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A body mass index above 40 kg / m2 indicates obesity, which is a health hazard. The most well-known health problems caused by obesity are type II diabetes, hypertension, sleep apnoea, osteoarthritis, post-myocardial infarction, PCOS and female infertility.

Kirsty opted for gastric sleeve surgery that took place in February 2020. In one year, she has lost 33 kg or 1/3 of her weight. Her initial weight was 100 kg and height 150 cm. Her body mass index has decreased from 44.4 to 30, which should significantly increase her chances of getting pregnant naturally, as well as the percentage of successful fertility treatment, should she need it. Before planning to become pregnant, it is advisable to wait until your body weight has stabilised, which usually happens between 12 and 18 months.

More about gastric sleeve surgery

Although the primary recommendation for people with body mass index over 40 is gastric bypass surgery, which allows for greater and more permanent weight loss in the case of a higher body mass index, the advantage of gastric sleeve surgery is the fact that food’s pathway through the gastrointestinal tract does not change and most of the necessary vitamins and minerals are absorbed from the daily diet even after the operation. Therefore, gastric sleeve surgery is a good choice for a young woman who is planning pregnancy in the future. There is certainly less anaemia and hypovitaminosis after gastric sleeve surgery (also during pregnancy), while long-term weight loss is somewhat less with gastric sleeve than with bypass surgery, especially with a higher body mass index (BMI over 40 kg / m2).
NB! However, vitamin replacement therapy is recommended after all bariatric surgeries.

During gastric sleeve surgery the volume of the stomach is reduced approximately 10 times (150 ml remains instead of 1500 ml). Food’s pathway in the gastrointestinal tract does not change. As a result of the operation, the amount of food consumed and the feeling of hunger are reduced, as the part of the stomach that produces the hunger hormone ghrelin has been removed.

If you have a certain plan to become pregnant after weight loss surgery, the choice of the type of surgery must be decided in cooperation with the surgeon. The choice depends on how much weight needs to be lost as well as on your comorbidities.

Pros and cons of gastric sleeve surgery compared to bypass surgeries.

• As food still passes through all parts of the gastrointestinal tract, possible deficiencies in vitamins and minerals are less manifested, but certainly not ruled out.
• Unlike standard bypass surgery, studies have not shown that sleeve increases the risk of alcoholism in operated patients.
• It is less likely to develop dumping syndrome and there is no risk of internal bowel obstruction, which affects about 1-2% of bypass patients.
• The most common possible problem after a sleeve is the development of heartburn or reflux, as well as the continuation of pre-operative reflux. According to various studies, 20-40% of sleeve patients need treatment from time to time or continuously due to reflux and 5-10% need new surgery for the same reason.
• Long-term weight loss is less than with bypass surgery, especially with a higher body mass index (BMI over 40 kg/m2).
• The likelihood of relief or recovery from underlying type II diabetes after sleeve is slightly lower (40-50%) than with standard bypass (60%) or mini bypass (80%).
• There are no significant differences in dyslipidaemia (elevated cholesterol and triglycerides in the blood), high blood pressure, joint or back pain relief.

Gastric sleeve surgery is suitable for patients:

• who do not have GERD (reflux disease)
• who are not passionate sweet tooths
• whose problem is large amounts of food rather than bad food choices (too much sweet and fatty food)
• who train regularly and whose BMI is less than 40 kg/m2
• who smoke and use painkillers at the same time, as this combination increases the risk of ulceration after bypass surgery
• whose alcohol consumption is moderate
• Gastric sleeve surgery could also be considered by patients with a pre-existing iron deficiency anaemia, as gastric bypass surgeries exacerbate this more than sleeve.
• Sometimes, in the case of many previous abdominal surgeries, the sleeve may be the only bariatric surgery that can be performed due to adhesions.

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After doing some research and talking to a friend with personal experience, Bariatric Services was the only place to go to in my opinion. Everything was so professional from the beginning. Their website was very informative and Kaire, the coordinator, answered all my questions personally and with respect.

September 5th 2017 is they day my new life began. That’s the day I had gastric bypass surgery performed by Dr. Ilmar Kaur. I was never nervous, not once. I was only excited and everyone took such a good care of me. Being a licensed practical nurse and now a nursing student I looked at everything at the hospital with different eye too and I can honestly say that everything was excellent both related to hygiene and professionalism. The staff was very helpful and kind and I felt very secure the whole time.
Dr. Ilmar was there when I came and showed me the hospital room, he then checked on me at least twice a day the whole time I was in the hospital. When discharged I got excellent patient education about life after surgery both from Dr. Ilmar and nurse Anni Laas and was ready to start my new life on my own – though I wanted to take everyone back to Iceland with me 🙂

Since I got back home I’ve been doing really well and have not experienced any complications. It’s now almost 8 months since the surgery and I have lost 35 kilos. I am only 5-7 kilos away from my ideal weight and that is something I thought I would never experience. I haven’t felt so good about myself in years and life is much more easier, both for me and the closest people around me.
I haven’t taken stomach medicine since I got back home but I took 40 mg of Esomeprazol daily before surgery because of bad acid reflux. I also do not need to take medicine for anxiety anymore. I was in high risk of getting diabetes type 2 but that’s not a problem now.

I can eat anything, really, but I now focus on meals as a nutrition so I choose my meals well. If I don’t do that it will result in less energy throughout the day and I don’t feel well physically. I also take vitamins daily, that’s really important and not as hard to remember as I thought it would be.
I now exercise because I want to and it’s a completely different feeling going to the gym and actually like it. I can also do things there that I could never do before. I can now sit on the floor playing with my daughter and run with her up and down stairs without having a hard time to breath.

I can not thank Dr. Ilmar Kaur and all of the Bariatric Services team enough. They will always have a special place in my heart and I will be forever grateful to them.

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I gained and lost weight dozens of times: losing 10 kg, gaining 15 kg. I knew very well how to lose weight by using diet and sport. And I knew how to hold it. But my problem was laziness. As soon as I lost weight, I failed to hold it: to celebrate the loss, I ate a lot and gained weight back.

It was 7 years ago, when I heard first about the stomach reduction surgery in a TV program, where there were very fat people. For them, this surgery was vital.

I made a final decision to go for the stomach reduction to lose weight in this way in 2013, after I met and talked to a friend who had undergone this surgery at Dr. Kaur’s clinic.

After meeting her, I signed up for a consultation with Dr. Kaur. I was 26 then and I weighed somewhere around 125 kg, although I’m pretty tall, 180 cm.

The surgery was appointed on 13 January 2015. During the New Year night, I certainly ate well, but after that I told myself to stop. Enough. And since 1 January, my new life has begun.

What in this entire saga helped me a lot in making a decision was the communication with people, who had already undergone this surgery. I also read all the forums and all the information on this issue on the Internet.

A month after the surgery, I lost about 10 kg.

As a result, a year and a half after the surgery, I have 47 kg off and I feel wonderful!

Today I’m not a full-figured girl looking at slim guys and dreaming. Now I’m a beautiful and slender girl, doing sports!

Now, when I am eating, my eyes play a major role. I know visually how much food I can accommodate. So I eat accordingly. If I eat a little more, I feel bad: food gets stuck in my throat. But this happens rarely – I get used to it. I eat whatever I want, but bit by bit.

If earlier, under stress, I immediately sat down and ate, now it’s the other way around. I do not want to eat.

Frankly speaking, my fondness for sweets persists. But today 2 to 3 candies are enough – I just don’t want more.

I’m very happy that I decided to take this step and underwent this surgery! I can wholeheartedly advise it to everyone, who has extra weight and who tried all the other ways.

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My husband and I flew to Tallinn from Iceland but I would not go alone and felt safer to have my husband with. We arrived 2 days before surgery, the lovely Merle booked hotel for us in the old town so we could view the town. Very beautiful place.

Merle picked us up on a Monday morning, we went to the hospital and shown the place, my husband was with me at the hospital, were just two in a room. The surgery was later in the day, it was all explained very well for me and all the staff was great. Almost all spoked English, I must say that all the people, nurses, doctor, dietician, just everyone who approached me were wonderful. I was in the hospital until Thursday and flew to Iceland on Friday.

It has all been successful. I’ve been under the supervision of my GP in Iceland, I received instructions from Dr Ilmar for my doctor for monitoring the operation. I also received a few emails after the operation from Ilmar to check my condition and I had full access to them by phone or email if I needed to keep.

I have lost 64 kg and now I feel so good. I’m in the gym to strengthen me and increase my stamina.

Now next on is saving money for surgery to remove skin from stomach, upper arms and thighs, the loose skin is the only drawback I see the operation ?

I recommend this place and I will come back there when I fix the skin. Awesome staff, it’s all there 100%

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