SLEEVE

I guess I am a little disapointed in myself for subscribing to the notion that with the VSG surgery the grhelin is 'cut-out' with the stomach. Maybe this was started by a doctor and perpetuated through all the 'sales agents' till everone now belives this to be true. I guess you cannot alway believe everything you read. Nevertheless, please note the following reprint of Dr. Watkins of Cincinnatti who understand how Grhelin actually works: Ghrelin, the hormone, gets a lot of attention these days. Here is what we know about ghrelin: Ghrelin is one of many hormones involved in appetite. We are learning that appetite is a very complex system and part of our body's survival mechanism. The brain wants us to breathe and eat - these two items are at the top of its list! The drive to eat is a very powerful biological drive. Ghrelin is a feedback hormone and pressure in the wall of the stomach is what suppresses it. In other words, when you eat, the food activates pressure receptors in the wall of the stomach and ghrelin levels go down. If you haven't had the pressure receptors in your stomach activated for a while, ghrelin levels rise and so does hunger. The most important way to suppress ghrelin levels is PRESSURE. Cutting out stomach that produces ghrelin doesn't eliminate ghrelin. The parts of the stomach that are left can produce lots of ghrelin but if there is pressure (food in the smaller stomach) then ghrelin levels will be low. After gastric bypass, ghrelin levels go way down even though the entire stomach remains. After Lap Band surgery ghrelin levels are suppressed in general and get low after eating and the food creates PRESSURE in the small gastric pouch. It is the pressure reducing these levels since the entire stomach is still there. Keep in mind that the ghrelin levels are a small part of a very complex system. When you talk to plication patients they have reduced appetite particularly after a small meal since the food creates pressure and activates the pressure receptors in the wall of the stomach. There are probably many pharmaceutical companies working on an "anti-ghrelin" drug but it is likely that even if such a drug is created and works, the other hormones involved in appetite will increase over time reducing its effectiveness. All this to say, the best way to reduce appetite is to stretch the wall of the stomach and if a stomach surgery has been done to reduce its size (band, bypass, plication, stapled sleeve, etc, etc) then you will get appetite reduction on smaller calories. One of the reasons weight loss operations work so well is that you are reducing appetite through normal biological channels, not a drug with side effects and decreased effectiveness over time. Many people worry about ghrelin levels. The important question is, "does the operation reduce appetite?" If the answer is "YES" then you have a very powerful operation for weight loss regardless of ghrelin levels. We know that weight loss operations are suppressing things that float around in the blood stream that are yet to be discovered. Vince Lombardi once said, "I don't give a #$&%! about statistics as long as we WIN!" Brad Watkins MD Now that i know what Grhelin is all about I am thinking of switching to the Sleeve Plication surgery instead of the VSG.

OK, i did find a local doctor in Metro Atlanta who will give me the follow-up care after surgery in Mexico. However, he charges an "upfront fee" of $2500.00 to take over your case. This does not include the $152 office visit fee. Anyone else know of a local bariactric doctor who will accept new patients?

Here is an updated Cornell post op plan. This one is great, in has charts and simpler instructions: http://www.cornellweightlosssurgery.org/pdf/dietary_guidelines_sleeve_gastrectomy.pdf

These lists of vitamins goes on and on.:thumbup1: Can anyone give me a 1. 2. 3. of the minimum amount of vitamins that are necessary after surgery? Or, what do you take regularly?

So after a month of research from India to Mexico I finally found Dr. Pompa Gonzales. The price is good and the surgical center looks very nice. Please go to the You Tube link to see the facility. [ame=http://www.youtube.com/watch?v=XSuhiAM6ATM]YouTube- Our State of the Art Facilities[/ame] That's all I can tell you now until my surgery on Tuesday March 9th. I will update you while I am there.:001_tt2:

I found this list on the 'Bariatric Advantage' web site and can anyone confirm that this is a good regiment of vitanmins? Is anything lacking on this list? Also do men sleevers need Iron?: Gastric Sleeve Prenatal Kit Contains: 1 - Bariatric Advantage Multi-Formula Chewable (180 Count) 1 - Bariatric Advantage sublingual B-12 - Black Cherry (90 Count) 1 - Bariatric Advantage 18mg Chewable Iron - strawberry (90 Count) 1 - Bariatric Advantage 400mg calcium citrate Lozenges w/ Vitamin D - (270 count) $ 116.80

Tiffkin, why do you take Omega 3? Is it recommended for all sleevers?

Tiffy or anyone, i need help with vitamin choice. You mentioned 20-30/day. What vitamin(s) does everyone take. Do i need calcium also and Nexium on a permanent basis? I am about 2 weeks out to surgery and i would like to get all that is needed in advance..

Yeah, i figured it out after i posted. Thanks for the link.

Huh, what is goves?:blushing:

Tiffy, I am still contemplating the sleeve surgery and the diet guide you posted kind of scared me off a little. Does everyone do everything the writers of the guide insist you do? Ie. 70 mgs protien, super multi-vitamins, calcium, b12, prilocet, food restrictions, no sugar ever, etc. etc. Although, thanks for posting it.

In India they require you to stay 4-5 days after the sleeve surgery in a 100 to 500 bed hospital. The cost for the surgery is around $6K to 9K. Everyone is very professional and they mostly speak english and they are quick to reply. My wife and i like to go to exotic places and meet interesting people so the $1200 airfare is worth it to us. I have done alot of research and i feel more comfortable with the India set-up all around. They will do any kind of surgery you can think of for a fraction of the cost. I will be back in mid March so i will let everyone know the 'real deal'.

I am considering getting sleeved in Delhi India. Can anyone recommend a hospital or doctor in India.