Hello - I am a danish woman, trying to loose weight.

ME:

36 years old

BMI: "only" 33

Comorbidities of my weight:

sleep apnea

High bloodpressure

Lower back problems are getting worse for every pound overweight (scoliosis/ Ishias problems)

Father diabetes 2, both mother and father are medicatet for hight bloodpressure. Sister underwent a Gastric Bypass en roux with a BMI of 40 with great succes

:rose:

I have tried almost every diet on earth, undergoing lifestyle changes, have been in therapy, have spent a lot of money on al kinds of thing.Iron, Calcium and Proteins, that I am digesting.:confused2:

Futhermore it seems that a sleeve operation is having a lower mortality rate and fewer post complications?:confused:

One of the reasons why I am overweight is the earlier use og sugar as a coping strategy for everything. I have worked through most of this - but see it as somekind of a dependency even if I do not use it as much as before. And this is not good with the sleeve? :eek:

Does anyone in this forum have eny experiences with.

If some of my earlier eating habits are due to cognitive habits, lower ghrelin secretion will not help me? Or?:confused1:

All you comments are welcome - my brain is exploding

I already know, that my BMI is low (but high enough to die earlier), and I am mostly considering an operation because og my health issues.

Just a few words, please?:angel:

I believe every person has to make a personal decision. That being said, I know that decision can be a difficult one, and hearing from others helps. I chose the sleeve over RNY, because of several reasons.

1. I am a person who likes to eat large amounts. I think the restriction will be the most important tool for me.

2. I am concerned about the malabsorption of the RNY. I have a brother in law who has done very well so far on the RNY, but I am still concerned. It is important to me to eat as close to a varied normal diet as possible once I have healed and reach maintenance levels. I know I will still have to take vitamins and B12 due to the limited intake and the need for b12 to be processed by the acids and enzymes of the stomach.

As for the sweets issue, people can sabotage their surgery by eating high calorie slider foods. Is this something you are willing to take ownership of and combat? The sleeve is a tool, and you have to work the tool by following the post surgery guidelines. That is true for all weight loss surgeries. You have to decide if you are ready for this.

Thank you so much for answeing, Eurika C!

You are right, that decision is difficult. Hearing from other, who have had the surgery - og could give some kind of input. I have trying to read a lot in here, and will probably read all, every thread, before I dicide.

"1. I am a person who likes to eat large amounts. I think the restriction will be the most important tool for me. "

I hope it is ok for me to ask you these.

Large amounts of intake is no longer possible, so it will give you some kind of resticted intake.

Do you think, that your urge to eat is so strong, that over time, you could stretching the stomach?

And you could digest larger amount over time?

What I am thinking about is, that no matter how strong ones feeling of succes is. It is difficult to know, if the old habits will get control over one again. I personally think, that I will do all there is to do, to keep a healthy lifestyle.

I have been looking into and working with all the emotions eating is giving me.

Mayby the ghrelin reduction will handle some of the appetite

"2. I am concerned about the malabsorption of the RNY. I have a brother in law who has done very well so far on the RNY, but I am still concerned. It is important to me to eat as close to a varied normal diet as possible once I have healed and reach maintenance levels."

That is also how I feel. What will happen in 20 years from now. It seems logical, that the long time Vitamin and mineral difficiency must be less with a sleeve operation. That is pointing me in the sleeve direction :-)

"As for the sweets issue, people can sabotage their surgery by eating high calorie slider foods."

Excactly - and how much is too much? I would do anything, but I also more and more see this urge to art like an addiction. Like alcoholism. I know, I need to take care of it every day

I have read that 2/3 of the people who have batriatic procedure is have some kind binge eating disorder.

" Is this something you are willing to take ownership of and combat? "

Yes - ownership is a good word. I need to struggle with after an operation - but I hope the struggle with get just a little easier in some ways.

"The sleeve is a tool, and you have to work the tool by following the post surgery guidelines."

Yes, and that tool could be so helpful - mayby I am to optimistic, but I see it as I am half way there with this helpertool of mine.

THANK YOU AGAIN!

