ouroborous

I might just do that. I have a lot of questions... more than Dr. L might be able to answer (although he was VERY candid and open during my one initial consult... I was impressed, usually docs take a "doctor knows best" attitude that annoys me, but he was super open about stuff. He gave me his personal email to send him the first five year studies of VSG outcomes that just came out.)

Yeah, my girlfriend had VSG with Dr. Billings in late November and is very pleased with the results and facility. I think Dr. Landerholm has comparable surgical stats and success rates, but I was curious if anyone had firsthand experience.

A lot; the grand total (includes the surgery, anesthesia, a hiatal hernia repair if necessary, and 2 years followup with the in-complex nutritionist/exercise physiologist) is just over $21k. I have the money in the bank, and I'm willing to spend it for a GOOD local surgeon, but I just wanted to know about his bona fides.

Anyone know anything about (or have experience with) Dr. Robert Landerholm? I'm tentatively scheduled for a self-pay surgery with Dr. Landerholm for May 6th. When I asked him how many lap sleeves he'd done, he said "hundreds." When asked about leak statistics (I forgot to ask about infections!) he said there was one leak, due to patient non-compliance with the post-op diet. He said that he'd not had any mortalities (one patient had died post op of a heart attack, but it was several weeks out and more likely due to a sick, obese patient than anything surgical). I've done a little research on Dr. Landerholm, and he is a "FACS" and I haven't seen ANY negative feedback on him from prior patients (and about 20-30 positive reviews on a site not related to his clinic, Puget Sound Surgical Center). I've asked his patient coordinator for the hard numbers. They're required to keep that, right? Hopefully they'll give the numbers to me. Anyone got any experience with this doc? He seems like a nice, competent guy, but we all know how little "seems like" counts for...

HAH... I've wondered about that. Would be a nice confidence builder to not have this giant shelf of gut between me and one of the last reminders that I'm really, actually a male!

I have seen a couple of posts from people worried about taking in too little food, and I thought I'd post this handy hint I learned a long time ago. It's called the "rule of threes" and is a rule of thumb for how long you can survive without basic necessities: 3 minutes without air 3 hours without shelter 3 days without Water 3 weeks without food 3 months without hope The point of my post is that you can survive for three entire weeks without a single bite of food. Obese people like us, perhaps four. So if you're only able to eat 400-500 calories a day, don't fret. You're not going to starve for a long, long time. Just try to make sure that the calories you ARE getting are high quality (enough Protein, enough micronutrients, etc.) And as the "rule of threes" shows, getting water is MUCH, much more important and urgent than food, and yet even here you could (theoretically) survive three whole days without a single drop (including the water you get in your food). So, if you're fretful or a hypochondriac like me, don't worry quite so much. Do everything the doctor tells you, tell him/her about any strange or worrisome new symptoms, and focus on recovery -- not "what could go wrong."

So, I'm about five weeks out from surgery -- May 6th. For reference, I'm a 39 y.o. male, BMI 42 (6'1, wt. 330). My cardiac scans were good, I'm going for an EGD on Thursday due to concerns about GERD and some upper right quadrant pain that could be gall bladder, but is more likely due to my enlarged liver. I have been diagnosed with fatty liver (without scarring, thankfully), but my liver enzymes are normal. My surgeon suspects that my upper right quadrant pain (it is very mild and intermittent) is the enlarged liver pushing against the "capsule" that it sits in. Hopefully with weight loss, this problem will resolve itself. I'm in generally good health otherwise -- I have sleep apnea, as you'd expect for someone who is 120 pounds overweight, but no diabetes or cardiopulminary issues. Aside from some recurrent allergies, sinus infections, I think I'm in decent health (for an obese man). So here's my question. I'm a worrier -- I worry (needlessly, most likely) about post-operative and perioperative complications. I know that my anxiety is normal and not the end of the world, but I'd like to know: 1. What is the real complication rate associated with VSG? I know that general anesthesia always carries risks, but these are generally small. What are the chances of leaks and so on? My doctor (Dr. Robert Landerholm in WA state) has performed "hundreds" of VSG's with "one" leak (due, he said, to patient noncompliance), so I'm hoping that surgeon competency isn't an issue. 2. What can I do now, in the month leading up to surgery, and after surgery, to increase my chances of a successful, complication-free operation? I suspect that with an already-diagnosed fatty liver, the pre-op diet is going to be crucial. I'm also going to start doing cardio work every single day to make sure my heart and lungs and immune system are as strong before the operation as I can make them. Is there anything else I can or should be doing?

