VSG Maintenance Group
2 year post of surgeon visit
I went to see Dr. Baggs yesterday. I really like this man a lot. He checked out the seroma on my leg that's been hanging out since post plastics and said that if it came to aspirating it, it would do it for me. YAY! I had not even thought of seeing him for that.
He was proud of me for shedding another 25 pounds since my 1 year appointment. Me too!
My iron and thiamine are low which is not uncommon after the extensive surgery I went through in December. I'm already supplementing them both. Everything else is mid-range on the charts. I was concerned about my A1C being 5.3 and he said not to worry. Anything under 6 is fine. It's more of a concern under 4 because of blood sugar crashes.
I asked whether he thought I should continue trying to lose more weight and he said there's no reason not to but that at this point post-op it would be really difficult. I think the reality is that if I can maintain, I'll be thrilled with that. Anything else would be a miracle!
Kaiser has only been doing the Sleeve for 2.5 years. I was actually one of their first, so their experience with Gastric emptying is pretty non-existant. He said that people with the RNY tend to stretch their pouch sooner after surgery and they start to regain and stop coming to support group. He sees their info from their PCP and can see that they are gaining weight. The Sleeve doesn't tend to stretch early out but we can certainly eat more as time goes on. I'm going to continue tracking what I eat and how soon after eating things do I get hungry again. He's interested in my findings and considers me one of his Sleeve pioneers. He's also interested in whether eating raw veggies with skin keeps them in the Sleeve longer than peeled veggies. I feel like a science experiment, but truth is, the only thing I care about is long term success.
Now about my sleevie, it's a 40f and at the time they were not oversewing or making them tighter, so what I've got is a loose 40f. Being one of the first, it was more about warding off complications than how tight the sleeve was made. I think I may need to be more dilligent than perhaps others to be sure that I don't have a regain. I don't think I knew enough about size etc when I had my surgery. I was just so excited that they were willing to give me a sleeve because I knew RNY wasn't for me. I still think I've gotten way more than my value for my $100 co-payment that included the night in the hospital.
On to year three and the challenges that may lay ahead.
He was proud of me for shedding another 25 pounds since my 1 year appointment. Me too!
My iron and thiamine are low which is not uncommon after the extensive surgery I went through in December. I'm already supplementing them both. Everything else is mid-range on the charts. I was concerned about my A1C being 5.3 and he said not to worry. Anything under 6 is fine. It's more of a concern under 4 because of blood sugar crashes.
I asked whether he thought I should continue trying to lose more weight and he said there's no reason not to but that at this point post-op it would be really difficult. I think the reality is that if I can maintain, I'll be thrilled with that. Anything else would be a miracle!
Kaiser has only been doing the Sleeve for 2.5 years. I was actually one of their first, so their experience with Gastric emptying is pretty non-existant. He said that people with the RNY tend to stretch their pouch sooner after surgery and they start to regain and stop coming to support group. He sees their info from their PCP and can see that they are gaining weight. The Sleeve doesn't tend to stretch early out but we can certainly eat more as time goes on. I'm going to continue tracking what I eat and how soon after eating things do I get hungry again. He's interested in my findings and considers me one of his Sleeve pioneers. He's also interested in whether eating raw veggies with skin keeps them in the Sleeve longer than peeled veggies. I feel like a science experiment, but truth is, the only thing I care about is long term success.
Now about my sleevie, it's a 40f and at the time they were not oversewing or making them tighter, so what I've got is a loose 40f. Being one of the first, it was more about warding off complications than how tight the sleeve was made. I think I may need to be more dilligent than perhaps others to be sure that I don't have a regain. I don't think I knew enough about size etc when I had my surgery. I was just so excited that they were willing to give me a sleeve because I knew RNY wasn't for me. I still think I've gotten way more than my value for my $100 co-payment that included the night in the hospital.
On to year three and the challenges that may lay ahead.
HW: 249 SW: 229 GW: 149 Age: 63 - Body by Sauceda - 12/2011
Dr. Baggs sounds wonderful. That was awesome that he said he would aspirate the seroma, if needed. What a guy!!
What did he say about the gastric emptying and the need to eat more often?
Your A1C is GREAT at 5.3. Mine was the same, when it was last checked in September.
I sent an e-mail to the bariatric internist who does the long term post-op follow up regarding gastric emptying. She is wonderful and everyone loves her. Here is her reply:
"First, keep a detailed calorie log not just of WHAT you eat , but also WHY you eat, WHAT your hunger levels is and what your emotional state is. This will allow you to Identify the emotional eating.
Overall your weight loss is EXCELLENT. You have EXCEEDED our expectations! Well done. Your weight is completely normal. If you are exercising a lot you may in reality NEED more calories to help you avoid the grazing . If you keep a log I can forward it to the dietitians for review. "
So, there you have it. She did acknowledge the increased gastric emptying, when I saw her last September, but I do think that there is an emotional component attached to the hunger at times.
