In Weigh Over my Head: WLS appt wasn't good today... :(

Thursday, January 26, 2012

WLS appt wasn't good today... :(

I will post about it this weekend when I have time to write a novel, but basically I have a failed sleeve. :( I have lots to think about and lots to decide over the next couple of weeks. The surgeon wants me to revise to a bypass. :( On another note, my personal trainer is sick today and had to cancel our appt., but I still went to the gym and worked out anyway. :) Go me. :)

6 comments:

Christine said...: great job lisa! A failed sleeve. Well just keep plugging as if you don't. Hugs!; January 27, 2012 at 12:08 AM
Kelliann said...: Oh dear - I'm sorry you had a bad appointment... I had the bypass 3.5 years ago - if you have ANY questions, feel free to e-mail me!
kelliannfesta@yahoo.com

Kelliann; January 27, 2012 at 7:22 AM
The Sassy Orange said...: That totally sucks - but it can't be completely failed - you did still lose a lot of weight!; January 27, 2012 at 7:40 AM
Anonymous said...: oh how disappointing...i hope things turn around for you. ((( hugs )))
Dawn; January 27, 2012 at 7:44 AM
Lori said...: I'm so sorry. I'll pray that you have the wisdom to make the right decision for you. My sister had gastric by pass nearly 10 years ago now, and she's doing great.

Good for you for going on to the gym. I know that was a mental battle for you...at least it would have been for me.
Lori; January 27, 2012 at 8:56 AM
Sarah said...: I am so sorry your having to go through all this :(; January 27, 2012 at 11:28 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!

Thursday, January 26, 2012

WLS appt wasn't good today... :(

6 comments: