Sleeved 6 1/2 years ago... now learning about revision options...

Hi, everyone -

I've lurked on these boards for a while and thought I'd finally make an account to say "hello". I got my sleeve in 2011. I've been very happy with it and it was truly one of the best decision I ever made! I never quite made it down to my goal weight, but I lost a significant amount (I lost 140 lbs when I got to my lowest - I went from 360 lbs down to 220).

I maintained that weight for a couple of years. I had a baby (yay!!!) and a couple of health issues (boo!!!). My weight crept up to 280. For the last two years I've been struggling to lose the regain. I lose, then regain... lose again, regain again. I'm almost at 260 now.

I've tried a back-on-track program, tried Keto, tried HMR, tried a trainer. Finally, I have decided to go back to my surgeon and get his advice. I'm thinking about a revision. To what, I'm not sure...

I have been debating if the revision surgery would a greater risk to my health or if my obesity is a greater risk to my health. I'm 42, and I want to live long enough to see grandbabies and enjoy some senior years (healthy senior years) with my husband.

It's so hard... to feel like I failed at this weight loss thing even with the help of surgery. So I am embarrassed to go back to my surgeon after all these years. But the good news is that I am still 100 pounds down from my top weight... and that is great. I just want to get under 200... it would still be overweight, but I know I would feel better and have more energy.

I know there is a revision board too, so I'm sure I'll be hanging out there as well. But I just wanted to say hi to "my peeps"... my sleevers! Despite all my screwups, getting the sleeve was the BEST health decision I've ever made. In two weeks, I'll see what my doctor says about revision.

Thanks for listening. If anyone has good info or advice on revision options, I'm all ears.

This can be so hard.... Take some time and see if you can identify the head issues that made you start eating again. You have gotten away from the basics and before going under the knife again (well scope) you want to make the changes you need. For example I found (by logging) I was eating thousands of calories while watching TV. No joke! Now years after my surgery I watch TV and knit.

While you decide what is best for you here is a list that helped me. While I have had RNY I think the basics are the same for us all.

Planning/Preparing

Remember when we were preparing for surgery? How many meetings, classes and such did we attend? We were told the more prepared we were the better our chances were for success. And they were right. Go through the house, car and work place and get rid of trigger foods. Stock up on foods that will keep you on track. I removed every bad carb/sugar temptation and replaced it with lots of protein, veggies, grains and fruits.

Journaling

Get back to journaling. This will help you identify when you feel like eating, stress factors and any triggers in your life. Once you identify these factors, this will help you put tools in place to keep you from eating. It became clear I was not taking time for me anymore. I worked my day job and then spent the rest of my time caring for my husband. It was easy to reach for fast, prepackaged food. Since I purged my home I have to eat clean as there are no other options LOL

Use a tool to track you're eating and exercise like Getting Started with Health Tracker. Once I started to track ever bite and drink it became clear why I had gained.

Goals/Rewards

Make a list of goals for yourself. Make them realistic and small. Some of mine were move more, purge all junk from my home, eat more protein. If you didn't make a Weight Loss Surgery bucket list when you first had surgery do it now. GREAT reminder of all the things you can enjoy in life after losing weight.

Food

In general, a long term post-weight loss surgery eating plan includes foods that are high in protein, and low in fat?, calories, and sugar. Important, vitamins and minerals are provided as supplements. (if you had a different surgery adjust this to your food plan).

Water

Water is our Best Friend. I have to say I never went back to pop or any bad drinks, however I was drinking tea like crazy. What is wrong with drinking tea? I was either using sugar or 3 equals and 3 sweet n lows per 32 ounce glass. I found once I started carrying one of the metal bottles of water to keep it cold I drank water all day.

MOVE!

I can't say enough about how key this was for me. The reason I kept my weight off for almost 10 years was no matter what, I kept moving. If I could not go to the gym I would walk. Grab a cart and walk all the isles at your local box store. I loved Zumba, bootcamp workouts, lifting weights. When I stopped, the weight started coming back. So for me I am starting slow to avoid injury by walking and using some of the workouts on my Demand TV. Find something you love to do and it won't feel like a pain in the *** to do daily.

Support

If it's an option "run" don't walk to a support group. Come here on OH daily for support and participate in one of the food threads. It helps you be accountable and also great ideas for food prep.

Keep me posted on how you are doing.

Thank you for your thoughtful reply! A lot of wonderful advice!! Much of it I have been doing (with varying success) as I did a formal "back on track" program, as well a commercial diet with weekly meetings for about a year. But I agree that it is often so easy to think we are taking in fewer calories than we really are. Thanks again for your support!

The first order of business should be to see if there's anything physically wrong with your sleeve. If you've got a fully functional sleeve, it's worth asking yourself what a revision surgery will do for you.

Yes, indeed. I'm honestly not sure if there is anything "wrong" with my sleeve. While I certainly have less restriction than I did back in 2011, I would think that is to be expected.

And, yes, that is the question to ask. If my sleeve is still just as "good" as ever, than why would a revision help? Clearly, re-sleeving wouldn't be needed and wouldn't do anything. Adding the malabsoprtion component might lead to some weight loss, but would that be permanent or would I screw that up too?

