Wasabubblebutt is in recovery

[WASaBubbleButt 41]

Hey Wasa, so I'm quite interested in the mechanics of how the sleeve works - I get that the stomach is now a "sleeve" hence the name, but I get the gist from what you are saying that they might cut out the section of the stomach that produces ghrelin? If so, that rocks! How exactly does that work? Do you mind telling me (us? ha) more? Or referring me to a website you've read that might explain it for me? What are the pros and cons of the sleeve?

I was going to PM you, but I thought others might be interested too....

Thanks in advance - as many others have said, you're an asset to this forum and have helped many - now you can educate us all about the sleeve

I'm really excited about it. I like the concept and I like how it works.

About 60-85% of your stomach is removed. I know I know, sounds freaky. But isn't that what we try to achieve with a band?

Along the top of the stomach is the fundus, the fundus is part of what is removed and that is the portion of your stomach that produces Ghrelin. Ghrelin is the hormone that tells your brain you are hungry. I haven't felt hunger once since I was sleeved and I'm on the post op diet. ;o) Some doctors say that the stomach will compensate for missing Ghrelin in about 2 years and other doctors say it is gone forever.

The pylorus valve is not removed, that is bypassed in gastric bypass patients and that's why bypass patients dump. But sleeve patients still keep their pylorus valve so we don't dump. We have a fully functioning stomach but smaller. No intestinal rerouting, none of that. Your pylorus valve is kinda like a sphincter like a rectum. It controls how fast food is pushed through to the intestine. So what you try to achieve with a band/restriction, I have naturally. So no fills, unfills, or restriction issues.

The stomach ends up being a tube shape, I can only eat so much. There are no restriction issues. Basically what I tried to do with a band, I have with a sleeve.

There are no aftercare issues with a sleeve, no fills, unfills, barium swallow exams (unless something is wrong), no slips, erosion, port, port pain, nothing. Just a little stomach. It is restrictive like a band but NOT malabsorptive like bypass.

They've been doing this since the 70s but 40 years ago it was a huge failure. They were preserving an elastic portion of your stomach and it would stretch out in no time. Today they are saving a more muscular portion of the stomach and it does not stretch. Five year studies show it is more effective than banding for weight loss but less effective than bypass. The sleeve has fewer complications long term than the band or bypass.

The grand daddy of all complications with a sleeve is a leak along the staple line. If you have a good surgeon the risk is incredibly minimal. My doc has done over 250 sleeves and never had a leak. I think the key is that he doesn't just use three rows of staples (standard) he also uses sutures and oversews the staple line then goes on to do three leak tests.

You measure how much stomach to save with a Boughie, or a tube they poke down your throat during surgery. It goes down to your stomach and the surgeon cuts around this. Boughies come in various sizes. The smallest size you'd want to use for a sleeve is a 32. My surgeon uses a 34 but explains that the way he oversews the staple line he tightens up the stomach with sutures so it ends up being a 32 Boughie size. The largest I have heard of for a sleeve is a 50 Boughie and the person was a revision patient and she quickly regained her excess weight, a 50 is just too big. Most want a 32 - 36 Boughie.

There really is a great deal to learn about this. People need to understand the procedure, the goals, the boughies, boughie sizes, safety precautions for leaks, DETAILS of leak tests (some leak tests are just plain dangerous but docs use them because they are cheap and the appropriate leak tests are expensive), number of leak tests, staple line experience, legit stats, the fact that the post op diet with a band means if you cheat you risk your band. If you cheat with a sleeve you risk your life.

After about 30 days there is no leak risk and you are done. You do your post op diet, lose weight, and go on with your life. NO AFTERCARE! Doesn't matter who did your surgery, there is no hassle finding aftercare because you don't need it.

Leaks usually happen right out of surgery, sometimes they happen due to not following the post op diet. But they are rare.

Sleeves do rock! I'm coming up with something similar to "researching Mexican band surgeons 101" only for sleeve surgeons instead. ;o)

Sorry, this is kind of jumbled, I'm still really wiped out from surgery. Revision is NOT an easy surgery. Totally doable and worth it, but not easy. It would have been much easier to work on a virgin stomach. This just goes to prove that with banding your stomach most certainly does not go back to as it was before banding. It is much different and revision carries more risk, more potential for complications. Lesson learned for me, pick the right surgery the first time. ;o)

Edited June 14, 2008 by WASaBubbleButt

[Oregondaisy 2,021]

I am really happy to see all the support WASa is getting on this thread. It warms my heart.

She is an extremely wonderful person and has been through hell with her band. Her band was not her friend the way mine is for me.

[WASaBubbleButt 41]

Lol the band police....I get the diet police. Grrr "can you eat that?"

I hate that. It really irks me.

I play enough mind games with food I dont need anyone elses imput on what I eat.

I am losing weight. Maybe not super fast. But I wanted the slower weight. Sometimes I just want others to mind their own business.

