CCJC

Nearly there now, tomorrow (Sunday) I fly to Sydney, have an appointment with the doctor plus a dexa scan on Mondy afternoon. My hospital admission is Tuesday morning at 6.15am, I am hoping i am first off!
My doctor focuses on body composition as well as the scale weight hence the dexa scan. Reduce body fat and increase lean body mass.
Feeling slightly nervous but being busy today will take the edge off that. Work for a few hours, visit my mother at her nursing home, last minute run to chemist and shop make sure I have the right supplies for when I return home first for the clear liquid diet and then free liquid diet. Oh and packing.

I am now in pre-op mode with three Meal Replacement shakes a day plus three cups of non starchy veges. The week prior to my pre-op diet I had started a less severe pre-op...two shakes plus a meal plus three cups of non starchy veges.
Yesterday was a bit of fail for the pre-op diet, but I did learn something. I haven't that full/bloated feeling from all the food I would eat since I have been on the pre-op diet, when I overate yesterday I realised I didn't actually like that full/bloated feeling. I think previously it felt like a comfort thing, yesterday it just felt bloated and uncomfortable. I shall draw on that feeling when I am tempted or strugging over the next 10 or so days.

It's a week before I start the official pre-op diet, but today I decided to get a bit of an extra start, figured it wouldn't hurt. I have adapted the pre-op diet for this week so its not so VLCD and I will have two meal shakes instead of three. The other meal will be a meat or fish dish with vegetables with yoghurt and fruit Snacks.
So far I am not inclined towards any food funerals, not to say it won't happen though after all there is a week between now and 1/10/2018. I've created a diet cheatsheet from the instructions provided by the dietician, hopefully it will help me focus.
I am on a Facebook ESG group (three actually), one of the members asked if I was nervous. Surprisingly I am not nervous yet, but I am sure as date gets closer I will be mighty nervous. Being under certainly doesn't worry me (I been under a number of times for colonoscopies, off course not to the degree of a GA), I haven't had endoscopy before so possibly that will be the thing that makes me nervous, even though I will be out to it. There has been mixed post procedure reactions to pain/nausea that I have read on the FB groups - some seem to have lots of pain and cramping as well as nausea, for others it seems quite minimal. What will be will be I guess, I will need to make sure I have the meds for the worse that I may experience.
The most discomfort I imagine is being without fluids for a couple of days, I will have infusions, but it is the extra dry mouth that concerns me. I will be taking mouth spray/lip balm and will swill Water and spit it out if needed. I have dry mouth to start with as a conseqence of sjogren's syndrome, I guess the good thing I will be better prepared than most for that.
I am just about to go sort out my wardrobe and the many clothes I haven't worn in sometime. Anything I am sure I won't wear again even if it may fit me it will be going in the op shop bag, the others will be arranged in order of size and I hopeful that I will get through them as I work towards my goal! Thankfully I have plenty of clothes to get me through each size. I have also been shopping already for some smaller sizes and I can remember the last time I wore a dress or a skirt, so I bought a LBD, I have never had a LBD. Not sure I will ever wear the LBD out and about (luckily it wasn't that expensive) but I would be very happy to fit into it!

Now its getting real and its getting real close. Procedure date is 16/10/2018. Had my skype appointment with the dietician today. Went over the phases: pre-op VLCD, clear Fluid diet, free fluid diet, pureed foods, soft foods and then finally on the 25 November I will be able to commence a transition to reduced portions normal foods.
Next monday is my appointment with the behavioural psychologist.
Over the course of my program (18 months post op) I have four appointments each with a dietician, behavioural psychologist and exercise physiologist and unlimited face to face access to the doctor who will carry out the ESG.

