Madam Reverie

I'm liking the sound of 'normal' - that's all I want to be. May I ask how you achieved and maintained that? As for the 'girls' and the belly, I'll be in exactly the same position. As for the decision, I'm a little too far down the road now. Got 4 weeks till D-Day! Arrrgh! The above isn't a deal-breaker, as such. I just felt I'd like some information from you guys who have done it already as to how I could prevent myself from looking like I just got liberated from Belsen!

Is it possible to 'choose' a higher goal weight and be able to maintain it? From what I've seen, this 'choice' is often taken out of their hands as people seem to struggle to get enough calories in to prevent the crash to gauntsville. Are there any tips and tricks to stop that? As for people looking 'better' with 100lbs on them - or not, as the case may be. I do believe, in contrast to some people who have taken the weightloss too far - whether it be intentional or unintentional - some people do appear to look better in their original form. Maybe that's all subjective; beauty being in the eye of the beholder and all that.... It's good to get opinions on that aspect.

Yeah, the double post was due to my realising I'd initially shoved the post in probably the wrong section. 'Cause it's not really a rant - more an observation. I thought, being the originator, I'd be able to delete the first one. Clearly not - unless there was something I missed? Maybe that's something an administrator and the system designer can sort out? I can appreciate that people didn't like the comment the lady in question had made about people looking better before the surgery. I hope I've made it clear that I'm not saying all people look better before - just some. Sometimes it's a stark contrast and sometimes, it almost looks, well, wrong. I'd be interested in your view on how long the 'gaunt' stage lasts? As for the supermodel package? Damn, if they had that available, I'd certainly be first to sign up! Maybe not the emaciated look, but certainly that 'dewy','rosey cheeked', 'the chanel drapes beautifully darrrlink' kind of look would do me nicely!

Thank you. I'm all up for a bit of meaningful conversation! I'm looking forward to comments and hope people aren't critical of it. It's just an observation of 'some', not all, people who have undergone the procedure. Glad you found it interesting reading, though. I have lots of these types of thoughts bouncing around my head and they don't seem to be covered. Maybe the feedback will generate some more observations - who knows!

I had my last visit before my surgery with the nutritionist today. He said 'if you're struggling to get fluids in, above everything and all, make what you drink skimmed milk. Ideally with some protein powder in it, but milk is essential. None of that almond or soya milk either, they're stripped of their nutrients. Your body desperately needs the calcium and the protein so if you can't manage anything else, aim for that.' Seems like fair advice. I feel for you and for the record, 5 kids are exercise enough! Don't be too hard on yourself, you're doing great. I hope you feel much better very soon. Hang on in there

Hey guys! I'm on the 2nd September, too! Except, I'm in the United Kingdom. It'd be good to keep in touch to see how each of us are getting on. I'm bricking it!! How are you guys feeling? I'm so worried about losing my hair, losing my boobs and having so much spare skin, I could re-cover the sofa with it, I don't know what to focus on first!

[Contemporary man] is blind to the fact that, with all his rationality and efficiency, he is possessed by "powers" that are beyond his control. His gods and demons have not disappeared at all; they have merely got new names. They keep him on the run with restlessness, vague apprehensions, psychological complications, an insatiable need for pills, alcohol, tobacco, food – and, above all, a large array of neuroses. (Jung, 1964:82).

I feel the need for alcohol.

No one likes a mirror held up to themselves and everything can be said - it's just all in the delivery. If you have an expressive face, like I have, I often fail in containing my horror to some things people say in real life.Consequently, I will never be in the diplomatic service! However, this is a chat room. My advice, for what it's worth? Be mindful of the fact that text can be open to interpretation and unless you're careful; timing, structure, punctuation and context is everything! If you blurt out a 'WTF?! You're eating burgers?!!' straight after someone's announced it to a room, it's going to put people's backs up. If you meant it as a more of an enquiry, as a form of self reflection for your eating preferences and restrictions; I may have couched it like this 'don't think I could stomach that at this stage. Does it sit okay in your sleeve?' If you can recognise what I did there... You'll be okay in the future. As for what you eat - it's your journey. It's your rules. Best of luck

