Other sleeve forums..noticing the trend Frisco referred to growing larger

Let me first say that I adore my sleeve surgeon.  He  was a gen surgeon who was proctored by some of the finest band, rny and sleeve surgeons out there, from other countries who were doing certain procedures first.  Let me also say first that he has been deployed to Afganistan, left July 18, to be a surgeon on the front lines...think MASH.  He leaves behind his wife and teen children.  My prayers are with him and his family...his 3rd deployment.

Anyways, talking to my NUT and his PA have always been 2 diff things.  NUT said from jump 11-1300 calories.  OMG. i'm 3 mos and 1 week out and am nowhere close.  She still says 64 grams of prot and under 60 carbs.  I've felt bad since day 1 because of her plan for us.  Even at my 3 mos out i still dont comee close.  I'm at about 46-53oz of liquid including protein shakes made with uns almond milk which ive only been able to drink at 9wks out.  I know liquids go through the pyloric valve but in truth they seem to make/keep me full.  That is usally breakfast too.  I'm at 1.5-2oz of protein for lunch and supper unless its cottage cheese or occasionally refried beans, then poss 2.5-3oz. I am nowhere near her carb amt and i'm fine with that.  My calories that i keep very close track of too, write everything down and look up what i dont know, are generally under 400.  It's not for lack of trying.  I just dont see the point in eating snacks to boost calories etc. if i'm not hungry. 

Just as our surgeons are individuals, so must be our plans. I've spent mos feeling bad because I cant measure up to my NUTs expectations or others.  Ive looked deep inside and i know im doing the absolute best i can at this point.  Is the weight flying off? I dont think so. I'm 3mos/1wk and have gone from a sw of 350 to my weigh in at my surgeons ofc yest of 273.  I'm at about 3lbs a week, maybe 4. I'm ok with that and honestly feel very blessed. 

I guess the bottom line is listen to your surgeon, hear/listen to the vets but first and foremost, listen to your body.  Do whats best for you.

tia

I am preop and my Dr has been doing the sleeve for about 5 years. I worry that i will go through all if this for nothing. Their preop diet and post-op are liquid diet 2 weeks before and 4 weeks after. I did put in MI forum if anyone has used him and received no replies. His partner has a lot of reviews that he's good but bad bedside manner. I consider changing to his partner but feel like I'm over reacting. Advice? Did I mention I can't find my Dr's profile on here?

I am from Mi... who is your doc?

Dr Edelman from Detroit, Harper hospital. Have you heard of him?

No, sorry....   I went out of Beaumont so I could fill you in on that practice if you want.  How many surgeries has your doc done, what are his stats, complication rate?  I find it a little odd he does not have any reviews here... most that have been doing them for a while seem to.  

I just did a quick search on him... I see reviews for a David Edelman (M.d out of WSU) but he is a cancer surgeon.  Is there a chance your guy just switched over from cancer to bariatric?  If this is the case I sure would triple check how many procedures he has completed.  On the Harper website he was listed as doing Lapband and Rny, but sleeve was not mentioned.  I dunno... just be sure to research this guy.  If it turns out he does not have much experience then I can highy recommend David Chengalis out of Royal Oak Beaumont.  They have a weight loss clinic located at 14 and coolidge.  Excellent program.  

Thanks for the help and taking time to look him up for me. I looked him up too and did a license search on mi board of medical licensing. There was nothing on him bad but not much info either. My insurance will only pay for certain hospitals. They have to have a 3 star rating, so that made me feel good at first. Now I'm learning so much more thanks to these forums and all of the wonderful people on here. I'm going to talk to the nut and see how to go about switching things around.

When I had my sleeve three years ago it was still a fairly new procedure and the band was still all the rage. Now I see ads on TV for the sleeve so researching your doctor is crucial.

I'm not sure I'm see this trend. I'm on lots of boards and on most of them I hear "protein first" and "carbs are evil" (which I don't necessarily agree with) and people are on a high protein/low carb diet and most of them are doing 800 calories or less. That seems like a very standards protocol, no matter what the surgery type. Some are doing 1000-1200 calories, but that's rarer.

I do think that there are a lot of mediocre programs out there with limited support once you've had surgery and a lot of people who don't do what they are told. What frustrates me the most is programs saying 60 g of protein is fine and having a cow if you have much more than that, especially for their RnY patients who -- hello -- are MALABSORBING some of it.

I do see a trend towards larger sleeves and it concerns me. The 32f sleeve wasn't a number that surgeons pulled out their ass. They started out doing sleeves with 48-60f bougies and regain was a big issue. So they gradually made the sleeves smaller until they hit on the 32-36f range. And then they started getting results similar to their RnY patients. So anything bigger than that makes me nervous. If 48f was too big before, how can 46f be fine now? I don't see it. I think those surgeons who are making sleeves with bougies that size are fooling themselves.

But what really worries me is surgeons making hourglass shaped sleeves. I've had too many friends with sleeves that shape that have ended up with big problems that had to be revised to RnY. I'm going to ask my surgeon about why you'd make a sleeve that shape at our next support group meeting because I don't get it. The banana shape was completely the standard for years and years. What problem is the hourglass supposed to be solving??

I'll tell you what drives me the most crazy though. Magic thinking. And "i want you to solve my problem without me having to do any work." Which I see as being related. I was talking to a woman who was over a year out from surgery and still having hair loss. I can totally relate to this. So I told her my story about how my labs were in range but my ferritin was on the low side of normal and my hair loss didn't stop until I got it up a bit. After some back and forth, it became clear that her zinc, which is something *known* to cause hair loss was below range. Not on the low side of normal but actually below normal. But she refused to take more zinc supplements because she was already taking "so many" pills and her doctor supposedly said her labs were "fine". I was so MAD that she had wasted my time that way trying to help her when she clearly wasn't interested in any real help. I felt like I'd been scammed.