Less than two months now for my ESG. Date is set for Tuesday 16 October, time off work booked and authorised, Sydney accommodation and airfares booked and paid for. Bought tickets to see Book of Mormon while in Sydney. All my appointments are set: dietician and behavioural coach one month before the procedure, doctor day before surgery, surgery :), infusion day following and dexa scan plus my follow up appointment with the doctor one week later. I have a friend coming with me who will be there up to the Thursday, I was going to be travelling solo, however, the doctor insisted that I have someone with me for 48hrs following the procedure in case of complications. It is a day surgery, no overnight stay in hospital is required which I am pleased with.
While Christmas is many months away, in Australia lots of workplaces are busily planning Christmas dinners, even my sister got in early yesterday, sending a save the date for a big cousin/family dinner out the Saturday before Christmas, and because we have family coming home for Christmas we are even planning our Christmas day. There is also a small group of school friends that meet up with once or twice a year, we will be having a get together in late November/early December.
There are lots of what could be awkward food situations coming up, fortunately I have plenty of time to plan how I will manage meals out and responses to any comments about what I am consuming (or not consuming for that matter). I wont't be telling very many people at all about my procedure (one so far, the friend above), but I am assuming that people probably won't be too interested with the food on my plate, but will be focussed on their own meals/drinks and enjoying the social situation.
I haven't updated my weight but have put on the two kilos lost, I am disappointed in myself, but today I am recomitting to my health! My doctor said he didn't care if I didn't lose weight before the procedure but to make sure I didn't put on weight, but with a two week pre op liquid diet I assume I would have lost some weight before the ESG. I will lose the two kilos gained and I hope to lose another three before my ESG, anymore than that will be a bonus, the more I lose before hand, the less need to lose after! At least five kilos is not unreasonable before 16 October. Now to work on the emotional / boredom eating and the sweet tooth so that goal is achieved.
I will be going back to basics from here-on-in, lots of Water, walking, occasional glass of wine, Portion Control but with increased Protein and reduced carbs, nil added sugar foods (sugar friend here, one skerritt of sugar and its a full on sugar fest).
Hadn't realised I had waffled on so much, fortunately I don't do it too often!
I hope to see more ESGers posting on the ESG sub forum, the support we receive and give is invaluable!

Yeah finally received confirmation for the go ahead for my ESG procedure. It won't be until mid October, timing is mine due to not long being with a new employer and the implementation of a new finance system being rolled out 1 July. This will give me some time to sort out the finances either early release of super, if not approved combination of loan and own funds.
Now I can make plans for airfares and accommodation.

I spent three hours at the pathology lab on Saturday morning doing my oral gluose/insulin test, only to get a phone call today saying I needed to redo as they didn't collect enough timed samples....aargh. My surgeon asked for a urea breath test and the lab is now going back and forth with the surgeon to confirm he wants a breath test not a fecal test. The surgeon asked for a breath test, I'm pretty sure he knows what he wants.
But anyways, I continue to make small changes eating better, eating less, walking more. Feeling better for it.

I had my phone consult with Dr Sartoretto yesterday, it was a good consult I thought. He asked a lot of questions based on my personal/history, allowed plenty of time for me to ask my questions. I like his approach to weight/fat loss with the focus more on body fat percentage / body composition than scale weight. Dr Sartoretto has done approx 160 ESG which is quite a good number given its a relatively new procedure in Australia.
While I had already done a range of blood tests, I now have a referral for a breath test and oral glucose test.
I was pleased to see that there wasn't a change in the Australian government budget with regards to early release of super for WLS (unless its still hidden in the fine print somewhere).

Today is my appointment day with the surgeon, my alloted time is 4.15pm but was told the doctor would likely call sometime in the evening. it's going to b a long wait

Congrats on starting you journey and I hope you are a good candidate for ESG. I would also add having had a VSG, that if opted to go with what you insurance covers it is a pretty minor surgery and a small incision. Either way recovery Fromm the procedure is going to be a minor part of your post surgical adjustment.