I'm in awe of you - really. I smoke 20 a day, which can jump up to 30-40 if I've been drinking. My surgery is planned for the 2nd September. They know I smoke, raised an eyebrow on confirmation of it, but didn't say in direct terms 'you must quit'. Consequently and like any true card-carrying nicotine addict, I rationalised it in my brain (because, like you, I like smoking and it is most definitely part of my identify), that it's okay to continue. I, too, bought one of the e-ciggie set-ups, but it ended up giving me Bronchitis (probably because I was puffing on it so intensely) so its been languishing in my drawer ever since. I hear though, that if you smoke after surgery, it's a sure fire way (other than slowing the recovery) to getting ulcers and excess acid? Did your Docs/nurses say anything about continuing using the e-ciggie after surgery at all? Again, absolutely well done you. It's truly a massive achievement and I am thoroughly envious of your levels of resolve and will power! All the best, Revs

I posted this on another forum and felt it might be useful for other people to have a read of, if like me, you like your scientific facts. Maybe the below will provide a bit of clarity as to the 'nuts and bolts' of some of the bariatric procedures and their long-term (within the limitations of the data) efficacy. This first academic journal quoted was published in May 2013. So, it doesn't get more 'up to date' with regards to evaluating the comparative effectiveness in the three biggest weight loss procedures. I have only reproduced the abstract and have quoted the source below as the abstract covers the salient information we'd be interested in. The second section is all about the metrics, with a snapshot of all the procedures being evaluated in a tabulated form (the table was removed from the cutting and pasting process, so read left to right) and the risks associated with the operations. The primary and secondary sources are also cited. Better to make decisions based on rigorous scientific research, than hearsay and charasmatic sales pitches, I feel... Hope it helps. Article 1: Abstract: Objective: To evaluate the comparative effectiveness of sleeve gastrectomy (SG), laparoscopic gastric bypass (RYGB), and laparoscopic adjustable gastric banding (LAGB) procedures. Background: Citing limitations of published studies, payers have been reluctant to provide routine coverage for SG for the treatment of morbid obesity. Methods: Using data from an externally audited, statewide clinical registry, we matched 2949 SG patients with equal numbers of RYGB and LAGB patients on 23 baseline characteristics. Outcomes assessed included complications occurring within 30 days, and weight loss, quality of life, and comorbidity remission at 1, 2, and 3 years after bariatric surgery. Results: Matching resulted in cohorts of SG, RYGB, and LAGB patients that were well balanced on baseline characteristics. Overall complication rates among patients undergoing SG (6.3%) were significantly lower than for RYGB (10.0%, P < 0.0001) but higher than for LAGB (2.4%, P < 0.0001). Serious complication rates were similar for SG (2.4%) and RYGB (2.5%, P = 0.736) but higher than for LAGB (1.0%, P < 0.0001). Excess body weight loss at 1 year was 13% lower for SG (60%) than for RYGB (69%, P < 0.0001), but was 77% higher for SG than for LAGB (34%, P < 0.0001). SG was similarly closer to RYGB than LAGB with regard to remission of obesity-related comorbidities. Conclusions: With better weight loss than LAGB and lower complication rates than RYGB, SG is a reasonable choice for the treatment of morbid obesity and should be covered by both public and private payers. SOURCE: Carlin A, Zeni T, Birkmeyer N, et al. The comparative effectiveness of sleeve gastrectomy, gastric bypass, and adjustable gastric banding procedures for the treatment of morbid obesity. Annals Of Surgery [serial online]. May 2013;257(5):791-797. Available from: MEDLINE with Full Text, Ipswich, MA. Article 2: September 2012: Morbidity and mortality associated with LRYGB, LSG, and LAGB from the ACS-BSCN dataset LRYGB LSG LAGB 30-d mortality (%) 0.14 0.11 0.05 1-y mortality (%) 0.34 0.21 0.08 30-d morbidity (%) 5.91 5.61 1.44 30-d readmission (%) 6.47 5.40 1.71 30-d reoperation/intervention(%) 5.02 2.97 0.92 SOURCE: Data from Hutter MM, Schirmer BD, Jones DB, et al. First report from the American College of Surgeons Bariatric Surgery Center Network: laparoscopic sleeve gastrectomy has morbidity and effectiveness positioned between the band and the bypass. Ann Surg 2011;254(3):410–20 [discussion: 420–2], in: Timothy D. J, Matthew M. H. Morbidity and Effectiveness of Laparoscopic Sleeve Gastrectomy, Adjustable Gastric Band, and Gastric Bypass for Morbid Obesity. Advances In Surgery [serial online]. n.d.;46(Advances in Surgery):255-268. Available from: ScienceDirect, Ipswich, MA

