pcindy

I can't believe it. After all the trials, tribulations, indecision and uncertainty, I'm actually going through with my VSG tomorrow at 2pm PST. It was a rollercoaster of a 3-week pre-op diet, having extra tests like an EGD, not knowing if my surgery was rescheduled (even up until today!), having no energy, being moody and short-fused (my huz is an earth-bound ANGEL). I was both reassured and scared to death by the various threads posted on this site! It took speaking to the nurse practitioner of another successful bariatric practice (a collegue of an aquaintance), who backed up everything my doc had told me and more, to get me off the fence. She talked to me about obesity as a metabolic disorder, reassured me that her practice also uses a 32 bougie and why, and offered me her support. Most importantly, she assured me that if gastric bypass patients could successfully get pregnant and maintain a healthy pregnancy with a stomach the size of an egg plus a diversion, so would I. That was huge. I also have a good friend who was sleeved 3 years ago and is happy and will be a good support system. Thank you to all the people on this site who posted their success stories, questions, and concerns. You helped me to ask the right questions, know what to expect (and what I might expect) without any blinders on. As a nurse, I thought I knew enough, but it's WAY different being on the other side of the needle, scalpel, nasal canula (I never knew how much they SMELLED- so plastic-y!). This experience will make me a better nurse, I know! If you have room in your prayers for me tomorrow, please add me to your list. Thanks again, folks!

The studies you are quoting show the "long-term" data on a procedure that hasn't been performed (for bariatric reasons) for a long time yet. The bougie sizes that those figures are based on, are larger than the sizes used now (32 being the "gold-standard" I am told by several nurse practitioners at different centers). The stats for the 32 are much better. I have a friend who was sleeved 3 years ago, who tells me that a lot of her weightloss at this point depends on what she eats. She went on a kick for about 6 months where she ate nothing but sugary crap and didn't lose anything. She got it back together and went back to healty foods and the weight started coming back again. Someone posted this on another thread, and I thought it was great: http://www.ssat.com/video/2008/SSAT%2049th%20Annual%20Meeting(3)-Cirangle.htm Hang in, sister!

I think that the vast majority of us ARE emotional eaters. You are definately not alone. This forum is good, but not a substitute for live, in-person support. I have found a great deal of support for my emotional eating issues at Overeaters Anonymous. www.oa.org The suggestion they make is to try 3 meetings before deciding if OA is right for you. Good luck.

I'm told that the reason whya 32 bougie is now considered the standard, is that it has a track record for the least amound of stretching. I agree with the earlier posts that state that the stretchiest part of the stomach is removed.

Good luck. It isn't easy. I added Fiber powder to my yogurt every morning to keep myself having regular bowel movements and it was a huge help. I think not having fiber mentioned in this pre-op diet is a big oversight. If you can't find fiber suppliments easily in Jordan, just add some Beans or some other very high fiber food. Also, drink lots of Water and take a multi-Vitamin. Best of luck to you! PS- do you have an english name you can post? Or can you write your name phonetically in the english alphabet so we can write back to you more personally?

I've been there and am looking forward to being there again. I remember feeling like I'd NEVER get below 200lbs with a long plateau. Congrats, girl. That's the BOMB!!!

Welcome! I too wish you the best of luck. I hope you can find a support group through your doctor in Jordan. I assume that you are 102 Kilos, not pounds! Weight loss will do wonders for your diabetes. I have a family history of that as well, and just found out that my cholestorol is high. My surgery date is in 3 days. You have many people on this website to support you. Keep us informed!

You could also try a Dulcolax suppository, and if that doesn't work, a Fleets enema. Sometimes you have to start moving things from below.

Heparin and Lovenox are closely related and VERY common for post-op. The heart pumps blood through the arteries, but by the time the blood goes through the tiny capillary beds, there is no longer pressure pushing it through to the venous system (back to the heart). Venous blood returns to the heart SOLELY through muscle contraction, namely walking. If one is sedentary (ie. after surgery, long airplane ride), the strong calf muscles are not regularly pumping blood up the legs and back to the heart. The blood can then pool in the legs. Blood that pools-just sits there, can allow for clots to form. When those clots break free, they can cause severe pain in the affected limb, or travel to the heart, lungs, or brain causing, pulmonary embolism, MI, or stroke. This is why even open-heart patients are mobilized the next day. Anyway, both heparin and lovenox anticoagulate. They both have a short half-life, which is why you have to take them daily, often twice a day. The abdomen is usually where we put it, and yes, it burns (heparin more so than lovenox). Because it is an anticoagulant, yes, you get bruising at the injection site (and more so if you rub it). These go away. DVTs suck. Take the heparin or lovenox if they ask you to, suck it up, and try to ambulate ASAP. PS- early ambulation will also help with stimulating gastric motility, relieving constipation (those narcs'll constipate you), prevent pneumonia, alleviate Fluid retention, and help with pain.

