Vertical Sleeve – VSG

There are so many options when looking into different weight loss surgeries, overwhelming amounts of information and a lot of things a person should take into consideration before making a choice. For me, the vertical sleeve was my best choice, one reason is because it removes the stretchy portion of your stomach that expands when you eat, and eat and eat. It also significantly reduces the hormone Ghrelin, which signals your body to eat, with the removal of 80 percent of your stomach you are not receiving as much of this hormone and it ideally decreases your eating.

The VSG (as it’s most commonly called) does not bypass any portion of the digestive system and the pylorus is kept in tact which means that your stomach is still doing all the churning and breaking down before entering the small intestine. Since I have a significant amount of medications I take for pain, fatigue, MS, nerve pain, muscle spasms, neurogenic bladder and many other issues this specific surgery allows my body to process all the medications the same way as pre surgery.

Most of the other surgeries either put in an object (band) or reroute your system which can lead to a lot more changes in medicines or possibly dumping syndrome, the vertical sleeve does not do that. The vertical sleeve surgery is where they go in via laparoscopy and cut 80 percent of your stomach off and remove it. The normal adult stomach can hold up to 80 ounces, after VSG the typical one year out capacity is 8 ounces. They seal your new stomach (called a pouch or “tool”) with staples. Some surgeons also stitch over the staples, over sew, which reduces risk of leaks.

Once I chose my surgery type I did so much reading, printing and bookmarking then highlighting because otherwise I don’t remember. So now I have a folder of all my printed notes, list of questions (with their answers now because I already asked my surgeon). I reviewed the information from the psychiatrist (a required portion of pre surgery), he had videos on what to expect, ideas on how to deal with eating for stress and books he recommended. I got the kindle versions of The Sleeved Life and Ultimate Gastric Sleeve Success: A Practical Patient Guide to Help Maximize Your Weight Loss Results. The first book is written from the perspective of the patient and the other is written by a surgeon. Both gave me information I had not found in medical sites or blogs and things to add to my questions. I am fairly certain my surgeon was not expecting me to ask things like how far left do you cut from the left crus of the diaphragm and what will be the distance from the pylorus? However, the book written by the surgeon gave the science info related to the actually surgery and explained how the distances from these areas can make or break complications like leaks and strictures I definitely wanted to ask.

I walked out of my preop appointment feeling confident with my choice and then before I left, my surgeon gave me his cell phone number incase I had any more questions or any concerns. The other thing I learned while researching is every surgeon is different in what is expected of the patient during preop. Some people need to follow a precise diet for several weeks and then liquids between 1 day and 1 week prior to surgery. I assume this also varies depending on how much you actually have to lose. My surgeon had links to videos for all the phases of preop and postop nutrition information. This was important for me so I knew what to expect and how to progress each week after surgery. I was able to assemble everything I am going to need after surgery, even if it is as far as 6 weeks post op. I have tiny bowls that only hold 1/4 cup of food, bread plates and appetizer utensils, using little dishes seems odd but it’s psychological, if you put your 4 ounces of food on a normal size dish it barely fits on the plate, but if you use a tiny dish and little forks then it seems more natural. You have to take 30 minutes to eat your meal!!!! So it’s a change in habit, I know that will be the most challenging for me because with 2 kids I usually eat quickly to get on with everything else.

I have been using the Baritastic app, very well known in the community, to track food, vitamins, water. It allows you to set reminders for pills, water, meals and you can track your protein, inches and weight lost before and after surgery.

They tell you not to weigh yourself for the first two weeks after surgery because everyone’s body reacts differently to the trauma. You will have internal inflammation, you will be bloated because they literally blow your stomach up with gas to work inside. You will most likely retain water. You also have to get up and walk a lot. For the gas buildup to go away and because you need to move to heal.

Personally, after I had by gallbladder out I was in bed most of the first week. My physical therapists are trying to work on core strength and having 4 holes put into your abdominal cavity to remove an organ doesn’t make your core work very well. I would get exhausted from the effort of holding myself up at the dinner table. I had a little (medium to large) pillow with arm rests I’d use while I was sitting up in bed. I forgotten how exhausting sitting after surgery was since my last c-section was nearly 9 years ago by then.

So my advice is to research. Some people think it’s an easy way out, but how can surgery be easy with lifetime modifications required and you cannot workout like a typical person because half a degree rise in core body temp turns your body to jelly or causes pain so severe you’re in tears? It’s not liposuction, work is still being done, it’s just being done in a way that may yield better results for a specific person.

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