VSG size, exercise, and intake adjustments

First, I'm really not intending to be a trouble maker.  That statement may make sense to those that saw my ******g contest on the VSG board.  If you did, please either ignore this post or give me a second chance to get to my point.

I'm a VSG, pre-op, insurance qualified individual.  I have my pre-op exam in a couple weeks and if all goes well I expect a surgery date in early to middle October.  I am struggling to understanding sleeve size (I won't say the "B" word) and getting enough Kcals during higher levels of exercise.  My prime form of exercise is the bike.  I'm 5-10, 285 with a solid build.  Based on some body composition studies I have had in the past I think that a reasonable goal weight for me is between 200 & 210.  I'm not sure that is Germain but in case it is, you have it.  

Part of my concern is that I am fairly well muscled underneath my layers of fat and concerned I will have a slightly higher metabolic rate than average.  That may or may not be a big deal in and of itself.  My main concern is that on exercise days I will burn about 1000-1100 Kcals or more per hour of riding at my goal weights range and riding speed.  My current riding is about 1.5 to 2 hours a day, 4-5 days a week.  My goal next year is to do at least 5 century rides.  There is also a chance I will get a crack at the Hotter'N'Hell 100 in late August.   

I clearly don't want a sleeve that is too big.  Currently I do OK with hunger issues on days I ride the bike in controlling food intake without over doing it.  On off days I suffer SEVERE hunger problems.  So I think I understand that "going big" for the big days can be rather stupid for the off days.

OTOH, I am also concerned that going too small may affect riding on hot, hard days.  That would be a bummer too.

So I guess I need some feed back from the exercise pros with VSGs on how things have gone for them and how they adapt meal plans for "on" days. 

My intent is not to start a sleeve size war but to understand how some of you perceive sleeve size affected your daily life and how you adjusted to those big days in the saddle or pounding the street.

For me this is important so that I can feel confident that the MD and I are on the same page.  If my MD is insistent on a specific sleeve size I need to feel comfortable with that or else move on to a new MD.

While I don't know if sleeve size matters, I don't know it doesn't either in context of what I am asking.  But, I dare not go further or I will say the dreaded "B" word and frankly, I just don't want all hell to break loose.  

I hope I am making sense.
   

Finally, once I get a handle on this long term issue, I will come back to ask about exercise needs during the first 6-12 months and still loosing weight.  I know you can't wait for that!

OK, one last finally...any of you with other than the VSG are welcome to share diet plans and advise on how you bump up Kcals as needed too.  I don't want to inadvertently start a war of VSG vs the rest.  I just don't think I could stand that.
 
Can you tell I'm frustrated?
 

 Hahaha.  I had to laugh. I don't have the answers you seek, but I also  find trouble on the VSG forums, especially sleevetalk.com. There is a lot of self righteous attitude on that site !!  
I have heard that surgeons tend to stick to one size "B word" that they are comfortable with, but I think if you voice your concerns to your surgeon he/she will work with you.   I'm guessing.

I'm not a VSG'r but an RnY'r , however, I am an avid cyclist and I believe my pouch is smaller than a sleeve. Either way, getting in proper nutrition on long rides is possible.

You just keep eating small amounts and though you may have to do some trial and error to find what works for you. I don't think it'll be the problem you think it is. Plus you don't have to worry about dumping on sugar (most likely) and that will help a lot.

Bonne Chance

:Danni

Debra P.
Nope, ain't going there.  LOL  Don't want to have to duck and cover. 

Inkd...

Thanks for that tip and maybe helping me get a good perspective.  I currently use a wide variety of sports drinks, carb gels and such without any problem.  I know that could change after surgery.

I guess that maybe I am looking for some thoughts on keeping everything balanced.  As an example, Can I develope a daily eating pattern that is traditional for the VSG and then simply supplement my Kcal needs with a moderate amount of extra food but close big gaps with my sports drinks and gels?  Perhaps another thing I think of is the tradiional carbo loading and whether that is still an appropriate practice for those big events? 

Again, thanks for taking some time to help me.

I'm with Danni - I have a RNY, so I just consume more often rather than large quantities when I need to fuel.  I also have been using trial and error in finding sliders that get into my system without taking much room.  Gels, sugary drinks, etc. 

I don't know much about VSG, so I don't know what the B word is, what your diet should be like, but I'm pretty sure that any bariatric patient can make their tool work with endurance activities.  We've got ultramarathoners and Ironman competitors here that get it done!

I have a VSG done with a 32f boughie. (This is about the smallest you can practically have.)

I train for triathlons and just did my second Ironman. I've done Century Rides and next season I am working up to a double century. I consume 2000-3000 calories a day most days and can get in 4000-5000, if I need to. (And, on days when I ride long or when I do an all day event, I do need to.)

I understand your concerns because I remember what it was like to be pre-op and convinced you are going to lose too much weight and not able to comprehend eating only half a cup of food at a time.  But, trust us on this, this concern is misplaced.

It is completely easy to eat around any surgery and gain back all your weight if you really want to. So, if people can do that, we athletes can figure out how to eat enough to fuel our own exercise and not gain back weight. 

Just get the smallest sleeve your surgeon can safely do and trust in the process. When it's time to do your endurance workouts, drink sports drink to get calories and eat slider food (bars, bites, shot blocks, gels, etc.) for more calories. You will even be able to get some real food in there, if you want to and are careful. One the bike I have consumed at various times:

Sports Drink
Water
Clif Shot Blocks
Gu Roctane (and  other gels)
Honey Stinger Waffles
Snickers Bars
Cheese Sticks
Energy Bars
Trail Mix
Powerbar Energy Bites
M+Ms
PB&J Sandwiches

Keep in mind that when you are actually riding, you won't be able to digest more than 200-400 calories and hour anyway. So stomach size is almost never a factor. The only thing to be careful about is that the foods you eat don't expand in your stomach when you add in water because getting foamies on the bike is not fun. This is why I stick to mostly slider food.

Also, I trained for my first triathlon starting 3.5 months after surgery when I was consuming about 700 calories a day. I was fine. Sometimes I'd come home from a workout and take a nap but it's not like I never did that pre-op. I mostly just ate any carbs I was going to eat around my workouts and ate high protein/low carb the rest of the time. I wasn't starving and I wasn't fainting. I didn't lose a lot of muscle tissue either. (All the working out helps with that.)

TANX MAC (May I call you MAC for short?)

I suppose I should have come here first with that question instead of the VSG pages.  Well, I kinda did but didn't push hard enough or didn't ask the question clear enough for anyone to respond.

I have gotten a couple other private responses off the VSG pages and they pointed to you as a great resource and thanks for living up to that hype. 

(For those that aren't versed in VSG, the "B" word is Bougie or Boughie.  It is the thing they put in the stomach to help size it during surgery.)

I feel much more comfortable now with not thinking I need to go bigger other than a  debate about 32F vs 34F and some slight differences in leak statistics.  But I now feel that anything bigger could be a waist.  (Yes...a bad pun.)

I won't get too far ahead of myself but once I get through the surgery and start getting back to exercise beyond simple walks, I'm sure I will be back with you on this topic.

TANX!!!

When you are ready, check out the article I wrote on my blog  about endurance fueling after WLS.

And, yes, you can call me Mac.  LOL