Gastric Sleeve

[WASaBubbleButt 41]

no grehllin slows your metabolism, it is removed during the Sleeve surgury so your metabolism sky rockets... its a awesome deal hehe...

No, Ghrelin does not affect metabolism. It is a hormone produced by the fundus of the stomach and a primary job of this hormone is to signal the brain that you are hungry. In sleeve folks the fundus of the stomach is removed and they do not experience hunger on the same level as a non sleeved person. But no, nothing to do with metabolism.

[MacMadame 81]

I"m not sure I agree that sleeved folks lose at the same rate as bypass, at the end of five years we have lost as much as a bypass patient but they lose faster.

In all the studies I've seen, the EWL % is similar even as early as 1 year out, though.

It's interesting and not what I expected, but I've read articles were people in bariatric profession say that the malabsorption of the RnY is negligible. I can't find exact numbers, but I've heard as little as 20% of calories are absorbed. That completely mystifies me since the bypass is often marketed as "you need the malabsorption to maintain" ... but if there isn't much???

I do think they are eating more than us by 1 year out as well. (Some are up to a cup of solid food by then.) Though I don't think anyone can be eating less than I do at this point in time. (I'm getting better at slowing down though and it's helping.)

The more I learn about bypass, the more squirrelly I think the whole operation is. No pylorus value, you can flush the food out by drinking with or after the meal, minimal malabsorption of calories, but significant malabsorption of micro-nutrients.

I really hope someday it isn't done and everyone who would have gotten RnY gets a sleeve instead.

[WASaBubbleButt 41]

In all the studies I've seen, the EWL % is similar even as early as 1 year out, though.

It's interesting and not what I expected, but I've read articles were people in bariatric profession say that the malabsorption of the RnY is negligible. I can't find exact numbers, but I've heard as little as 20% of calories are absorbed. That completely mystifies me since the bypass is often marketed as "you need the malabsorption to maintain" ... but if there isn't much???

I do think they are eating more than us by 1 year out as well. (Some are up to a cup of solid food by then.) Though I don't think anyone can be eating less than I do at this point in time. (I'm getting better at slowing down though and it's helping.)

The more I learn about bypass, the more squirrelly I think the whole operation is. No pylorus value, you can flush the food out by drinking with or after the meal, minimal malabsorption of calories, but significant malabsorption of micro-nutrients.

I really hope someday it isn't done and everyone who would have gotten RnY gets a sleeve instead.

You can't really say that malabsorption is "X%" with bypass because it depends on how much intestine they bypass. For example, if you bypass 120cm of intestine you will malabsorb 1/3 of your caloric intake. Since they are eating about the same quantity of food as us for the first year they are going to absorb 2/3 of the calories we do. For those that have ERNY they will malabsorb even more. It's pretty impossible for us to keep up with them and I wouldn't want to keep up with them. They have that nasty "dead" gray look to them from losing so fast. I'm sure part of is is malnutrition in some people as well.

I suspect the studies you are reading are the folks that have less malabsorption than standard because they do tend to lose much faster than us in the beginning.

The only way they would be eating more than us at the end of one year is if they are overeating and stretching their pouch and stoma and that is exactly what they do when they push food through with liquids. Check out OH's revision boards. It's half bypass people that stretched their pouch and stoma and half banded people wanting sleeves or bypass.

[MacMadame 81]

I think pouch stretching is a big downside to bypass. In fact, I don't understand why they don't do the bypass with a sleeve stomach. I think it would make it a much better operation! :biggrin:

But I've read that both bandsters and bypassers can eat 1/2 to 1 cup of food at 1 year out and that's expected. I don't think we'll be able to do that at 1 year out. Maybe softer food, but not chicken breast and veggies. Our stomach just isn't that stretchy.

(One study I was thinking of was a meta study of all bariatric surgeries done from about 1990-something until 2006. So they are all mixed together - distal, proximal, good programs, bad programs, good surgeons, bad surgeons.)