For me, RNY just wasn't an option because of the regain stats, and long term complications from friends that I know in real life. I can tell you that studies show only 30% of RNY patients "dump" on sugar meaning that it's no guarantee that you'll get sick if you eat sweets. Out of the 8 friends I have that have had RNY, only 2 of them dump on sugars/fats, and all of them have either gained back 75% of their weight, and are now seeking revisions, or have had major complications with vitamin/nutrient deficiencies, bowel obstructions, strictures, pouch and esophageal dilation, and a whole slew of other issues. Are some of the complications directly related to their compliance level, YES, but some of them have struggled from the beginning.

For me, I chose the sleeve because it made the most sense. Least amount of long term complications, no rerouting, zero food or medication restrictions, no blind stomach left behind that can't be easily scoped yet can still develop cancer and ulcers.

None of the surgeries cure cravings, head hunger, or emotional eating. That part of the journey is all on you, and you have to be willing to battle those issues along with the assistance of whichever surgery you choose. I've done extremely well with the sleeve, and live a perfectly normal little life eating anything and everything I choose, I enjoy a balanced diet, and really enjoy not worrying about foods that might make me sick, or if I've taken all my Vitamins. I do take a high quality adult mulit-Vitamin and a sublingual b12. I took multis before surgery because it's recommended for women my age.

You'll be able to "eat" around any of the surgeries. They operate on our stomachs, not our brains. We have to form new habits, and work on our own issues.

Well.... I was going to post and answer, but Tiffy pretty much said everything I'd have said anyway!

But I will add: With your BMI starting as low as it is already, for ME the risks of the bypass wouldn't be worth it.

Yes, Tiffy's answer pretty much says it all. I also agree with Stacy - if you don't have as much weight to lose, why risk the lifelong nutritional deficiencies of the bypass?

The portion of the stomach they leave behind is the least stretchy part of the stomach and is far less likely to stretch than the bypass pouch. It will stretch a little over time, but not anywhere near what it was prior to surgery.

If you wouldn't mind posting information about your potential surgeons on a new thread, it would be very helpful to some of us living overseas. I'm currently in Germany and flew all the way to Mexico for my surgery because I couldn't find a surgeon very experienced with VSG in my area. If you're in contact with a few that do VSG in Europe, you should post their names and information so that other folks can have them as an option as well.

Best of luck to you,

~Cheri

YEAH!

I got more answers - I am so gratefull

All your inputs really helps me!

In Denmark this procedure is almost unknown - it is only used very seldom. Most of sleeve-procedures on danes is done abroad

Thank you for your respond, Tiffany!

"RNY just wasn't an option because of the regain stats"

The statistics shows that weight regain RNY is more likely to happen?

That is very interesting - if I have understood it correct?

That was the main reason why, I would consider a Bypass.

I know that there is a lot complications already now. How will it look in 30 years? :-(

"I can tell you that studies show only 30% of RNY patients "dump" on sugar meaning that it's no guarantee that you'll get sick if you eat sweets."

That is an important argument for not believing, that this will "cure" your cravings. So it is not as beneficial in this way - only the malabsorbtion works "better". But unfortunately also on important Vitamins and minerals.

"and all of them have either gained back 75% of their weight"

WHAT? Thats a lot!!! The surgery sites claims, that only 20-30% will have the weight regain.

"and are now seeking revisions, or have had major complications with vitamin/nutrient deficiencies, bowel obstructions, strictures, pouch and esophageal dilation, and a whole slew of other issues."

That really helps with my decision. I think that we perhaps are not so up to date in Denmark, because the boom in operations startet only 2 years ago. So we havent seen all the difficulties yet. Well a lot of people is writing about Hernia - does anyone know, if hernia is less common in VSG-operations?

"Least amount of long term complications"

As far as I can read in the journals, they do not have enough results yet to know how it will work on long term? But it is so LOGICAL to me that it will have far less complications

"no rerouting"

Yes, I am not religious - but it is easier for me to have my stomach reduced instead of changing the way the digestive system works. I can better accept the "halfway-just-as-before-procedure-with-a-small-stomach"

"no blind stomach left behind that can't be easily scoped yet can still develop cancer and ulcers."

Are the taking the rest of the stomach out of the body in a VSG? Some say that they just staple it? I wanted to ask my surgeon this.

If it is left in the body, will it still produce Ghrelin?