The good thing is that my surgeon has a "full service" kind of set up... meaning he has nutritionists and psychologists on staff. So I would imagine that with this sort of question, it might be helpful to talk it through with the psychologist.

Thanks for your response!! I think you are right on the money.

Step 1: Identify what caused the regain.

Step 2: Figure out if it was because of a physical problem with your sleeve, or because of your behavior.

If you ate around your sleeve and had poor habits, there's nothing preventing you from doing that with a second surgery.

Yes, you are absolutely correct!

What caused the regain ... most of it happened during pregnancy but then I gained a little more when my thyroid was removed. From there, I've been yo-yoing trying to get back down to my "low weight" (which, it might be important to point out, was actually still technically obese).

My surgeon had recommended the RNY initially because of my very high starting weight (360) but I found the sleeve very appealing and it seemed less surgery was a safer option. But now I am wondering if I really did need that malabsorption to get down to a lower weight.

I don't know... if I had the answers I wouldn't be so fat right now. Haha! :). But I agree that I need to determine why I didn't quite reach goal and then regained, then I need to see if my sleeve was the issue (Which, honestly, I kinda doubt) or if I was the issue (yeah, more likely...)

Its very frustrating. I was very strict with the HMR program, and it seemed like everyone was losing weight but me. This was a food log/weekly meetings/weighins, etc. etc. tightly controlled program. I only ate the food they gave me for the program. It was really challenging, but I stuck to it. I did lose some - about 20 pounds - but that took a year and I gained I back. I makes me want to cry.

I get that I'm older, thyroidless, etc... but it just makes me wonder if I need that metabolic boost of RNY or DS. Restriction, maybe, isn't enough.

Thanks for listening and for offering solid advice.

I have about 5% thyroid function from Hashimoto's and still have lost weight. I had to revise my surgery due to GERD. Originally it was going to be a second stage DS, however the GERD was terrible and multiple doctors (some of whom specialize in the DS) said it was not advised. I opted for a much more long version of the RNY. In my case my sleeve was damaged and wound up being completely herniated, so I'd have needed surgery to repair it and resect it, regardless.

Even with a DS or RNY diet matters tremendously. You are an obligate carnivore with a DS and commit to strict supplements for life. The RNY is not as strict but still requires adherence to diet and lab monitoring. With the DS and the RNY it's the metabolic changes, rather than the malabsorption alone, which causes the thrust of weight loss. The VSG does have metabolic changes too, but they are not as pronounced. Even then it's a bit minimal between procedures. The metabolic boost lasts about 2 years with the RNY and DS, and 1 year with the VSG.

To be honest, I lost 300 pounds before I even had surgery, which I kept off, from being in counseling. Surgery helped me lose another 180. It was hard to admit that because I didn't want to acknowledge that my choices were the issue...I struggled with that for a long time.

But I do get thyroid dumbness. Stupid thyroid...if they ever remove it I'm going to kick it for good measure.

Thanks for responding here too (you also responded to my post on the revision board - thank you!!)

My thyroid was healthy and fine until it got cancer. D'oh! So they took it out, along with a bunch of lymph nodes, and nuked it with some radioactive iodine for good measure. Buh-bye, thyroid. You'd think keeping my levels right would be easy without having a thyroid at all, but of course the pituitary comes into play and then there is the conversion of t-4 to t-3 and all of these mysterious algorithms that our bodies do to arrive at a level... My meds actually change frequently, but I'm also on a suppressive dose (meaning overly medicated) in order to keep the cancer away. I should be losing if Im basically hyperthyroid, right? Sigh. No. Oh well, it's hard to complain because I'm still here and kickin'.

I definitely have some reflux issues but I don't think I have GERD. I just get some upper middle back pain after I eat and frequent sore throats. But, nothing too dramatic.

The DS would be great because I could keep my more natural stomach (pyloric valve I mean) but the diet would really hard for me to get right. I'm not a meat eater...

It sounds like you've and an amazing journey... you are a strong person. Thanks for sharing some of your story here, and for the encouragement!

Hello,

We have a similar journey. I was sleeved in 2012. Lost 145lbs but never made goal. I have since gained back 65lbs. It started after 2 yrs and a hysterectomy and hernia repair. I'be struggled with the scale going up 10 and down 15, over and over again. I recently went to a metablolic doctor with thought of getting a revision. (I really do not want another surgery) I'm currently working on losing the weight to have my hip replaced. So the doctor suggested a combination of Optifast 800/meal replacements and Belviq. Today is Day 1. Whew! The Optifast tast terrible. I have the vegetable soup and I added 1/2 cup of kale. I'm struggling to eat the 1 cup.

So what is my advice. If you feel you have exhausted all of your options and more surgery is the absolute last chance then go for it. I need to lose 100lbs before my hip replacement in 6mths. I lost 100lbs in 6 months with the sleeve. Let's see how this works. I will post more regularly. Send me a friend request to follow my journey.

Good Luck to you.