[WASaBubbleButt 41]

I think pouch stretching is a big downside to bypass. In fact, I don't understand why they don't do the bypass with a sleeve stomach. I think it would make it a much better operation! :Dancing_biggrin:

But I've read that both bandsters and bypassers can eat 1/2 to 1 cup of food at 1 year out and that's expected. I don't think we'll be able to do that at 1 year out. Maybe softer food, but not chicken breast and veggies. Our stomach just isn't that stretchy.

(One study I was thinking of was a meta study of all bariatric surgeries done from about 1990-something until 2006. So they are all mixed together - distal, proximal, good programs, bad programs, good surgeons, bad surgeons.)

It sure seems like with a bypass person it is not a matter of "if" they will stretch their pouch/stoma but "when" they will stretch. Spooky.

[MacMadame 81]

Yeah and they use the fundus to make the pouch too. To me, that's the bad part of the stomach that I wanted cut out!

[smahoney 0]

Which doctor did you have do the sleeve in Tiajauna Mexico? I have been researching doctors in mexico and have narrowed it down to two so any input would be great.

[jlweb55 0]

I used Dr Huacuz, He did not get my pouch small enough, He will not do it again without full payment. I would not use him again for this reason. thanks jlweb55

[jlweb55 0]

there is a doctor that does a bypass with the sleeve in washington I think it is the henkie or hankie bypass. It has his name.

[MacMadame 81]

Which doctor did you have do the sleeve in Tiajauna Mexico? I have been researching doctors in mexico and have narrowed it down to two so any input would be great.

I think the two best surgeons in Mexico are Dr. Aceves and Dr. Rumblaut. Dr. Aceves has done more sleeves, I believe. Dr. Rumblaut has a band himself. They are both very experienced in bariatric surgery, have excellent reputations, and are capable of doing complicated revisions.

[ISOME 0]

Hello aceduece! Im so happy for you! I really want to have the vertical sleeve done, but Im several months out, due to being a self payer.. Hopefully sometime this fall/winter 2009. I researched the lap band, and was set until recently hearing about the sleeve. Im sold! this is the procedure of my choice! I appreciate all info you can post. Im really not scared or have to many concerns, because Im so tired of the way I have been living, well tired of the way, I havent really been living. This gives me hope, to begin to live, and enjoy life, instead of hiding. Im ready. Im willing. And Im excited! I hope you will update us on your progress. Thank you so much for sharing your journey, you are a winner!!!!

[mzreeda 1]

I'll be honest, if (a) insurance covered it; or (:confused: I had the money to pay cash for self-pay I would have probably gone with the sleeve. However since my insurance covered most of the lapband procedure and there was no way I could afford to self-pay in the next few years, I jumped at the chance for the lapband. I hope to utilize it for all its worth.

If for some reason several years down the road, I end up having problems with the lapband and insurance then covers or I have enough disposable income, I would probably look into the sleeve again.

I agree with you! i wasnt given option my insurance coverd all of it thats better than coming out of pocket and when your health is going down the hill you do what you can at that time

[NaijaLite 0]

Thanks for your post aceduece. Any updates? I am still undecied on whether to do the lapband or go for the sleeve. I live out of country hence the aftercare/fills will require my travelling to the US. I do not have any fills doctor within a 6hr flight range. How are you now? any complications? please share your story.

[WASaBubbleButt 41]

Thanks for your post aceduece. Any updates? I am still undecied on whether to do the lapband or go for the sleeve. I live out of country hence the aftercare/fills will require my travelling to the US. I do not have any fills doctor within a 6hr flight range. How are you now? any complications? please share your story.

Under the circumstances, how is it even a question?

How will you get an emergency unfill if need be?

Inamed's own stats are showing that after 5 years people average losing about 55% of their excess weight. Those are not great stats. Sleeves show about 80% at 5 years.

[NaijaLite 0]

I am afraid the doctor I am in contact with does not do the 'sleeve'. He recommended the Bypass which I believe is too invasive. Do you know of any doctors in Houston that do the sleeve? Dr Kuri in Mexico would have been a good choice but I do not have a visa to mexico.