But I am glad the people on here are being suportive. It is nice to know we have a good group here.

I have missed you. And glad your doing well.

Keep up your strength

It was on OH, that board just sucks. However, the person that wrote the "no rights to revision" surgery routine is a person from here that posts on OH as well. On OH that stuff is routine, members don't permit it here so I should have probably explained what I had planned. I did refer to it in PMs, I just didn't want it posted. A handful of people knew but I just wasn't in the mindset to deal with it over here too. In retrospect I don't think I would have had the issues here that I did there. Members moderate the boards pretty well here without moderators. So it would have been fine to post it here.

I was scared, I was unsure of changing procedure types. I was afraid it wouldn't work. I had all the usual fears. I was afraid I was making my problems permanent and forever. I'm realizing that being gun shy of WLS was needless, life is good again! It's just that banding wasn't for me. As each day passes I am more and more positive I made the right decision. I haven't barfed except for one of the leak tests. That stuff was vile and disgusting!

[Froggi 4]

I'm glad WASa is doing so well. it sucks that the band wasn't working for her. But I am so glad she finally found something that will work for her. Good luck WASa

[WASaBubbleButt 41]

You just have to continue to post. I want to hear all the wisdom that you have gained. Yes wisdom. You have succeeded with the band and given countless of us insight to gain our own success. Your new journey, is one you didn't wish for but when a door closes you have to open another.

I know you will succeed with the sleeve although I don't envy anyone with 2 months of liquids. Good luck from another AZ person.

Wow... thank you. Thank you very much. That is very sweet of you.

And not that I was counting or anything, but it was over THREE months of liquids. With the post op diet it will be four months of liquids. But really, I'm not counting months or anything. HA!

July 4th KittenQutie's grandmother is making me Southern fried chicken. I can't wait for that wing! ;o) I may just take the whole day and work on a thigh. I know, I already mentioned it but just in case someone missed it! SOUTHERN FRIED CHICKEN! OMZ, I can't wait!

I want bell peppers, salad, southern fried chicken, yellow squash, zucchini, more salad, veggie salads, cucumbers, apples, and maybe even a veggie Whopper. It will take me days to get through my list of food I want but I'm willing to do the work, I'm willing to eat my way through a few weeks after the post op diet. ;o))))))))))))) I tried to tell my doc that I have 4 months to make up for. I get the impression he doesn't agree with me.

What does he know? Let him do four months of liquids, right? His idea of splurging right now is using whole milk in my Protein shakes instead of Water. No Can Do. I swear I see butter chunks floating in whole milk. Yuck.

Bell peppers w/Thousand Island dressing, I can't wait.

Who needs Ghrelin? My head is telling me I'm hungry. HA!

[She Smiles 2]

Thank you SO much for your detailed response to my questions Wasa, I really appreciate you taking the time when you aren't yet feeling 100% from your surgery.

The sleeve sure sounds like a great option! Ghrelin is a nasty piece of work, isn't it!?!? I hope the revision it allows you to resume a better day to day eating regime. Thanks again

[SueAZ 3]

FOUR MONTHS OF LIQUIDS, YOU ARE SUPERWOMAN !!!!!!!!

Heck I was lucky to survive 3 weeks. Glad to hear you are on the mend and like the rest of us dreaming about tall dark and CHOCOLATE...

[losingjusme 12]

wasa,

thanks so much for your post and courage to post ... i know some on here have given you hell over some of your views...

the sleeve sounds like something i would consider if my band were to fail for some reason.

question - you know how you can 'eat around the band'? is that possible with the sleeve? what happens if you eat too much? i know you would eventually stretch the pouch, but is there anything immediate - like a PB?

thanks!

[MacMadame 81]

This just goes to prove that with banding your stomach most certainly does not go back to as it was before banding. It is much different and revision carries more risk, more potential for complications. Lesson learned for me, pick the right surgery the first time. ;o)

I have to say that when I first watched a lap band surgery online, I was a bit taken aback to see the surgeon grab a bit old piece of stomach and hoist it up and sew it in place. :frown:

Lots of LB articles don't mention this at all or about how scar tissue needs to form to adhere the band in place.

[WASaBubbleButt 41]

I have to say that when I first watched a lap band surgery online, I was a bit taken aback to see the surgeon grab a bit old piece of stomach and hoist it up and sew it in place. :frown:

Lots of LB articles don't mention this at all or about how scar tissue needs to form to adhere the band in place.

It does not bother me as much that studies don't explain about adhesions and post op diet, it makes me damned angry that doctors don't explain this.

Most people...if you are honest with them and explain what the deal is and the reason for the post op diet, they can deal with it. But most believe the post op diet is for swelling issues and that just isn't true. So people are blowing the post op diet completely.

I have explained it time and time again in detail on this board and I finally gave up. When the vets tell me I don't know what I am talking about, they ate solids during the clear phase and they lived... I give up. People follow the diet or they don't.

