Hi all, I am just trying to figure out what is a good bougie size for a BMI of 36.9. I want to lose around 70lbs. My Dr. uses a 32 but Im thinking a 36 might be fine for me.

I just talked to my surgeon about this today. It sounds like there is alot more to it than just the size. I have a 40, but lately he has been doing "loose 38s" He said it is a percentage of 12 mm difference. so barely any. I have great restriction. I did have acid reflux early out. It seems to be diminishing lately. I no longer take a PPI, but I do get heartburn on occasion (2x/week?)

My surgeon said that he worries about anything smaller than a 38 and making the lesser curvature of the stomach too narrow, potentially leading to a lager pouch at the top and/or near the bottom.

Mostly what I took from his info is that there is alot of technique involved, not just a bougie of xx size.

And to answer the initial question, by starting BMI was 43.

Hello Jane, The reason I asked the question is because I read that the larger the bougie the less problems you have with acid upset. Did you have any problems?

Hi Christina, not now on the whole, but I did take a PPI for about a year. It was pretty uncomfortable for 3 weeks when I stopped, I had already gone from 30mg daily to 15mg daily, but then it all went OK. I took loads of gaviscon in those weeks, avoid tums and calcium carbonate based remedies because they trigger something called acid-rebound, which ultimately makes the acid worse. before the op I had dreadful indigestion and reflux, but i just lived with it, now I am fine except occassionally I eat something that disagrees and sets off heartburn. I think the issue about acid after the surgery is more to do with the pressure from below in the stomach and the strength of the muscles between the stomach and the oesophagus stopping the acid from rising.

Hope this helps,

Jane x

That was a great video. I did lots of research for my appeal and concluded that the largest I would be comfortable with would be a 36f. But I also noticed how much variation there is from surgeon to surgeon depending on how tight they pull the stomach, where they start, and whether they buttress the staple line with oversewing or other methods. In the end, I felt the surgeon I chose was best qualified to decide based on his experience and data. I went with Dr. Aceves and he uses a 36 with an oversew that makes it closer to a 32 or a 34. I have a lot of restriction and think it will work fine for me.

In the end if the differences end up being a tablespoon or two then it really is up to me to use my tool to be successful regardless of the bougie size. I love that people seem to have sleeves from 32 up to 40 and still do just fine.

What I wouldn't have known before surgery is how big the lack of hunger would be for me. While I love the restriction and think it's what will help me re-reach my goal, it's hard to say that a lack of hunger wouldn't have worked for me all by itself. I understood restriction from having had a band but I really underestimated how big a deal the lowered production of ghrelin would be.

I'm too early in the process for my BMI to be helpful when considering bougie size :-).

Who are you going to?

When I finally had my mind made up I had gotten my BMI down to 32.6 but it had taken me a year to get there and was starting to gain again. I am not sure how big my Bougie is but I know it only hold 3 oz. I know it is scary pre op to think of only eating 3 oz and being happy but honestly it is wonderful! I wouldn't have any other way. I dont have a VSG though I have the TGVP.

Who are you going to?

When I finally had my mind made up I had gotten my BMI down to 32.6 but it had taken me a year to get there and was starting to gain again. I am not sure how big my Bougie is but I know it only hold 3 oz. I know it is scary pre op to think of only eating 3 oz and being happy but honestly it is wonderful! I wouldn't have any other way. I dont have a VSG though I have the TGVP.

Hello Mellifrits, I will have my surgery Aug 18th with Dr. Almanza. I will talk to him about what the best size for me would be. I'm a little worried about losing too much weight and acid reflux.

Hello Mellifrits, I will have my surgery Aug 18th with Dr. Almanza. I will talk to him about what the best size for me would be. I'm a little worried about losing too much weight and acid reflux.

I depends on what I eat but I haven't had much heart burn at all and I'm sure if I was better about taking my acid reflux meds I wouldn't have any at all. I guess I was scared that since I'm 23 I'm going to have this new stomach the rest of my life and in time it might get a little bigger. So I wanted to start out small in hopes that when I'm in my 40 I will still have my smaller stomach. But I would just talk to your dr about it more. I'm only a month out and he has a lot more insight than I can give you.

I think your doc is the best source of info on what size you should have. I really don't think telling him how to do his job is going to win you any brownie points. He has his reasons for size--he didn't flip a coin.

As a nurse who has been in the medical profession for 15 years, I couldn't disagree more. A well-informed patient who has the intelligence and self-confidence to research and question their treatment, tends to get the best treatment. Those who have well-informed and inquisitive patient advocates also get the best treatment. The idea that people should be more informed consumers when it comes to buying a car than in undergoing a major procedure on their own body is incredible. Why on earth shouldn't a patient question their doctor??

As far as "brownie points" go, one doesn't go to a doctor to seek approval, but to accomplish a healthcare goal. "He" (umm... sometimes "he" is a she, by the way), may have reasons for his choices, but if those reasons don't jib with me, I'm going to trust my instincts and go to another doctor. Doctors (although they sometimes think they are), are not omnipotent. I counsel my patients to ask, ask, ask. This is 2010, not 1952.

