I was hoping to find others here to comiserate with. I had my surgery last August 2008. I lost 45 lbs in 4 mos and only 7 lbs since. And that soesn't even count because it was surgically removed. What now. Lost motivation to keep going.

Lisa:confused1:

oh cwalck , i am so sorry for what has happened to you. i guess i missed that part. hope you get to feeling better. hang in there and it will happen for you too.

I have heard that when you are "losing" to not weigh more than once a week, but once you reach goal, weigh everyday. I cannot honestly say I can do that. I weigh way too often, but I will share the "wisdom." I kinda think stalls are just part of the journey - not that that is a great comfort, but I know it took me a long time to gain the weight and I need time to lose it also. It is all about the long-term results, right. Try and think of this as just a little road block.

I havent had the VSG but planning on it. Just wondering why some are slow losers. I have read so many different things on the boughie size. I know some think that the size doesnt make much difference, and that is my research now. I have read Drs think anything over size 40 patients have regained wt.

1)WHAT SIZE BOUGHIE DID YOU HAVE?

2)DO YOU THINK IT WOULD HAVE MATTERED IF IT WERE SMALLER WITH YOUR WT LOSS? 3)DOING IT ALL OVER AGAIN, WOULD YOU REQUEST A SMALLER BOUGHIE?

Thanks for your help!

hi determined1, no i don't think boughie size has anything to do with it, but i do think how much you have to lose has lots to do with it. . .for example, if me and someone else had surgery on the same day but i'm 6'0 tall and weighed 332 lb and the other person was 5'2 and weighed about 220 lbs, i would loose faster because i have more to loose. . . does that make sense? I also think it has alot to do with your metabolism (which makes sense to me) how you handle your diet, for example i will not eat many carbs at all and keep my calorie count under 600 for the day, i have lost 53 lbs in 7 weeks. . . so i think it depends on you really. . .

600 calories a day????? that sounds like starvation. That is like 3 protein drinks a day and that's all?

Determined: My plan does not use any Protein powders or supplements. I'm 1 week out having 1/4 cup of nutrition, three times a day. I can have up to 1/2 cup when I'm ready for it. I count every calorie and carb that I ingest. My calories are more like 200 right now.

I asked my doctor about the bougie size, he said that Kaiser has researched it and deemed that the 40 gives the best results in the long run. I trust him. If I doubted him, I would have self-payed to Mexico but then I would never have known. Maybe I would have had severe nausea or other complications.

To think about this as failsafe won't work. No doctor can guarantee that you'll keep your weight off, regardless of the bougie size because we determine how to use it.

I think that if you keep asking, you'll keep getting the same responses from all of us. Now it's time for you to decide what makes sense in your life.

Here are the Cornell recommendations:

Weeks 0-2: Total Cal: 400-600 Total Carbs: <40 Total Protein: 70

Weeks 3 - 3 months (Soft Foods): Total Cal: 600-800 Total Carbs: <40 Total Protein: 70 - 90

3 - 12 months (Regular Food): Tota Cal: <800 Total Carbs: <40 Total Protein: 70 - 90

After Reaching Goal (Regular Food): Tota Cal: 1000 - 1200 Total Carbs: 40 - 60 Total Protein: 70 - 90

I think that what matters is:

1. Amount of weight to lose

2. Exercise

3. Calories and Carbs

I really don't think that bougie size has anything to do with it. How we work our tool has everything to do with it.

I havent had the VSG but planning on it. Just wondering why some are slow losers. I have read so many different things on the boughie size. I know some think that the size doesnt make much difference, and that is my research now. I have read Drs think anything over size 40 patients have regained wt.

1)WHAT SIZE BOUGHIE DID YOU HAVE?

2)DO YOU THINK IT WOULD HAVE MATTERED IF IT WERE SMALLER WITH YOUR WT LOSS? 3)DOING IT ALL OVER AGAIN, WOULD YOU REQUEST A SMALLER BOUGHIE?

Thanks for your help!

People lose slower because:

#1 they don't follow the rules post-op and either consume too many carbs, or do not change their eating habits in hopes that the sleeve will just magically fix their weight problems. If they choose to suck down a 2,000 calorie milkshake from Sonic instead of eating 200 calories of steak, they can't necessary expect surgery to help them lose weight. And, yes people do this. They may not admit it publicly, but they do it and wonder why their weight loss is stalled.

#2 Because every person is different, and several factors go into the losing weight equation. If someone is insulin resistant, have thyroid issues, or maybe they only had 80 pounds to lose versus someone that has 150 pounds to lose. Losing for these people may be a bit slower, but possible.

#3 Maybe they don't or can't exercise due to physical constraints, or scheduling conflicts

#4 Maybe some are slow losers because they were not properly educated on what life during the losing stage would be like, and they don't make the proper choices with foods, nutrients and exercise

Boughie size does matter if you're comparing a 40 to 60. But, I asked my surgeon on Monday what the measurement difference is between a 32 and 40, he told me in terms of measurement by circumference it is literally less than 2-2.5mm after the swelling resolves post-op. I asked him is the fundus is removed just as adequately with a 40 because I knew that was one of your concerns, he said yes, because the boughie is used to measure diameter, not how much of the fundus is removed.

