CowgirlJane

My surgeon also uses a 38 - I am told that is where they think the whole risk of stricture and issues versus benefit of smaller size balances. It is often said that the bougie size is just one factor on the actual stomach size. surgical technique and how long your stomach is may have an important impact on end size.

I am almost 5 months out and while I am super thrilled with my weight loss, it is definately slowing down. I know that is normal, but i still have a long ways to go so I would really appreciate tips from those of you that managed to keep the momentum going. I started with a total of 150# to lose to get to my personal goal and although I am more then half way there, the remaining is still daunting. I have been cranking up the exercise intensity and frequency. I am doing pretty well with food, but i notice that I am more likely now to get hungry (appropriately, when I haven't eaten) rather then forgetting to eat. This seems a normal progression to me, and I am still eating under 1,000 calories a day but it feels like a warning sign that old habits could creep back - extra diligence is in order! I would love to stay rolling along as best I can and I know there are a bunch of you out there that have done this! I may not lose 150 in my first year, but I want to get as close as I can. Thanks!

It is just a yardstick and if you are heavily muscled it will show you as too high BMI over someone who is lighter but out of shape. I have never in my adult life been below 24 BMI. When I was down at that weight, I looked slim and trim. I do pay attention to it as guidance, but just like the scale, it is just a measuring stick and not the end all. What I do know is that people who stay under 28 BMI appear to have some statistical health benefits. Again, another guideline, not rule.

I wonder if your baby sleeve has woken up fully and is sending all the signals back to your brain. I suggest you follow the guidelines given, for both types and quantities of food even if you "can" eat more you should stay with very small portions as you are still healing.

I guess it is more art then science... My surgeon's office says that their guidelines are based on the best available data from their own practice and other surgeons. There are some things they used to routinely do that they don't anymore and vice versa, based on actual outcomes. They are experts, but they are not all knowing. My strategy was to pick a surgeon that has a good reputation, good stats, good results and TRUST him and follow his guidelines as best I can rather then being concerned with what others are doing.

Other then sharing on the sleeve support boards, i don't tell people how much i have lost or my absolute starting weight. If i did, I would include my 8# preop loss,

The other thing that pushed me over the edge was finding out that my insurance changed as of Jan 1st and the sleeve was not covered (but they did cover gastric bypass and lapband). I was preapproved for the sleeve on my old insurance so I decided to go for it. I went to the same surgical practice for the two operations but actually had different surgeons. My original one went on vacation for the month of December so I was promoted to the chief surgeon! They were both awesome and I am very happy with them. One thing I considered is that these guys do a fairly high number of sleeves and a decent number of revisions. Nothing like the higher volume Mexican docs, but pretty good by local standards. The sleeve is now the main weight loss procedure they perform so they have worked the kinks out. i feel like they have seen it all before and my chances were better of having low complications. The sleeve isn't that complex of a surgery, but the scar tissue and all that can make the stapling an issue. Especially if you are a revision, seek out an experienced surgeon with as good of a history as you can find. Did you really join this forum in 2006? That is a long time - they weren't doing many sleeves then, were they? I was under the impression that it has been more like the last 3-5 years that the sleeve surgeries became so popular.

Mine were two seperate surgeries almost 3 months apart. The reason is that it is thought (not sure of the evidence!) that this is lower risk. Most importantly, I wasn't ready to be sleeved - mentally - but that band needed to come out as they feared i could have a critical problem if it slipped further. It was a bummer to do 2 surgeries, but the advantage is they removed alot of scar tissue from the stomach (the band was encrusted in scar tissue, the photos are gross) which theoritically helped with having more good tissue to staple the sleeve shut. The other advantage is that I knew beyond a doubt that I needed a replacement tool because i was just so hungry starting about 5 days after the band was removed. Oddly, the band removal surgery kinda depressed me/made me feel icky. I happened to catch a virus right after, but I also think the anesthesia kinda messes with me.

