educationrulz

I was supposed to post these questions awhile ago. I didn't write the answers as we talked so I can't remember everything he said, but I think I remember the answers to the important stuff. 1. Number of VSGs done? can't remember this one, but I think he said over a hundred 2. What size boughie used? 40 french 3. Impact of boughie size on maintaining goal weight and not losing too much weight? I think he said this is different for everyone and more related to changing your eating patterns when you reach goal, not so much the boughie size. 4. How much stretching of the sleeve can be expected? the sleeve will not stretch unless you overeat and push it past capacity. 5. Number of leaks you have had? 1 6. Treatment for leaks? go in and reinforce the leak area. then treat as needed in hospital/at home with fluids, etc. until leak heals. risk of leaks with VSG patients is greatest because there are more staples placed. (obviously this is a more complicated issue. this is just the gist of it) 7. Worst case scenario for leak not healing, i.e. loss of stomach functioning? leak will always heal eventually with proper treatment. should not expect to lose your stomach due to a leak. 8. Other complications you have experienced? occasionally incision site infections, but rare. 9. Risk for ulcers? no more so than general population. 10. Is esophagus at risk duing surgery? there is some risk but not a significant concern since staples are kept as far from esophagus as possible. (there was more to this issue that I can't remember) 11. Difference in type of staples used? there really is no difference (can't really remember how I phrased this question, so there may be more there to explore if it interests you) 12. Sew over or buttress staple line? yes, either a sew over or organic (think that's the term he used) reinforcement material is used on the staple line. 13. How do you decide who gets sew over vs reinforcement material? it depends on what is available in the OR. if the reinforcement material is not available, then sew over is done. (of course, this made me want to call the OR and tell them to have that stuff available on my surgery date, but I restrained myself. :crying: I didn't go into which was better as it seemed to be more a matter of convenience to have the reinforment material versus having to do the sew over by hand. I figure with only 1 leak, he's perfected both methods.) 14. Should I expect issues with scar tissue from prior surgeries that might impact this surgery? no 15. Issues with finding a hernia/gallbladder problems? if a hernia is found, it will definitely be fixed during the VSG. the gallbladder will only be removed if it is significantly diseased. 16. Is single incision VSG possible if a hernia is found? can't exactly remember the response to this but I think it was that the single incision will depend on ability to fit necessary instruments into stomach area, not on the hernia. 17. Will I need meds for gas/heartburn postop or for lifetime? this varies by individual (can't remember this part too well but I think more was said) 18. What are some good natural food protein sources for immediately post op? the immediate postop phase is about survival. it is more important to get in fluids. no one is able to take in the recommended protein. (how true!!! it's amazing that I remember this part very clearly but still ended up getting dehydrated. ) :scared0: 19. Recommened vitamins for postop? any store brand multivatim is fine. will need to supplement calcium. (this part was discussed with the nurse when getting all of my postop diet info).

Well, today I am officially two weeks post op and still not quite sure how I actually feel about the surgery. I definitely don't regret it, but it hasn't been a breeze. :scared0: I struggled quite a bit the first week and a half with being able to drink and eat. I ended up having a hiatal hernia repair with my sleeve surgery and I think this increased my pain level post op. It also made my esophagus very sore and restricted, making it painful to drink and eat. Getting that hot poker sensation every time something went down my throat was NOT conducive to me getting in my fluids. So, I ended up with a slight case of dehydration a few days after coming home from the hospital and it was not pretty. :crying: I discussed this with my doctor's office on several occasions and was always told there was nothing that could be done about it. I'm not convinced that is really the case since I've talked to at least one other person online who was given medication for esophageal spasms. But, at two weeks out, I have improved significantly with my ability to get liquids and foods down, so I don't feel the need to push the issue anymore. I just hate it when doctors and medical people are misleading, for whatever reason. It's insulting to my intelligence. Anyway, I've been very lethargic feeling even though my body is clearly healing well. I can tell that everything is fine on the inside, so the lethargy was either from PMS or from a developing sinus infection. I hope to see a big improvement by the end of week 3. I haven't been walking nearly as much as I need to because I've felt so weak and lifeless. But, last night when I went walking at the park, I noticed a big difference in my stamina. I think it's also related to me not getting in enough nutrients to support my body. But, my food intake has increased over the past few days and I can now get in a decent amount at each sitting. I started out being able to get in a couple of teaspoons of food. Now, I'm at about 2 tablespoons of solid food per sitting. My postop diet progressed pretty quickly, so I'm able to eat most foods now, but I don't push it by eating anything too extreme. I've also discovered that I like the Isopure protein drinks and I'm really excited about that because I know I wasn't getting in enough protein. I've only tried one flavor so far, but I plan to get some more today. Even though some people feel they are expensive, I've saved so much money on food since surgery, that it'll still be a bargain to just buy the ready to drink Isopures. As I understand it, the Isopures have the best quality of protein, the whey isolate, so this is good news for me and one less thing to worry about. As for my weight loss, it is definitely coming along. I lost about 14 pounds on the preop diet, which is amazing. As of the last time I was weighed, I had lost 7 pounds since surgery, but that was last week. So, I should have a bigger loss to report this afternoon. My 2 week followup appointment is later today. I'll probably come back and update this blog with the outcome of that appointment. Overall, I know this surgery is what I needed to do for myself even though it still seems drastic to me sometimes. I have had some food regrets since surgery, but nothing that has lasted more than a couple of minutes. I've been able to talk myself through those moments by reminding myself of why I did this and the outcomes I expect in the end of the process. I have had some dark moments, but it does get better each day as my body adjusts to the changes. I guess you just have to keep on pressing on and deal with the changes as they come. I certainly don't want to discourage anyone from doing this surgery by not painting a rosey picture of life post op. You just have to be prepared for a few rough times post op and know that it does get better. I thought I was preparing myself for that preop, but there's nothing like the actual experience. :ohmy: Update: My 2 week followup appointment was uneventful. The doctor was not in the office so I talked to the nurse. She said my incisions look great and I'm cleared to take baths. I will have to wait until all of the scabs and surgical glue fall off before I go swimming. I am cleared to do light hand weights and elliptical, which is great because I want to start working on these arm flaps when my energy level increases. We reviewed what I had been eating and my supplements. She said I am right on track with about one pound a day of weight loss. I'm sure that won't hold up, but that's okay. I'm determined not to stress about the stalls that will be forthcoming. I did ask about the medication for the esophageal spasms and gave the name of a drug that someone else said they are taking for it. She said she would ask the doctor about that. I really don't expect an answer. I just want them to know I'm not a dummy.

I have been able to eat cereal after letting it sit in the milk and get soggy. Even after that, I chewed it to mush like everything else. Seems like it could be a slider food to me eventually after my stomach can take more volume but I don't eat a lot of it anyway.

Anybody heard from TiffanyisMajor? I'm kind of worried about her since she hasn't updated here or on youtube. It's like she totally dropped out of sight after that stuff with her incision sites. I hope she's ok.

DDP is Diet Dr Pepper. My postop diet went to full liquids to pureed all by the end of the first week, so I think that did help cut down on a lot of craving issues for me. By the time I was able to eat stuff like scrambled eggs and oatmeal I fell almost like I was eating regular food. And no, I didn't put the doritos back in the bag. :confused:

I just tried my first Isopure RTD. After reading everyone's comments, I expected to "puke" immediately after taking a sip. :tongue_smilie:Surprisingly, it's not bad. I got the Mango Peach flavor because the lady at Vitamin Shoppe said that's a popular flavor. I guess I'll try the grape one next. I hope I can continue to tolerate them because I am getting in little to no protein at this point.

Congratulations Ally! It sounds like you're coming along nicely after surgery. I don't know if I can say anything to put your mind at ease because it seems like everyone is so different with how much their new stomachs can hold. I do think that in general it is not good to judge your stomach volume while on clear liquids because they are made to slide through pretty much like water. So, your volume would be limitless to some extent. Just serve yourself the recommended amount from your postop diet and you should be fine.

This is funny. I licked some Doritos on my day of Clear Liquids the day before surgery. Yummmmmyyy! Right now, I'm craving a soda real bad! I'm thinking about putting some DDP in my mouth and spitting it out but I'm scared some will slide down my throat. I'm pretty sure I'll need an ambulance if that happens considering how little I can handle in my stomach right now. :001_wub:

Does anyone have any thoughts about the type of milk we should be drinking right now? I'm thinking about this because when I came home all I had in the house was 2% since that's all I buy for me and my daughter. My preop diet does call for skim/1% but late one night during my full liquid phase, I really wanted some milk. I was weak and thristy, so I drank the 2%. It tasted like heaven! I just didn't think about it much after that and continued to occasionally drink the 2%. I probably drink about 1/4 cup every other day, if that much. I actually drank it a couple of times because I was getting SOOOO little fluids and food in that it seemed like a good source of nutrients for my body. At least it has some substance to it. I'm still strugglng with eating and drinking and not getting enough of anything in on a regular basis. I know it's more calories and fat, but I feel like my body needs something more right now. I finally bought some skim yesterday, but went to put it in my Cereal this am and it was totally unappealing to me - as it always has been. So, I poured it out and put the 2% in there. I wanted to try the skim now so that I could bump up to 2% as needed when I hit the maintenance phase but I couldn't bring myself to drink it. This is honestly the only thing I've strayed from on my postop diet. Does anyone know of a reason this might be a problem to just continue with the 2%? BTW, I think I'm going to fess up to my surgeon at my 2 week followup this week and see what he says. I can just imagine.

Here's how I handled this. I told no one except my sister before the surgery. None of my friends or coworkers knew I was having surgery. Had I not been on vacation and needed to request medical leave I would have told them it was some other kind of surgery. Who cares if they find out the truth later? Before surgery, I didn't want anyone's opinion about what I was doing and what they thought I needed to do to lose weight. I did my research and knew what I wanted to do. Since I kept quiet before surgery, I never had to hear any crap from anyone about me having surgery. Now, that the deed is done I pretty much plan to tell people I know IF they ask how I lost weight. But, I only plan to tell them I had WLS. I'm not sharing the gorey details or becoming the poster child for WLS who runs around explaining it every time someone asks. I'm not sure about telling what kind of surgery I had because once I reveal that it opens the door for more questions that I won't want to answer. If they want to know what's out there in terms of WLS, they can google it. So far, I've only talked to one friend from work and I could tell she was surprised I had kept it from her but she was supportive. I figure that after I've had surgery, what the hell can they say, "Don't do it!" "It's dangerous!" Here's what I'll say to that: TOO LATE party pooper, my stomach is all gone bye-bye! And in case you haters haven't noticed, I'm looking better every day.

Yeah girl, you are officially HERE on the bench! Congratulations!!! I am one that agrees with you about the first days being awful, but it does get better. Trying on clothes is really fun and should be even more fun after about 20 pounds or so.

My boughie size is a 40 and my doctor does some type of oversewing or reinforcement of the staple line that may decrease the volume of the sleeve. The oversewing is when they stitch around the staples to make the outer edge of the stomach more stable while it is healing after surgery. So, you would have a line of staples and then stitches of some kind all around the staples. Somebody help me if I described that wrong. I'm not sure yet if I got the oversew or the reinforcement material. I keep forgetting to ask. As far as volume goes, I can't even get in 2 tablespoons of solid food right now. This may work out in the long term as things level off, but it's frustrating now because I'm struggling to get in Protein. I sometimes have difficulty with liquids and mushies, but I think that's a side effect of the hernia repair and the stress on my esophagus. Have you talked to your surgeon about this yet?

Wow, we are all so diffirent! I developed diarrhea soon after coming home from the hospital. Once I started pureeds and quickly moved to softs (per my postop diet) things leveled off and I actually feel pretty regular right now. I've been going once a day, maybe once every day and a half at the most. I hope it stays this way but I was told to take a stool softener if I got constipated, like miralax or dulculax. However, when things get stuck, I prefer natural methods like foods that move me EVERY time. Do you like collard greens? You can try drinking the liquid part from the cooking process if the leaf part is too much for you. (This is fondly known as pot liquor for those of you'll not raised in the South). I have never eaten collard greens and not have something coming racing out by the next day! BTW, collard greens are chocked full of Vitamins that promote healing after surgery.

I didn't have this issue with my PCP because he actually did my 6 month supervised diet documentation for insurance. I do remember that when I first told him I planned to get surgery and needed him to do the documentation, he seemed surprised briefly but was back to business in a second. This past week, I had to go to a different branch of my PCP's practice and my WLS history was not in their file. So, when the nurse was updating my chart, she commented on the fact that I had lost weight since I was last there. That was my opening and I took it. You might get a minor reaction from the doc, but I doubt it will be a big deal, especially since you're going there about some other issue.

I had an IV for most of the time I was in the hospital. I got dehydrated after I came home. Drinking was extremely painful because of my hernia repair I guess and I just kind of gave up on it. Big mistake. But, I'm back on track and it's less painful now.

Congratulations Leo! I hope things are going well for you. I've always liked Dr. Garth Davis on tv. Is he pretty cool?

My doc ordered my upper gi the afternoon of my surgery. Needless to say, I was not happy. I felt like I'd been run over by a truck, could barely move, and wanted to puke at the thought of putting ANYTHING in my mouth. After unsuccessfully requesting to do it the next morning, I went on down in the wheelchair for the test. I surprisingly drank the concoction without vomiting and went back to my room and promptly fell back to sleep. The good thing was that I was able to get ice chips and liquids once I'd passed the leak test. It seems odd to think about drinking stuff so soon after surgery, but when you think about, they've actually tested your stomach for leaks in the OR so you've already had something in there before you get to your room. That second leak test isn't going to hurt your stomach anymore than the one in the OR did.

I've never been good at (or interested in) counting calories, carbs, etc... And I've dieted successfully in the past without doing so. It seems to me that if you follow the guidelines that everyone seems to agree on, to use sugar free and fat free products and to focus on proteins first, then veggies, then occasional carbs, you won't overdue the calories or the carbs. I'm working from this standpoint right now within the guidelines of my post op diet and I hope it will allow me to live "counting" free.

