In Weigh Over my Head: Update from my dr. appt

Tuesday, November 22, 2011

Update from my dr. appt

Well, it turns out I am indeed the 1% of people who has scar tissue expand. Whatever. I am still VERY happy with getting this surgery and will do a revision if I have too. I am on kind of a pre-op diet again to see if the mass will shrink or if it does not which will tell the dr. the options for revision. I am STILL at 236. I swear my body is working against me at all costs to keep from going down from that number. :) The baby is so perfect and such a joy. All of our kids are adjusting so well to her and having her during this holiday season makes it so much more fun. :) We are having my fiends from out of state join us for Thanksgiving and they will stay a few days. I love hosting guests especially when my body allows me to participate in the fun. We just bought tickets to the Polar Express. I am not worried about the food. I will make the Thanksgiving feast just as I have EVERY year, only this year I will not be rolling around on a chair. :) I hope everyone has a GREAT Thanksgiving!

4 comments:

Lori said...: Lisa,
Have a great Thanksgiving. Your attitude is great. You'll make it through this little hiccup with the scar tissue and skate on down to ONEderland soon.

Thanks for letting us come along with you on your journey.
Lori; November 22, 2011 at 5:14 PM
Amanda said...: Happy Thanksgiving! And rats on the possibility of a revision, but good for you for doing what you need to do if that is it.

Snuggle that baby!; November 22, 2011 at 6:57 PM
Anonymous said...: Happy Thanksgiving - I am so happy for you! Enjoy the baby! :) Ahhh, BABIES!
I understand about statistics - I am .02% of the population who is IgA deficient (to do with celiac disease). You'd think I'd win the lottery too! (guess I'd have to buy tickets...)
Dawn; November 23, 2011 at 6:22 AM
Sheila said...: Fingers crossed that it shrinks, but if not it sounds like you have a great attitude about whatever steps are next. Glad your new little one is settling in with your family...many congrats!; November 23, 2011 at 10:42 AM

My Weight Loss Surgery - NOT THE BAND OR BYPASS!

Vertical Sleeve Gastrectomy (VSG) - Also known as Sleeve Gastrectomy, Vertical Gastrectomy

The Vertical Sleeve Gastrectomy procedure (also called Sleeve Gastrectomy, Vertical Gastrectomy, Greater Curvature Gastrectomy, Parietal Gastrectomy, Gastric Reduction, Logitudinal Gastrectomy and even Vertical Gastroplasty) is performed by approximately 20 surgeons worldwide. This forum is titled “VSG forum” to include the two most common terms for the procedure (vertical and sleeve). The earliest forms of this procedure were conceived of by Dr. Jamieson in Australia (Long Vertical Gastroplasty, Obesity Surgery 1993)- and by Dr. Johnston in England in 1996 (Magenstrasse and Mill operation- Obesity Surgery 2003). Dr Gagner in New York, refined the operation to include gastrectomy(removal of stomach) and offered it to high risk patients in 2001. Several surgeons worldwide have adopted the procedure and have offered it to low BMI and low risk patients as an alternative to laparoscopic banding of the stomach.

It generates weight loss by restricting the amount of food (and therefore calories) that can be eaten by removing 85% or more of the stomach without bypassing the intestines or causing any gastrointestinal malabsorption. It is a purely restrictive operation. It is currently indicated as an alternative to the Lap-Band® procedure for low weight individuals and as a safe option for higher weight individuals.

Anatomy

This procedure generates weight loss solely through gastric restriction (reduced stomach volume). The stomach is restricted by stapling and dividing it vertically and removing more than 85% of it. This part of the procedure is not reversible. The stomach that remains is shaped like a very slim banana and measures from 1-5 ounces (30-150cc), depending on the surgeon performing the procedure. The nerves to the stomach and the outlet valve (pylorus) remain intact with the idea of preserving the functions of the stomach while drastically reducing the volume. By comparison, in a Roux-en-Y gastric bypass, the stomach is divided, not removed, and the pylorus is excluded. The Roux-en-Y gastric bypass stomach can be reconnected (reversed) if necessary. Note that there is no intestinal bypass with this procedure, only stomach reduction. The lack of an intestinal bypass avoids potentially costly, long term complications such as marginal ulcers, vitamin deficiencies and intestinal obstructions.

Comparison to prior Gastroplasties (stomach stapling of the 70-80s)

The Vertical Gastrectomy is a significant improvement over prior gastroplasty procedures for a number of reasons:

1) Rather than creating a pouch with silastic rings or polypropylene mesh, the VG actually resects or removes the majority of the stomach. The portion of the stomach which is removed is responsible for secreting Ghrelin, which is a hormone that is responsible for appetite and hunger. By removing this portion of the stomach rather than leaving it in-place, the level of Ghrelin is reduced to near zero, actually causing loss of or a reduction in appetite (Obesity Surgery, 15, 1024-1029, 2005). Currently, it is not known if Ghrelin levels increase again after one to two years. Patients do report that some hunger and cravings do slowly return. An excellent study by Dr. Himpens in Belgium(Obesity Surgery 2006) demonstrated that the cravings in a VSG patient 3 years after surgery are much less than in LapBand patients and this probably accounts for the superior weight loss.

2) The removed section of the stomach is actually the portion that “stretches” the most. The long vertical tube shaped stomach that remains is the portion least likely to expand over time and it creates significant resistance to volumes of food. Remember, resistance is greatest the smaller the diameter and the longer the channel. Not only is appetite reduced, but very small amounts of food generate early and lasting satiety(fullness).

3) Finally, by not having silastic rings or mesh wrapped around the stomach, the problems which are associated with these items are eliminated (infection, obstruction, erosion, and the need for synthetic materials). An additional discussion based on choice of procedures is below.

Alternative to a Roux-en-Y Gastric Bypass

The Vertical Gastrectomy is a reasonable alternative to a Roux en Y Gastric Bypass for a number of reasons

Because there is no intestinal bypass, the risk of malabsorptive complications such as vitamin deficiency and protein deficiency is minimal.

There is no risk of marginal ulcer which occurs in over 2% of Roux en Y Gastric Bypass patients.

The pylorus is preserved so dumping syndrome does not occur or is minimal.

There is no intestinal obstruction since there is no intestinal bypass.

It is relatively easy to modify to an alternative procedure should weight loss be inadequate or weight regain occur.

The limited two year and 6 year weight loss data available to date is superior to current Banding and comparable to Gastric Bypass weight loss data(see Lee, Jossart, Cirangle Surgical Endoscopy 2007).

Let's Shrink!

Tuesday, November 22, 2011

Update from my dr. appt

4 comments: