barbara n
" I started the journey of looking at weight loss surgery in the summer of 05. First attended a seminar on RNY. In answer to a question about eating bread after surgery the surgeon told a true story of a man who broke his diet and took a bite of hot dog in a roll. He didn't chew it enough and between the bread and the hot dog it made a "perfect" plug in the area between the stomach and the intestines. This was a major event for the man and resulted in a long hospitalization. That made me very concerned, certainly I'd do something stupid like that too. I also felt concerned about the portion of the stomach that was left producing acid without any food intake. Seems like a perfect recipe for cancer. And gastric juices going right into the intestines without being neutralized in the duodenum also concernd me. Then I started researching and found that there are many strictures and bowel obstructions that happen with the RNY. Decided that wasn't for me. After all, what's the chances that I won't at some point forget to chew 25 times before swallowing! Then through this site I became interested in the DS. Everyone seems to do really, really well, no problems. So I started calling around and one surgeon told me that if I was serious about wanting the DS I should go to Gagner- he's the guru. So I took his advice, made an appointment and went to see Gagner. I was left with the opinion of a doctor who no matter what he did would put his all into it, not just after the easy bucks. I continued researching though and found many, many studies showing malnutrition problems with the DS, even when taking all the supplements, I also found a yahoo site for post op DS'ers only. If your not a post-op DS you can lurk, but not post. It was insightful. These people were having a lot more problems and even if some of their problems were not related to the surgery, they worried that perhaps they were. I decided I couldn't live my life like that. Surely sickness and diseases come to all, I don't want to think that I caused it. So then I got to thinking that if the super morbidly obese could lose weight with the sleeve gastrectomy why couldn't I. I know the stomach stretches, but if I'm careful and listen to my stomach, won't I be able to keep the weight off? So this is what I decided to do. I thought my idea was unique. Then I came back to OH and found that there was now a group for VSG. My idea wasn't unique. I also found studies showing a reduction in those hormones that make us hungry and never full. Studies that showed that having the DS without the sleeve did not give good weight loss! So on 3/8/2006 I finally had my surgery, the sleeve gastrectomy, or verticle sleeve gastrectomy. At this point I am one week out. It has not been an easy week. But, I'm doing better now and hopefully will continue to get stronger daily. I just want to add one more thing. While I was waiting for my surgery, into my mind came many friends with weight problems. Would I want them to go through major surgery just to lose weight? Would my feelings for them be any different? The answer is no. I would love them just as they are. I think we are so much harder on ourselves than anyone else is. I started with a BMI or either 39 or 40. Weight 234 height not quite 5'4"
Today I am at day 17, I went back to work after 1 1/2 weeks off. I was able to keep up, but I have a desk job. I certainly couldn't do lifting or hard labor. I worked 4 days this week and by the end of Thursday I was dragging. Part of this is because I've had to stay up late trying to get in all the required protein and fluids. Right now I've been working on eating 2 sea scallops ( the big kind). I actually have 2 of the smaller ones, I could eat a little over 1/4 of the scallop and that was it. Then I have to wait 1/2 hour before eating or drinking anything else. So even though I started at around 5:30 it is now 8:30 and I still have one whole scallop left. Eventually I get out the skim milk. Regular skim milk has 8 grams of protein per cup and Simply Smart has 9. It really is hard work getting in the protein and water. Seems like I have to be working on it all the time. I don't have any hunger though. Oh and I've lost 18 pounds. I go to the surgeon and nutritionist on Tuesday- last trip to NYC, after this I'll will have the blood work done here and do everything else by phone.
Well today I am 4 weeks and 2 days out, I've lost 25 pounds and when I did my measurement there were some inches lost everywhere. I used to have a kind of funny feeling in my throat, but it is gone. I can eat a little more, but still less than 1/4 cup. Well I can eat 1/4 cup of very liquidy food- for instance well-cooked summer squash with lots of italian salad dressing. I take only one protein drink a day, that being one cup of Hood Carb Control Choc Milk (90 cal) with 1 scoop of Any whey protein powder. This gives me 25 grams of protein. The rest I am getting through food. That is what my dietican recommended, even trying to eliminate the protein drink when I can. Don't ever want to "drink our calories" again. I made a huge pot of chili using 90% lean hamburger, 1 can of kidney beans- rinsed,1 can of chopped tomatoes, 1 can of puree tomatoes, chili powder, onion powder, garlic powder, salt and a little bit of splenda. It was really good and I had this for many meals, was usually able to eat 1/2 cup of chili a day, sometimes a little more. Of course I had to eat it in 3 installments. Breakfast, lunch and dinnner. My son also liked it so it only lasted about 5 days. The one problem I am having is constipation. I am taking 2 colace tabs, one tablespoon of benefiber daily and still am only having one BM every 3 days. Amy has suggested a tea- something like smooth moves- that my husband is trying to find for me right now. I'm also wondering about those special yogurts. I try to get at least some vegetable in every day, but it is hard, especially when I'm at work. I tend to just forget to eat. I am doing much better at getting all the fluid in but still have to work at it. I have no reflux, no heartburn, and almost no gas, even with eating chili with beans! I do have quite a bit of burping. Seems like more than I had at the beginning, but maybe that's because the food is moving so slowly through my system.
