sleeve sizes

i have heard many of you talk about the size of your sleeve what are all of the sizes you can get how much can it  hold ect... whats best?

I wasn't given a choice on the size of my sleeve (not sure anyone does?).

My sleeve currently holds about 1/2 - 2/3 cup of solid food or about 8 oz of fluid (never drink during meals or 30 minutes before or after a solid food meal). I was told that the sleeve would stretch to a slightly larger capacity over the course of 1.5 - 2 years... Craig

bouige if thats the right spelling but lowest they go is 32 highest 38 me I am haveing 32 cuz thats what dr. does

Hi! The size of the pouch is guaged by the bougie your surgeon uses.  Try not to get so wrapped up in this though because it varies.  I think the average bougie is 32-38, however, for the DS surgery the surgeons like to use a 40 bougie.  My surgeon explained it like this....

If you were sewing a piece of stretchy fabric you'd have your pins holding the fabric together.  The pins are a guide as to where you're actually going to sew.  You don't actually sew ON the pin line though... it's slightly off to the side, right??  Well that's how a bougie works for the surgeon.  They'll put it into the stomach and use it as a guide as to the shape of your new pouch.  If your surgeon uses a size 32 or a size 40 it doesn't matter too much because a surgeon who uses a 40 but stretches the stomach around the bougie and then staples is actually creating a pouch smaller then the actual bougie because when it's removed, the stomach skin relaxes into a smaller pouch.  Does that make sense?  Another way of thinking about it is if a surgeon uses a 32 and then staples a good 1/2" from the bougie, well that's not quite a 32 is it?  

I've read a lot about people who have 40 and higher tend to regain but don't be concerned with this.  My surgeon uses a larger bougie but stretches the stomach TIGHT around the bougie before stapling so that when years out your pouch has relaxed a bit, it's not any larger then the bougie he used since he stretched the stomach around the bougie. So when you think about it like that... a dr who uses a 40 and stretches it or a dr who uses a 32 and staples 1/2" away from the bougie isn't too much of a difference in reality.

This might help also to ease your mind on bougie sizes. 



Good luck!
Ginger

Also, the bougie determines the width of your sleeve, but capacity is also determined by length, which can be quite different from person to person and depends on height and other factors.  Generally most sleevers can accommodate about a half-cup or so, after all healing - say 3 months out - and a bit more, perhaps 3/4 to 1 cup at 18 months or so.  I'm currently at 8 months and can comfortably eat about 2.5 oz. of dense meat like chicken or beef, 1/2 cup cottage cheese with 1/2 cup blueberries, 12 almonds (very dense!), one scrambled egg with 1/4 cup shredded cheese, etc.

One thing I've followed is veterans sleevers advice about how much to eat - eat a measured amount, don't stuff yourself at every meal, and that will help keep your sleeve nice and tight and prevent too much stretching.  (While you're learning what a comfortable amount is for you, you'll get too full here and there, don't worry that this will stretch your sleeve, it's the constant, daily, meal-after-meal stuffing that does the damage.)

My doctor does a 36 bougie and oversews so that it's pretty tight.

 You hear so many different stories. When I met with my surgeon last week and asked he said it varies on the person. They will use anywhere from 32-40 and it all depends on the persons size of their esophagus as well. He explained you dont want to put a small 32 bougie on a person with a larger esophagus bc then the food will get stuck or have a hard time going into the stomach and also cause more vomiting and acid problems. He tests several sizes to see which fits best for that person during surgery.  So that I have no idea until I come out of surgery what size would be used. 

 I'm sorry anywhere between a 32 and a 50 is what he said ....had to look at my notes :) 

I didn't have a choice. My surgeon uses a 38 bougie. That's it. Besides the other replies you've gotten about over-sewing, etc., the bougie is measured in milimeters. Find a tape measure or ruler that has inched and milimeters. My 38 bougie is about 12.5 mm. That's barely 1/2". A 36 bougie is about 12 mm. Not a lot of difference. It's what you do with it that counts.

I have very good restriction. I don't eat much at all. I have half of a scrambled egg sitting here that I'll throw out to the birds.  

I'm a preop, so the only thing I know (ha!) is what I've read on other posts. Bougie size is just a guide and in the end may only mean the difference of a couple of tsp in volume.

That being said, my surgeon ONLY uses a 32F, which he oversews. I'm nervous about this... it seems sooo tiny (too tiny??)

Curious to hear from anyone else with an oversewn 32F....

thanks everyone for the replies very helpful i don't know what im getting i haven't met with my doctor yet im getting the surgery done out of town so i will meet with him two days before i get it done