines are your friends? Do they drink when eating? Do they still inhale their food? That is something I used to do and still struggle with at times when I am out with friends, laughing, talking ... I slip into old habits of shoveling one spoonful after another. The sleeve reminds me to slow down, though.

Thanks for sharing your story, it's very inspiring! I do know one of my friends really miss her chocolate fix...she says she feels sick on any small amounts, she also gets sick if she drinks orange juice (I guess from the hypoglycemia) so from that aspect, I know she is not being totally compliant with her diet.

From a medical standpoint I was told the reason behind the "dumping like syndrome" and hypoglycemia was that food empties quicker and has fast emptying in the small Sleeve stomach. However with the lap band stomach, our food empties very slow which gives us a "full feeling" really quick.

I think is she is lactose intolerance now, she will get foamies if she try to eat too much food at one time, it's a bit different with us bandsters, we get the slimies...LOL

[PdxMan 4,292]

chocolate is definitely one of those items that slides right through. I also find it helps other foods slide though, so, if I am feeling the restriction and I have a piece of chocolate, the pyloric valve does open and lets everything slip through, so it is one of those things I moderate (just like a "normal" person! ) Orange juice, of course, is going to go right on through and is pretty sweet. If she is drinking it while eating, sure ... there will be issues.

If we eat our lean Protein first, it gives us that "full feeling" really quick. Eating protein first, though, is important for all of us as muscle loss is so prevalent with rapid weight loss. I had foamies once at about 6 weeks post when, on pain killers for a separate, unrelated procedure, I didn't chew well enough and ate too quickly. Just wasn't thinking. Learned my lesson there. I put my utensil down in between bites to slow myself down and chew far more than I used to.

[HotButterFly 981]

My sister had the sleeve done a month before I had my lap band. I suggested to her that she should have lap band, but as usual, she didn't listen. Her weigh loss has been remarkable, but at a great cost!! She can't really enjoy her meals.... I wish she had listened to her little sister.

[PdxMan 4,292]

My sister had the sleeve done a month before I had my lap band. I suggested to her that she should have lap band, but as usual, she didn't listen. Her weigh loss has been remarkable, but at a great cost!! She can't really enjoy her meals.... I wish she had listened to her little sister.

I'm sorry to hear your sister is struggling. When did she get sleeved? It takes about 6 months before you are able to re-introduce ALL of the foods back in. Salads were the last thing for me, which did frustrate me as I have always LOVED salads of all kinds. Kale, spinach and romaine are so fibrous, it was no fun trying to eat them. But, as I progressed, I was able to eat them no problem. I would say it was at this point, I was able to enjoy eating again, but in no way is it like pre-sleeve. Again, I abused food ... used it at a crutch ... to Celebrate ... to mourn ... it was not healthy. I don't want to "enjoy" food in that way again.

So, I'm guessing your sister may still be in this window. I do know of some sleevers who do still struggle with enjoying eating after the month mark, but it has always let back to the individual's relationship with food. Having to take smaller bites, chew better, slowing down ... frustrations like that. As I like to define it, though, these are the behaviors which allowed me to abuse food, so i am quite happy I had to adopt them. It can be difficult, sometimes, to recognize some of our struggles as blessings. If she is in this window, ensure her it will get better and she will enjoy food again. Her expectations may have been a little ahead of reality.

I've asked this a couple times in this thread, but it has never been answered. Don't banders have guidelines they must follow for success? And to add one, do you "enjoy" eating with your band?

[Sharpie 3,306]

Okay I will make one more comment on this subject.. When people say oh the aftercare is so much trouble with the band... Really? I go every 3 months.. if I am doing well, losing like I should be and have no problems it's in and out.. If I need a fill it takes about 10 minutes more... then I have to have liquids that day and take it easy the next day on what I eat.. Otherwise the aftercare is no big deal.... I've had hang nails that are more trouble... so if that is what you base your decision on I would tend to look at it realistic.. As time goes on with the band I will be going less and less as long as I am either at goal or do not have issues.. The main thing you have to do with the band is be aware of how much you eat and how fast you eat but isn't that you want ? I wanted a healthy alternative to starving myself to death all the time.. I have never been "starving" since day one...

[☠carolinagirl☠ 18,721]

Okay I will make one more comment on this subject.. When people say oh the aftercare is so much trouble with the band... Really? I go every 3 months.. if I am doing well, losing like I should be and have no problems it's in and out.. If I need a fill it takes about 10 minutes more... then I have to have liquids that day and take it easy the next day on what I eat.. Otherwise the aftercare is no big deal.... I've had hang nails that are more trouble... so if that is what you base your decision on I would tend to look at it realistic.. As time goes on with the band I will be going less and less as long as I am either at goal or do not have issues.. The main thing you have to do with the band is be aware of how much you eat and how fast you eat but isn't that you want ? I wanted a healthy alternative to starving myself to death all the time.. I have never been "starving" since day one...

dang GF,.....you wrote what i wanted.......great comment

[PdxMan 4,292]

Okay I will make one more comment on this subject.. When people say oh the aftercare is so much trouble with the band... Really? I go every 3 months.. if I am doing well, losing like I should be and have no problems it's in and out.. If I need a fill it takes about 10 minutes more... then I have to have liquids that day and take it easy the next day on what I eat.. Otherwise the aftercare is no big deal.... I've had hang nails that are more trouble... so if that is what you base your decision on I would tend to look at it realistic.. As time goes on with the band I will be going less and less as long as I am either at goal or do not have issues.. The main thing you have to do with the band is be aware of how much you eat and how fast you eat but isn't that you want ? I wanted a healthy alternative to starving myself to death all the time.. I have never been "starving" since day one...

It is great to hear you are having no issues with your band and that maintenance is very low for you. Sounds like you have found a great solution which works for you. My friend (the one I spoke of earlier and how we found this thread) is leaning towards the band as she just can't wrap her head around having part of her stomach removed nor does she want to be re-routed. It is good to read stories such as yours. Like product reviews, people who have no issues rarely post about it. You will read several reviews of, "This knife won't cut a Tomato, it is so dull!" but seldom will you read, "The knife cuts tomatoes just as advertised."

Just curious ... which WLS surgery "starves" you? I get about 1,400 - 1,600 calories in a day, as do most sleevers who are past the initial healing phase, so, are you referring to RNY? How many calories do you consume a day? I am actually seeing my cousin (who had RNY 5 years ago) tomorrow as I am traveling to SoCal for business. I will ask him what his caloric intake is.

If you're referring to sleeve as being "starving" ... then someone has been selling you some swampland, 'cause ... trust me, there's no starvation with the sleeve ... quite the opposite, actually. Gotta remember, we had most of the fundus removed which is the gherlin producer. I don't get "hungry" in the conventional sense and those who say they do are most likely dealing with "head hunger", which goes back to what I mentioned earlier about not dealing with one's issues with their relationship with food. If eating was a coping mechanism for you and you do nothing to address that, then yes, you may feel unsatiated by not being able to abuse food the way you used to, but ... isn't that true for banders, too?

[HotButterFly 981]

I'm sorry to hear your sister is struggling. When did she get sleeved? It takes about 6 months before you are able to re-introduce ALL of the foods back in. I would say it was at this point' date=' I was able to enjoy eating again, but in no way is it like pre-sleeve. So, I'm guessing your sister may still be in this window. I do know of some sleevers who do still struggle with enjoying eating after the month mark, but it has always let back to the individual's relationship with food. It can be difficult, sometimes, to recognize some of our struggles as blessings. If she is in this window, ensure her it will get better and she will enjoy food again. Don't banders have guidelines they must follow for success? And to add one, do you "enjoy" eating with your band?[/quote'] thank you for your response. Her surgery was in June, so she within the six months window you speak about. I really hope it DOES get better for her because I'm afraid of malnutrition. I will tell her what you said. Also, I will suggest she finds a support group (but she never listens :-/ ). Yes, of course we have guidelines and I'm assuming they are very similar to sleevers. I'm happy to say that I still enjoy eating with my band... I would be miserable if I was in her shoes. XOXOXOXO

[Dulci 108]

I have come to believe that no matter which WLS one chooses, most of the change has be done in the mind. If the patient is ready, willing and able to make changes, they will succeed. If the patient thinks that the band, sleeve or bypass is going to do the work and they will passively watch the weight melt away; they will fail.

If I ever have to lose my band, I will revise to a sleeve, if I can.

[tipsyb 71]

You know I have learned over the fourteen months that I have been banded that I do not need to be precious about my decision. I have still three stone to lose , do I think that the band has failed me ? No I don't , do I think I should have had the sleeve , bypass ect no I don't. All of these procedures are because we are primarily addicts who have looked for the quick fix on each occasion. I am facing my daemons for the first time because I have no option. It's making me see life as it is and should be not as it once was through a haze of over eating and self loathing. I'm sure in years to come my band may need changing adjusting taking out. There may be a better intervention. I'm just glad today I'm here , five stone lighter and happy. It's all I need for today.

[michpell39 399]

I have the lapband and at just about 4 months out I have lost 50 % of what I need to lose , do what you think is best for you , I think success is individual and you get what you put in regardless of what kind of bariatric procedure