Houston we have a problem

SW 225 current 173 lowest 160

2006 RNY starting weight 225 - considered lightweight and doctor did not make my stomach as tight as he could have.  Only lost 65 pounds.  Moved out of state and stayed around 165 despite doing everything right.  Cannot remember the name of my original surgeon.

2010 started gaining weight but had severe reflux. Found a new doctor and he went in and did a hiatal hernia repair. Said I had a large hiatal hernia and it was in my chest.  Pulled my stomach back down and said he tightened it a little and made the opening to my intestine smaller as it was very large.  

2014 had stomach pains and had gallbladder removed.  Most people go to the bathroom constantly with no gallbladder, not me it caused just the opposite - constipation.

2015 started having a lot of reflux again. 2016 doctor said I needed hiatal hernia repair again and this time he would put a mesh around it to hold it in place. While doing that my insurance also approved a revision since I had gained weight.   Surgery was scheduled, arrived at the hospital only for them to say all surgeries were cancelled due to weather conditions.  Surgery rescheduled a week and a half later but late afternoon 4:30. Note - prior to wheeling me in for surgery I asked him to make everything as small as possible. Woke up in recovery around 10:30 p.m. spent the night in hospital. Woke up around 3 am and got up and walked the halls.  The sooner you get up the quicker you heal. Then discharged later that day.  Got home, sore from the cuts from surgery but other than that normal. A week later went to the doctor and told him "are you sure you did a revision because I feel normal and I have no problems eating or drinking". He said well your stomach was still small so you really didn't need a revision and I only made a little bitty revision.  What the hell?  I need to lose weight and insurance approved a revision.  If you took a frozen thin crust pizza and cut it into 8 pieces, if I wanted to I could eat 3 pieces with no problem, so, how in the hell can my pouch be small? Asked about my stoma and he said it was still small.  Told me to just cut out carbs and I would lose weight. Also, said not to drink my protein but to eat it. He said I am the type if I look at food I will gain weight and to keep my calories around 800 daily. I want to cry.  I feel like contacting my insurance company to make sure that they do not pay for a revision.  I feel like checking with another doctor but I just don't know what to do since they normally do not want to see another doctors patient. 

Advise please!

I'm a pre-op... 

But from everything I've read here, as well as other sites, what your doctor told you is correct.

No drinking 30 min before, during, and after a meal (otherwise, you are just washing all that good protein straight through).

Good proteins first, meats, cheeses - non-starchy veggies second (broccoli, green beans, cauliflower - not carrots, potatoes, etc). At leaset 60g of good solid protein a day. 

120 ounces of water. don't drink your calories (that includes alcohol).

Cut out ALL sugars/flours/breads/crackers, etc. after about 10 days you will lose the cravings.

You have a tool, and it sounds like your doctor has checked out your pouch, and it's working as it's supposed to. Now you have to work on your end to make the magic happen.

I disagree.  I drink at least a gallon of water a day. I do not drink alcohol at all. I get my protein shakes in. I can walk 3 miles a day and no weight loss.  The point is if there was any type of a revision, you would feel it and you would know it because the first thing after a RNY is that they take you in for a test to make sure there are no leaks - that was not done. So, I would assume since that wasn't done then the revision of the RNY wasn't done either.  Last week I only had sugar free Popsicles and tomato soup each day = no weight loss.  I even stopped taking my estrogen hormone replacement (54, post menopause) to see if that would make a difference.

Ask for a copy of your surgical notes to see exactly what went on during surgery. You might need another professional to review what has been written and give the info to you in lay man's terms.

Got he surgical notes. No mention of revision to pouch or the size of it.  So, as long as my insurance wasn't charged for it I am okay. I do not want them thinking something was done that wasn't.  I will have to see how it goes it I cut out all carbs.  Thanks for your input. 

You might just be uber sensitive to carbs.  S/F popsicles have 4gms of carbs each. Tomato soup is pretty loaded with carbs, too.

What about Atkins for 2 weeks just to see what happens?  Drastically limit all carbs to 20gms daily for 2 weeks.  If you lose well, it's your diet.  If you don't, it could be a metabolic problem and testing your BMR would be in order.

The carbs from the popsicles and the soup could be causing water retention.  Also, the salt could be causing water retention.  In a week, you will not see a difference if you are having water retention issues.

What I would recommend is googling a BMR calculator i.e. this one.  This will give you a guesstimate of your caloric needs for maintaining your current weight.  Shave off 500 calories to start and use that as your beginning guide to how much you need to eat a day to lose weight.  Start weighing and measuring everything you eat and logging it.  Myfitnesspal makes logging quite easy, but you can use a different tool or even pen and paper.  If you are not losing within about two weeks (give the body some time to adjust), try lowering your calories, rinse repeat until you do lose weight.  

If you are eating more than 1000 calories per day below your BMR and still not losing (giving yourself some time), then there is something medically wrong that needs to be investigated.

As for what to eat to avoid water retention, try to reduce salt.  Eat less than 100g carbs/day.  50g or less is even better.  See how you feel and adjust.  Try to get as low as you can.  Low-carbohydrate foods are meat and low-starch vegetables.  With Myfitnesspal, it's pretty easy to keep track of the carbs and figure out how many carbs are in what foods.

Try to rely more on measurements than a scale, also.  Body weight naturally fluxuates and can be misleading.

During the weight-loss phase (as opposed to maintenance), most people here seem to shoot for under 25g of carbs per day. Some allow up to 40, but definitely not 100.

I tried this calculation. If I ate all the calories it says I can eat I would gain all my weight back. I can maintain at about 1200 but this says I can eat 1881. I wish this was true

That's why you never use BMR as an absolute.  People have different metabolic rates and activity levels.  I'm always over my BMR.  For example, at 330lbs my BMR was 2100.  I could eat 2400 and still lose 1-2lbs/week.  Unfortunately, I was hungry as hell and ate like 3500+ far too often.  When I did stick to 2400, I lost, but it was the battle from hell.