If you haven't seen this, I found this on OH, and think it'll give you an idea of honestly how minimal difference in a 32 and 40 really is.

Just a visual to offer more pictures of how minimal the difference is between the sizes your concerned about.

Here is a fabulous link for bougies. It physically lists every size of bougies, with the millimeter measurements.

Scroll to pages 3 and 5 to see the table of reference for bougie sizes.

http://www.medovations.com/pdf/Esophageal_Dilatation.pdf

I'm honestly not trying to convince you stick with your surgeon, but I think you need to have as much information as possible to form an educated, and true thought process on this surgery.

In this situation, I would of probably chosen to have a bit bigger bougie size. I'm having a very difficult time maintaining. I've dropped 10lbs in the last 17 days. And, I've increased my calories, carbs, and doing my very best to eat more, but I am honestly not able to consume anymore food per day. I'm about to make the horrible decision to start back on Protein drinks and possible weight gainer because I can not and do not want to lose anymore weight.

Many people think they want to have the problem of not being able to get the loss to stop, but when you drop 133 pounds in less than 9 months, and you are not able to get it to stop, there comes a time when it gets a little scary. I'm 5'2" weighing in today at 130 pounds. I'm wearing a size 7 jeans, and most of medium tops are too big on me at this point, I've just recently moved to small tops.

Really, I think you have to be dedicated to changing your habits and lifestyle with any size bougie. I'm not sure what the hangup is on bougie size, but there comes a time when you have to accept that your surgeon is far more educated, trained, and well-versed on this subject matter than any of us out here on the internet. I'm not trying to be harsh, but I'm brutally honest, and at some point support isn't about blowing sunshine and rainbows up someone's hiney. In all reality, you have to decide if the sleeve will work for you. You can still eat half a gallon of ice cream with a 32 fr bougie just as you can with a 40fr, 60fr, or with the huge stomach we have before surgery. It'll slow ya down some, but you'll still be able to bad choices regardless of bougie size.

Honestly this is the first post I have seen in the month or so I have been researching about bougie size. I still have no idea what it is and how it is connected to the sleeve process. When I went to the seminar I thought they just cut the stomach and make it smaller into a banana or sleeve shape. Obviouisly i don't have all the information. Meanwhle, i have my stress test tomorrow with a broken rib in another nor'easter snow storm with another 8" of snow. Boy, I must be determined. So please explain boughie to me.

People lose slower because:

#1 they don't follow the rules post-op and either consume too many carbs, or do not change their eating habits in hopes that the sleeve will just magically fix their weight problems. If they choose to suck down a 2,000 calorie milkshake from Sonic instead of eating 200 calories of steak, they can't necessary expect surgery to help them lose weight. And, yes people do this. They may not admit it publicly, but they do it and wonder why their weight loss is stalled.

#2 Because every person is different, and several factors go into the losing weight equation. If someone is insulin resistant, have thyroid issues, or maybe they only had 80 pounds to lose versus someone that has 150 pounds to lose. Losing for these people may be a bit slower, but possible.

#3 Maybe they don't or can't exercise due to physical constraints, or scheduling conflicts

#4 Maybe some are slow losers because they were not properly educated on what life during the losing stage would be like, and they don't make the proper choices with foods, nutrients and exercise

Boughie size does matter if you're comparing a 40 to 60. But, I asked my surgeon on Monday what the measurement difference is between a 32 and 40, he told me in terms of measurement by circumference it is literally less than 2-2.5mm after the swelling resolves post-op. I asked him is the fundus is removed just as adequately with a 40 because I knew that was one of your concerns, he said yes, because the boughie is used to measure diameter, not how much of the fundus is removed.

If you haven't seen this, I found this on OH, and think it'll give you an idea of honestly how minimal difference in a 32 and 40 really is.

Just a visual to offer more pictures of how minimal the difference is between the sizes your concerned about.

Here is a fabulous link for bougies. It physically lists every size of bougies, with the millimeter measurements.

Scroll to pages 3 and 5 to see the table of reference for bougie sizes.

http://www.medovations.com/pdf/Esophageal_Dilatation.pdf

I'm honestly not trying to convince you stick with your surgeon, but I think you need to have as much information as possible to form an educated, and true thought process on this surgery.

In this situation, I would of probably chosen to have a bit bigger bougie size. I'm having a very difficult time maintaining. I've dropped 10lbs in the last 17 days. And, I've increased my calories, carbs, and doing my very best to eat more, but I am honestly not able to consume anymore food per day. I'm about to make the horrible decision to start back on Protein drinks and possible weight gainer because I can not and do not want to lose anymore weight.

