Madam Reverie

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!

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

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...