Does anyone know if, for men, minoxidil will slow this process? I know that this is not androgenic... just wondering if using some Rogaine post-surgery will help me offset or delay the problem.

Thanks for all the responses! I actually asked my surgeon about this, and he pretty much agreed with what you all are saying; of course, I can't do any heavy lifting until I'm healed, and even then I'm not supposed to go too heavy for a couple of months, but after that my stomach should be back to basically full strength, and the weightlifting should help to counteract the muscle wasting and loose skin, so I'm excited about that. And it sounds like the malaise and fatigue can be avoided if I'm careful to keep my food intake high-quality. As a man who's used to wolfing his meals in vast portions and not eating for hours and hours on end, changing my mindset to small portions, eaten slowly, taken regularly, is going to be tough! But the outcome is worth it. I'm still six weeks out (I go for psych, nutritionist, and pre-op endoscopy next week), but I'm starting to get a little excited, despite my trepidation.

Congratulations on your surgery. It's good to see more and more guys getting this done. I'm about 6 weeks out from my surgery and (to be honest) scared silly, but I know that the result will be worth it!

Thanks for this tip. I know that there's a severe weight limitation in the first 6 weeks, but it looks like I should keep it light for the first three months, too. After that, I guess, it's just basic exercise common sense and smart lifting (the old lift with your legs, not your back, kinda stuff).

Anyone >2 or 3 months out from sleeving? I'd really like to know long-term energy levels, since I'd really like to start weight lifting again (and back in my day, I lifted HEAVY) once I'm healed up. Wondering if I'll be too tired and sluggish from caloric restriction to do that. I would REALLY like to avoid losing too much muscle mass with the fat! My sleeve date is 5/6/10.

I think that the most positive thing America (assuming we're Americans here... Canucks and limeys, feel free to correct me ) can do for obesity would be to STOP MAKING IT A MORAL issue. Overweight and obesity are NOT character flaws. The truly compulsive, mentally ill eater is the rare exception to the rule; far more common are simply people who don't know how to eat properly, or are trapped in busy-but-sedentary lifestyles. As a computer programmer, I know very well how you can be busy 10-12 hours of the day, and still get almost zero physical activity. And still, the TV would have me believe that I'm just fat because I guzzle ice cream and sit on the couch all day. I wish it were that easy!

One concern I have about VSG is being able to do weightlifting again. I know that I can't lift more than, what, 15 pounds for six weeks? But after that -- after I'm *structurally* healed, will I have enough energy on a restricted diet to actually build up my muscles? I'll be turning 40 this year, and along with VSG as a birthday present, I'd like to start hitting the gym and building back the muscles I was so proud of in my 20's. Is that going to be out of the question on a 500-600 calorie/day diet? As we get older, we tend to lose muscle. I don't want to accelerate that process with severe protein deficiency; I want to reverse it! Anyone (even the ladies) got any thoughts on bodybuilding and weightlifting post WLS (and post-VSG in particular)?

I actually have the opposite problem as you, Kahuna. I'm a fairly large man (6'1, very broadly built), so people always expected me to have a "hearty appetite." The problem is that that hearty appetite has bulked me up to 335 pounds (BMI 42) and serious health problems. On the "pigging out" front, I WANT to eat less, because one odd thing about being obese is that I've always felt self-conscious when eating around others. I feel like the giant portions I consume must really be off-putting to watch. So I avoid eating out in fear of this! So, I'm actually looking forward to being able to feel really satisfied with a small to "normal" sized portion. Plus, of course, getting rid of the aches and pains, CPAP, and other health concerns, as well as really feeling like I look fit and healthy again... THAT, I can't WAIT for! (Wouldn't mind getting my sex drive back, either... )

As a lurker, I would like to thank you guys for these replies. I'd really love to see more info from men with WLS (it seems to be primarily women). I'm about 6 weeks out from a VSG surgery, and I'm terrified -- but hopeful. I'm wondering if I'm finally going to be able to get back into weightlifting, and if the VSG will allow me to have enough protein/calories/energy to do that, but bulking up muscle seems to be primarily a male concern :confused1: The other major trepidation I have is missing my beloved beer! I may finally become a wine drinker, since it seems like much more of a "sipping" beverage. Thanks again to all those posting. It's very illuminating stuff.