As a nurse who has been in the medical profession for 15 years, I couldn't disagree more. A well-informed patient who has the intelligence and self-confidence to research and question their treatment, tends to get the best treatment. Those who have well-informed and inquisitive patient advocates also get the best treatment. The idea that people should be more informed consumers when it comes to buying a car than in undergoing a major procedure on their own body is incredible. Why on earth shouldn't a patient question their doctor??

As far as "brownie points" go, one doesn't go to a doctor to seek approval, but to accomplish a healthcare goal. "He" (umm... sometimes "he" is a she, by the way), may have reasons for his choices, but if those reasons don't jib with me, I'm going to trust my instincts and go to another doctor. Doctors (although they sometimes think they are), are not omnipotent. I counsel my patients to ask, ask, ask. This is 2010, not 1952.

:tongue_smilie: I work in health care too and I wholeheartedly agree. Also, people love to tell people to just follow their diet plan, etc. But it frustrates me that there so many different plans out there for the same surgery! Better to ask and fully understand than just blindly follow, IMO.

Yay Cindy and Syacie, you are both so right. We should not be passive consumers of what others deem best for us. We have been given brains and the tools to research so we should.

Jane x

Good luck Christina!! Its just around the corner, how are you feeling, I have a month to go which Im sure will fly by, Im so excited!!

My bougie is a 32 ... whos your Doctor?

Good luck Christina!! Its just around the corner, how are you feeling, I have a month to go which Im sure will fly by, Im so excited!!

My bougie is a 32 ... whos your Doctor?

Thank you Calgarygirl! I love all the great support and advise I get from here. I feel like I have a whole new set of friends. It is very touching how everyone checks on each other.

This week has been dragging..LOL. So today im a little scared. I am having my surgery done by DR Almanza. Im not just scared of the surgery, Im scared of the emotional side too. What about you? How are you feeling?

I depends on what I eat but I haven't had much heart burn at all and I'm sure if I was better about taking my acid reflux meds I wouldn't have any at all. I guess I was scared that since I'm 23 I'm going to have this new stomach the rest of my life and in time it might get a little bigger. So I wanted to start out small in hopes that when I'm in my 40 I will still have my smaller stomach. But I would just talk to your dr about it more. I'm only a month out and he has a lot more insight than I can give you.

Mellifrits, I wish I had this done at 23. You look great! Your so young still and now you can enjoy life like a 23 year old should. People keep telling me to work out and diet. I tell them I have been fighting my weight my whole life. Yes, sometimes I lose 15,25 pounds but it just gets harder. Im at 215 now I know for a fact if I didn't do this now I will weigh 230 by 40 and maybe 300 by 50. They don't understand how much harder it will be then. If I would even live to see 50.

Youre funny Christina, you will still be living when youre 50!! lol And I couldnt agree more (jealous of mellifrits) getting this done so young..... I wish I would have instead of doing the yo yo dieting for so long!! ohh wow, so how am I feeling, oh my gosh... every feeling in the world... at first i was worried about the surgery, now Im just worried what I need to wear at the hospital... Im scared, excited, not sure how my family is going to handle this one, and really happy reading everyones stories... Im like thank god I found this lol

But yes youre right - the emotional side!! its a lot of changes, but the vertical sleeve will help make us more aware... I dont know whats its going to be like until we get to that point... do we go running instead of eating?? lol I dont know... Im hoping we have lots more energy and I seriously cant wait for the new me!! Im looking forward to watching your progress, feel free to add me as a friend, and I agree, the support on here is amazing!!! Good luck this week!!!!

Youre funny Christina, you will still be living when youre 50!! lol And I couldnt agree more (jealous of mellifrits) getting this done so young..... I wish I would have instead of doing the yo yo dieting for so long!! ohh wow, so how am I feeling, oh my gosh... every feeling in the world... at first i was worried about the surgery, now Im just worried what I need to wear at the hospital... Im scared, excited, not sure how my family is going to handle this one, and really happy reading everyones stories... Im like thank god I found this lol

But yes youre right - the emotional side!! its a lot of changes, but the vertical sleeve will help make us more aware... I dont know whats its going to be like until we get to that point... do we go running instead of eating?? lol I dont know... Im hoping we have lots more energy and I seriously cant wait for the new me!! Im looking forward to watching your progress, feel free to add me as a friend, and I agree, the support on here is amazing!!! Good luck this week!!!!

Oh yes the working out part...lol...I went to a water park this week with my two kids, we walked up a million steps and walked and walked. Lets just say I thought I might need major pain killers the next couple of days...How am I ever going to work out..OMG

My BMI was 41 preop and my surgeon uses a tight 36 bougie that he then oversews. He expects us to be very restricted in the first several weeks. I am at postop day 17 and just tolerating some purees.