has anyone sucessfully talked their Dr in to a smaller bougie size?

[MeMeMEEE 206]

If so, I am interested in how you did it, any information you used to persuade them, etc.

[tntransplant06 20]

There is no reason to. My doc (w/out me asking) told me what size he used and why. He said anything under that did not guarantee any additional weightloss but did have more complications/nausea/etc. Sometimes it's just better to go with what the doc's that do this everyday know. My doc was a pioneer with this surgery and has been doing weightloss surgeries for 30 years. I trusted him. You should trust yours, he really knows what's best, and like my doc said, it won' t guarantee you any addl loss.

[Rootman 1,101]

Yep, what TNTsplant06 said. Trust your doc.

[MeMeMEEE 206]

I am very concerned because the little bit of research out there suggests the higher the bougie the more chance of weight regain - that is my concern, not that I lose faster or more but that it be the tool I need to help me keep it off.

[tntransplant06 20]

Well, the only way I can forsee you will regain weight is if you go and eat all junk. (please correct me if I'm wrong, people) I'm currently eating 1400 calories a day and am losing 1.5-3 lbs a week. I can't imagine eating more than that....well, let me clarify....if I eat cake, chips, candy, and all that b/s it will up my calories and i'll gain. But, if I stick to a healthier diet (eating those things occasionally) how can I regain???

[MeMeMEEE 206]

I'm more concerned after the 2 year mark, not in the losing stage where it seems you are, TNT. I have some documentation and I do plan to talk to my surgeon - he uses 40, originally used a 32 but changed due to less complications - I don't want a 32, would be happier with a 36-38 than a 40. I completely understand that the chance of complications is larger with the 32 - again, not what I want. He told me he used the middle - what I am finding that is more of a 36/38 with the range being 32-40. This is a one time thing, I am not interested in converting later on to DS or RNY,

[thinoneday 445]

my doctor put in 30/32 F . that was his standard. I trusted him with that and didn't question him. make sure you discuss all this with the doctor and are happy with the explainations he/she gives. . ask a lot of questions.

[ldydrgnkpr 49]

All you can do is research and trust in your Surgeon's decision and choice that he/she will be using for your surgery. My surgeon used a 40 fr bougie on me. I am very happy with what I have lost so far. Yes I asked why so big? His reply was the difference between a 36 and 40 was just mm. That he felt it would benefit my loss. I trusted his decision in this choice for me. He did over sew the staple line. Which made the 40 a 38. ( In my mind anyway LOL) This journey is what you put into it will be what you get out of it. I give it everything I got everyday. I understand that the potential for re-gain is with all wls not just with the sleeve. I know that this is a lifetime change not just for the moment. The changes we make are for the long run. I live to be stronger, healthier and wiser for the choices I make everyday. Good luck with your journey.

Deb

[former_vbg 198]

I'm more concerned after the 2 year mark, not in the losing stage where it seems you are, TNT. I have some documentation and I do plan to talk to my surgeon - he uses 40, originally used a 32 but changed due to less complications - I don't want a 32, would be happier with a 36-38 than a 40. I completely understand that the chance of complications is larger with the 32 - again, not what I want. He told me he used the middle - what I am finding that is more of a 36/38 with the range being 32-40. This is a one time thing, I am not interested in converting later on to DS or RNY,

Well, what the others said is true- HOWEVER...... I do feel you have a right to have a concern. I have had several conversations with people on this issue. I did a GREAT deal of research on all of the procedures out there and when I settled on the sleeve, then I deep dived into the sleeve. Because the sleeve is relatively new for the purposes it is being used for now, there isn't a ton of data out there, however, I did find white papers and some other research that did support the fact that the those who had a higher bougie were more likely to regain their weight. Yes, the difference is only in the measurement of MM's, however as times goes on after your surgery, your stomach will adjust and the difference of the adjustments of the smaller and the larger bougie's was exponentially according to the size of the bougie.

Now, this is just my personal opinion. Just because a surgeon uses a larger size bougie doesn't mean they aren't qualified/ experienced/ good, etc. However, I do believe that sometimes docs get into a routine and if they think what they are doing works, then why change. To some degree I support that, except that if they aren't routinely looking for the ongoing stats collected on this, they are only doing their "looking" through a very narrow window.

One of the criteria I used when selecting a surgeon WAS the size of the bougie he used. It was extremely important to me because of what I just said. That isn't to say that a person who has a larger bougie used can't or won't be able to maintain the weight loss- it's just that the stats show the odds are higher for regain. I think I have a post or two with links to some of that data. I can try to dig them up if you are interested.

If you aren't comfortable with the size bougie he is using and you can't convince him to use a smaller size, then find another doctor. This is YOUR life. He / She doesn't have to live with the choice- only you do. Do what you think is best for you. I don't always take everything a Dr. says as golden. They are human and are not immune to judgement mistakes or errors, just anyone else.

A side note- my doc used a size 30 bougie. My limit was a size 32.

[ldydrgnkpr 49]

I'm more concerned after the 2 year mark, not in the losing stage where it seems you are, TNT. I have some documentation and I do plan to talk to my surgeon - he uses 40, originally used a 32 but changed due to less complications - I don't want a 32, would be happier with a 36-38 than a 40. I completely understand that the chance of complications is larger with the 32 - again, not what I want. He told me he used the middle - what I am finding that is more of a 36/38 with the range being 32-40. This is a one time thing, I am not interested in converting later on to DS or RNY,

http://www.ghc.org/all-sites/clinical/criteria/pdf/vertical_sleeve_gastrectomy.pdf

[MeMeMEEE 206]

former_vbg I would love it if you can find your posts (or even give me ideas on title)

ldydrgnkpr - thank you for the link!

[former_vbg 198]

former_vbg I would love it if you can find your posts (or even give me ideas on title)

ldydrgnkpr - thank you for the link!

Here is one of the articles I came across that I found.

http://www.laparoscopyhospital.com/Laparoscopic_Sleeve%20Gastrectomy_%28LSG%29_In_Morbid_Obesity.html

Look for a PM coming soon.

[meggiep 57]

Ok so I feel a bit better about my 32 ;-P

When I first started solid foods, pureed, I was a big whner- I can fit 1/4 cup max of food- never a bite more, and often less. I wasn't whining because I was left hungry , because I am never hungry. I just find it hard to get a lot of Protein in without a couple of Protein drinks a day...and it is hard to get a variet- Protein, veggies, fruit, with so little in each meal. When advised to get more calories- it is TOUGH!

However, I am pleased to think it will serve me well in the future!