[Daisalana 33]

Thanks for writing that.

I belong to several boards and I posted on one of them that I was really having problems with my band and didn't have any fight left in me to continue fighting band problems. I wrote that I wanted to revise to a sleeve.

One person from here who also posts on the other board chewed my butt telling me I didn't have a right to a revision surgery (I was self pay for banding and revision) since I was at goal. I was eating ice cream and frosting at the time to maintain my weight and she told me I was anorexic with body image issues. How many anorexics do you know eat frosting and ice cream to maintain/gain weight? She is one of the pro-band folks, only banding will work for anyone, blah blah blah. I had made mention of the revision surgery here and I came back and deleted the posts deciding I wouldn't say anything to anyone until after it was done. It was a hard decision to give up my band and I just didn't need the crap so I didn't tell many about it until it was done and over.

Then I had others telling me I should chew better. How much should I chew a Protein Shake? ;o)

Of all boards I should have probably mentioned here what I was planning but due to the experience on the other board, I just didn't want to, so thanks for writing what you did.

I'm really lazy with the boards lately, haven't been reading outside my month's thread.. this title caught my attention, so I read the 1st 2 pages.. just wanted to reply before going to bed!

I knew you were talking about the sleeve, did not realize it was so soon, glad you're feeling better already!!!! Good luck with the weight gain -- jeez who says that to a bariatric patient? :frown:

And screw the person on the other board, you know it doesn't take anyone else to tell you how some people in the world are just daft. I'm always interested to hear about surgeries after banding, just in case (knocking on wood too!!!) I ever lost the band due to something, I really don't want RNY, or the your-shit-smell kills people surgery.

[Oregondaisy 2,021]

I would imagine if you tried to eat too much with a sleeve it would be painful . After all, we are talking about a stomach size less than the size of a golf ball. WASA has explained that they use the non stretchy part of the stomach. I am sure she will correct me if I am wrong about this.

I would definitely go for a sleeve if I lost my band for any reason. I have heard people say "but it can't be reversed" Well who would want it reversed. Not me, that's for sure. Anything reversed on me would reverse my weight loss. I don't want to go back to a size 24!

[RavenLunatic 0]

Hey.."M"...( The Bariactivist ! )

:unsure:I am SO sorry... That you have had all the problems you have had ! "You didn't deserve it !"..... I Hope this new sleeve will be everything you want, And more !! (( It is for me ! )):frown:

I look forward to hearing all about it,when you have the time. Take care... Much Love,

Randy

[WASaBubbleButt 41]

I'm really lazy with the boards lately, haven't been reading outside my month's thread.. this title caught my attention, so I read the 1st 2 pages.. just wanted to reply before going to bed!

I knew you were talking about the sleeve, did not realize it was so soon, glad you're feeling better already!!!! Good luck with the weight gain -- jeez who says that to a bariatric patient? :frown:

And screw the person on the other board, you know it doesn't take anyone else to tell you how some people in the world are just daft. I'm always interested to hear about surgeries after banding, just in case (knocking on wood too!!!) I ever lost the band due to something, I really don't want RNY, or the your-shit-smell kills people surgery.

BWAHAHAHAHAHAHA!!!!

You know, a good banded friend of mine died last night. Totally unrelated to banding, she had a heart attack at age 38 and died. Her 15 y/o daughter called me to tell me. I've been in a funk all day today and I've also been pissy and nasty.

With that said, reading, "I really don't want RNY, or the your-shit-smell kills people surgery"... I LOL in real time after readingt that! You have NO idea how much I needed that laugh!

I wasn't ready for permanent and forever when I was banded, I never thought it would work to begin with. I thought when the band did not work I'd just have it removed and be done with it. I was floored when it did work.

Now I have a taste of thin.... I'm not giving it up for anything. I think the sleeve is going to work well for me. But, time will tell.

I'm still tempted to go to the newbie boards and post that I can't do the post op diet and ask if I can eat a few chickens today. ;o)

[RavenLunatic 0]

:biggrin:When I was shopping for a surgeon, ( And didn't really Know which procedure i was wanting or needing.. I was Lucky I had someone like "Wasa".. Step up and Offer me all the advice and info. No one else was willing to share, She helped Me QUICKLY rule out the LB and the DS right off the plate !

I then thought i needed the Mini Bypass, But .. after talking to my surgeon, and him having an issue with my BMI.. I was suggested the "Gastric Sleeve"... I liked the safety Stats -vs- the other procedures..And the never having to worry about fills,Slippage, Erosion,and constant struggles with vomiting, and nausea, and WORSE..:frown: I also liked the faster recovery time.

SO... Thank you again,and many times Over.. "WASA" !!

I have to say that when I first watched a lap band surgery online, I was a bit taken aback to see the surgeon grab a bit old piece of stomach and hoist it up and sew it in place. :smile:

Lots of LB articles don't mention this at all or about how scar tissue needs to form to adhere the band in place.