Come post some helpful tips for my friend

Hey all you successful sleevers out there!

I have a friend who is revising from band to sleeve after some complications. She was successful weight loss wise with the band and only has maybe 20 lbs or so more she wants to take and keep off.

She had some questions for me and I tried to help as much as possible, but I think a wide variety of experiences/opinions would be good as well, so I thought I would post some of her questions here. I don't think she would feel comfortable making an OH account, but I do think she would come here and read your responses.

First of all, how many of you lost your hunger? Did it return...when? How many did not lose your hunger?

What have been your reflux experiences? Did you have reflux before? Did anyone have significant reflux that was not effectively treated over-the-counter...if so, what did you turn to?

For someone who is hoping more to maintain weight loss, what are your thoughts on appropriate bougie sizes? I think her surgeon may be thinking of a 40 bougie, thoughts on this? Would a history of reflux change your opinion?

Thanks so much for your thoughts and experiences!

Lindsey

 I was not a revision but I'll answer what I can for you/her.

1. Yes, I lost my hunger. Not right away, had to have the ghrelin work it's way out of my system first. I do think it's kind of returning, but not the same way I would get hungry before. And anytime I think I'm hungry, I do a mental checklist of could it be acid? Boredom? Thirst? Or is it true hunger? Most times it's one of the first three.

2. No reflux before or now. I do still take an over the counter PPI everyday because I feel like it helps with the acid vs. hunger issues. Not always, but most of the time. And I did go several months without taking a PPI and still did not experience any reflux.

3. I'm not a doctor, so I can't really say what is best as far as bougie size is concerned. I know a few people that have a 40 that have more issues with maintaining, but that could be contributed to drive/want to maintain, eating choices, activity level, and a ton of other stuff so I can't say for sure it's the size of the sleeve. I know for me, I would not have been cool with a 40. 

I lost my Hunger. It never returned although at points I thought it was coming back. But as Leah said I believe it was mostly boredom and drinking something or distracting myself usually did the trick. I do get some serious cravings at times. I still can't eat much but I sure can graze like crazy. So I keep a mindful eye on that.

I never had reflux before or after surgery.

I have a size 38 bougie. I'm one that believes size doesn't matter. I didn't have a choice as a matter of fact I wasn't supposed to have the sleeve. I was supposed to have an RNY but complications lead me to the sleeve life and I had to make use of what I have.

No physical hunger still. I do get munchies/head hunger and think that learning to manage that has been very important to my success.

No reflux, ever.

I am a skeptic on the relative impact of bougie sizes based on a sample size of one: My surgeon uses a 40 bougie and my sleeve is if anything a little too small. I say this because I am having trouble maintaining my weight and have become a vegetarian so I can get enough calories in (I am very active and burn a lot, and I do use shakes for my protein).

I believe that surgeon technique has AT LEAST as much as bougie size to do with the final capacity of the stomach. My surgeon makes a very tight sleeve at 40f; I know some folks with 32f sleeves that can eat circles around me at less than 6 months out. I still cannot eat 2 oz of meat by itself most days. Throw in some gravy or mayo in a meat salad and I can probably get the full 2 oz; just meat, not so much.

Typed out a whole damn post and my browser crashed when I hit submit. This will be a recap haha.

1. I had complications so my situation was a bit different but the long and short is I did not get hungry till 6 months out. If I skipped a meal on accident I would feel sickly, not hungry. I still usually do not get really hungry but again more sickly. I do though get actual hunger feelings now from time to time.

2. Reflux. Never had it but it is bad now. I may be looking into another endo soon to see if I have a hernia. I take over the counter twice a day and tums for breakthrough during the day which is not healthy and it is getting worse.

3. I will not speak to this as I had a plication which works a bit different but I will say I can eat more then about any true VSG I have seen on the boards. I am talking about 4-6 oz. Of dense protein if I so chose to. I did not though and got me weight off in less then a year. Stomach size does not depict a true picture of what you choose to shove down your throat. That is up to the individual and if you constantly over eat you will end up being able to eat more later on regardless of the bougieman.

This post is mho only and if you are offending by it please die via fire. (That is a jk, stop looking at me like that)

Unfortunately, I never lost my hunger, fortunately, I get full quite fast.

I had reflux before, worse after, 2 Nexium a day usually controls it.

I always thought that the smaller the bougie the better chance of success, but I am not 100% sold.  Good question on whether or not the size would help reflux. 

Thanks everyone for all of your input! Very helpful!

Would love any more experiences if anyone else wants to chime in as well.

Lindsey

I lost my hunger and it has not returned.  I usually eat according to a schedule.  If I forget to eat I will start to feel shaky and weak.  Head hunger still comes around, though!

I didn't have reflux very often before surgery, maybe once a month.  After surgery and my hiatial hernia repair I took a PPI for three months.  I tried to stop then but the reflux came back within 3 days.  I stayed on my PPI until month 7, stopped taking it, and haven't had a problem since.

Along with others, I'm not sure I believe that a 40Fr is going to be that much different, in the hands of a good surgeon, than a 38. 36, or smaller.  Mine is a 36.  I think a lot depends on how tight the surgeon staples to the bougie, how wide the top and bottom of the sleeve are where it's not stapled, and how much junk food the patient consumes.  Really, 4 millimeters is tiny and shouldn't make a whole lot of difference in capacity.

Hey Lindsey, you look great!

It took me about 2 months to lose my hunger, now a year and a half later it only comes back when I forget to eat...yes I've become one of those stupid people who does that!

I never had reflux with the band, woke up from my sleeve revision with AWFUL reflux and after taking Prilosec for about 6-8 months it got much better. Now I only get reflux from too much red wine or if I eat too much of something very acidic.

My Dr. did a 34Fr bougie oversewn and for me it works, I got down to a size 0/2 in under a year. I can still only eat about 2-3 oz of solid protein and 5-6 oz of soft like yogurt at a time. I'm maintaining beautifully and am not sure the bougie size is the end all/be all to the sleeve...the eating habits are more important in my opinion.

Good luck to your friend!

Michelle

Thanks for posting your tips, Michelle!

It is so great to hear from you...hard to believe it has been well over a year since your revision! You have done amazing and I'm so happy for you. 

Lindsey