Sleeve Size & Other Pre-Op Questions

[ellie123 374]

I’m going for my pre-op this afternoon. Surgery in a week!!! In a moment of semi-serious weakness, at my last appointment, I asked my surgeon if I could have my sleeve slightly bigger than a banana (due to the fear of never being able to eat much of anything). To my surprise, he answered “Yes! I can give you the French something something (don’t recall the name), don’t worry, you’ll still loose weight”. Woa? I did not realize there were different sizes. Can anyone shed light on this an the pros and cons. Also, my mind is racing, I’ve tried to put together a list of things to ask the surgeon. Any ideas of what I need to ask?? Your thoughts will be very much appreciated!

[pr_pitbullgrl 1,039]

i didn't want to be the one to say this but....did you do the psyche eval? are you sure you're ready for this?

the reason i ask that is because most of the sleevers i know would not write something like " fear of never being able to eat much of anything". like i am thrilled i won't be able to eat a lot. that's the whole point kinda. i know everyone has their own journey i just want to ask the question so you don't regret the decision later on down the road.

[ellie123 374]

Pr pitbullgrl,

The answer to your question is of course I have had an Eval. I do not think that any reputable doctor will perform this kind of surgery on anyone who has not. My feelings of trepidation are very normal and to be expected in cases such as these and I believe this website is supposed to be a haven for people to express such feelings. I have already had bariatric surgery in the past with a two year prep program, so I am very much aware of what a restriction feels like and what kinds of lifestyle changes are expected. The fact that you are thrilled to not being able to eat a lot does not make you anymore or any less prepared for this surgery than others. Everyone processes this experience differently. But the one thing we all share in common is that we are all overweight and unable to control it on our own or we would not be here.

Also, by you saying "I did not want to be the one to say this..." , I believe that you are insinuating that you represent the view of the majority which I really don't think is the case. I posted this same question in this same format on many other forums, and I got some very insightful, educated compassionate, and helpful responses.

Good-luck to you on your journey.

[pr_pitbullgrl 1,039]

I am not at all insinuating I am more or less prepared than you or anyone. Just wanted to pose the difficult question in case no one else would. I support you either way because we are "sisters in sleeves" as they say. I can't offer any insight on the results of various sizes at all as I do not know. Best of luck to you and keep us all posted.

[ellie123 374]

Oh good!! Well, below is a great answer to my question that I would like to share with you and others. This was new info to me!

Answer:

The instrument he uses to measure the size of your sleeve is called a bougie, and it's size is measured in FR. The typical bougie size is 36 fr, but they generally fall between 32-40 fr. Personally, I had a 38. My surgeon said that he has seen the best results with a 38, despite the fact that that is not the smallest available. There are very good reasons to want a bigger sleeve, as long it is small enough to eliminate most of your ghrelin cells and to create the satiety benefit after a small meal. After that, the differences are negligible, and indigestion is more likely than additional weight loss. Anything higher than 40, however, runs the risk of not getting the full benefit of ghrelin elimination, which is the key benefit of this surgery (restriction can be had at similar levels by all the other surgeries).

Be sure to ask him how your diet progression will go afterwards, as I have seen some variation. I only had to do Clear liquids for 3 days, but some need to do it for 3-4 weeks before moving onto purees. I am now seven weeks out and I am able to eat everything (with nutritionists' approval).

[ellie123 374]

And here is another insightful answer I found very helpful:

Answer:

It is called "bougie" and it is a topic of much discussion on these forums. Do a search and you will find at least 100 threads on it.

I am unconvinced of how relevant it is though - I had one of the "larger" ones at a 38 and I have been maintaining a 150# weight loss for a few years.

what does appear to be a factor (although you should check with current research) that really tight/small sleeves are more prone to chronic reflux. I don't actually know if this is true - but that was what I was told in 2011.