No worries. Hope it is useful.

Hard, but exciting. Jump right in, because when you're much older, you'll be looking back on these times with a sense of wonderment and a dirty big grin on your face! Enjoy!

Enjoy the delicious sense of awkwardness and nerves! It's the best part! Just be assured that she's going to be just as nervous as you, my dear. Go get 'em!

Maybe the below will provide a bit of clarity as to the 'nuts and bolts' of things. This first academic journal was published in May 2013. So, it doesn't get more 'up to date' with regards to evaluating the comparative effectiveness in the three biggest weight loss procedures. I have only reproduced the abstract, for copyright reasons and have quoted the source below. Besides, the abstract covers the salient information we require anyhow. The second section is all about the metrics, with a snapshot of all the procedures being evaluated in a tabulated form. The primary and secondary sources are also cited. Better to make decisions based on rigorous scientific research, than hearsay and charasmatic sales pitches, I feel... Hope it helps. Abstract: Objective: To evaluate the comparative effectiveness of sleeve gastrectomy (SG), laparoscopic gastric bypass (RYGB), and laparoscopic adjustable gastric banding (LAGB) procedures. Background: Citing limitations of published studies, payers have been reluctant to provide routine coverage for SG for the treatment of morbid obesity. Methods: Using data from an externally audited, statewide clinical registry, we matched 2949 SG patients with equal numbers of RYGB and LAGB patients on 23 baseline characteristics. Outcomes assessed included complications occurring within 30 days, and weight loss, quality of life, and comorbidity remission at 1, 2, and 3 years after bariatric surgery. Results: Matching resulted in cohorts of SG, RYGB, and LAGB patients that were well balanced on baseline characteristics. Overall complication rates among patients undergoing SG (6.3%) were significantly lower than for RYGB (10.0%, P < 0.0001) but higher than for LAGB (2.4%, P < 0.0001). Serious complication rates were similar for SG (2.4%) and RYGB (2.5%, P = 0.736) but higher than for LAGB (1.0%, P < 0.0001). Excess body weight loss at 1 year was 13% lower for SG (60%) than for RYGB (69%, P < 0.0001), but was 77% higher for SG than for LAGB (34%, P < 0.0001). SG was similarly closer to RYGB than LAGB with regard to remission of obesity-related comorbidities. Conclusions: With better weight loss than LAGB and lower complication rates than RYGB, SG is a reasonable choice for the treatment of morbid obesity and should be covered by both public and private payers. SOURCE: Carlin A, Zeni T, Birkmeyer N, et al. The comparative effectiveness of sleeve gastrectomy, gastric bypass, and adjustable gastric banding procedures for the treatment of morbid obesity. Annals Of Surgery [serial online]. May 2013;257(5):791-797. Available from: MEDLINE with Full Text, Ipswich, MA. September 2012: Morbidity and mortality associated with LRYGB, LSG, and LAGB from the ACS-BSCN dataset LRYGB LSG LAGB 30-d mortality (%) 0.14 0.11 0.05 1-y mortality (%) 0.34 0.21 0.08 30-d morbidity (%) 5.91 5.61 1.44 30-d readmission (%) 6.47 5.40 1.71 30-d reoperation/intervention(%) 5.02 2.97 0.92 SOURCE: Data from Hutter MM, Schirmer BD, Jones DB, et al. First report from the American College of Surgeons Bariatric Surgery Center Network: laparoscopic sleeve gastrectomy has morbidity and effectiveness positioned between the band and the bypass. Ann Surg 2011;254(3):410–20 [discussion: 420–2], in: Timothy D. J, Matthew M. H. Morbidity and Effectiveness of Laparoscopic Sleeve Gastrectomy, Adjustable Gastric Band, and Gastric Bypass for Morbid Obesity. Advances In Surgery [serial online]. n.d.;46(Advances in Surgery):255-268. Available from: ScienceDirect, Ipswich, MA

