Ginger/Toby

Nothing wrong with your question dear. Nor with the answer moregoodtimes gave...........moving right along......
Grehlin is a peptide hormone, as you mentioned. So it circulates throughout the body (just like insulin - also a hormone). So Grehlin itself cannot be removed.
There is however an area of the stomach in the Greater Curvature (the fundus) where the P/D1 cells produce Grehlin. As this part of the stomach is removed in the vertical sleeve gastrectomy (VSG) procedure, there is a significant reduction in Grehlin production in the body (though it is still also produced in the epsilon cells of the pancreas). The less Grehlin in your system, the less hunger you feel.
The pharmacological mechanism is complex and I won't go into detail. However, it is important to note that Grehlin works in partnership with another hormone (Leptin) that induces satiation (a feeling of fullness and hunger satisfaction). Before you eat, increased Grehlin levels make you hungry and after you eat, increased Leptin levels let you know you're full (in addition to stomach stretch receptors).
In this equation, if you reduce the amount of Grehlin, but leave the amount of Leptin constant, your body will feel full faster (biochemically), in addition to the mechanical signal of fullness from the smaller stomach.
There is however no longer a stretch receptor area in the stomach (also removed in VSG procedure), and it takes time for the brain to register signals from stomach to tell it to stop eating. That is why VSG patients (especially in the beginning of solid food phase) can easily overeat. 1-2 additional bites past capacity happen frequently unless the patient is weighing their portions. The brain can't keep up with the mouth!
It is also important to note that Grehlin has other much more important and useful functions for the body! The ability to learn and adapt to change are influenced by Grehlin availability. It also has a role in glucose metabolism and cell transcription/migration. Some other studies point to Grehlin's role in protecting against stress-induced depression and sleep duration and quality.
So you don't want Grehlin removed completely!
Of course no amount of physical change to this complex interwoven system can fight the evils of head-hunger! That is a learned response that we must each battle through in the beginning and good routines, will-power and in many cases supportive psychotherapy are key to ongoing success!

I had my pre-op today and got the green light for my surgery on the 21. I was also told to start my 2 week liquid diet tomorrow. They want me to use the "new directions" shakes (I heard they are awful). Please wish me luck. Good luck and prayers go to all my fellow sleevers. Hugs

I had my VSG on Feb. 5. I have been meaning to mention something to everyone who is pre-op. The anesthesiologist came by and asked if I had ever had a bad reaction from anesthesia. I told her just a sore neck from the intubation and nausea/vomiting post-op from the anesthesia--"but that's normal, right?", I asked. I almost didn't mention it bc I thought it was unavoidable. She said it's not normal and that they could give me something early on (not sure if it was before, during, and/or after surgery) to avoid the nausea. Guess what? it worked! No vomiting post-op and very little nausea...just a little once I was switched from the morphine pump to Percocet 1.5 days post op, but that nausea was from the pain med, not the anesthesia. So I wanted to say, make sure you speak up bc nausea is such a horrible feeling as we all know, and in some cases it may be preventable. She also told me they would be gentle with my intubation so my neck wouldn't hurt as much--and they were.

Thank you for that! It sounds delicious! Going to make this as soon as I can.

Hi Taurabird, you are giving me good news. One of the main reasons for me having this surgery if taken a lot of the weight fast to help with my osteoarthritis. I would love if I can get to stop some of my medications. Specially celebrex, since it is so expensive. I know several people that take voltaen and they say it is wonderful for the pain. Unfortunately I cannot take it, I am allergic to it, I break up in hives and the two times I have taken it I have ended up in the ER. Good luck to you. When is your surgery?

I just checked my insurance website and it changed from yesterday "pending" to "APPROVED". I am so excited!!! My surgery is March 21.

I just checked my insurance website and it changed from yesterday "pending" to "APPROVED". I am so excited!!! My surgery is March 21.

Fabulous!!! Thanks so much for doing this, I know it was very time consuming. You totally rock!