What would you do?

 - GOOD RESPONSE GRIM

What I wouid do is is try very hard to work with the existing surgery.

you have been a bariatric patient for many years and so obviously should know how things should be. BUT you say that when you were banded you only had a small area to fill. This is wrong! It used to be thought (pre-around 2008/9) that we filled the area above the band but research over the years has shown this to be incorrect, we should never fill that area. To do so causes oesophageal problems. Well-chewed food should pass through a well-adjusted band in under a minute. You say you filled the area and regularly got stuck. In that case, your band was too tight.

Now I have never been sleeved! So I don't know how it feels. But in your position, I wouid get lots of professional opinion on how the sleeve shouid be working in case you have misunderstood. 

I was banded in 2007 so yep that was the thinking, I have seen it evolve over the years but unfortunately it was too late for me. I stayed about "3 bite tight"  for a long time and because of that I have a very dilated esophagus that you can still see in my x-rays. 

I was lucky. I was banded in 2006 but my doctor kept right up to date and so I never ate to "fill". 

maybe because of the  dilated esophagus that your surgeon decided to make the sleeve larger? 

Also - I am not a band person - but many people who had issues with band (like you did) report feeling less restriction after they have been revised to sleeve. 

Also - IMO- the food you list you are eating may be the issue.  It is more of a slider food, so you may need more of it to make you feel as full as yo did with a too tight band that caused esophagus damage.

if they make the sleeve too small - that may happen again and may eventually lead to cancer...you probably already have some permanent damage there.. 

Plus - some people deals with scar tissue from the and - stomach damage - so maybe that was the reason he gave you bigger sleeve to avoid stricture. 

going smaller after the band - if you don't know how it affected the stomach may be unwise...

Yes I think that had a lot to do with it and at the time he was not all the experienced with the revisions unfortunately.   I have the fears about the scar tissue and the risk of cancer as well, and you're right I don't know what things are really like in there without  further testing.  All I know right now is there is significant difference in the post op pics at 1 day and one year and I can eat very large portions without feeling full. 

I had RNY 7 years ago... and my pouch is still rather small ... but...if i eat too many carbs - I lose sensitivity.. and I can eat and eat and eat. Only when I really limit carbs.. and give it 2-3 days (i get supper hungry) I can get back my restriction...I am not sure why is that... but too many carbs (even from veggies or nuts  trigger my insulin response make my pouch less sensitive to pressure from food...

I can eat 1-2 cups of dense food.. (yes - including steak or grilled chicken) 

but on low carb diet - not on;y I feel much better.. but I get full much faster and it lasts much longer...  

 I am not on carb binge...(relatively speaking) and I need to carb that... because I hate how hungry I get...and how much food I can "stuff" inside my poor tool..

I know i need to take charge...  

Yoursleev may be mature now - and yes - another surgery may make it smaller.. physically... 

But if I were you - I woudl first change my diet (less carbs, more dense meat, proteins), and give it a fair trail for 2-3 weeks without cheating... only non starchy green veggies, no fruits, and limit dairy that has sugar..and see if that would help you .

BTW; artificial sweeteners (splenda - aspartame) makes me feel like I am starving... 2 that my body tolerates - is natural stevia(liquid) and saccharine (when I don't have stevia).

Interesting, thank you !  I will do some experimenting with this.