Let's see tomorrow will be 7 weeks for me. I've lost 33 pounds so far. I'm feeling wonderful. The weight loss isn't rapid, but steady and I'm fine with that. I feel great. I wanted to post a few links that I think may help people searching for information about this surgery.
http://www.facs.org/education/gs2004/gs33lee.pdf#search='sleeve%20gastrectomy ' this is an excellent link by the doctors from lapsf.com. There information about the size bougies used by Gagner is not up to date. for my surgery he used a size 40 french which is 11 millimeters in diameter!
http://www.emediawire.com/prfiles/2005/06/02/247495/lapsfstudy6205.pdf#search='sleeve%20gastrectomy'
This is an article by the same doctors pretty much says the same thing. the first URL is more of a power point presentation.
http://www.medscape.com/viewarticle/471952_1
This site does not mention the verticle sleeve gastrectomy at all, but it does have 8 pages of information regarding the other choices and some of the complications related to these choices
http://www.jci.org/cgi/content/full/111/5/565?ijkey=ca9c56b707fb3447df69647312ca097de39fbc94&keytype2=tf_ipsecsha
This site is wonderful, it explain how we are affected by hormones. This is one you'll wish everyone could understand. And one to give to people who say all you need is willpower. In the same way that a diabetic cannot make insulin by willpower we too are very affected by the hormones in our bodies
http://jcem.endojournals.org/cgi/content/full/89/6/2576?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&fulltext=Oxyntomodulin&searchid=1123442839962_1903&stored_search=&FIRSTINDEX=0&sortspec=relevance&journalcode=jcem
Another excellent site about leptin and ghrelin
http://jcem.endojournals.org/cgi/content/full/89/1/174?maxtoshow=&HITS=10&hits=10&RESULTFORMAT=&searchid=1123291783228_5333&stored_search=&FIRSTINDEX=0&minscore=5000&journalcode=jcem
This site is rather technical, but it deals with trying to figure out the relationship between growth hormone, insulin and leptin and has some interesting stuff in it
http://archinte.ama-assn.org/cgi/content/abstract/137/10/1381
This one is about people who lost weight with Optifast or something similar and their "lack of success". It's just proof that it isn't just me that has this problem and that there has to be more to the problem of obesity than "willpower".
okay I remembered about one more, I don't have the URL but I like to put my old post here. This is a post I wrote just a few days before my surgery about some research studies. #1 " duodenal switch without gastric resection: results and observations after 6 years" from obesity surgery volume 14 number 10, November/December 2004 pp 1354-1359.
In a nutshell the DS was done without gastric resection ( without the sleeve) on 24 "mildly obese" patients. The results: "BMI reduction and weight loss were not large".... "our long term results suggest that in carefully selected patients suffering from serious hypercholesterolemia or type 2 diabetes with insulin reserves still at an acceptable level and with BMI 30-40, DS without gastric resection can be proposed as a surgical treatment for metabolic diseases by NOT FOR OBESITY." Did you get that, without the sleeve gastrectomy the DS did not result in any significant weight loss. I really loved this one, because part of me was still scared that by not choosing the DS I won't lose and keep off the weight, but I WILL!
#2 "Sleeve gastrectomy and gastric banding: effects on plasma ghrelin levels" Obesity Surgery 15, 1024-1029. Conclusion: " As a consequence of resection of the gastric fundus, the predominant area of human ghrelin production, ghrelin is significantly reduced after laproscopic sleeve gastrectomy but not after laproscopic adjustable gastric banding. This reduction remains stable at follow up 6 months postoperatively, which may contribute to the superior weight loss when compared with laproscopic adjustable gastric banding" . I'm not trying to put others down, it's just reassuring to feel that I've made the right choice. If anyone is interested in reading more of these articles, just copy the whole title and the quotation marks and then paste it in your search engine box. It will find the article for you. Hope this excites someone else like it did me.
