HELP! Considering Revision/Correction - need opinions!

 Hi,
i used to be on this forum all the time as Mary in St. Louis.  I got my DS in 2007 with Dr. Unson.  He did a great job and I would recommend him.  I went from 300 lbs. to 200 lbs.  and was well and healthy.  Today, I weigh 227 and am struggling.

I have been to see Dr. Alfonso Pomp at Cornell and he looked at my report from Ungson and believes my procedure may have been too conservative.  My alimentary track is 300 cms, and my common channel is 100 cms, according to the surgical report.  I have had no diarrhea or malnutrition and great labs.  However, it is a constant struggle with my weight now, and yes, I do cheat and eat carbs somestimes.  I must be honest.  I am really trying to stick to the post op diet, but clearly the window is gone.

Has anyone had this type of correction or revision? I believe he will shorten the common channel but am not sure yet.    I would be so grateful to learn more about this.  Any resources would be appreciated.  Any stories or experiences or advice.  I know you are not docs but I remember there were many people on this forum whose opinion I greatly respected.

Thanks, in advance, to anyone who will help me.

Mary

A 100cm common channel is fairly standard, and many of us have cc's longer than that.

Have you tried adjusting your diet first? You say you cheat with carbs, but we absorb pretty much every carb we eat, so that's like not having any WLS at all.

Could you try some things that feel like treats that are actually decadent due to fat? Like, cheesecake? It's considered naughty because of the high fat, but we don't absorb about 80% of that, so it's a better cheat. Made with splenda it's even better.

I'm just throwing this out there because surgery carries so much risk (particularly revision surgery) and is so hard on the body, and you don't get a guarantee that you will lose any easier afterward, or any guarantee that you won't battle deficiencies either.

 Thank you so much for your post.  And every word you say I believe is true.  I just was hoping for a "jump start'" but at what cost?

Any other opinions are greatly appreciated.

And thank you for your candor.  This is just what I needed.

Blessings to you and yours,
Mary

 Mary you may also want to check on this site. There are a lot of helpful people with a lot of knowledge.
http://weightlosssurgery.proboards.com/index.cgi?

Hi Mary, I read somewhere that resleeving is more effective than changing the CC for regain in DSers, unfortunately I can't find that thread.  The one below however should be of interest.

This thread does discuss DS regain http://www.obesityhelp.com/forums/DS/4398034/REPEAT-SLEEVE-FOR-WEIGHT-REGAIN-OH-MY/#36361897

There are some people out there with 50cm CCs but that seems very short to me (I have a 75CC).  It's been said many a time that 25cm isn't much in the great scheme of things so I wouldn't revise to simply 75CC.  There are 65s out there...

Anyway whilst a resleeve is more effective it's also more risky as the skin gets thinner.

You should get back to basics while you're considering your options as it should help regardless of what you decide.  The following 2 links I find particularly good for recipes:

http://www.ibreatheimhungry.com/

http://247lowcarbdiner.blogspot.co.uk/2011/03/mr-peanut-sand wich-bread.html

 In the big scheme of things, we are talking about a 27lb gain in what?  5 years?

Honestly before I even considered surgery again I would be trying Atkins Induction.  That's pretty much how we are supposed to eat anyway.  Cut the carbs completely.  It will be tough for 4 or 5 days but after that, you will even out.  It's really simple.  Meat, cheese, and eggs.

As we go further out from surgery, everyone absorbs more of what they eat.  Your body adapts the best it can.  The DS won't do all the work forever.  Also go back to tracking what you are eating.  Every bite.  You will probably be amazed how many carbs have worked their way back into your daily intake.

And sugar is sugar.  Doesn't matter if it's from soda or fruit.  

Hello Mary.  I wish there were more cases known about how well (or not-so-well) such revisions do.  I really believe many of our common channels lengthen over time. (This is aside from villi getting longer to absorb more.)  Yours may have grown longer and sooner than most other DSers'.  There isn't much known about this, because there is so seldom a good enough reason to do the invasive surgery it takes to get such a measurement.  The first time I read of this lengthening phenomenon was here on OH some years ago when a member needed surgery for a bowel obstruction, and his DS surgeon is the one who fixed it, and while there she measured the common channel length, and it was longer than she had originally made it.  A different DSer I read said Dr. Buchwald once found a Dser's cc to have doubled, but that most don't lengthen that much.  (It is often pointed out that different doctors measure the same intestine differently, depending on how much the physician stretches the gut, but, in my opinion, the same surgeon probably uses about the same degree of stretch each time.) 

Even if your common channel hasn't changed much, the fact that you don't have diarrhea or malnutrition and do have great labs (and excess weight) is strong evidence that you could benefit from a common channel (and possibly alimentary channel?) shortening, in my lay opinion.  For myself, my DS is fine for me now, but I let myself fantasize about getting a common channel  (and alimentary channel?) shortening in, say, 8 years, when I'd be 10 years out from DS.  I am unsure if I would go for a resleeve at that time; for now, I'm thinking not, but I'd see what literature comes out on the topic by then.  If you can put up with low-carb living for the long haul, of course that would be preferable to surgery, but I find low-carbing miserable, and it's not something I'm willing to do often.  The thought of my only recourse being low-carbing is just depressing, whereas the thought of possible revision makes me feel better.

 Probably almost 10 years ago there was a woman here who had a DS when she was 16.  She had surgery again when she was in her late 20's and learned her CC had grown.  It's not common but it can happen.

Most likely the OP had a free ride for the first 5 years or so.  Now she is going to have to work.  The free ride is done.  Many people lose the weight so effortlessly that they forget it will change down the road.

What evidence is there that the lengening is not common?  How many cases do you know of where the common channel has been measured and found to be the same as originally made? It is just so seldom measured at all after the DS surgery.