Now what?

I had my surgery 5 years ago. I never reached my goal of 150, but I did lose 135 pounds, and weighed 200, give or take 5 pounds. Over the last 2 years I have gained back over 70 pounds, even though I haven't changed how I eat and I still exercise by walking and swimming every week. My surgeon has retired and my family doctor is no help. He has tried to keep up with my labs and helped me with vitamins.  When I had my BPD/DS, I was told that there is usually some weight gain over the years since our bodies try to recover from the original surgery, but I didn't think it would be this much. I wonder what kind of revision I could get? Any Ideas?

Hi Beverly, I'd like to invite you to come to the DS forum for some suggestions.  Your case is indeed not the common rule.  The customary bounceback is only around 20 lbs.  Perhaps we can help offer suggestions and you can find some comraderie. I can offer one suggestion off of the top of my head: Try going back to high protein, high fat and very low carb, eliminataing sugar and flour for a while.  We have some that are a few years out, and doing this kicks their metabolism back into gear and they are losing again.  I've stayed within my 5 lb comfort window for a year now at goal, but if I should start to creep up, I'm confident that I can work it back down again.  I weight myself monthly so I can attack anything before it gets out of hand. As for revisions, do you know how long your common channel is?  That might possibly be able to be shortened or your sleeve reduced if its pretty stretched out.  Just throwing out ideas here.  I'm hoping some consumption alteration might be your key, though.

Beverly, Can I ask who your surgeon is?  Do you have your surgical report from the time of your DS?  Do you know the size that your surgeon made your gastric sleeve, alimentary limb, and common channel? How long since you've had thorough post-op labs?  (I.e., should be between 15 and 20 vials of blood taken after a 14 hour fast). Some of the folks who were given pretty large gastric sleeve capacity at the time of their surgery have found that gaining more than the typical "bounce" 10% is not unusual.  Several of the leading DS surgeons in the world are now offering revisional type procedures where they go back in (and if it were me I'd TOTALLY insist on a lap procedure if at all possible!) re-sleeve to give a very small gastric sleeve capacity (in the 30 to 50 cc range), and then measure the alimentary limb and the common channel and make adjustments if they are found to be grossly out of proportion. I know several folks now who have had their DS "tightened up" so to speak.  If you'd like to talk about the specifics, let me know. Blessings, dina

I didn't know that Dr. Sugarmen did the BPD/DS as he was such a pioneer with the RNY How great that you had such a fantastic doctor and a shame he is retired have you contacted another surgeon for a follow up and continued after care.

Hi Beverly- I am very sorry to hear of your situation.  It caught my attention because my surgeon too set my goal weight at 150 and I have only made it to 197, and don't anticipate ever making it to his goal.  I feel somehow like I am his only failure!   May I ask when  you started with your regain and how quickly it came on for you?  How have your labs been? Take care!  I will be thinking of you.

I gained back about 20 pounds after  3 years. I tried to lose it but it just would not go! The the rest just kept piling on in this last 6 months. My pcp checked me for fluid retention, but taking Lasix only resulted in a 5 pound loss. I still exercise and I don't eat cakes and candy type food. I always eat the protein part of my meal first and I do eat fat.  I really don't understand what has happened. I have read so many who had BPD/DS who eat everything and stay at their low weight.  I don't think I eat more than 2000 calories a day, and some days much less. I don't know what to do. Is there a revision for BPD/DS?

I do not know much about the revision options, other than I have read that there *are* options.  If it were me and I was considering a revision, I would go to the DS board and post about it over there.  I am sure they would know all about it and they are very nice and helpful, not to mention incredibly supportive.  They have saved my sanity over there more times than I can count. Do you have a doctor in mind?