May 12, weight loss is now 40 pounds, I'm 9 weeks out from sx. I'm adding a url from Weill cornell that has my dietary plan for the first 3 weeks. Dieticians differ, but this was the directions I was given.
http://www.cornellweightlosssurgery.org/pdf/dietary_guidelines_sleeve_gastrectomy.pdf
I've had only 2 problems, constipation and a feeling like a lump in my throat. The throat thing seems to be getting better, and I only mention it because I'm good at forgetting about things like this after I know longer have the problem. So I don't know why it's there, if it had anything to do with entubation or not, but it's been present since about day 4 on. And constipation is a major issue. I take benefiber usually two TBS/day, 3 colace tabs and still usually need to use either a suppository or laxative in order to have a BM every 3 days. I did have one BM during this last week without the use of these aids. I had started eating peanuts to add some roughage, I don't know if that was the secret or not. Still eat less than 1/4 cup of food at a time. I don't take any protein drinks of supplements, instead I work on getting in 2 ounces of protein for each meal ( there is between 6-9 grams of protein in one oz of most protein)
May 22- 43 pounds down, Melissa just sent a really good url link about weight loss surgery and having periods of stalling. It's a little bit nasty about not wanting to hear people whine, but overall I found it very encouraging so here it is. If you enter a weight loss stall, click and read this. http://store.bariatriceating.com/thismonthsrant.html
June 4- Well, I'm down 48 pounds. It hit me yesterday, how close that is to 50 pounds. That's a lot of weight, half of 100. If I lose 100 I will be estatic and here I am already 1/2 way there.
June 10 I reached the lost of 50 pounds on June 8, exactly 3 months out. I went shopping today and all I tried on was size 16 clothes. Most fit. I bought some. I looked at the Woman's section and was so glad I didn't have to go there. And I realized that I can now start thinking about my style of clothing. Before, I certainly had standards of things I wouldn't wear, but just finding something that fit right was such a challenge that I usually bought the item. Now I have choices! How cool is that! Okay I'm going to add a few more URL's here
http://www.beadbaker.com/VSG. This is a link to a site that Nan set up packed fill with some great information regarding VSG
http://www.endocrine-abstracts.org/ea/0007/ea0007p42.htm This one will help you stop the guilt about being overweight.
http://www.ingentaconnect.com/content/fd/os/2004/00000014/00000010/art00014 This is the article about the people who had the DS without the sleeve gastrectomy. I mentioned this earlier but here's the URL
This is a link to articles found in obesity surgery magazine. You can click on the month and year and the articles that were in that magazine will come up and then you can click on the individual article you are interested in. Now some of them require a fee, but most have a free summary and are worth reading. If you want to read more of the article you can sometimes type the name of the article with quotations at the beginning and end in your search engine and sometimes you can get the whole thing to read free. Everyone should spend time researching the research!
http://www.ingentaconnect.com/content/fd/os
Oh I was looking through the obesity surgery magazine article and found this one, says "Conclusions: BPD-DS is associated with markedly suppressed ghrelin levels, possibly contributing to the longlasting weight-reducing effect of the procedure. Leptin levels decreased and adiponectin increased, as expected, after weight loss. Sleeve gastrectomy with resection of the gastric fundus seems to be the main cause of the postoperative reduction in ghrelin levels"
http://www.ingentaconnect.com/content/fd/os/2006/00000016/00000005/art00005
http://www.ingentaconnect.com/content/fd/os/2006/00000016/00000002/art00010 this one is very interesting. Our chances of success are high, but it is possible to fail. Same goes for all the other surgeries also
Well I should wait till tomorrow to post, but here I am. I will be exactly 4 months tomorrow and I've lost 59 lbs. I'm thinking by tomorrow that will be 60 since it reallyis 59.6 today. I'm comfortably wearing size 16's -started at 22's.
August 27- 50 years old today, oh I'm reading my last post and it has been a while. Let's see on exactly my 4 month anniversary I lost 60 lbs and then on exactly my 5 mn anniversary I had lost 70 pounds, and if you look back you'll see that on exactly my 3 month anniversary I was down 50 pounds. and today I'm down 74 pound and saw the 150's for the first time today 159.6, actually weight loss is 74.4 lbs. In order to keep up with my trend I'll have to lose 6 more pounds in only 12 days, so I don't think I'll make it. Still I'm going to try to get a little more exercise in to see how close I can make it. Sure makes it easy to remember.
September 9. Well I didn't make it to 80 pounds for my 6 month anniversary. Close though 77 pound! So things are slowing down a little. And i also am having more times where I feel hungry. I am determined not to fall back into bad habits and don't eat any sweets. i do though pop a cherry tomato from off one of my plants into my mouth without a drop of guilt. Same goes for raspberries from my plants, or strawberries. I only have one of two and that's all I need. i do know that the farther out from surgery I get the more it will be necessary for me to have the control.
November 8- I just converted this from the old profile to thenew and lost the pics I had on here. I am now officially "normal". First I was morbidly obese, then obese, then overweight and today I am Normal! Wt is 145, down 89 pounds.