Colace is NOT a stimulant! It is not a laxative. It is a stool softener.

LOL! Great discussion! I've always said that if I could just move my stomach up about 10 inches, I'd be a bombshell! Seriously, congrats on losing inches. Most people on this site are probably looking at plastic surgery down the line- I know I will be. For now, congrats on losing the back aches and bra strap pain! My huz would would feel he died and went to heaven if I got implants. It ain't happenin'!

You should talk with your psychiatrist NOW, so that he/she can put you on a different SSNRI or SSRI if necessary, and phase you down in a controlled way, if that is what's necessary. Your medical team should address this issue- NOW, not post-op. Good luck!

Sounds like a typical upper GI to me. They should have told you that the barium can constipate you. Don't worry, you don't have cement in your colon! You just need to drink a TON of fluids, and get yourself some Colace (it's what we give just about every in-patient in every hospital, everywhere). It is a stool-softener and you can get it OTC. You must DRINK, though. Try the Miralax too. If you're allowed to with your gastric issues, drink some prune juice. We give that in the hospital as well. Tastes like motor oil, works like a bomb. You'll poop soon, no worries.

To everyone who replied to this thread, I want to say, thank you. My conflict and indecision about going through with the surgery was getting worse, not better, as the date got closer. I was lucky enough to be connected through an aquaintance, to the nurse practitioner of a different, though equally renouned bariatric practice. We talked on the phone and she told me that all of the latest research shows that the 32 bougie is now considered the gold standard, and that I should have no difficulty supporting a healthy pregnancy after VSG. Apparently, gastric bypass patients have healthy pregnancies, and we all know about their post-op plumbing! She talked with me about the latest findings about obesity as a metabolic disease (is even teaching a class on it to 1200 RNs soon- of which I hope to be one). Anyway, she talked me down off the fence and I am feeling so grateful. I really just needed an expert second opinion from someone totally impartial, and I got it. Thank GOD! So, I had an EGD yesterday (throat is SORE) and the "duodenal polyp" that they thought they saw in the upper GI is non-existant. I'm starting on Prilosec for the little bit of erosion they saw though, so at least, I'm going into this VSG with uber scrutiny! They even found a small hiatal hernia, so I'll get that repaired as well. I'm still not losing as much pre-op weight as they want, but I think I'll be okay. Thank you all for being a supportive part of my journey.

Your original question was "BUT really why?" Anatomically, the stomach is partially hidden by the liver, which must be retracted (pulled aside to get it out of the way) to access the stomach. The liver is a VERY dense, highly vascular organ. This means that if it is fatty, it is even more dense and difficult to retract. This increases the chance of rupturing or lacerating it interoperatively, which can be very serious, leading to hemorrhage and peritonitis. At the very least, as mentioned, it lengthens the surgery (adding more chance of complications related to anesthesia, clots, stroke, etc...). At the very very least, it's a pain in the ass to the whole surgical team, who are there trying to give you the best possible surgery. Stick to the pre-op diet that THEY give you (not us- i posted mine for those who were never given one). It will make your liver smaller, floppier, and easier to deal with in the OR. This is not a root canal. It's major abdominal surgery. If you have questions, ASK them of your doctor. If you don't understand the answer, ASK again, and ask her to EXPLAIN them until you understand them. Don't let them rush you or discourage you from asking. This is YOUR body and YOUR life. There is a reason that you sign an "informed" consent. Your doc is legally, professionally, and ethically obligated to make sure you are fully informed, but only you can determine if you understand everything. Speak up, and good luck!