I feel a little stupid, but I have treally tried to find as many informations - so I am so glad, I found this site.

"None of the surgeries cure cravings, head hunger, or emotional eating."

No, you need to have gotten the brain in order first. I almost have - but I know, that when I am stressed or sad, it could trick this, if I am not cafeful and monitor my feelings and hunger for the rest of my life. But I have worked with this a lot more than others.

(I am also writing these things to myself, to be "aware" - thinking out loud)

"I've done extremely well with the sleeve, and live a perfectly normal little life"

I am so glad to hear that! It really makes me believe that it can help me too. Just enough to get into the healthy section

"We have to form new habits, and work on our own issues."

I am speculating - how many have had their cognitive emotional in check before an operation - and how many are working along with the issues - after the operation.

THANK YOU SO MUCH!

-------------------------------------------------------------

And thank you Stacy160 - if you are thinking the same as Tiffany, it just backs up, what she is saying .

And with my "low" BMI, the risk of bypass is not worth it.

As far as I have read, the mortality-risk of a bypass is 5 times higher than a sleeve. Thank you. You are backing me up!

------------------------------------------------------------------

Thank you for your message, Cheri :-)

"if you don't have as much weight to lose, why risk the lifelong nutritional deficiencies of the bypass?"

That is just what I am thinking. But in the danish forum everyone is supporting the bypass-thinking Because it is the thing, that works.

And because 95% of them had that operation.

So I needed to read other stories, to make my desicion.

But a lot of new reseach has shown, that the two operation, have almost the same results. But I can not seem to find the medical documentation...

"The portion of the stomach they leave behind is the least stretchy part of the stomach and is far less likely to stretch than the bypass pouch. It will stretch a little over time, but not anywhere near what it was prior to surgery."

That I didnt know - I am so glad to read this! That calms me a lot. Not that I will try to strech it. But I didnt wanted to waste money and health on an operation, that didnt work much.

"If you wouldn't mind posting information about your potential surgeons on a new thread, it would be very helpful to some of us living overseas. I'm currently in Germany and flew all the way to Mexico for my surgery because I couldn't find a surgeon very experienced with VSG in my area. If you're in contact with a few that do VSG in Europe, you should post their names and information so that other folks can have them as an option as well."

Mexico is a long way from home.... I would be happy to do that.

I found two surgeons i Belgium, but they mostly recommend and perform Bypass, but have experience in Sleeve as well. There is also a center in Northern Germany wch are very popular in Denmark, they perform a lot of sleeve operations as well.

And I found a great (I think) surgeon in Grecce. He is educated i Denmark, where I am from, and have worked in Sweden for many years.

There is also a center in Stockholm, who have a fantastic 3 year follow up with psychologist, dieticians, hotline, and a workshop - all included in the price.

But I will try to find the right place to post the operation.

But what is "Experienced"? How many operations is that.

Thank you Cheri

YEAH!

I got more answers - I am so gratefull

All your inputs really helps me!

In Denmark this procedure is almost unknown - it is only used very seldom. Most of sleeve-procedures on danes is done abroad

Thank you for your respond, Tiffany!

"RNY just wasn't an option because of the regain stats"

The statistics shows that weight regain RNY is more likely to happen?

That is very interesting - if I have understood it correct?

That was the main reason why, I would consider a Bypass.

I know that there is a lot complications already now. How will it look in 30 years? :-(

"I can tell you that studies show only 30% of RNY patients "dump" on sugar meaning that it's no guarantee that you'll get sick if you eat sweets."

That is an important argument for not believing, that this will "cure" your cravings. So it is not as beneficial in this way - only the malabsorbtion works "better". But unfortunately also on important Vitamins and minerals.

"and all of them have either gained back 75% of their weight"

WHAT? Thats a lot!!! The surgery sites claims, that only 20-30% will have the weight regain.

"and are now seeking revisions, or have had major complications with vitamin/nutrient deficiencies, bowel obstructions, strictures, pouch and esophageal dilation, and a whole slew of other issues."

That really helps with my decision. I think that we perhaps are not so up to date in Denmark, because the boom in operations startet only 2 years ago. So we havent seen all the difficulties yet. Well a lot of people is writing about Hernia - does anyone know, if hernia is less common in VSG-operations?

