Dr. C's support group tomorrow

Hi guys,

I will not be able to make it to the support group on Wednesday due to work conflict.  However, I do have a few questions for Dr. C and I was wondering if any of you would be willing to ask for me and report back to the group. 

1) Has he done any studies or is he aware of any studies that show our sleeve increasing in size after the third year?  I know he says that after one year you are done stretching, but I am seeing different anecdotal reports that this is not true.  Is there any science behind his opinion?

2) I seem to notice that my stomach is empty faster now, than a year ego.  Do our sleeve's empty faster or is this my imagination?  I know that this happens with RNY because of the pyloric valve, but does it also happen with us?

3) He had mentioned that he will be publishing new results soon, when is he expecting to do this? 

Anybody else has any questions? 

Thank you in advance if you are willing to ask these and let us know what he said.

Hi all, on a related note, I hope those of you who go to these bigger support groups, or any support group for that matter, will post a summary of the discussion or just a note on anything interesting or insightful that came up. I go to a Dr. C support group in our small town and am thankful for it and it is always good, but we are a small group with only a couple of sleevers showing up and I would really like to hear more about topics and tips that come up in the big city groups. Happy holidays. Diane

Sorry to hear you can't make it tonight, but I'll try to ask these for you Elina.

So I rearranged my schedule and was able to make it to the support group meeting after all.  Jim was really helpful as he wrote all my questions out and we got our answers.  Here is what I got from Dr. C yesterday.  Anybody else who was there can add in as you like.

1) No, OUR stomachs will not increase after 12-24 months.  Other doctors who make larger sleeves or who do not make the lower part of the stomach smaller will have different results.  Our stomachs stretch to the power of four in size.  This means that every little bit that is removed makes a huge difference down the road.  There is a part of me that wants to post this on the VSG board, but I would hate to hurt anybody with a larger sleeve.  Still thinking about the value of this info for pre-ops vs. post-ops feelings.  HMMMM.

2)I was a little confused by this answer, but I think the basic answer is yes, we do empty faster, but it still depends on what we are eating.  Solids stay in longer.  If you were there and got more out of this please share.

3) He is going to publish more long term studies this summer.  Can't wait to read them.

I was not there and this is purely anecdoctal (and I realize my experience is not a global truth) but ABSOLUTELY my stomach empties out faster than a normies (my husband for instance) and I know that the difference between how long I stay full when I eat dense meat ALONE versus dense meat WITH things is about an hour (I get hungry at the 2 hour mark if I eat meat with things, versus 3 hours, with just meat alone). 

If its yogurt, salad, steamy veggies, puddings, beans, breads, basically anything BUT dense meat - I am hungry in an hour.  

This makes perfect sense though.  I think that our stomach doesn't necessarly empty at a faster rate than 'normies' it just seems that way.   For instance, let's say, for argument's sake that our stomach can hold 8 oz and a normie can hold 24 oz.  If both stomach empty at 4 oz per hour, a vsg stomach would be empty in 2 hours and you would get hungry whereas the normie stomach would empty in six hours and would not be hungry until then.  Makes sense?  We get hungry sooner so it seems like our stomach is emptying faster, but in actuality it is emptying the same rate, but we just have less in our stomachs.

mary

Our stomachs do empty faster, and not just because of the size. It's because they take out the stretchy part of the stomach and leave in the more muscular part. It's like you can imagine, a balloon empties faster than a cotton sack.

There was an interesting study on this, I should try to find the link again. If you put the exact same amount of food in a regular stomach or a sleeved stomach, it will sit in the regular stomach and be digested for much longer, the sleeved stomach will empty quickly into the intestine.

The other thing about the study- there was a lot of variability. Not every sleeve patient has what they term "rapid gastric emptying", but some do. So that may be the reason some of us get hungry every few hours and others don't.

If you do find the link again, I would appreciate it!!  I will bookmark it so I can keep it for handy dandy referencing!

Its also the only thing I can really attribute my lack of protein absorption to, since I do not run through protein like MzMac!

Makes sense!  I think your right......smart lady!

Great info, Elina. Thank you. I agree that it's tricky posting the info about stomach size on the main board because it's SO controversial. On the other hand, his explanation that techniques vary widely and make a big difference, even when using the same size bougie, explains a lot. For example, the DSers are convinced that sleeves stretch--and for them, they probably do, since they weren't made specifically to stay small and they need to eat so much more. And yet I know mine hasn't stretched much after all these years--for which I am profoundly grateful!!

On the emptying, do you think he meant that we empty faster than we did immediately post-op or faster than non-sleeved people? I remember at a bit over a year out, Dr. Jossart ordered a gastric emptying test for me as we were trying to figure out what to do about my acid. As I lay there, absolutely still, I could see my radioactive scrambled egg slowly leaving my stomach. It was pretty cool, and the results were normal. I too feel that my stomach now empties a bit faster, but not a HUGE amount, or it may have been so gradual that I don't notice it. Or because I still take 2 PPIs daily.

Thanks for rearranging things to go--I wish I could go sometime, but San Jose is just a bit too far for me!

Lizanne