Thanks all for the responses. On the hypochondriac front, I'm a "rational hypochondriac" -- like any hypochondriac, I fear every health-related thing that goes "bump in the night," but I also know the actual likelihood of various bad things. Also, a LOT of my hypochondria is weight-related; my father had a serious heart attack when I was 6, and I think that ever since then I've been terrified that just like him, my heart will just "stop" one day. Add that to what I know about diabetes, sleep apnea, and so forth, and you see that the majority of my hypochondria is related to my weight. As to the "willpower" thing, I think that the realization that I'm coming to is that it's BECAUSE I have poor willpower that this might be right for me. I tend to overeat (and drink, I even drink Water in huge quantities with giant gulps, and I eat like a starving wolf), and something that literally *forces* me to slow down and eat less might just be the best thing. It would mean that I didn't have to rely upon willpower alone; there would be (to an extent) a "hard limit" on how much I could eat or drink at once. Part of the reason that I have so many doubts/questions is that, due to having had some elective surgeries that were worse than useless (RF tongue ablation for sleep apnea, for instance), I'm leery of the risks and costs of surgery if the likely benefit is little to nil. But I've also had some surgeries that dramatically improved my quality of life (LASIK surgery to get me to 20/20 vision, nasal surgery to repair a deviated septum), so I'm trying to keep an open mind. Again thank you very much for your input. I'm going to see if my insurer -- Aetna -- will even cover a part of my costs. I'm not SUPER hopeful on that front, but it might be worth the fight. I don't mind if I have to go on a six month medically-supervised diet first, since that would help me learn "how to eat" and quite possibly shave 10-20 pounds off my current 330 (I'm 6'1 and very heavily built, but still 330 is very obese for me).

Interesting, thanks for that. With the amount of acid reflux I have, I suspect that I have "PB" quite a bit already.

Hi, first of all, thanks to anyone who takes the time to read this post. I have many, many questions. First of all is the biggest one. Why WLS? I have been obese almost my entire life. There was one time period when I was not obese; I was a young man working at a very physically strenuous job (unloading semi trailers for UPS). Now, I'm a middle-aged man working at a desk job (computer programmer), and all of my efforts to lose significant weight have either failed or yo-yo'ed (which I'm sure everyone here is familiar with). I've read about the restrictions after lap band, and some of them are simply the restrictions that any diet should have: avoid sweets, avoid white, bready foods, chew slowly, stop when you're full, control portion size, exercise lots, and so on. Additionally, there are some WLS-specific restrictions: NO (?) carbonated beverages (there goes my love of Diet Coke), NO alcohol (I'm not a lush, but I love a summer beer or vodka cocktail), NO (?) caffeine (so I can't even have coffee?), plus a lot of scary things about how for instance taking a whole pill can lead to chain vomiting. So what it seems like to me is that WLS requires the same degree of willpower -- which I've failed to demonstrate -- that a successful diet requires. Which begs the question; if I'm going to have to do all the "work" of a diet anyway, and stick with it if I want to see progress, why not skip the surgery and just do the diet? Either I'll succeed or fail (with or without WLS), but if I don't get the surgery, at least I don't risk surgical complications, and can drink a beer, and am (probably) tens of thousands of dollars better off. Second question, what are the real limitations? I have read so much, conflicting stuff. I know you can't shouldn't eat, for instance, Snickers' bars (and why would I want to sabotage myself that way), but what about coffee? Carbonated beverages? Alcohol? Do I have to give up all of life's little pleasurable vices for this goal? Also, I've read a lot about things getting "stuck" in the stomach pouch if you eat to fast, or if you swallow a large pill, or something. What does this mean? Vomiting? Discomfort? A stomach pump? Along with being obese (BMI of 41) and having sleep apnea (a comorbidity; if insurance companies weren't so difficult, I'd be a shoo-in for the surgery), I'm a hypochondriac. What are the real RISKS post lap-band, versus just discomforts. Discomforts I can live with (assuming, of course, the benefit is worth it -- see my first question). Finally, some health-related stuff. I know most/all here aren't doctors, but I have a fatty liver (diagnosed w/ultrasound) and quite possibly a duodenal (not gastric, that's important) ulcer. Am I disqualified from the surgery on medical grounds? Again, sorry for the book-length post, but I have a lot of questions and am still very unsure about whether the surgery is really a good choice (remember, I'm only 39, given my family's long life-span, this is something I'll need to live with for another 40 years or more), whether I -- weak-willed as I am -- can live with the limitations, what the risks are, and so forth. I'd love to hear advice, answers, and opinions on the subject. My girlfriend is also contemplating lap-banding (although she's much more enthused about it than I am) and I'm trying to find the right balance between skepticism towards any "magic wand" weight loss cure, and real optimism at the possibility of, for the first time in my life (barring the six months I worked for UPS) really being closer to my ideal weight. Thanks in advance for any information or answers!