mattr2

A little more info:
The size of a bouge is the # of mm x 1/3. So a size 40 FR bougie is 13.3 mm in diameter, or a radius of 6.65. The stomach, after being sleeved will resemble the shape of a cylinder.
If you take the volume of a 40 Fr bougie and compare it to the volume of a 32 FR bougie, there is about
Formulas:
Volume: (r x r) x (3.14) x (height)
The length of a stomach is 10-12" or 254 mm.
I have also read the sleeve surgery includes removal of 85% of the stomach.
I know there are a few assumptions and other factors, like how closely the surgeons sews, length of the stomach, maybe even how much elasticity an individual has (althought he stretchy part was removed), etc, but am I way off on my logic?
Just for kicks and giggles, here is the volume difference in the different sizes of bougies:
32 FR = 10.67 mm diameter = 22686 cubic mm
36 FR = 12.00 mm diameter = 28712 cubic mm + 27%
40 FR = 13.33 mm diameter = 35447 cubic mm + 56%
46 FR = 15.33 mm diameter = 46879 cubic mm + 107%
50 FR = 16.67 mm diameter = 55386 cubic mm + 144%
60 FR = 20.00 mm diameter = 79756 cubic mm + 252%
There is clearly a larger difference than meets the eye when looking at the instrument itself. The size of the bougie simply HAS to correlate to the amount of stomach volume remaining.
I found an intersting article on this from India here:
http://www.bmi-india.com/does-bougie-size-in-sleeve-gastrectomy-matter/comment-page-1/#comment-22904
Originally the standard was a 60 FR bougie size at this practice. They now recommend 34-38 FR.
Now, the next step would be assuming how much of a stomach on average is generally removed with a 32 FR bougie. If that number is 85%, then the next step would be:
32 FR - 15% remaining
36 FR - 19% remaining
40 FR - 23% remaining
46 FR - 31% remaining
50 FR - 37% remaining
60 FR - 52% remaining
I would also think, the larger you go, the greater the possibility of stretch later down the road as well as greater possibility of not removing the portion of the stomach that creates the hunger hormone grehlin.
Also in the article, the end result of stomach volume after a few years is similiar, so why not remove less if the results are close to the same in an irreversible procedure?
Another interesting article:
http://www.obesityhelp.com/member/carmelita/blog/tag/bougie+in+vsg/
That is certainly logical. Starving your body will result in weiht loss. To me, the journey does not need to happen in 4 months, 6 months to a year is fine, maybe even 2-3 years. Is the progress, long term prognosis, and overall quality of life that I am most interested in.
I would really like to hear from someone that used a size 40+ FR bougie AND that was lower BMI going into it. Is that too much to ask. LOL.
Sorry for going on. But, I would really like to hear some other opinions on this. I can also forward this to my surgeon to get his feedback. The more the better!

Man, this sleeve thing just gets better and better doesn't it! If there was one food I was hoping the sleeve would accommodate, it would be popcorn.

I am now 8 months out. I can easily go until 1:00 pm and not feel hungry. I eat because I know in my head that I need nutrition and fuel.
At 175 lbs, I don't want to lose any more weight. I even throw in a little ice cream if I feel I am too far under my daily calorie goal or if I burned a lot that day.
Hunger, if it ever comes is from boredom or just in my head. Best part, a few bites of anything and I can be satisfied. Trust me, this is the real deal.

It's way easier to control my swing now. When everything weighs less, I am finding I am able to make my misses less dramatic so I stay in play a lot more often. I lost a little distance, but that's simply because I have lost a lot of muscle too. I am certain the muscle will come back over time as the diet slowly increase back to a higher caloric level.
I also had a bit of an over swing, now I can stop a parallel when I make a conscious effort. That may also explain the better control.
I am still trying to find a downside to the sleeve but have to keep looking.

Carolina, first key me say you are smokin' hot. thanks for sharing. What you described is exactly how I feel as well.
NtvTXN, that's for sharing. I am about 5 months in and and finding the same thing. I love that I can have a few bites of anything and not have it kill me for a week. The Portion Control is fantastic and empowers me to make decisions and actually manage my lifestyle.
No regrets whatsoever from this low bmi-er!

Carolina, first key me say you are smokin' hot. thanks for sharing. What you described is exactly how I feel as well.
NtvTXN, that's for sharing. I am about 5 months in and and finding the same thing. I love that I can have a few bites of anything and not have it kill me for a week. The Portion Control is fantastic and empowers me to make decisions and actually manage my lifestyle.
No regrets whatsoever from this low bmi-er!