"Least amount of long term complications"

As far as I can read in the journals, they do not have enough results yet to know how it will work on long term? But it is so LOGICAL to me that it will have far less complications

"no rerouting"

Yes, I am not religious - but it is easier for me to have my stomach reduced instead of changing the way the digestive system works. I can better accept the "halfway-just-as-before-procedure-with-a-small-stomach"

"no blind stomach left behind that can't be easily scoped yet can still develop cancer and ulcers."

Are the taking the rest of the stomach out of the body in a VSG? Some say that they just staple it? I wanted to ask my surgeon this.

If it is left in the body, will it still produce Ghrelin?

I feel a little stupid, but I have treally tried to find as many informations - so I am so glad, I found this site.

"None of the surgeries cure cravings, head hunger, or emotional eating."

No, you need to have gotten the brain in order first. I almost have - but I know, that when I am stressed or sad, it could trick this, if I am not cafeful and monitor my feelings and hunger for the rest of my life. But I have worked with this a lot more than others.

(I am also writing these things to myself, to be "aware" - thinking out loud)

"I've done extremely well with the sleeve, and live a perfectly normal little life"

I am so glad to hear that! It really makes me believe that it can help me too. Just enough to get into the healthy section

"We have to form new habits, and work on our own issues."

I am speculating - how many have had their cognitive emotional in check before an operation - and how many are working along with the issues - after the operation.

THANK YOU SO MUCH!

Thank you Cheri

I never really was an emotional eater, or had any compulsive tendencies, but I was a volume eater. It was nothing for me to eat an entire large pizza by myself, or eat an entire box of mac-n-cheese. I loved food, and I loved that absolutely stuffed, unbutton my pants feeling. Now, I hate it if I take one too many bites.

Gastrectomies have been performed decades upon decades for people with ulcerative conditions, or stomach cancer. I researched gastrectomies outside of weight loss surgery, and found 1000s of people living very normal, fully-functioning lives with most if not all of their stomachs removed. Yes, there are people that have had to have their entire stomachs removed, and a new stomach reconstructed out of intestinal tissue. They do need to take different medication, and food supplements to help with digestion, but they are not taking 20 vitamins a day to battle malabsorption.

The VSG has studies out for 5+ years showing great success as long as the surgeon uses a small bougie (which is the measuring tool they use to staple off and remove the stomach from the body). 32fr to 40fr is the standard measurement for bougie sizes.

The fundus (big stretchy part of the stomach) should be removed from the body for it to be called a Vertical Sleeve Gastrectomy. If they don't remove the organ, there is no "ectomy" performed.

I could give you the laundry list of complications and weight regain stats for all my "real life" friends that have had RNY, but it would take me forever. I won't deny that RNY is a good surgery for some, but the stats were just too alarming for me to choose that procedure.

Plus, I had the band before, and the band gives you a pouch just like RNY. Well, let me just say that pouches suck. They are not natural, my body rebelled against the pouch, and I knew that I wanted a normal functioning stomach with my pyloric valve intact.

If they are talking about hiatal hernias, they are common in obese patients and usually repaired during surgery. If your surgeon chooses to perform an upper GI, that would be diagnosed before surgery. It's "not common" to the surgery, it's common among obese patients. I did not have any type of hernias.

Since you are in Denmark, I would highly suggest talking to your surgeon about being prescribed an acid reducer. This helps protect your staple line, and can help decrease false hunger caused by acid reflux that sometimes occurs post-sleeve. Here in the US, most sleeve patients are put on an acid reducer such as Nexium, Prilosec, Protonix, Prevacid for 3-6 months post-op. I'm still on my acid reducer (also called PPI - proton pump inhibitor) at 16 months out because I love not ever being hungry, and I don't want to deal with any acid issues even though I didn't have any pre-op.

If you have other questions, please feel free to message me.

Dear Tiffany

Once again, thank you so much for your great answers.

Someone should hire you as a writer for these Sleeve sites. When you explains it - everything make sense.

"but I was a volume eater. It was nothing for me to eat an entire large pizza by myself."

When you descibe this, I become aware, that I am a volume eater too. Regarding everything.Every food.

