Sleever Fever (subtitle VSG versus RNY)

Thanks to everyone for swinging about my GIST issue.  I posted the latest about that in the original post. 

Now I need to begin collecting info on VSGs, since the WLSurgeon and I agreed to move from RNY to sleeve.  I've done some reading, but would appreciate if some of veteran sleevers could tell me what to expect, and do I need to discuss sleeve size with him? ?????

Also, the doctor and his staff said that I could expect to lose only about 50% of my excess weight.  WHAT?!!! I want to improve those odds.  Could you please give advice based on your own success? 

Hi there!  I am only 10 months out so not much of a veteran but I can tell you that the sleeve has been nothing but awesome in my experience.  I lost all of my excess weight (83 pounds) in 8 months and would have lost it faster if I were a ruler follower (I do my own thing...lol) but I was totally happy with my pace and I didn't experience a single stall which was nice.  Hang out on the VSG forum and you will find that most people lose 100% of the excess weight and pretty much everyone is as happy as a clam.  Life with the sleeve is just easy honestly.  The surgery and the recovery were a breeze as well.  Wishing you ALL the best!!

I had the VSG not quite 4 months ago and have lost around 40% of my excess weight.  I have not followed every rule and have a lot of tolerance for "bad" foods but the great thing is the reduction in ghrelin production... I am almost never hungry and I feel soooo much better already.  Any time someone asks me if I would have this surgery again my reply is "in a HEARTBEAT."  Best of luck to you.

Kat70

 I was set on the RNY and that was all my insurance would approve. Then my surgeon suggested the sleeve. His reasons were that you can take aspirin/advil which I need, since I have arthritis, I had multiple abdominal surgeries (two hernia repairs, full hysterectomy) with lots of scarring, and I have an autoimmune liver disease. Somehow, the sleeve allows access to the biliary tree (don't ask me what that means). 

Long story (this all took 11 months), I have the sleeve and am thrilled. It took insurance appeals and lots of effort, but worth it. I had several weeks of nausea, but once I got past that, I am fine. We are all different. I get hungry, but cannot eat more than toddler size portions, 2-3 T. cottage cheese and 1/4 banana for breakfast, for example.

I am losing steadily. My health is so much better already. 

I love my Sleevie!  My surgeon would not allow the RNY or Band because of my history with Rheumatoid Arthritis and my mom's Celiac Sprue which is hereditary and something that I'm already showing minimal signs off.  I also had to take cancer type meds at one time which I may need again someday so the Sleeve made sense.  I think it's a great surgery.  I had zero complications, was able to get in my 64 oz of water on day 5 and was able to get on the treadmill on day 5 as well.  I had my surgery at 59, now I'm 60.

I'm not great at following all the rules set out by my surgeon.  Eat 3x time a day, no snacks and no protein supplements.  I've been a slow loser and perhaps would have lost faster following his rules more closely.  You can see from my ticker that I've shed more than 50% and intend to get to 100% before this is over. I have confidence in my Sleeve and the lessons I'm learing along the way.

Good luck with your decision.  I know that whatever you pick will be perfect for you.

I love my sleeve.  I have never been able to lose weight like this in the past & definitely unable to keep it off once I lost it.  

If you follow the rule of excess weight ... you would take my original weight (203) and what my weight needed to be to have a "normal" BMI (155 or under 25) ... That would have been 24 pounds to be at 50% of excess weight loss. 

I was there in 3 months.  Within 9 months, I was at my lowest adult weight (142) ... within 10 months, I was at teenager weight (135), and today, I weigh what I did in middle school (hovering around 125).

I hear 50% thrown around a lot.  But, if you follow your plan (I did 90% of the time) you WILL be successful.  And the great thing is, you pick what "successful" means to you.

As far as sleeve size, you'll want to talk to him about bougie size.  Most people who get VSG as a stand-alone have surgeons who use 32 to 36.  This is just a guide!  So, be sure to ask your surgeon if he cuts/staples close to the guide or if he leaves room.  The more room he leaves, the more stomach you have.  that also means that more elastic part is left that can stretch.  Most surgeons won't go below a 32 due to concerns with strictures (or stomach twists). 

Let us know what other questions you have.  How exciting to be starting your journey.  You must be thrilled, nervous, ... about 100 emotions all at the same time!  Congratulations.

Thanks!  Dr. Long talked to me today, and said he uses a size 40 bougie (boo-zhee is how he pronounced it, how chic!) because the risk of complications increases under 40. 

i didn't ask him about cutting close to the guide. I know he is a conservative doctor. 

My weight (was) 209.  A BMI < 25 for my height is  127.  Half that excess weight is ~40 lbs.  
But my goal is 118.  The nut said my bones were too big to drop down to that weight.   I don't want to get obsessed over a number-- my goal is to stop staring diabetes in the eyes, lose the HTN and the cholesterol, and be able to move freely again.  Still....

Frankly, I think could probably drop 40 lbs off just my caboose and thighs...

 I have heard so many nuts say "bones too big to drop to that weight".  My nut and psych both said that and claimed that155 was my goal.  I asked my surgeon if I could go lower - he said he didn't see why not.

But, all of that is to say ... you don't have to figure it all out now.  Have mini-goals.  If you find you like a spot along the way, you can stop there.  I like your first goal of ditching the diabetes and HTN.  Those are awesome goals!

I wouldn't worry to much about the 40 - as long as he goes close to the guide.  The difference is very minimal  - if you search on here, you can find a picture of different sizes related to various pens.

Can't wait to see your progress.

My surgeon uses a 32f. They used to use a 48f but there were too many issues with regain so they went smaller. Personally, I'd be concerned about using a 40f and also being told to expect a 50% EWL. It seems those two things go together. I'd want 36 or lower.

My surgeon's figures for people with a starting BMI of 45 or less is 80% average EWL. He told me he didn't see why I couldn't lose 100% though and I did. In fact, technically, I lost more since they count 100% as a BMI of 24 and mine is around 22 most of the time.

This may be heresy here but you might want to ask your doc about Dr Elariny's method of doing a sleeve with a permanent band. He gives you a sleeve using a 50 or 60f bougie but adds the permanent band to keep the stomach from expanding over time. Dr E believes the 60f bougie gives the patient less reflux and blockage issues, and lets the patient eat a little more normally (not as much mushies) and the band keeps the restriction lasting much longer. His average sucess rate with this 70% and he thinks it's a good one for lightweights that need help controlling the volume they eat at meals...a grazer and sweeter will "beat" any restrictive only WLS. Just food for thought.

--gina