Not owning a scale seems to do the trick for me.:blushing: I actually haven't owned a scale for many years. I suspect that it wasn't a good thing when the pounds were creeping up on me, but it always helped when I was actively dieting because I focused on how I felt, looked, and how my clothes fit - not what the scale said. I almost broke down and bought one right before surgery because I had to lose a few pounds preop to make up for weight that I gained after my initial consult. But I was able to work it out by weighing myself here and there and I made to surgery successfully. I'm a little tempted to get one now to track my progress, but I go to various doctors enough between myself and my daughter that I can get to a scale fairly regulalry. If all else fails, I can step on one at the store. I've decided to hold off on buying one until I reach goal weight. I figure at that point I may have to start playing with my diet more to maintain weight and I'll need to be able to pull myself back after a couple of pounds of gain. I guess if you want to go cold turkey like me and some other people do, you'd have to throw yours away. :thumbup: Or, you could try putting it somewhere that's really inconvenient to get to, like in the garage or a storage closet under a bunch of stuff.

My surgeon recommends that any store bought multivitamin will be fine. I read the labels carefully and chose the chewable with the most nutrients in one pill. It's difficult to find any with enough calcium, so that one has to be separate. Right now, I'm using some samples from the docs office that are Bariatric Advantage chewable calcium with Vit D. They kind of have a sourness to them and are cherry flavored. They are huge so I hate to be bothered sucking them down but the taste is manageable. I'm on the hunt for a store brand that I can use when those run out. I guess I need to check the iron level in my multivitamin because I can't remember if it's high enough...

My general pain subsided by day 5. The pain from the hernia repair has been longer lasting and started to subside on day 10.

I'm 11 days out and until yesterday couldn't even think about pants without an elastic waist. Just last night I tried on some regular waist pants and was able to fasten them but the smaller sizes that fit everywhere else were very uncomfortable in the waist. But, I'm probably an exception to have this issue go on for so long. Luckily I haven't had to force the issue by wearing any nice pants since I'm on vacation right now. I think I may have more swelling because I've had so much trouble getting fluids in. Maybe I'm just starting to really flush some of that stuff out of my body. I'm determined to wear something cuter than my rubber waists today so I'll figure something out. :thumbup:

Your paperwork is being sent next week but you don't know if your plan covers bariatric surgery. I'm confused. Have you or your docs office talked to a UHC rep yet? Generally you need to do that before you initiate the process and they would have told you then if it was covered. I had to go through Bariatric Resource Center before I could do any of the preop requirements.

I'm going to play devil's advocate here and say that I don't think this was all THAT bad. In fact, if this is the rudest thing anyone has ever said to you then you've led a blessed life. I've had much ruder crap said to me, even by doctors. Does that make it right? No. Does that make it the end of the world, or cause to go running to a new doctor who doesn't know your history and hasn't already seen your insides? No. Unless you have questions about his general competence, technique with your banding, or track record with revisions, it doesn't seem worth it to start over with a new surgeon. Although it might have been a little out of context, your surgeon's comment ("You have to look at what you're eating when you have bariatric surgery, you can't just eat everything you see.") is very true and very important. But, it sounds like he might have been frustrated with your lack of success (hey, he's human and you're frustrated too, right?) and he let it get the best of him. Maybe his personality doesn't allow him to say things in a more nurturing way. That's not new in the world of doctors. :glare: I guess my point is that maybe your emotions about your lack of success with the band have caused you to read more into this than there is. I don't say this to criticize, blame you, or demean what you are feeling. I just think that sometimes we have to get past the small stuff and keep our eyes on the prize. My surgeon isn't warm and fuzzy either and sometimes I leave an encounter with him feeling a little disregarded emotionally. :thumbup: But, he took good care of my insides, he answers my questions, and has a great track record and reputation. I can't say this about all the doctors I've had over my 40 years of life. So, I'll just have to get my warm and fuzzies elsewhere. :blushing: Maybe you can go into your next appointment with him from the perspective of tackling the problem with the band head on and developing a plan for success. That should make you feel better and give him less time for rude comments about your weight. Please keep us up to date on how it's going and I hope this doesn't offend you. Good luck with your revision.

I think that the techniques your doctor used to learn this surgery are the way doctors around the world learn various procedures, especially watching other doctors do it. Since the head of the bariatric team trained your doctor, then it's not like he just went out and self taught himself. My only follow up questions to your doctor would be how many of his 6 VSGs were supervised by his mentor. I would be concerned if none of them were supervised. Alot of people think that the number of surgeries performed is the top factor in chosing a surgeon. I don't agree with that if you can demonstrate a proven track record with similar surgeries, openness about techniques, and access to backup in the event of problems. If you're confident about those things and comfortable with your surgeon, you should be ok. Try asking if the doctor's office can put you in contact with those 6 VSG patients so you can talk to them directly...