VSG/Bougie/Capacity: New Findings !!!!!

I say AMEN to Frisco's post!  I have been feeling really down ever since my 1 year post op group appt last month.  I was the only person there to have lost 100% of my excess weight.  There were several who had lost only 30 pounds!  In a year!  We all went to the same preop education, had one of the same 3 surgeons, the same post op diet and follow up.  I feel like Kiaser threw away a lot of money on some of these people.  Getting th surgery has become too easy for many, and they think they can go back to old habits and still succeed. One guy said he was there to find out what he could eat now that he was a year out since his friends for other programs had more liberal diets.  I just sat there feeling sick over the whole thing.  Sure, have 80 or 85% of your stomach removed FOREVER, then go back to your old habits.  And laugh while you admit it's your own fault for not losing weight.  As a society that will be seeing more and more WLS as time goes on, everyone should be alarmed by these "failures".  As a Kaiser member and employee, I am frustrated at the money being spent without more rigorous pre and post op monitoring.  Here's another sad fact: it cost me almost nothing to have surgery.  Sure, I had to take a few days of sick leave to go to SSF for all the preop groups and surgeon visits, psych, nut, etc and I had the cost of driving.  But after surgery, I was reimbursed for mileage and two night hotel stay for my hubby while I was in the hospital because we had to travel more than 50 miles from our home facility.  They practically paid ME to have surgery.  So it is my responsibility not to screw it up.  I almost think Kaiser should make us pay upfront, say $2500, then refund part of after hitting initial goal weight, more after maintaining, etc. At least then people would have some fink avail stake.

and no, I am not complaining about how easy I had it.  I know I was very fortunate, but I also took the time before surgery to see if I thought I could live with the diet for the rest of my life. No corn? No peas? No pasta or rice?  I made myself wait an extra two months so I could really see how that would be.  In the end, I decided I could live with it, and I have. No pasta, rice, corn,peas, pizza for 19 months.  I admit that I miss peas!  But the rest of it? No.

sorry for the rant.  But Frisco is right. It is all about what you do wit it.

It's all about what you do with it with WLS period. Trying to shame someone for bougie size is BS. And if someone doesn't trust his or her surgeon and has to rely on strangers on the internet for sleeve size, then maybe a new surgeon is in order.

And the people who are not compliant in your group?It sounds like they need extra help.

How is Frisco right? His original post asserted that the only important factor is the size of your sleeve. And you discuss a cross section of patients in the same practice with the same docs, and presumably the same sleeve size. With a whole range of results. So if you are saying sleeve size didn't matter, how can you also say Frisco is right?

What I am saying is that it is all about what you do with your tool and your lifestyle.  I do not in any way see that Frisco gas trying to shame anyone for boogie size.  I think he was, somewhat sarcastically perhaps, saying that you can do whatever you want with whatever you have and either succeed or fail.if you are happy with a small weight loss, then more power to you.  If you want to go for it al, you have to dig deep and commit.  I think there are not nearly enough studies for us to definitively say which size is best.  

I also think people on this forum need to stop being so hypercritical and hypersensitive about people they don't agree with.  I took Frisco's first post as maybe he was tired of some of the whining of the people who don't follow a program and then complain that they din't lose weight. I took many of the replies as people looking to pick a fight.  And frankly, that oissedme off.  Frisco is nothing but helpful and honest with people and does not deserve the attitude.  He is also more than capable of defending himself. So go ahead!  Piss him off and drive hi away from the board, and do it to anyone who says something you don't like.  Maybe eventually those vets we all want to hear from will be gone and the new vets will be people who are not vets at all, like me.  I don't pretend to know everything, but I do know an attack whenI see one.

I agree that Frisco's post is a little difficult to follow, but if you read the whole thread, I think you'll be able to see what everyone else is reading.

The science doesn't lie - even Elina's study shows that the size of the bougie doesn't affect success, just as the size of the pouch and bypass in an RNY has no effect on success or failure.

All WLS success or failure is dependent on the person in charge (and that is definitely NOT your surgeon!) - only YOU are able to determine your success (however we measure that)   Hopefully everyone who has read this thread will be sure of that now that scientific studies have been provided.    I love science - don't you?  Embracing that will make you a great vet in a few years, Connie,  and I look forward to seeing you steer people in the right direction - we can always use educated vets who are happy to stick around!

It's up to each of us individually to either follow the plan set in front of us at the pre-op appointments we ALL went to or say screw it and go back to eating the way we used to. Personally I choose to log my food daily. I choose to keep my weight off. My surgeon asked me when I came to see him what my goal was and I told him, I wanted to change my life and I felt this would be a great tool for me to do that. We all know people who've had various WLS and regained. I read the article  about the study that was done in Cincinnati. Mostly I felt, the study was done so a pill could be made instead people needing surgery. Whatever! I'm thrilled with my new life, I'm happy with my choice and I really hope all of you are happy with yours as well. I enjoy scientific facts but frankly there is nothing scientific going on when you are alone with your refrigerator every night. Just my own opinion. Everyone has one.

As a newbie to having my sleeve but not this board (been reading on here for a year) this thread makes me sad. Suddenly the shine is a little tarnished from the "support" perspective of this forum. I took classes, I read a crap load of stuff, got counselling all before surgery but still felt I could come here to ask for real help from real people when I needed it. Those who've walked before me. Feels different now.

Don't let this series of posts stop you. You are doing this for you. You'll get support on this forum.

I don't think anyone is shaming bougie size. I sure don't. It boils down to having the knowledge beforehand though. Some people expect a small capacity and wind up with a much larger one. They weren't expecting it and perhaps weren't told. I've seen it happen. I think the shock of it for some people is not fair. They either didn't do proper research before surgery on their surgeon and technique or they were told one thing and woke up with another. To me that's wrong. The question for pre ops is: Do you want a small sleeve? Do you want a larger sleeve? It really does boil down to that. If you want a small sleeve then find a surgeon that gives them safely. If you want a larger sleeve, find a surgeon that gives them safely. Easy peasy. As far as EWL goes, I think the smaller sleeve is better. However, I do know I could drink a ton of liquid calories and gain weight even with my small capacity. So it boils down to diet choices as a large percentage as welll! I think it's a combination of capacity and diet changes and a lesser percentage is exercise. I wanted a small sleeve because I felt I'd rather be safe than sorry since it's a one-shot deal. There are some with larger bougies that do great. It's a combination of all of it really. People shouldn't downplay the significance that bougie size and surgeon technique plays in the long term. It really is part of the equation. Is it 30%? 75% I don't know but it IS a part of it. I don't know why anyone would think it's not.

Thank you !

frisco