That boughie size thing again

Elina mentioned in the thread about our last support group meeting something about how our stomachs grow over time. I was going to respond to her implied question, but forgot. I can't find the exact post now so I'm just starting a new thread.

This is what Dr. C told us a couple of support group meetings ago (Might have been Oct.):

He uses a 32f and makes a 1-2 oz. sleeve that over time grow to 4-6 oz. This is about a 4x growth (give or take).

Because the sleeves grow exponentially, a bigger sleeve, say one that holds 2-3 oz. at first, will not grow to hold 5-7 oz but 8-10 oz. I believe a 48f makes a 2-3 oz. sleeve.

Now I know talking about this stuff always makes some people defensive so I just want to say:

-this is just information, not judgment
-even though a bigger sleeve increases the risk of regain, people are not statistics and it's not like *all* people with 48f sleeves regained *all* their weight
-just because a surgeon uses a 32f doesn't mean their sleeves are smaller than another surgeon's who uses a bigger boughie -- some don't pull as tight against the boughie as others

 
Let me preface by saying ..... I think you can make any size bougie work to a point.....It is proved everyday here on OH

Here is my take on it......

Dr.C may be one of only very few VSG surgeons that has done enough VSG's and keeps track of statistics to get a accurate sampling of his procedure.

Every time there is the bougie question on the main board......they all read the same......someone always posts the picture of the pens to show the relative size difference. Than people chime in and say......minimal difference.
Than there is a group of newer folks that say......"I have a 40f and I'm 3 months out and losing just fine....bougie size doesn't make any difference"
The other thing that is always mentioned..... "My surgeon uses a 40f cause there are far less complications and the recovery is easier".

Well everything mentioned is pretty true.

The VSG is a non standardized procedure as of yet. The common misconception is that it's just a staple line cut around a tube. Get it done anywhere by anyone....there all the same.

Another myth I hear is: "My surgeon has only done 3 sleeves but he has done tons of DS's and RNY's" Than someone always chimes in and says "If he can do a DS he can do a sleeve".
The assumption should be that if a surgeon has done a lot of DS's he is very competent at running a staple line. But....as were finding out.... It's more than just a staple line.

Dr.C can use a 32f with a very minimal complication rate (.3%) because experience tells him where and what to cut out to avoid, strictures, twists, leaks and such.

His finding are that when he used the larger bougie (40-46??) years ago..... Patients lost weight just fine....... but there was a high rate of regain at the 2-3 year mark.
His longer term regain rate has been much less using the 32f His newest study will be out this summer.

As far as stomach stretch goes.....At the last meeting Elina asked him to clarify..... What I heard him say..... a 32f makes a 2oz. sleeve that will eventually get to 4oz. and the difference between a 32f and a 60f is 16x

frisco



Same disclaimer as Macmadame:

-this is just information, not judgment
-even though a bigger sleeve increases the risk of regain, people are not statistics and it's not like *all* people with 48f sleeves regained *all* their weight
-just because a surgeon uses a 32f doesn't mean their sleeves are smaller than another surgeon's who uses a bigger boughie -- some don't pull as tight against the boughie as others

 
I have to add.... and make VERY CLEAR

The bottom line is that it is up to the patient.

What ever bougie size you got...... you can make it work !!!!!!

Does Dr. Cirangle have patients that don't make there weight loss goals? ----YES

Does Dr. Cirangle have patients that re-gain?------Yes

It is ultimately up to the patient......

frisco

Glad I got mine when he switched to a 32f!!!

My Story:
-  I asked my surgeon what size bougie he used
-  He said 32F oversewn
-  I specifically asked him if he could do mine "as small as he could safely do"
-  He was able to do mine the equivilant of a 28F bougie, which is a 30 F oversewn
-  I have a very long stomach, he said he had to use a whole extra cartridge of staples on me
-  I have had no complicaitons whatsoever, none not one problem with my tiny tummy
-  I have good restriction, but I can eat a lot more than others
-  I takes a lot for me to gain weight
-  It has been easy to maintain
-  I eat like I did when I was a kid
-  I am surprised by how much I can eat, and I am so thankful I asked for the size bougie I have
-  I want every single chance of keeping this weigh off
-  My metabolism is very good now, I can eat a good amount, and not gain...

I LOVE my Sleeve and my surgoen for giving me this tool to lose and keep my weight off.

Cindy

good info, Marie, I am very interested in this stuff and don't hear it many places.

I know my surgeon uses a 34 and over-sews the staple line. I had such restriction the first few months I lived on about 400 calories - mostly sytrax nectar with water - just to get in all my protein.

now that I am so far out I am VERY glad that it started out that way.

Unfortunately, I was one of my Kaiser's early Sleevers and I got a 40f.  I know that last summer they switched to a 34f.  I honestly wish I had waited until Summer, but I didn't so I have to deal with what I have. 

Losing has been incredibly difficult for me.  Even with hours of exercise daily, 3 pounds a month is great for me.  I know that I started out with 3-4 ounce capacity which means that I'm going to have a bigger Sleeve at 2 years out.  I can already see that I can eat more than people with a 32f and still feel hunger.

Am I going to freak out when thinking about 2 and 3 years down the road?  Not really because I don't think that would help me get to goal and stay there.  But that said, I'm really glad to have my eyes open to the differences because I can hopefully use all of this information and keep myself on a really good food plan without being fooled into thinking that I can "get away with treats" etc once I'm at goal. 

ACK... ok, so a little freaked out.  I'm going to ask my surgeon when I see him for my one year follow-up on the 17th if he oversews etc.

I'm grateful for all I learn from you maintenance people!!

I think I am actually REALLY glad that I do not know what I have. My military surgeon said she would do the size she felt was best for me, and that was the end of that conversation, lol. At the time I was annoyed that she wouldn't discuss this stuff with my, but now I am happy to not have to worry about regain just because I do know.. if that makes any sense at all..

Research has shown that larger boughie sizes in the range of 48 and higher do have a higher rate of weight regain at 2 years, but the studies were performed on people with very high BMI's, so sometimes it is difficult for me to extrapolate downwards. But, I think people can eat around the smallest boughie sizes. We read about this everyday on OH. It still boils down to making healthy choices, not eating to full capacity, and changing ones lifestyle. The sleeve is a tool to get us to a healthy weight and we have to make the right choices to remain at that weight.

42 F bougie here and wasn't over sewn @ almost 3 years out. Still can only eat 3 to 4oz's of dense protein with a Sm side or 2. It's all about what we fill our sleeves with that will become the outcome. Plus, with added exercise is needed. We have the tool, we just have to remember we are out of the honeymoon phase and need to work it a bit harder. But, you all know this!! (O:

Hugs and loves

Donna