Hi everyone! I see a lot of questions on this site about pre-op diets. I thought I'd post the one I was given, just as a guide for those who aren't prescribed one, but think they might need or want one. Good luck to everyone. PS- I am going into week 3 and losing my mind on it. Doesn't mean I don't think it works. Anyway, for what it's worth: Pre-op liquid Diet It is recommended by your surgeon and dietitian to follow a low calorie, low fat, low sugar and high Protein liquid diet for ___ days prior to undergoing bariatric surgery. The purpose of the liquid diet is to reduce the size of the liver, reduce the risk of bleeding during the surgery and to show commitment to the program. Below are the nutritional guidelines for the pre-op liquid diet. You will need to measure your intake and keep a food journal. Depending on which items you choose to consume throughout the day, your intake should be approximately 1000 calories and 60-80 grams of protein. You will be expected to lose 5 lbs per week on this plan. The nutritional guidelines are as follows: UNLIMITED SECTION: These liquids can be taken in any amount since they do not contain sugar. 1. sugar free or diet beverages such as Crystal Light (Great Value @ Walmart), Sugar Free Kool-Aid, Sugar Free Tang, Diet Snapple, FUZE, Powerade Zero, Diet V8 Splash, Propel, Fruit 2 O, coffee, Tea and Water. 2. Low Sodium broth Soups (chicken, vegetable, beef- tomato Soup is not a broth soup). It needs to be a clear liquid and can NOT contain bit and pieces of meats, tofu, noodles or vegetables. Each 8 oz serving shouldn?t be more than 140 mg of sodium. Bullion cubes are not acceptable as they are too high in sodium. 3. Sugar Free Jell-O and Sugar Free Popsicles LIMITED SECTION: Please do NOT consume more than the maximum # of servings listed in each category for each day you are on the diet: 1. Juice: Limit intake to 2 cups or 16 oz per day. Fruit Juice(apple, orange, cranberry, grape, and grapefruit),Gatorade, G2, Vitamin Water, Life Water, Snapple, Powerade, Low Sodium V-8 juice and V-8 fusion ? limit intake to 2 cups or 16 oz per day. 2. Limit to 3 servings per day: ? cup of Regular Jell-O, Popsicles or NO ADDED SUGAR Fudgesicles. 3. Limit to 3 servings per day: 1 cup (8 oz) of milk (skim, 1%, Lactaid, Almond, or Soy), 6 oz of LIGHT or Greek Yogurt (no more than 110 calories and 12 grams of sugar/serving), ? cup of SUGAR FREE Jell-O pudding, ? cup of FAT FREE or LOW FAT Cottage cheese 4. Protein Shakes: Limit to 2 servings per day: The following are approved protein shakes: Muscle Milk LIGHT (costco, Target, GNC and major grocery chains), Pure Protein shakes (Trader Joe?s), Premier Protein Shakes (Costco), NO ADDED SUGAR Carnation Instant Breakfast (Target), EAS 100% whey Protein (Walmart), Isopure (GNC or The Vitamin Shoppe), Zero Carb Isopure (GNC or The Vitamin Shoppe), Body Fortress Protein Shots (Walmart), Body Choice Liquid Protein Shots (Costco). *** DO NOT BUY SLIM FAST, ENSURE OR BOOST ? these drinks are high in calories and sugars. If you chose a brand that?s not listed above please check the nutrition label first and make sure it meets the following criteria: less than or equal to 160 calories, less than or equal to 6 grams of fat, 15+ grams of protein and less than or equal to 6 grams of sugar. ***For those that are lactose intolerant please choose the following: Isopure, Zero Carb Isopure, Body Fortress Protein Shots or Body Choice Protein Shots. ***For those patients with diabetes, we recommend that you consume 15 grams of carbohydrates every 1-2 hrs. Be sure to monitor your blood sugars and contact your doctor if necessary. If your blood sugar is >150 mg, spread out your sugar sweetened liquids over a 3 hr period. __________________

You MUST get fluids in, especially if you have a fever. If you can't get fluids down orally, you'll need to get them in the ER via IV. If your fever gets ANY higher or you really can't get 64 oz of fluid in (and try some vitamin water or gatorade- pedialyte makes popsicles), go to the ER. You are NOT a 'normal' person with a cold, but a post-operative patient with a fever. To you from a nurse, please get seen.

LOL, Sparkle! If you don't have a hair-trigger gag reflex, try scraping the back of your tongue with a spoon. It's just as effective as the tongue scrapers you can find in the oral care section of the drug store. It's good practice anyway, as we hold a lot of bacteria there. Also, a saltwater gargle might help debride some of the fur back there. Good luck!

I have no advice, other than agreeing that you should CHANGE THAT MONIKER!!! My beloved mentor, now deceased called her thighs her "water wings," saying they made her more buoyant! She loved swimming and that was how she mader her peace with them. As for you, come up with a new name (keep the avitar with the rolling ball though- that's cool)!

This is GREAT!!!!!!!! Everyone who considers this surgery (and their families) should see this! Thank you!

You are dear, as are you all. Your indignation on my behalf is great! As far as getting mad, my poor beleagard husband can attest that I have had no trouble in expressing my anger and frustration. He should be bronzed and epic poems should be written in his honor. I really appreciate the support you are giving me. I'll let you know how my weigh in goes tomorrow and if I keep my cool or not! I am getting a second opinion to see if I can find a doc who is more open to a larger bougie. Thanks, guys.:confused1:

Thanks, ladies. My scheduled date is June 29. Don't know if they'll want to reschedule me since I haven't lost the full 5lbs/week on the liquid diet. Don't think I can go through it again if they don't keep this date. Good luck, all.

At this point, I'd urge you to go to your emergency department so they can give you some IV pain meds and rehydrate you (you're probably dehydrated at this point). You may even need some electrolyte replacement as well. They will contact your surgeon who will be forced to deal with the situation and get it under control.