Lee, I have been experimenting with veggies, and I have found that eating them with the skin definitely helps, but I did have some problems with sweet potato skin and something else that I can't remember right now. Carrots are satisfying, but they are higher in carbs, so you have to watch those. Broccoli, artichoke hearts, peppers, cucumbers are satisfying. I need to try some cauliflower. I had some problems with celery, so be sure to chew it very well. Sometimes the acidity of tomatoes bothers me. Asparagus is good, as you probably already know.
As far as the sleeve size, it is what it is, and it is up to us to make it work long term and to continue with the lifestyle changes that helped us to get to our goals. Actually, I am satisfied with what I can eat and I wouldn't really want to eat less, due to nutritional and energy needs. 2.5-4 ounces of dense protein is just about right, depending upon the protein source. It isn't the dense protein that gets us into trouble, but the nasty carbs and other troublesome foods. Even with a small sleeve, those things can get through.
Sounds like your visit was very positive.
Take Care,
Gail
What did he say about the gastric emptying and the need to eat more often?
Your A1C is GREAT at 5.3. Mine was the same, when it was last checked in September.
I sent an e-mail to the bariatric internist who does the long term post-op follow up regarding gastric emptying. She is wonderful and everyone loves her. Here is her reply:
"First, keep a detailed calorie log not just of WHAT you eat , but also WHY you eat, WHAT your hunger levels is and what your emotional state is. This will allow you to Identify the emotional eating.
Overall your weight loss is EXCELLENT. You have EXCEEDED our expectations! Well done. Your weight is completely normal. If you are exercising a lot you may in reality NEED more calories to help you avoid the grazing . If you keep a log I can forward it to the dietitians for review. "
So, there you have it. She did acknowledge the increased gastric emptying, when I saw her last September, but I do think that there is an emotional component attached to the hunger at times.
Lee, I have been experimenting with veggies, and I have found that eating them with the skin definitely helps, but I did have some problems with sweet potato skin and something else that I can't remember right now. Carrots are satisfying, but they are higher in carbs, so you have to watch those. Broccoli, artichoke hearts, peppers, cucumbers are satisfying. I need to try some cauliflower. I had some problems with celery, so be sure to chew it very well. Sometimes the acidity of tomatoes bothers me. Asparagus is good, as you probably already know.
As far as the sleeve size, it is what it is, and it is up to us to make it work long term and to continue with the lifestyle changes that helped us to get to our goals. Actually, I am satisfied with what I can eat and I wouldn't really want to eat less, due to nutritional and energy needs. 2.5-4 ounces of dense protein is just about right, depending upon the protein source. It isn't the dense protein that gets us into trouble, but the nasty carbs and other troublesome foods. Even with a small sleeve, those things can get through.
Sounds like your visit was very positive.
Take Care,
Gail
" 
Gail, that's a great response that you got.
I think that Dr. Baggs doesn't have the answers about the gastric emptying. That's why we are going to have an ongoing discussion about the realities of the sleeve. I am going to be more specific about my logging so that it becomes a better glimpse into hunger and how often it happens, what keeps it at bay etc.
I remember reading here that Dr. Cirangle recommended eating veggies with skin because they take longer to empty from the sleeve. I'm going to try that.
So we all appear to be a science experiment!
I think that Dr. Baggs doesn't have the answers about the gastric emptying. That's why we are going to have an ongoing discussion about the realities of the sleeve. I am going to be more specific about my logging so that it becomes a better glimpse into hunger and how often it happens, what keeps it at bay etc.
I remember reading here that Dr. Cirangle recommended eating veggies with skin because they take longer to empty from the sleeve. I'm going to try that.
So we all appear to be a science experiment!
HW: 249 SW: 229 GW: 149 Age: 63 - Body by Sauceda - 12/2011
I should experiment too. I can certainly eat more and sometimes that scares me. But then, it's those slider foods that I can eat more of. Evil carbs!
Wanda
Some people might not support my WLS decision.
Those people remind me of slinkys. Not good for much but it would would bring a smile to my face if someone pushed them down the stairs.
Ticker includes Pre-op weight loss 24 lb.
Some people might not support my WLS decision.
Those people remind me of slinkys. Not good for much but it would would bring a smile to my face if someone pushed them down the stairs.
Ticker includes Pre-op weight loss 24 lb.
Lee, you've doing fantastic!!!
I had a 42f sleeve with no overswen!...When eating the right way with protein first and all...I am fighting to eat the 1200 calories a day...With added exercise, I don't know where I'm gonna find room for more food.
Hugs N loves
Donna
Leaky sleeve survivor!!! 2008/2009 ~ 5'7"~ 42F Bougie 