Especially when it is "free" or "most for you money in the buffet" kind of things. Embarrasing, but thats how it is/was. And recognizing, that I am volume eater too, make me even more sure, that this is the operation for me.

Now, I hate it if I take one too many bites.

If I could have that feeling, I would be halfway there.

"Gastrectomies have been performed decades upon decades for people with ulcerative conditions, or stomach cancer. I researched gastrectomies outside of weight loss surgery, and found 1000s of people...."

That make me feel so secure. I am glad you have reserched so much - it has been difficult for me to find all the medical journals, statistics and material.

I am sure, that this is the most healthy operation to choose - BUT still 10% afraid, that I will not loose kore than 10 pounds. But if I work with this, put a lot of effort in it, visiting dieticians ect. It can not go totally wrong. :-)

I am much more likely to succed.

And I am sure, when I have read all the succes stories here - I will believe, that it could happen to me.

"The VSG has studies out for 5+ years showing great success as long as the surgeon uses a small bougie"

I am so glad, you told me this, exlained the word to me.

Now, I will ask the surgeons about this too.

If you have the time and energy - What will happen if they use something bigger? More tissue damage, or complications or?

If they don't remove the organ, there is no "ectomy" performed.

Now I understand - and the remain of the stomach is the least strechy part. Intelligent :-) And can not se, how they will get the rest of the stomach outc - but thats perhaps what the bougie is for. Investigation....

I could give you the laundry list of complications and weight regain stats for all my "real life" friends that have had RNY, but it would take me forever. I won't deny that RNY is a good surgery for some, but the stats were just too alarming for me to choose that procedure.

There is not that much focus here in Denmark on these complications - but mayby there will in a few years. The bypass have boomed the last 3 years. I dont know how much help other countries get post operation. But In Denmark the healtcare system is free - I would imagine, that you will get your helth checked much more, when doctors, hospitals, test ect is free.

pouches suck - got it - thats what a lot of people experience. :-(

If they are talking about hiatal hernias, they are common in obese patients and usually repaired during surgery.

I tried to find the medical term in english, but could not.

Hernia is a lot of things - what I mean is, when the small instestines are twisted, or go through the incistion holes.

A lot of people have problems after surgert with these kind of hernias/twisted intestines - and its lethal/mortal.

But as far as I can se, this is more common for bypassers than for sleeve-patiens?

Since you are in Denmark, I would highly suggest talking to your surgeon about being prescribed an acid reducer. This helps protect your staple line, and can help decrease false hunger caused by acid reflux that sometimes occurs post-sleeve.

I am so glad you told me this!

here is nothing about this on the different websites. I will keep all the ino, you have given me, and ask my surgeon. Interesting, that acid kan promote some kind of fake hunger.

That is fantastic, that this can help so much.

.

Thank you so much Tiffany!

I leaned so much new

Hugs from Copenhagen

[/color]I tried to find the medical term in english, but could not.

Hernia is a lot of things - what I mean is, when the small instestines are twisted, or go through the incistion holes.

A lot of people have problems after surgert with these kind of hernias/twisted intestines - and its lethal/mortal.

But as far as I can se, this is more common for bypassers than for sleeve-patiens?

One of the reasons that my brother in law had to get wls was that he was getting hernias from his stomach muscle being stretched out too much and leaving weak spots. He was told that the surgery was likely to cause another hernia since he had them already. Sure enough, he got two hernias after the surgery. They kept him in the hospital and patched them all up with this mesh stuff after he lost 50 pounds, and they haven't returned. He did have RNY, but I don't think his hernia was due to the type of surgery, rather his weight and they way he put on weight below the muscle with this large round firm belly, like he had an exercize ball under his shirt.

Thank you for answering, Eureka C!

I am sorry for your brother - but it is nice to know, that it kan be fixed!

Now I understand - and it is easier to get the hernias , the more overweight you are, because of the musclestreching = weak spots! Perhaps the surgery gave the hernias a chance "come out".

Mayby Im not so prone to have them, when I am "only" 60-70 pounds overweight.

It should be so painful - and very dangerous. But he probably already knew he would come back with them,

so he reacted quickly on the pain, I would guess.

And thank you for your earlier message, you probably have already seen my answers

Have a wonderful day!