Back - AGAIN - 14+ years post-op

Hi all! Boy, everything's changed since the last time I visited here...and that's been oh, 6-ish years? At least. Still looking for familiar names. We used to keep this board hopping constantly!

Anyhooooo...Long story shortish, I maintained my weight loss for a couple of years, and slowly let the sugar monster back in--not even being aware at the time that there WAS such a thing and that it 100% my biggest issue. Lots has been learned since then! I've been up and sort of down, up and sort of down....here I am again at 220 (172 was my maintenance weight). And right back to the pre-op days, I have tried E-VER-Y-THING to bring my post-sleeve self back again and just...well, you know how it goes.

Currently, I'm giving serious thought into looking into a revision. Do they even re-sleeve? I don't want to DS or a RNY. Just my sleeve tightened back up. I started checking around this morning and my surgeon has retired.

I'm in Michigan, and my surgeon was Mark Pleatman. I was also self-pay, and the total cost was a little over $12,000, if I remember right. I know it's a longshot, but did anyone else have Pleatman, find a good replacement, and have a revision? OR, self-pay for a re-sleeve anywhere? I'm wondering about cost as much as anything. I know insurance won't cover it.

TIA! :)

Revisions do not normally work. To lose the weight again you have to eat less than you burn. I highly recommend Weigh****chers book The Shift. My lowest weight after surgery in 2007 was 128. Today I was 129. It took three years of daily WW meetings online and learning a new way to eat.

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 Stacy!!

I think I was meant to find your post. Sugar is the devil!! I no longer live in Michigan, but my surgeon was Mark Pleatman also. I do remember it being around 12k out of pocket. I had a VSG in 2011, my original weight was 345. (I'm around 5'9") currently 220, which is about 30 pounds over my goal weight of 193 (which I did achieve!). I think being over 40 and perimenopausal has a lot to do with that - but that's a story for another day lol. I have seen a lot success stories for many VSGers who have had revisions. Perhaps for gastric bypass patients there is less success(?) but there are a lot of VSGers on here that have had revisions. I am not in that number, but please dont be discouraged!

Dr. Pleatman was great and no nonsense. I really appreciated his straight forwardness and candor. Keep us posted!

Hi there, Skylark! So I'm not going that route, but I have found what I think is my key to success...updating below! :)

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,

Hi there! I had my sleeve in 2010. These boards were so helpful at the time. I went from 360 to about 170, stayed at 190 for 8 years then started working third shift, and eating more often. I still have great restriction, I just eat bad things, and drink pop. I gained to 260, now I am back at 228...trying to get back below 200. It's a struggle. I am in MI too, I had Dr. Foote in GR

Hi Dawnie! I actually remember you from back then...not specifics, but your name at least! Posting a separate update below. :)

Thanks for your replies, everyone! I have Notifications turned on, but didn't get a single one letting me know anyone had replied until Dawnie's this morning. Anyhooo...

So I ended up doing some research on Semaglutide (one of the newer medications being used for diabetes and obesity treatment). After reading and reading, and looking at SO many patient reviews and experiences (particularly post-VSG people), I decided to go for it. It's amazing how the tiniest little injection works so well... for me, I started feeling the effects immediately. The day I did my first injection, I could only eat maybe a cup of chicken Caesar salad that night (usually I can put down a lot of salad) .... just filled up SO fast. Food noise is gone, appetite is gone -- I literally feel like I did in the first months after my surgery--able to eat anything, I just don't want to. I'm not constantly thinking about what's next. Not going through my head what's available at home to snack on after dinner, and whether or not I need to stop at Dollar General for junk food on the way home. It's amazing.

My thinking is this: My sleeve is still there, it still works great IF I eat what I'm supposed to. Using this to help re-train my thoughts and habits to get where I need to be is showing me that; it's teaching me again to watch for my full signs (hiccups), stop when I'm full (and full does NOT mean stuffed where you can't eat another bite), and not take a break for a few minutes and start again. Between this, and knowing what I know now about sugar addiction, and what my danger situations are, I think is going to keep me from gaining it back again in the end.

Anyway....that's where I am now. Oh, I lost 15 lbs the first month and have been hovering there the last 3 days, but we all know how that goes! :D Thanks again everyone!

Before you contemplate more surgery can I sincerely suggest you read the book "Food Junkies" by Dr. Vera Tarman 2nd edition. This is a book about sugar addiction and how to abstain.

I too had VSG in 2011 - weight loss lasted less than I year and I started to regain and lose just like pre-surgery. I binged and restricted and got deeper and deeper into the bad food again.

I read Food Junkies and FINALLY recognized that I had a food/sugar addiction - just like alcohol or drugs, sugar lights up the dopamine in your brain and you are in trouble. I joined the website that Dr. Tarman has and learned that I was not alone. I learned I could not do moderation and that one bit of sugar led me to a binge over and over again. This isn't an issue of willpower but rather what sugar does to the brain. There are many many bariatric patients on the website that like me were told to moderate all food. That doesn't work for many like me.

I started abstaining from sugar back in 2018 after gaining a lot of my weight back. I would go many months and then relapse. I kept fighting the desire to be "normal" and kept convincing myself that I could moderate. I have now been totally sugar free for over three years. I had to limit grains as well as grains are so processed and turn into sugar in our system. I lost most of my regain (10 pounds short of my goal) and for ONCE in my life my weight is stable and has been for a few years now. I no longer have 3 different sizes in my closet. I can wear clothes I bought several years ago because surprise - they still fit. For once in my life I have food peace - no cravings, no food hangovers, etc. etc. I do not feel deprived and for the first time in my life I feel in control of my eating.

I would highly suggest you give this way of eating a try - more surgery is not going to fix anything if you have a sugar addiction. Check it out and see if you recognize yourself.