Greetings,

So I am one year out from sleeve surgery and I am just curious if what I am experiencing is normal.

I seem to have more tolerance now for foods and don't get the foamy mouth like I used to if I ate or drank too much. Granted I am not trying to push myself to try to trigger the "foamies", but I sort of liked that I had that feeling to stop eating or I may throw up. It was like added assistance for me to maintain things.

I am just wondering if I am at that crossroads now - where some people start gaining the weight back because the stomach has now adapted (I know the stomach doesn't stretch back to what it was) and having more tolerance now for foods - people can fall back into their old patterns if they are not careful.

I am still losing weight slowly, but that is of course better than gaining weight back slowly.

I am so happy that I had the surgery and I wish I did it 10 years ago, but I am curious to hear feedback from other people when they were at their one year mark.

Thanks!

FW

I would use it.

I tend to agree with White dove in that revisions don't have a great record on regain problems, as if one learns to eat around the original surgery, one can do it again. The RNY is done sometimes to correct GERD problems that some have with the VSG, but doesn't do much for regain as it is metabolically too similar. The DS is better as it is metabolically stronger, and a straightforward revision (some would say "completion") for the VSG as it starts out with the VSG as its basis, but you say that you don't want to go that far. Fair enough - it's an individual decision and not eveyone is cut out for a DS, or an RNY.

Resleeves can be done, if that is the problem, but can be tricky for some surgeons who aren't fully sleeve savvy. Someone to consult in MI (Grand Rapids area, if that's anywhere close to you,) is Paul Kemmeter. He is one of the old school DS surgeons, which means that he also is an old school sleeve surgeon. Like you, I had my VSG done in the early days when many surgeons were just learning it and there was a fair number of failures and early revisions back then, but my doc was also one of those old school DS surgeons who had been doing sleeves for around twenty years at that time, so well up the learning curve.

I don't know Kemmeter other than by reputation (the DS world is a small one,) but he would likely be able to give you good advice on how to correct your sleeve if it needs it, or go to a DS or SADI if that is more appropriate and you want to go there.

First thing to do, though, is to get that sugar monster back in its cage and get the diet squared away. Even if that doesn't yield substantial weight loss, it is an essential first step to whatever route you ultimately take. There seems to be a growing consensus in the bariatric world that the new class of diabetes/weight loss drugs are a particularly good fit for bariatric post ops who are struggling, so that may be something to consider as well.

Good luck in it all,

Welcome back. They can do revisions to sleeves, but that depends on if there is actually anything that needs revising. The first step is to find a surgeon and get a thorough exam and scans, and see if anything is wrong. There's no point in getting ahead of yourself. Enough time has passed that a full bariatric checkup is advisable anyway.

Most VSG revisions are to RNY. I wouldn't rule it out.

Hello Dr. Alvarez!

I'm looking at your website currently. Do you do sleeve revisions? By that I mean a re-sleeve...re-tightening, whatever the terminology is. I'm soooo very much considering this. :)