duckydoom

It's hard to imagine that just 6 months ago I was 263 pound I'm currently 155 
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I'm two and half years out and have experienced the bounce and weight gain as well. It's hell getting it off.
And to all those newly sleeved or early on offering advice.........thanks for the well intended advice, but it's not the same as at the beginning. We know and have already tried all the usual stuff.
I feel for @@stefaniwg and what she is going thru. It is frustrating this far out when we think that we already KNOW what to do and then no matter what we do, it no longer works. I was at my wits end trying to lose some extra pounds, when I got sick from some unknown bug and lost 12 pounds. I'll take it however I can.
Now I watch the pounds even more closely to avoid gaining.
So, just food for thought newbies.......it may not be easy street farther out.......pay close attention.

Thank you for your responses. I hate that this is happening but it does make me feel better that I'm not alone. That this is "normal" as much as it sucks. I won't give up as I can NEVER allow myself to get back to where I was before. Maybe it was just easy before and now I have to fight. It's hard pill to swallow but I will continue to fight!
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Never heard of Staywell. If it's your medical plan and one of its genius phone answerers said, "I dunno," get back in there and demand an accurate answer from an appropriate party. It may be better to send a written complaint to the customer service "complaints & grievances" office. Crap. How dare they. And they are par for the course.
Between you and me, the person who handles insurance applications at your chosen bariatric practice should be able to give a definitive answer.
After all is said and done, I'd be surprised if the answer is Yes.

Hey, stick around. This forum is more entertaining than TV and cheaper than going to a movie.

Hi all, I'm newbie and am surprised at the level of hostility and arguments on here. Most of them come down to religion, I'm an atheist and don't particularly like people saying things to me like 'I'll pray for you' or basically mentioning religion in anyway shape of form. It offends me. But that's me and my opinion, I don't complain about it to them. It comes from a nice, meaningful place for that person. Why does everything seem to degenerate to some form of argument which is of no use to any of us here to seek advice and support. Think I'll be signing off. This forum appears to have a lot of helpful caring people and a handful of narky, miserable, trouble causers and it's not what I need to waste my time reading right now. Thanks for the helpfulness and positivity from most of you. Ciao for now
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A couple of colleagues knew I'd been off for an operation and wouldn't stop asking me what it was I'd had done. I've told them I've had the first stage of my sex change!!! None of the have asked another question since. They were just annoying me so I thought I'd send them down the wrong path for a laugh. I will tell them it was for GERD / hernia or something I guess, they know I've always been on some form of diet and I've lost heaps of weight before and regained it, this time, the weight loss will appear to them as no different, hopefully I'll just keep it off this time
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@@OutsideMatchInside

Since this is a temporary type of hair loss, why not have fun with it any get you a few wigs or extensions? I'm just 3 weeks post op but I plan on going to a local wig shop and trying on some wigs once I go through this.
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My surgery date is 6.21.16. Using nioxin and scalp repair for thinning hair. Biotin daily. And today I got the cutest hair cut ever. It is what it is. But I will not go down without a fight!!
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if everyone could please take turns coming by to massage my head for the next 6 months, I'd like to test this theory out.

Just an update. I had my first weight in today, I did lose 5lbs within the first 30 days. My Care team did prescribe me a weight pill I believe it's called topiramate which looking at reviews is not so bad. We talked about it being a tool for right now until it's time for surgery.
It's all a self process that I am learning. I am currently a full time medical assistant along with being a full time nursing student so my stress levels are up the roof. As much as I want to be able to stop everything cold turkey and manage my stress issues right away I know it's a process and it's okay to use tools like surgery and pills (temporarily) to help condition myself.
Thanks for everyone's feedback.
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Look up Jeremy Clarkson rocket launcher Porsche on YouTube. My husband and I discuss the imminent need for this technology on the regular. I can't stand people who don't take constructive criticism or assistance well, and who can't ever be wrong. I'm in training at work and one of my co trainees is ALWAYS right and ALWAYS has to talk over the trainer and make a big deal about how it's not her fault it's the system etc. even though she consistently makes the same mistakes after they've been addressed and nobody else has issues. I was her trainer previously for a couple of specialties and I just wanted to strangle her. 3 more weeks of sharing a classroom with her
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i forgot to post this week cuz someone hurt my feelings and told me i looked sickly yesterday and i got all butt hurt and was crying all night. see "surgery day" for details. anyways here's the latest. 148lbs.

I've tried OTC diet pills before and they've had the worst affect on me. I felt jittery and uncomfortable and didn't lose any weight. What I did to lose the weight was cut out all carbs like bread, Pasta, and rice. If you go on pinterest you can find recipes that are high Protein carb replacement. My face are cauliflower mash and cookie dough bites made from dates and peanut butter! These foods made me feel great and I lost weight.
Best of luck!
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Here I am!!s.w.248 c.w.168.s.d.9/24/14

Personally when I've tried diet pills in the past, they made me jittery and overall even more stressed and spazzed out. My insurance considered it one of my "tried and failed" diets though, so that was a plus side I suppose.

Diet pills, just mess up your quality of life... Have you consider herbs or chromium picolinate?
"We can't solve problems by using the same kind of thinking we used when we created them"
Einstein

Personally when I've tried diet pills in the past, they made me jittery and overall even more stressed and spazzed out. My insurance considered it one of my "tried and failed" diets though, so that was a plus side I suppose.

Since WLS surgery? Nothing. Not even the (relatively mild) gall bladder attack or GB surgery / recovery 4 weeks post-WLS.
But pre-op -- it was WAITING FOR THE DAMN SURGERY TO FINALLY FREAKIN' HAPPEN!
My surgeon was so backed up with huge demand. So jumping through all the pre-op hoops took a long time. It made me so crazy that I finally put myself on a diet and lost 11 pounds prior to the liver-shrinking diet.
Pre-op, I also practiced all the post-op eating behaviors -- eating slower, chewing lots more, not drinking with meals, drinking 64 ounces of Water daily, walking more (bought a Fitbit and got up and moved), took Vitamins, started tracking all my food on My Fitness Pal, etc.
I was like a kid who wore a Batman cape everywhere because he thinks he's Batman.
So when I hear about pre-op patients who are having a month of last suppers and whining about the liver-shrinking diet and worrying about losing their hair somewhere down the road and drama-llamaing about potential loose skin and not being able to close down the bars every weekend and other s**t like that, I just shake my head.
Don't they know how wonderful this surgery is going to be for them and that it will be worth any inconveniences and lifestyle changes required of them?
Again -- shaking my head.
(I may have had too much coffee this morning.)

Don't forget those who grouse about incorrect usage, grammar or vocabulary and then commit the very sin about which they grouse. You can find it for yourselves. I shan't name names, lest I bring the wrath of @@4MRB4PHOTO upon my head: "How about people who must always one up someone else instead of letting them enjoy their moment." It can also be such fun to see them swing from their own nooses.
Let's not overdo the martinet routine, though. There really are honest typos.

@@mmy, here is the post I was referring to:
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.

Coming up on twenty years married and two years post-op. Our marriage is stronger than ever.

Interesting article!
http://www.nbcnews.com/health/scientists-obese-have-higher-levels-hunger-hormone-their-blood-6C10639235

We talked about it here
http://www.bariatricpal.com/topic/360260-ketogenic-diet/
I eat Keto. It is nice to follow post-op. It is hard to get the fats in really. I keep my carbs low easily and my Protein goals I meet daily. If I fall short on fat, it isn't the end of the world.