Anyone from Southern CA with Kaiser have a failed RNY??

I've been unable to lose any weight in five months, and I had my surgery eight months ago.  I am completely compliant.  Nothing I do helps.  I gain weight VERY easily from refined carbs, have very little dumping, can chug water like no tomorrow (never had to sip).  No amount of exercise helps.  Outside of starving myself, surgery has trapped me.

Initially I thought I was having a hormone issue (I have PCOS), but after finding this forum, I'm seriously rethinking that.  I'm SO glad I found this forum today, because it's sounding more and more like not enough of my intestine was bypassed.  If I was connected too high, then I was connected in the area where my intestine is very absorptive.

That would explain why I have very little mal-absorption issues.  It would also explain why every time I eat carbs (even healthy ones, as in fruit), I gain weight in whole pounds (or more).  It would also explain why following my doctor's orders in what to eat keeps me from gaining weight, but does not allow me to lose it.  My body is literally soaking in everything I give it, even at 1100-1200 calories a day.  Every lab test I've had shows no thyroid problem, no vitamin deficiencies.  I do get full when eating protein first, like most people, so the problem is not my pouch.  The problem is in the absorption.  I lost the first 20 pretty much right out of the hospital (and or course was on liquids, so that's why).  It's been a fight ever since.  I can't lose anymore, and have only lost 40 pounds.

What I hate is that if this is the issue, it's going to require another surgery to fix it.  My husband was NOT happy to hear that.  He has no idea.  A revision surgery is two to five times more risky than the first one.  Otherwise, I've been trapped at 235 pounds for the rest of my life, unable to lose weight.  And because I am at a an extremely high risk for diabetes, I need to get the rest of this weight off.

Does anyone have Kaiser in Southern CA and know if insurance covers revisions?

wow i just want to say that i'm in your boat too! i had surgery 10 months ago and lost what 70 pounds BUT i learned that my body does love the carbs too (crackers and stuff) and i gained weight eating some and completly haulted my weight loss. I have now purchased the medifast meal program and STILL having slow issues! i've been on it going on 2 weeks and lost 2 friggin pounds! when others loose 5 plus the first week. So we shall see. I guess what i'm saying is that its comforting to know your not alone. And i have done the 5dpt too try that and see if it kicks you into loosing again

www.5dpt.com

Hi, Deborah!  It's nice to meet you.  It IS so comforting to know you have kindred spirits!

Well, in what I HOPE is a good turn of events, I went to see my PCP today (well, sort of; she's out for four months after having surgery, so she has a sub).  I was diagnosed with PCOS 15 years ago, and it has two symptoms that can make weight loss near to impossible -- insulin resistance (too much insulin in the blood turns everything into fat), and excess androgen hormones (male hormones).  I have the hair growth on my chin, upper lip & sideburns, had gestational diabetes, hardly ever had a normal period in my life.  While I've had PCOS for a long time, it's never affected my weight loss before.  But after surgery . . . something kicked in.

My doctor prescribed Metformin for me today.  I'm eager to try it and see what happens.  It's supposed to work on both issues -- insulin and the male hormones.  Lord knows, I'm not looking for a magic pill.  I KNOW what I'm supposed to eat and how I'm supposed to use my tool.  No one has to tell me that I need to work the tool!  But if the tool's being held hostage by your hormones, there's not a whole lot you can do until that's straightened out.

Just a thought -- have you seen an endocrinologist to have your hormones tested (estrogen, progesterone, testosterone)?  If your hormones are out of whack, almost no diet in the world can help you until that gets straightened out.

I also kept coming across the South Beach Diet being mentioned in several of the forums I'm a member of.  I pulled my book off the shelf this evening, and have decided to try and make use of it.  It specifically lists lots of low GI (Glycemic Index) foods that will help those of us who have an insulin response to processed foods and/or foods high in carbs.

In a way, I'm glad carbs make me gain weight.  It'll keep me from eating the wrong things too often (especially since I don't often dump on them!), but on the other hand, eating low carb hasn't worked well for me much either.  I have an appointment to see my endo next Friday and have my hormones tested, but I've always known I had a high level of testosterone due to the PCOS.  Maybe he'll have some other tricks of the trade to share with me.

i've had that checked before and came out fine. but i tell ya i see my doc next month for the 1 year follow up and i'm going to demand answers. he always says just give it a good 2 years and you'll be down to your goal weight, some people are just slower than others. I want to hurt him when he says that i'm slower than everyone!

i was wondering also if my insurance would cover another surgery we shall see.  keep me updated as to your loss with that metaformin

Metformin has performed an absolute miracle.  The morning after I took it for the first time, I'd lost 1.5 pounds.  The next morning, 2.3.  The next morning, again over a pound.  Within a week, I'd lost 9 pounds.  That's no accident.

