Hi All,

I just had my phone consult with my surgeon and he said that he uses a 32 bougie, he just called it a french which makes sense. I'm a little alarmed at such a small size, he admits that he does what is called, "a tight sleeve", meaning that even a year out you can fit in a single boiled egg. This concerns me, yes of course I want a smaller stomach that's the point of the surgery, but I have lurked on these boards long enough that I know that more problems arise the smaller the stomach is.

Also, were I to get pregnant, I would want to be able to consume enough nutrition without it being a constant scary concern.

Finally, we have no data on WLS patients when they become elderly. If my stomach is that small and oversewn so it won't stretch, what will I do when I am 80 and have difficulty getting enough nutrition anyway? I'd really love to hear what everone has to say before I go and freak out on my surgeon.

32f (f is for french, which is a unit of measure, i believe) bougie is fairly common. That is what my surgeon here in the US uses too.

yup i have the 32F boughie. . . it works pretty well. . .no problems yet and I'm 5 months out. . . good luck

You can always get more in by eating more often. Heck, any bigger, and you will have trouble with weight gain, and if you eat too often, you will still be capable of gain. Just nothing like you are capable of now.

Mine's a 32, and at 4 months out I can definitely eat more than one boiled egg. I think he's talking about your initial capacity right after surgery (not that your stomach would let you eat a whole boiled egg at that point anyway LOL). Honestly, I wouldn't want it any bigger, although from what I've read the difference between a 32 and even a 40 is minimal.

And no, there aren't any studies if long-term VSG in the elderly... but there are many, many people who have had full astrectomies for things like stomach cancer, who have gone on to live healthy, normal lives. If you search Tifffykins' posts, somewhere she's linked to studies such as those. :thumbup1:

My surgeon uses a 32fr, and I'm able to consume 1500-1800 calories per day with zero issue. I do eat at least 6 times per day, but getting in enough nutrition for a healthy pregnancy is not an issue. At almost 1 year out, I can easily eat 1 hard boiled egg, and some meat. I can consume 1 cup/8ounces of mushy foods. I can fit in about 4-5ounces of dense meat in one meal. I don't feel weak, or lethargic with my calorie intake at all.

Partial and total gastrectomies have been performed for decades upon decades for stomach cancer and ulcer patients. My comfort level with VSG came from reading many personal stories and research articles on patients that have part or their entire stomach removed. They lived fairly normal lives and many into their late 70s without issues related to their gastrectomies from 20-30 years prior.

My surgeon used a 40f bougie. I'm almost 9 months out and my eating capacity seems to be less than what some people with a 32f bougie describe. I can NOt EAT more than 1 hard boiled egg at any given time. I am full to capacity after about 3-4 ounces of dense meat. This can be accommodated for by eating more frequent "meals". For me the time seems to move too fast to eat often, but I am not yet at goal so I'm not yet working at maintenance. In fact all it takes for me is a small high carb food and I gain weight. All and all I am glad he used a size 40f.

Heck im joining the 32 club on friday 4th i dont want any bigger:thumbup1:

If i lose too much I will be elated I can always drink a high Cal mushy drink or something like that:thumbup:

Wish i could FF to a week from now

Soon to join the winners on the losers bench!!

Cheers Don..

As for the last part you said - when we are 80, etc.... this is the way I see it. Good luck getting to 80 years old at all if you are obese and in poor health right? Someone else had brought up the same thought and that is what occured to me.

32 is very common. The difference between a 32 and a 40 is about a tablespoon.

Thanks everybody! you've helped put things in perspective and calmed my fears. It's one thing to talk about getting WLS, but now that I've set a date and begun the ForReal journey, I'm probably getting a little manic.=)

With such a surgery I think you're entitled to be a little manic!!

I'm in for my 32f next week..... and starting to get the butterflies already!!

Good luck

I have a 40f and I'm doing fine with no complications. At 3.5 months out I can eat 4 oz of shrimp, 3 oz of dense meat if I eat slowly.

I understand your concerns. I talked with my surgeon, because after reading lots of information, I had decided that I did not want the smaller bougie sizes. I was anxious about an increased risk of strictures, possible osteoporosis from overly rapid weight loss, GERD, and difficulty eating some foods. He laughed when I told him that I did not want a stomach the size of a Bic pen. (He had not seen the photos comparing bougie sizes to pens and markers until I brought them to my appointment.)

Anyway, my surgeon said that he typically uses a 40f to reduce the risk of those problems (although he was willing to change that if I wanted him to)--but what he also explained to me in a diagram, is that the bougie is used to determine the size of the upper portion of the sleeve, but that you still have a small "pouch" type area at the bottom that is larger than the bougie size itself. He said that there is a lot of surgeon judgement that affects how this area at the bottom of the sleeve is measured/shaped, and the amount of food it will contain. So even though the bougie size is important and causes you to feel restriction when you eat, the bougie size alone is not the only thing that determines the stomach's capacity.

Some surgeons use the smaller bougie sizes in hopes of improving weight loss/reducing the risk of regain. Those things are important to me and I would love to be thin, but at 54, I am equally concerned with overall quality of life issues. For me, a 40f was a reasonable choice that would reduce my anxiety about possible problems. It's possible that at some point, I could wish he had gone smaller, but at 10 weeks, I am satisfied that my surgeon did a good job. I am eating small, but satisfying amounts of food. I haven't had any problems with reflux/acid (and I'm not taking a PPI). I'm losing satisfactorily--and would lose more if I were exercising more. I advanced my diet slowly, and thankfully, I haven't found any foods that I can't eat comfortably.

I don't think it is unreasonable to be concerned about aging issues. For me to get adequate Fluid intake, I have to pay attention/work diligently to drink 64 oz a day. Alzheimer's runs in my family--and watching my mother last week made me very much aware that she would not be able to "sip sip sip" all day. At this point, she's doing well to know when she needs to go to the bathroom. It may be that some aging people with gastrectomies do very well, but I don't think there is enough research for us to know how this may affect those of us who develop problems with dementia/Alzheimer's.

I had to make a judgement call. Is it better for me to be slim and be able to enjoy the years immediately before me, while taking the real risk that it may complicate nutrition/hydration problems if I develop Alzheimer's as I age...or is it better for me to stay fat and miserable now, so that I can insure my ability to eat and drink at some point when I am older and may not even know my name? For me, it was an easy choice. Let me LIVE now, and if I have to be rehydrated with IV fluids when I'm older because I can't remember to drink fluids, then so be it.

Katt,

What a wonderful, well thought out post. My mother died with advanced Altzheimer's so I understand your concerns. I too have a 40f and at 59, I'm very pleased with it. I may not be losing as quickly as a 30 year old with a 32f, but I think my progress is wonderful given all of the factors. My quality of life is already improving. I have pictures of my Sleeve and I don't see the larger pouch that you're talking about. I'll have to give it a closer look and ask my surgeon at my 6 month follow-up in August.

Congratulations on your great progress!

The next upper endoscopy I get, (hopefully soon due to "silent" reflux issues), I'm going to ask beforehand for pictures. My bougie is a 40f and at 9 months out I've got tremendous restriction! I am about 15lbs from goal and need to exercise more. In hindsight, I would not have wanted a smaller bougie size, no way.