I know that some people really do have a hard time. However, I have been reading these forums since last year and what I have noticed is that MOST of the people who feel like they are dying/feel horrible/regret the surgery are actually having either emotional or compliance issues. OR they really didn't know what to expect. People have unrealistic expectations and do things like progress through food too fast, don't pay attention the Fluid intake, don't pay attention to the Protein needs, dont take a PPI etc. etc. I also think some of the "pain" that people feel is food denial. I don't know if any of this applies to your friend. A nurse at my Docs practice is a band to sleeve revision. Presurgery she told me that revision patients don't have all the problems she hears about from sleeve patients because they know what to expect, understand the rules, understand small quantities and understand about separating food from liquids. This is just one nurse's opinion, but I think i see this in the forums too, some people just don't know what they signed up for so then complain mightily when they have some discomfort and emotional distress. You have been through this once so have an idea of what to expect. I also saw a bariatric doctor (not a surgeon) who is a (dissatisfied) band patient herself and has several patients who are revisions. She warned me that I would feel worse then I did after the band surgery (true). She also warned me that the exhaustion/recovery seems much longer and that is primarily due to dyhydration, also true. She encouraged me to seek the IV drip if I got dehydrated, don't suffer. It is true that it was harder recovery then the band, but for me, not because of pain but because eating/drinking was just harder the first month or two.

My surgeon really laid out the risks of a revision - and it scared me. The risks of a revision to a gastric bypass were even scarier. i think the main risk in a revision is the higher risk of leaks. If I remember right, leaks might be 3-5% of revisions. I got the idea that there aren't alot of published studies on actual occurance of serious complications for revisions either so the information seems less structured. So, after getting this big long horror story, I asked about the results of the revisions done at their practice. Well, in their practice they have not had so many complications and no deaths either. I am also told that statistically, revision patients don't lose as fast. for myself, and others that post here regularly, that hasn't been a problem and I am very happy with my weight loss. I have lost more 4.5 months post sleeve then I ever lost with the band. I have not had complications and am very happy with my choice, but I do think it is wise to really research and understand the risks. I had the band for 10 years. After the first couple of years, I had to have all the Fluid removed so I was sitting there with an empty band which eventually slipped. So, I had the band removed and became so hungry 24/7 - I was in misery. That is what convinced me that I needed to get the sleeve, that I needed that tool because I wasn't doing it on my own. If I could have gotten control over my appetite and eating without surgery, I would have done that. Obesity has created a real imbalance in my system and I need help to overcome that.

I started with a higher BMI then you did. Honestly, nobody really noticed anything until I had lost 45-50 pounds. Just the last 2 weeks everyone is suddenly REALLY noticing. I only lost maybe 15 pounds over the last 5 weeks, but I dropped maybe 1-2 sizes in that time. I notice that it comes in spurts. I saw my primary care doc last week, I have lost 30 pounds since I last saw her. She didn't really seem to notice much difference when I lost the first 40# but was just wowed when I saw her last week. Don't be discouraged, people will start seeing it soon enough. I like the compliments, but my motivation comes from within - my bloodwork results from my 3 month was enough to keep me excited for quite awhile. My fasting blood sugar, which wasn't great at 99 preop came up as 77 on my 3 month check!!!!

Me too! I had a wardrobe that covered basically 18W to 26W. I have now donated pretty much everything except for the 18Ws! I am looking forward to buying more new clothes! In the past, i would have boxed it up saved the bigger sizes. I really am believing in this!

You have gotten some great advice. I think you should pat yourself on the back for coming out and saying all this too - laying everything on the table will help make your next steps clearer. Someone I worked with had great success with her weight after gastric bypass, and then a few years later I heard she was dead at 42 - died in her sleep of organ failure. Turned out it wasn't the WLS that killed her, it was the booze combined with her diabetes. This is a serious situation, and I hope you don't feel shame but instead can be open to getting meaningful help. All of us here have some sort of "situation" in our relationship with food - this could happen to just about anybody. First, I don't think you have wasted your surgery. I think that consuming all those sugars(booze) and other carbs combined with erratic eating habits is messing with your body. Be nice to yourself for a few days or a week - no drinking, healthy, low sugar/low carb, plenty of Protein type food in small quantities SEVERAL times a day and I bet you will feel so much better. I bet you will also start to feel restriction again once you get off the sugar merry-go-round. I am thinking that if you could get feeling better nourished getting back on track with everything else would be easier too. I have lost every week except for the weigh in after a one week business trip - small gain. I didn't feel that I was overeating, but every meal in a restaurant and I stopped losing weight. I now go out to eat every once in a while, and I eat part of my husband (or son's) meal. If I go to fast food I get a salad with chicken breast and just eat some of it, taking the rest home for future meals. If I went out to eat alot I would not be able to lose weight well. I feel like I should be able to just be there and eat as healthy as at home, but apparently i don't! Restaurants as a mainstay for meals are really hard. You didn't say if your boyfriend is also your best drinking and restaurant meal eating partner, but I am guessing he is. I know that counseling may not be financially in reach right now, but I think reaching out to someone who really supports you (sister, good friend?) would be great. In my personal experience, it was very hard to give up a lifestyle vice while living with/spending most of my time with someone who was continuing in that behavior. I think you really need to talk all of this over with someone you can trust. I don't have the answers, but know that Your health and your goals are important too. You might consider AA or some other free resource too. Good luck and hang in there.