I first read about ESG late last year and was immediately interested in it as I liked the non-surgery/minimally invasiveness of the procedure. I have private health insurance but in Australia ESG isn't covered by medicare therefore private health insurance doesn't give a rebate for the procedure.
I am about 5ft1 and weigh 95kgs. I have been overweight a long time and like many have tried many different things. I did lose weight about 10 years ago, and got down to 65kgs, while that wasn't in the healthy weight range for my height...I did like how it looked on me. That lasted about two years or so, and I put the weight back on along with another 12kgs and it is still slowly rising.
I have been being doing my research and have finally decided it's time to take action. I have had a number of blood tests and will be talking to my preferred surgeon 9th May to find out if I am a good candidate for the ESG. While I am eager to talk to the surgeon and set a date, it is likely that I won't be having the procedure until Sept/Oct.
If I am not a good candidate for ESG I don't know what I will do...my insurance and medicare would cover a band or the standard sleeve and bypass, but I looked into the band some time ago and determined it wasn't for me. Not sure if I up to the surgical options even if covered by insurance and medicare.
I have started some light exercise (mostly walking and weights) and have just commenced planning my meals and working on Portion Control.
This photo was taken the other night, I am the overweight one! The other three standing are my younger sisters and that's my mother sitting...and to think I thought that top fitted me quite well when I looked in the mirror lol, certainly looks different in a photo.
I will take some more before photos in the next day or so, I realised I have very few photos as I typical hide from the camera.
I've enjoyed reading a lot of posts on Bariatric Pal in general and realised its about time I put me out there! I particularly like reading posts from ESGers please keep the updates coming.

I am so glad I did the esg! I was at the low end of the BMI range (31) for the procedure. Thought I would lose very slowly but that was not the case! I’m 9 weeks post op and have lost 33lbs. Last 4 weeks I’ve lost 3 or 4 lbs each week! You do need to follow your dr instructions exactly....protein and Water are key.

How many ESG procedures have they done?

Talk to @LynnV she is a recent veteran from my home state of Ohio. She seems to be doing very very good! Good spokesperson for ESG.

There is a facebood group for USA ESG its called: Endoscopic Sleeve Gastroplasty Support Group USA, its fairly active if you do not get sufficient responses here.
I am in the early stages of my ESG, just started normal foods at one cup volume three times a day. My recovery was pretty good, had intermittent cramps for three days/two nights only. My diet hasn't been perfect, but my results you can see on the left there.
Some people on the three ESG Facebook groups I belong have regretted their ESG...they say they do feel any restriction and/or have put on weight, others have had great success some losing over 40kilos.
While results vary due to the individual, I also think its due to the skill of the doctor/surgeon...best to ask how many ESGs they have undertaken, what the average weight loss is for their patients, how many failures/complications their patients have experienced. What post op support programs they have in place. The skill is needed to judge where the sutures go and how many to sutures to insert so as they give proper restriction and have the best chance for endurability.

Hope it all goes well for you.
Some questions to ask should they not already be on your list of questions: how ESG has the doctor done? Success rate? Failure rate? What caused the failure? Anyone experience complications and what were they? Average excess weight loss of their ESG patients? Post op support program - is there one and what does it entail? What post-op medication is prescribed to help deal with initial pain?

This just answered a lot of questions I had. I go tomorrow for my consultation and go from there. Wish me luck !

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In Australia (self pay too) it may be different than where you are but,
1. Standard blood tests to establish base points and any comorbities (not that I probably needed comorbities my weight was high enough), also need a test for H-pylori (negative for me), if positive would have needed a course of antibiotics.
2. General anesthesia
3. Yes, but this really depends on the doctor. Some doctors do it to ensure a pattern of compliance, if someone can't do two weeks pre -op liquid/shake diet how will someone be able to manage the post-op liquid diet? ?
4. None for me.
Some people for various reasons have lost restriction. Tests have revealed that the sutures have become lose or undone. Reason may include non-compliance with post op guidelines, doctor inexperienced with ESG and suture placement, some people who have had a gastric balloon prior to ESG have a higher failure rate, some people with severe vomiting (due to other illnesses) which has caused sutures to loosen...and then there are the people for some inexplicable reasons the ESG has failed even though they have followed all the insructions and they have experienced doctors etc.
Some points to bear in mind for ESG: weight loss will likely be slower and lower than the surgical options (average weight loss is 20% of excess weight, some people have lost a lot more, some people have lost less), adherance to post op guidelines is vital - it will help the suture anchor points heal which will help the restriction hold tight. Like the surgical options there is a weight loss sweet spot, for the ESG it is probably the first six months to 12 months. It's tool, we need to make it work to ensure the best weight loss, this means a compliance with post op guidelines for diet and exercise, will need to change all those not so healthy eating habits particularly emotional eating.
Generally the ESG is not reversible, and it has been said that for those who choose to have a revision (where the ESG has failed) that a VSG is not a safe option (though I have seen research where such revision has been successful) - i think it may be a chase of the suture anchor points may get in the way of a VSG. Bypass seems to be the surgeons' choice for ESG revision to surgical option. Another ESG is also a viable revision.