A little more info:
The size of a bouge is the # of mm x 1/3. So a size 40 FR bougie is 13.3 mm in diameter, or a radius of 6.65. The stomach, after being sleeved will resemble the shape of a cylinder.
If you take the volume of a 40 Fr bougie and compare it to the volume of a 32 FR bougie, there is about
Formulas:
Volume: (r x r) x (3.14) x (height)
The length of a stomach is 10-12" or 254 mm.
I have also read the sleeve surgery includes removal of 85% of the stomach.
I know there are a few assumptions and other factors, like how closely the surgeons sews, length of the stomach, maybe even how much elasticity an individual has (althought he stretchy part was removed), etc, but am I way off on my logic?
Just for kicks and giggles, here is the volume difference in the different sizes of bougies:
32 FR = 10.67 mm diameter = 22686 cubic mm
36 FR = 12.00 mm diameter = 28712 cubic mm + 27%
40 FR = 13.33 mm diameter = 35447 cubic mm + 56%
46 FR = 15.33 mm diameter = 46879 cubic mm + 107%
50 FR = 16.67 mm diameter = 55386 cubic mm + 144%
60 FR = 20.00 mm diameter = 79756 cubic mm + 252%
There is clearly a larger difference than meets the eye when looking at the instrument itself. The size of the bougie simply HAS to correlate to the amount of stomach volume remaining.
I found an intersting article on this from India here:
http://www.bmi-india.com/does-bougie-size-in-sleeve-gastrectomy-matter/comment-page-1/#comment-22904
Originally the standard was a 60 FR bougie size at this practice. They now recommend 34-38 FR.
Now, the next step would be assuming how much of a stomach on average is generally removed with a 32 FR bougie. If that number is 85%, then the next step would be:
32 FR - 15% remaining
36 FR - 19% remaining
40 FR - 23% remaining
46 FR - 31% remaining
50 FR - 37% remaining
60 FR - 52% remaining
I would also think, the larger you go, the greater the possibility of stretch later down the road as well as greater possibility of not removing the portion of the stomach that creates the hunger hormone grehlin.
Also in the article, the end result of stomach volume after a few years is similiar, so why not remove less if the results are close to the same in an irreversible procedure?
Another interesting article:
http://www.obesityhelp.com/member/carmelita/blog/tag/bougie+in+vsg/
That is certainly logical. Starving your body will result in weiht loss. To me, the journey does not need to happen in 4 months, 6 months to a year is fine, maybe even 2-3 years. Is the progress, long term prognosis, and overall quality of life that I am most interested in.
I would really like to hear from someone that used a size 40+ FR bougie AND that was lower BMI going into it. Is that too much to ask. LOL.
Sorry for going on. But, I would really like to hear some other opinions on this. I can also forward this to my surgeon to get his feedback. The more the better!

Man, this sleeve thing just gets better and better doesn't it! If there was one food I was hoping the sleeve would accommodate, it would be popcorn.

A big thank you to both Katie and Ali!
Having a little less to lose than others on this board and having this procedure makes it helpful to ask others in the same sitation.
I'm curious, what size bougies id your doctors use?

I hear ya ILMD, I felt the same way. I was a BMI of 33 and love the step I took to get healthy. I am sure people will think I am crazy for turning to surgery but I know I just made a major change for the better.
My family is all overweight. I was well down the path of diabetes and knee replacement surgery. After 3.5 months I am 10 lbs from goal and feel like a champ. Only two people know I had the surgery, my wife and my twin brother. He's a doctor and wants to do the same as I did, but his wife wont let him.
I went to Dr Rod in Mexico. His team was awesome.
Best wishes!

Wow, what a change! Congrats!
Now that you are a year out, how does your food volume for one meal compare to where you were at say, 3 months, 6 months, 9 months.....

I agree with everyone here. Go see a Dr. ASAP. At just over 8 weeks I am definitely getting more and more comfortable with food and liquids. You should be able to tolerate a good variety at this point.
Which Dr in Mexico isn't responding to you?

I'm day 2 post op.
The pain the day of was about a 4 for me. Last night was rough becuase I couldnt sleep, took a pain pill and a gasx and viola, I went down. Maybe there is a little pain but I don't notice it? Maybe just laying in bed for the last three days made me stir crazy. I still made my rounds walking every two hours and that helped a ton.
Once they took out the drain and the IV it was easier. I also sleep walk and tried getting up in the middle of the night which made my main stitch hurt. I remember that.
The next morning (today) I think pain is at a 2. liquids are getting a little easier too.

Incredible!
Love how the before has a full stove of food and the after its all cleared.
Averaging 25 lbs a moth for six months? That's crazy talk.

Man, this sleeve thing just gets better and better doesn't it! If there was one food I was hoping the sleeve would accommodate, it would be popcorn.

I was sleeved on 8-13, here is my typical day:
Wakeup
Water
Breakfast
Egg and piece of toast -or-
Protein shake -or-
Greek yogurt
snack
String cheese
lunch
Protein (4 oz chicken) with a sauce, veggie if room
Soup
Taco
Snack
String cheese
dinner
Whatever is on the table, just smaller portions
Water

Sounds to me like so many Sleevers choose to leave their old life behind, including their responsibilities and relationships with their spouses. Maybe they made that choice a long time ago and associate that life with their old self and can't get away from the sour memories without a clean cut.
I could see it the other way too with a spouse being insecure when their significant other is now so much more "marketable."
For me, my wife is extremely supportive. Then again, I am doing this for both of us, not just me.
I do think there is a lot of selfishness involved. When you share your life with someone and your role has been to help with cooking while the other goes to work, helps with the house, dedicated,to kids sports etc, and you decide you are the one no longer interested without including the other in that decision, then there is selfishness involved.
Sorry, that's just how I see it.

Sounds to me like so many Sleevers choose to leave their old life behind, including their responsibilities and relationships with their spouses. Maybe they made that choice a long time ago and associate that life with their old self and can't get away from the sour memories without a clean cut.
I could see it the other way too with a spouse being insecure when their significant other is now so much more "marketable."
For me, my wife is extremely supportive. Then again, I am doing this for both of us, not just me.
I do think there is a lot of selfishness involved. When you share your life with someone and your role has been to help with cooking while the other goes to work, helps with the house, dedicated,to kids sports etc, and you decide you are the one no longer interested without including the other in that decision, then there is selfishness involved.
Sorry, that's just how I see it.

I was sleeved on the 13th by Dr. Rod in Juarez. He was great and I never felt unsafe. The hospital is about 5 mikes over the boarder is all.
I have had zero problems since being banded. You are in excellent hands. There are actually three very good doctors taking care of you while you are at star medica and a staff that is better than anything I've had in the states.

K, so I was sleeved on Monday, August 15. The entire experience has been waaaaaaaaay easier than I expected. Much easier than what many have reported on this board, so I thought I would share my daily routine with community. Maybe it will help, maybe some replies will help me improve!
I am 40 years old, was a 32 BMI, was always active, and never ate a lot of food but could never maintain any weight loss. I have lost 8 pounds since surgery (boooooyeah!) and the pre-op diet was successful so I know it's not just Water.
I am still on the clear liquid stage of the post op diet. I have no problems getting enough liquids. At first I would feel a moderately painful bubble about 5 seconds after each sip/gulp of water. The larger the sp, the longer/larger the bubble. That has lessened just a bit each day. I still feel it now, but maybe only 1 of out five and the pain is almost gone, but the "pressure" is there. I drink, wait for it, fist pump when nothing comes and go again. I was able to drink about 20 .oz of water in 20 minutes while driving my daughter to soccer practice today. I think just making sure you get the water as much as you can in the right quantities trains your new sleeve to be more comfortable with the water workout.
I have also found that Isopure premade clear liquid Protein Drinks are KEY in the clear liquid stage. I buy mine at GNC and they are pricey but not too bad with the deal GNc is offering right now - buy one ($5.50) get the next half off. I am not sure if it just my store, but if you spend $50, they give you another $10 off. The result is 12 bottles for $38. The babies have a whopping 40 grams of whey Protein isolate in a 20 oz bottle and they taste fantastic. There are two types, one with 25g of carbs, and several with 0g of carbs. I drink one of each a day. The "Apline Punch" includes the carbs and taste the best by far. We need carbs so this is what I drink mid morning. I drink the zero card for dinner. This equals 40 oz of water and 80 grams of protein alone and they go down EASY.
Here's the rest of the routine:
Vitamins :
- adult gummies from costco, 2 per day. Chew up until its nearly dissolved
- sublingual B12 fromo Costco, small pill dissolves under the tongue, awesome for energy
- calcium chews from GNC, 2 per day
Protein supplements :
- Isopure whey protein isolate bottled clear protein, 20 oz. each, from GNC. After discounts about $4 each. Goes down easier not refrigerated.
---- 25 carb in morning
---- zero carb in evening
- powders? utm_source=BariatricPal&utm_medium=Affiliate&utm_campaign=CommentLink" target="_ad" data-id="1" >unjury chicken broth protein, not that great tasting, but if you mix with organic chicken broth and dilute it 2x with water it works. Gets your daily protein total to 90-100g
- Gatorade recover drink
Other food :
- sugar free Jello
- apple juice
- sugar free Popsicles
- 40 - 60 oz. of water throughout the day
I have zero energy issues, in fact I have a hard time falling asleep, usually midnight and wake up around 6:30. I walk constantly and can barely feel the incisions. The "other foods" are getting very old, but only 5 more days of that which I think I can handle, then full liquids will be much better, creamy Soup, tomatoe soup, regular Protein shakes, ect.........
That's about it. Like I said, no one even can tell I had surgery. I feel like I could have easily gone back to work on Thursday (but didn't to be safe.) I need to watch myself now so I don't over do it.
Fellas, share you pr go to foods!

