Bougie size does not completely determine the size of your sleeve. A surgeon can use a 36 and stitch tight to the guide, or use a 32 and go a bit looser, and both sleeves would effectively have the same capacity.

Realistically, the difference between a 34 and a 36, volume-wise, is about one bite.

Nutrigrain bars are not a "healthy snack," they're nothing but sugar and carbs. Try having a snack with low carbs and lots of protein, like cheese, meat, or a protein bar (at least 10g protein per 100 calories), it may help your hunger.

Have you called your insurance company to ask what their requirements are to cover a revision? Call the customer service number on the back of your card and ask for their "coverage guidelines." They can lay out exactly when they'll approve a revision, so you can see if insufficient loss is covered before submitting.

So I used to be a big-time Diet Coke addict. At 4 weeks post-op, my surgeon gave me the OK for caffeine and carbonation (in small amounts). I tried a tiny sip of Diet Coke this week... and it tasted SUPER GROSS! I've heard that surgery can change your taste, but I didn't expect anything like this. So you never know!

Find something to replace it with. Crystal Light, sugar-free Gatorade, or something else flat and calorie-free. Just keep that on hand and it makes the transition much easier!

While it can be a little awkward to get used to sleeping with a mask on your face, the honest truth (from what I've seen on many years of OH) is that people get TREMENDOUSLY better sleep on a CPAP. I'm a stomach sleeper and used a CPAP prior to WLS, and I even found a way to sleep on my side/stomach with the correct pillow and mask.

To be honest, what you "want" to do here and what you're "down for" are pretty irrelevant. Untreated sleep apnea can have fatal consequences, and your surgeon's office is looking out for your well-being.

True story: I was on a CPAP at time of my VSG, but somehow the machine didn't make it to the OR for me to wear during surgery. They flipped on the anesthesia, I got knocked out, and I very nearly had a stroke less than ten minutes in because of the sleep apnea; it took them nearly two hours to get me stable and I very well could have died. This is no joke.

I converted to VSG to RNY because of GERD 10 days ago. My acid was quite bad, but I have not had any GERD trouble since coming home from the hospital.

Per my surgeon, most people don't lose nearly as much weight after a conversion surgery, and when they do it's much slower. My goal is to lose only 50lb, and the doctor says he's had people with much lower goals-- or even people who just wanted to maintain after changing the surgery.

I did look into the alternatives as well. Fundoplication is not an option for us, as we do not have any excess stomach to use for the procedure. Outcomes for the LINX are not nearly as good; research shows that about 75% of patients see their GERD mostly/totally resolved, whereas RNY is 90 - 95%. Plus there may be some complications with it; I recall reading that the implant makes it physically impossible to throw up, which seems problematic.

Good luck!

Testing your pouch can LITERALLY kill you. Progress your diet too quickly and you could rupture your staple line, cause a leak, and die. No joke.

You are probably experiencing "head hunger" right now. Excess stomach acid can also mimic the physical sensation of hunger.

I had mine out several years before WLS, and I remember the recovery being pretty miserable. I basically slept for an entire week and used all the pain pills they gave me! I remember the incision definitely hurt, I had to put a heating pad on mine to get any relief.

As long as you're not running a fever, and your incisions aren't hot to the touch or oozing, you're probably ok. Good luck and speedy healing!

Go back and start reading through old threads on the board here, both in the VSG section and the general section. This question gets asked a lot so you'll get some good info, and also get insight into others' experiences.

If you have already done the supervised diet, I imagine it's very likely that your insurance company would accept that towards the RNY.

Many of the risks inherent to RNY also apply to VSG. People with both surgeries deal with hair loss (google "telogen effluvium"), need to follow the exact same vitamin regimen, and face the risk of ulcers or hernia. If you follow your supplement recommendations exactly, which means roughly 200% RDA on all vitamins/minerals plus bonus iron and calcium, and NO Flintstones vitamins, the risk of developing deficiencies is very low.

The notion that VSG has "fewer complications" only applies to the immediate post-op period of a few days. The long-term complication and mortality risks are very similar.

According to my doctor, the recovery is VERY similar for VSG and RNY. For both operations, assuming they're done laparoscopically, you'll spend one night in the hospital and be home from work for two weeks.

Personally, I am preparing to revise my VSG to an RNY in a couple of weeks due to GERD, though I've never had acid problems in my life before WLS. If I could have solved the problem with a single surgery in the first place, I absolutely would have done so.

To answer your questions:

Yes, I had a VSG 5 years ago, and I am converting to RNY. I have gained quite a bit of weight back, due in part to the fact that my stomach has stretched back to almost its original size (surgeon says it's super rare and not my fault) but GERD is the primary reason for revision.

Insurance is paying for the revision. To revise because of GERD, I need to have acid that has not resolved after eight weeks of medication. My insurance also covers revision due to weight regain, but I don't qualify under that route; because my BMI is between 35 and 40, I would need a comorbidity and I (fortunately) do not have one.

Many people are having to revise their VSG due to GERD. I would suggest calling your insurance company to find out what their coverage guidelines are. Good luck! :)