I'm in exactly the same boat, except I haven't had mine yet. Scheduled in for 2nd Sept. I'll be honest, I'm bricking it! I vacillate between wanting it and then thinking 'dear lord, you're cutting half your stomach away you stupid woman. There is no going back on this one. You're taking such a severe route!'.Can both you guys give me a run down on how you coped with those feelings (if you had them) and how you felt immediately post surgery and for the first few days afterwards? Are either of you saying 'OMG, what have I done?'

Many thanks for the warm welcome, it's nice to be here.

And that should have been a smiley face - not a 'look of horror' face! lol

I'm totally new to this site. After perusing for a while without signing up and knowing I was going to be sleeved, I thought it a good community to get involved in. Primarily as there are so many of you on here, the information you provide is truly invaluable and it is often served in a witty and compassionate way. It is also remarkable that it is hosted for free. Because I'm new, but certainly not new to the internet, I thought I'd state what I think is a view with fresh eyes. I can see parity in certain behaviours between this website and others. This place is a community - just as you would get outside in the 'real' world. With groups and hierarchies and cliques and quite importantly and rightly, rules that govern us and our behaviour. The condition of being severely overweight, is often a solitary condition. With pre-op people, like myself, feeling quite vulnerable and alone on our journey as we haven't got a clue what to expect and are genuinely apprehensive. If you are not lucky enough to have a support network in the 'real world', I can see how people become reliant on the kindnesses of strangers; particularly ones who have walked this path already. Consequently and however well intentioned, I can also see how whether through selfless altruism or indeed, for social or fiscal reward (and there is no accusation in this, because I know squat about the personalities here), how lines can be crossed. In my appraisal of what I've seen so far, I can recognise the 'pluggers', but I can also recognise those, and these are in the majority, who just want to give a shout-out to the person(s) who helped change their lives. While the attempt to 'catch the person out' was albeit a clumsy one, I can see why concern was raised. Not everyone, like myself, are cynical and alert to what is 'out there' on the internet. Some people can be really quite vulnerable and as a consequence, easily misled in their search for the 'right' answer. Of course, this cuts both ways, which is why there is a duty of care by those who manage the site (particularly if you have business interests in providing WLS) and those who participate in the site to not put people 'wrong'. I know some people genuinely want to be of assistance. However, it is fair to say that in their heartfelt endeavours, it is easy to lose site of the rules that govern the vehicle they are using and why those rules were instigated in the first place - for protection. In conclusion and this is how I'm going to approach it. I'm going to ignore what appear to be plugs, I'm going to do my own research -as wisely said above (sorry, I can't remember your name), enjoy this vehicle; sharing in the community experience and hopefully making new cyber-chums. However and most importantly, I will try to maintain clarity and crucially, objectivity. Nice to meet you all )

Very good idea.. But.. I can't help but feel a bit weird about someone who has not been sleeved, writing a book about the sleeving procedure with what appears to be little academic referencing. I'm sure it's well researched and is very helpful, but...