Congratulations on your weight loss efforts and results. I know you are just sharing but I am assuming you didn't have a personality change along with the WLS so why would your friend want the old you back? I don't expect an answer from you...just pondering really.

What a wise nutritionist. Something for us all to consider, and I know I will be giving it some deep thought.

I assume its three shakes plus the foods you have mentioned in your post?
You could try make a fairly basic ricotta bake adapting to the egg and ricotta cheese amounts you are able to have.
When I was on my pre-op diet which allowed only three shakes and low carb vegetables, a few times if I needed something different I would have cottage cheese or chicken in place of the shake but made sure it was to the same calorie count or Protein amount as the shake. I would have the low carb veges with it. It wasn't the right thing to do, and I certainly don't want to encourage you to do it, but it did save my sanity and kept me on track for some of the time, unfortunately I wasn't the best pre-op person, thankfully I am much better at post op haha

It sucks! I’ve done this a few times and it’s absolutely true-once you start, you crave it. There’s no easy fix, you just have to detox. Get it out of your system 100%

I have a shocking sweet tooth and generally do much better if I don't go there in the first place, but try to have an exit strategy if I do. For instance if I want something sweet, I now buy a packet of what it is....take it to work, take one, leave the rest in the lunch room for everyone else. Sometimes this works, sometimes all I can think about is heading back to the lunch room to grab another one or two before they all disappear.
I am definitely not a moderator do much better when abstaining. I am trying to work on other ways to get sweet from other foods...blueberries, yoghurt, small handful of nuts with a few raisins even a small drink of skim milk. Sometimes I find that having something like Protein or high fibre with something sweet helps keeps further sweet cravings at bay.

I had avoided this thread, but let me share what I had posted elsewhere:
"Who would I be if I weren't fat...I had actually avoided this 'thread' when I first came across it on another social media site. I had immediately thought of the times I had allowed being overweight/fat/obese/heavy (whatever is your preferred term) to interfere in my life, my happiness, my career, my relationships. I don't share personal well, but I will share a couple of more recent experiences.
My then current partner was of average weight,I wasn't of course, and I use to get embarrassed with public displays of affection, I mean what would people think of a slim to average man, who was pinching my backside as we walked upstairs or out of a restaurant, when I was very clearly overweight. While I am putting it out there, I had let how I think about me impact on our sex life, here was a man who clearly adored me, but I continually pushed him away.
I was lined up for an job interview (only one of two people to be interviewed) which would see me progress in my chosen profession. It was with a well known company, I had a vision of 'beautiful' people who would work there, and that wasn't me because I was fat. I called the contact and made my excuses, I lied as to why I couldn't make the interview....I very much regret that, I regretted it as soon I put the phone down.
So I have had an ESG, and I am losing weight, I still have a ways to go, but no longer will I allow my obesity to hold me back, where I go to from here will be my own responsibility and no more excuses. The sad thing is I have always been an advocate of the saying...what anyone else thinks of me is none of my business...I wasn't walking the talk, but I will be from now on!"

Your guidelines are goals to work up to. No one is drinking 90 oz of Water and having 90 grams of Protein the day after surgery.
Immediately after surgery, focus on your Fluid intake to avoid dehydration. Keep water by you to sip. If you are allowed warm broth, sugar free popsicles and the like then that counts too. Sip small amounts of Protein Shakes if you tolerate them.
Each day you will slowly be able to sip more and you will progress through your stages.