Mine is 38, I am happy with my weight loss results - I have had steady losses month after month and I am really thinking I can lose 90# by the time I hit the 6 month mark which would be great. I was a band to sleeve revision too. I can eat more then a tablespoon of food for sure, but my portions are very nicely controlled. I feel quite happy with where i am at, but i think someone already mentioned that the bougie measure is just a guide, there is more to it then that in determining your stomach capacity.

Awesome! I am sure you will inspire and help many people with your new career.

I think it is great you are reaching out. I figure it is never too late to get back on track!!! A thought would be to start with doing the 5 day pouch test - google it for details. This is supposed to help you feel like you have some restriction again. I might also suggest that you start using a tool like myfitnesspal.com and journal EVERYTHING - no exceptions. Target for at least 60 g of Protein and less then 50-60G of carbs. That is not super restrictive but is low enough it will keep the sweets out. There are different ideas of how many calories you should have but it seems like most people are getting around 800 or so during the active weight loss phase. I work out alot, so do sometimes eat more, but 1000 is a pretty big day for me. I suggest that you not belabor the past, since you can't change it, but each day think about what you will do this day, this week and look forward to much success!

I am so incredibly pleased with my progress. I feel so much better losing 75 pounds - even this has changed my life for the better. I know that the second half of the journey is likely to go much slower, but I feel so wonderful that doesn't bother me at all!

Start learning to pay attention to your body. Eating by schedule is really good at first, but over time, need to learn the queues that tell you "enough" Forget about trying to be "full" eat until you are satiated or no longer hungry. It is possible to stretch this new tummy out and we want to try to minimize that. Follow the basic rules - Water, Protein and increase activity; Whenever you aren't getting the results you want, go back to those basics and make sure you haven't started drifting away from them.

Dooter, that pretty well describes me too. I wasn't a binge eater, and though my portions were obviously too big, I never was one to eat a whole pizza or multiple burgers at once or anything like that. It is really more like I just consistently ate too much AND often the wrong thing too. I ate alot of healthy foods, but then would have ice cream for dessert like every night. The sleeve has helped me in two important ways. First, small portions sizes and second, reduced appetite so it easier to make good choices. I still have to make deliberate good choices (protein and veggies and exercise!) but it just isn't the struggle with that "drive to eat". I sure hope this continues!

I had alot of those same doubts. the doc I see for sleep apnea gave me the best counter argument.... he said "so, lets say in 5 years you gained back some weight and in 10 years all of it - you still had 5-10 years of a much higher quality of life! 10 years of less pain, of being able to do the things you want to do. 10 years of having your life back." I couldn't help but think he had a good point. Even post surgery, I saw the NUT a month post op and had lost 30 pounds. I can remember telling her that I was still skeptical and I would know it is really working once I lose at least 50#. Well, I am at almost 70# off and even though I am still obese, I feel soo much better. It is hard to describe the incredibly good it feels. As i have headed down this journey I am becoming more convinced that long term success is possible. I am not naive, anybody can regain after ANY weight loss surgery. I guess I am just starting to think that it is really possible to get this weight off... and keep it off permanently. The journey continues...

The pain wasn't that bad - it was the feeling horrible that was horrible! I was maxed out on anti nasuea drugs and even though I never puked, I felt really awful immediately post op. The good news is that it passed really quickly and it wasn't too long before I was up and walking around.

I love the imagery. The mind is a powerful thing, who knows it might help you release some excess fat - I might have to try that!

Everybody is different - and it will depend alot on how much you lost on your preop diet becaues weight loss tends to be fast at the beginning due to Water weight loss. I lost only 8 pounds on my preop diet so my losses were big immediately after surgery. I lost 10 pounds on week one, and 10.4 on week 2.... it slowed down after that but I have been losing pretty steadily.

I think having the band helped me with post sleeve eating. I haven't had a lot of problems with vomiting or anything - the sleeve is such a breeze compared to the crapband.

started at: 308 lost 8 pounds on the 2 week preop diet, weight on day of surgery 300# current: 240 weeks since surgery: 16