Man, this sleeve thing just gets better and better doesn't it! If there was one food I was hoping the sleeve would accommodate, it would be popcorn.

K, so I was sleeved on Monday, August 15. The entire experience has been waaaaaaaaay easier than I expected. Much easier than what many have reported on this board, so I thought I would share my daily routine with community. Maybe it will help, maybe some replies will help me improve!
I am 40 years old, was a 32 BMI, was always active, and never ate a lot of food but could never maintain any weight loss. I have lost 8 pounds since surgery (boooooyeah!) and the pre-op diet was successful so I know it's not just Water.
I am still on the clear liquid stage of the post op diet. I have no problems getting enough liquids. At first I would feel a moderately painful bubble about 5 seconds after each sip/gulp of water. The larger the sp, the longer/larger the bubble. That has lessened just a bit each day. I still feel it now, but maybe only 1 of out five and the pain is almost gone, but the "pressure" is there. I drink, wait for it, fist pump when nothing comes and go again. I was able to drink about 20 .oz of water in 20 minutes while driving my daughter to soccer practice today. I think just making sure you get the water as much as you can in the right quantities trains your new sleeve to be more comfortable with the water workout.
I have also found that Isopure premade clear liquid Protein Drinks are KEY in the clear liquid stage. I buy mine at GNC and they are pricey but not too bad with the deal GNc is offering right now - buy one ($5.50) get the next half off. I am not sure if it just my store, but if you spend $50, they give you another $10 off. The result is 12 bottles for $38. The babies have a whopping 40 grams of whey Protein isolate in a 20 oz bottle and they taste fantastic. There are two types, one with 25g of carbs, and several with 0g of carbs. I drink one of each a day. The "Apline Punch" includes the carbs and taste the best by far. We need carbs so this is what I drink mid morning. I drink the zero card for dinner. This equals 40 oz of water and 80 grams of protein alone and they go down EASY.
Here's the rest of the routine:
Vitamins :
- adult gummies from costco, 2 per day. Chew up until its nearly dissolved
- sublingual B12 fromo Costco, small pill dissolves under the tongue, awesome for energy
- calcium chews from GNC, 2 per day
Protein supplements :
- Isopure whey protein isolate bottled clear protein, 20 oz. each, from GNC. After discounts about $4 each. Goes down easier not refrigerated.
---- 25 carb in morning
---- zero carb in evening
- powders? utm_source=BariatricPal&utm_medium=Affiliate&utm_campaign=CommentLink" target="_ad" data-id="1" >unjury chicken broth protein, not that great tasting, but if you mix with organic chicken broth and dilute it 2x with water it works. Gets your daily protein total to 90-100g
- Gatorade recover drink
Other food :
- sugar free Jello
- apple juice
- sugar free Popsicles
- 40 - 60 oz. of water throughout the day
I have zero energy issues, in fact I have a hard time falling asleep, usually midnight and wake up around 6:30. I walk constantly and can barely feel the incisions. The "other foods" are getting very old, but only 5 more days of that which I think I can handle, then full liquids will be much better, creamy Soup, tomatoe soup, regular Protein shakes, ect.........
That's about it. Like I said, no one even can tell I had surgery. I feel like I could have easily gone back to work on Thursday (but didn't to be safe.) I need to watch myself now so I don't over do it.
Fellas, share you pr go to foods!

Man, this sleeve thing just gets better and better doesn't it! If there was one food I was hoping the sleeve would accommodate, it would be popcorn.

I'm day 2 post op.
The pain the day of was about a 4 for me. Last night was rough becuase I couldnt sleep, took a pain pill and a gasx and viola, I went down. Maybe there is a little pain but I don't notice it? Maybe just laying in bed for the last three days made me stir crazy. I still made my rounds walking every two hours and that helped a ton.
Once they took out the drain and the IV it was easier. I also sleep walk and tried getting up in the middle of the night which made my main stitch hurt. I remember that.
The next morning (today) I think pain is at a 2. liquids are getting a little easier too.

I have to respectfully disagree Bean. But what do I know.
If you increase the diameter of cylinder, the volume is greatly changed. Think of the difference in surface area of a tv. Do you notice the difference between a 32" and a 40" TV? Then add another depth element to it and the volume difference is that much greater.
All we can do is trust our surgeon that they make the correct choice for us. I had read that larger bougie surgeries experience less complications and less acid reflux effects, but also may have a higher change of stretching. I am sure the surgeons have waaaaaaaay more data points to support their reasons for doing what they do that we forum trolls have to consider.