Many people think they want to have the problem of not being able to get the loss to stop, but when you drop 133 pounds in less than 9 months, and you are not able to get it to stop, there comes a time when it gets a little scary. I'm 5'2" weighing in today at 130 pounds. I'm wearing a size 7 jeans, and most of medium tops are too big on me at this point, I've just recently moved to small tops.

Really, I think you have to be dedicated to changing your habits and lifestyle with any size bougie. I'm not sure what the hangup is on bougie size, but there comes a time when you have to accept that your surgeon is far more educated, trained, and well-versed on this subject matter than any of us out here on the internet. I'm not trying to be harsh, but I'm brutally honest, and at some point support isn't about blowing sunshine and rainbows up someone's hiney. In all reality, you have to decide if the sleeve will work for you. You can still eat half a gallon of ice cream with a 32 fr bougie just as you can with a 40fr, 60fr, or with the huge stomach we have before surgery. It'll slow ya down some, but you'll still be able to bad choices regardless of bougie size.

Tiff, I can't thank you enough! You have no idea how much YOU & this site with so much education has helped me. I have spent so many hours online looking for an actual boughie and here you come! )))thank you(( I am going to stick with my surgeon with the 40. After research and talking with people here, I now feel confident that this is the size for me. I am so appreciative of your intense knowledge from research and from experience. Thanks again, determined1

Hi Carol, You're just starting out. Keep asking questions. My response was geared towards Determined who's been asking about bougie size.

Determined, I'm so happy that Tiffy's response finally hit a chord with you! YAY!

Honestly this is the first post I have seen in the month or so I have been researching about bougie size. I still have no idea what it is and how it is connected to the sleeve process. When I went to the seminar I thought they just cut the stomach and make it smaller into a banana or sleeve shape. Obviouisly i don't have all the information. Meanwhle, i have my stress test tomorrow with a broken rib in another nor'easter snow storm with another 8" of snow. Boy, I must be determined. So please explain boughie to me.

Bougie is simply a measuring device they use to guide the stapler when they excise the large portion of the stomach.

This tube is slid down your esophagus by the anesthesiologist during the surgery. It is placed in the stomach, and then the surgeon uses it as a guide to align the stapler correctly.

That is why it's so important to find a surgeon that has performed at a minimum 300 sleeves. The reasoning is that statistically the complications decrease, and the technique is improved with more surgeries. The bougie is just a measuring tool. It's a very small part of the equation for this surgery. Surgeon's technique, and experience play a much larger part than the bougie size.

Tiff, I can't thank you enough! You have no idea how much YOU & this site with so much education has helped me. I have spent so many hours online looking for an actual boughie and here you come! )))thank you(( I am going to stick with my surgeon with the 40. After research and talking with people here, I now feel confident that this is the size for me. I am so appreciative of your intense knowledge from research and from experience. Thanks again, determined1

I'm so glad this information helped. Believe me, I'm one of those super-geeky researchy type people. I armed myself with as much information as I could before deciding on VSG. So, I know how important it is to get as many facts.

My husband always says "you're such a hot little geek." I'm not sure if that's one of those backhanded compliments, or if he just thinks I'm hot LOL LOL.

You're going to do fabulously with the sleeve, and we'll all be here for you to support you through this life changing experience.

I have lots of links that I actually paid for from medical journals, and abstract studies, research literature, but due to copyright infringements, and the terms of service, I'm not allowed to copy and paste the articles here or anywhere else for that matter.

Most articles are between $5 and $10. The most expensive ones I paid for were around $31.50-$35.

I can supply links if you or any other members are willing to pay a little money to get the articles and research literature. I found the information invaluable, but I'll be honest, I spent a lot of time Googling certain terms/conditions/verbage in the articles because it is literally A LOT of medical mumbo jumbo. And, I think my brain cells nearly imploded with all the information overload I put them through during my researching.

Tiff-Thanks for that. It is only recently that I started hearing that term. Of course I spent months on the lap band site before switching the surgery to the sleeve. So it has been a very short run for me here. Coming into this forum I had already been well into my testing and then switched surgeons and hospitals. My primary care dr. wanted me to have the sleeve instead and wanted me at the University of Pennsylvania Hospital. So now, I am at the end of the road with the stress test tomorrow but I am still afraid that this broken rib is going to de-rail me. If I can get thru the stress test, then I will feel better about things. I asked the doctor how I would know if I was ok and he said NO PAIN. I cannot see that day yet. It has been 13 days and I still can't sneeze without screaming. But I have until April 5, so maybe. I also cannot imagine EVER saying that I need to stop losing weight. OMG, I am 60 and have 1 picture of me thin from my whole 60 years. Ig uess that was one minute in time. Carol

So let me get this straight: Do our tummies end up as tiny as those pens?

I cannot imagine! MlKPas You only have 60 pounds to lose total? i thought they would not even do the surgery unless it was 100 pounds or a BMI of 40. How nice for you.