My endocrinologist is running insulin, glucose, progesterone, testosterone, and DHEA tests.  The issue may be deeper than simple insulin resistance caused by my PCOS, but when all the tests come back I'll know for sure.  I've gotten the glucose, testosterone and DHEA tests back already.  Glucose was lower than last time, testosterone was normal (which surprised me), and I'm currently doing some reading about what's considered normal for DHEA-S tests.

I went off Metformin for 72 hours before taking the test yesterday, but my testosterone and glucose are showing normal levels this morning (I can see my test results on Kp.org).  I wonder if that was long enough, and if Metformin skewed those results.

If I were you, I'd go see an endocrinologist.  I'm telling you right now that your surgeon is going to have NO IDEA what to tell you.  He's a surgeon, not a hormone specialist.  I called my surgeon yesterday to tell him I was on the Metformin, and he sounded surprised.  Why?  Because it never occured to him.  He's more concerned with the mechanics.

And don't go to your primary care doctor.  They're great people, but they're going to look at your numbers VERY differently than a specialist.  Case in point: the last time I went to see my PCP, my blood clucose was 94.  She dismissed my concern that it was close to being over the limit (100).  With a very literal wave of her head, she said, "It's fine."  But my ENDO said, "Now this is a very interesting number.  You are within normal limits, but on the HIGH end of the range."  I wanted to scream!  That' s EXACTLY what I said to my PCP!

See?  A specialist is going to look at your test results very, very differently, very specifically, and he will order tests that your regular doctor would NEVER order for you.  I'd call my PCP right away if I were you, and ask for a referral to an endocrinologist.  They are precise and much more willing to dig deeper into the complexities of hormonal issues that a general practitioner will gloss over.  You might be surprised at what you find.

WOW that is so great! i will do that asap! thank you so much please keep me updated that is incredible i know you are jumping up and down

By the way, how many calories are you eating per day?  I ask because in addition to the Metformin, I upped my calories.  I've been eating 1100-1200 for the last five months, and decided to do more reading about starvation mode.  I had upped my calories once before, but I had done it for just a couple of days before I had an appointment to see my surgeon.  When he saw my journal, he asked why my calories were so high (1500) and I told him it was because his nurse said I probably wasn't losing because I was hardly getting anything in.

At the time, I had upped my calories by adding refined carbs.  Not sugar, but carbs that were easier to fit in that were made more of white flour.  The healthy carbs are full of fiber and fill you up, and because our stomachs are so small, I couldn't eat 1500 woth of health carbs, so I tried to get them in any way I could.  But instead, he told me to up my protein drinks.  I lost for about a week, but plateaued again.  I had been thinking all along that it was the extra protein that made me lose the weight.  But now I really don't think so.  Protein drinks have calories in them.  I think it was the extra CALORIES from the extra protein drinks -- not the protein IN them -- that caused the loss.

But then I had to back off of the extra protein drinks because they were giving me headaches.  After that, it wasn't the loss of protein that then made me stop losing; I lost those calories.

I got the protein from food, but because I was getting so few carbs, I couldn't get in that many calories.  Protein is high in protein but low in calories.  So I was getting one, but not the other.  And the only way to up your calories while eating high protein is to add carbs.  The whole carb/protein/calorie thing has been so confusing.  They drill "protein, protein, protein" into you, that I took them literally and was eating VERY few carbs!

And because of that, my calorie intake was low.  I had assumed that surgery changes your body to the point where you exist on very few calories now, especially because so many people I read about were eating like 700 calories a day and losing, which made me think that's what I was supposed to be doing, too!  Even on 1100 to 1200 I wasn't losing -- which caused me to think that I've got a hormone problem (and to some extent I do).

When I started the Metformin, my monthly started.  I hadn't had one in five years.  It was light though -- not really a flow.  I thought I was done on Friday.  But Friday is when I started reading more and more about starvation mode and decided to up my calories the healthy way and see if I could fit in 1500 calories.  I bought whole grain bread, fruit, low calorie Wasa crackers, etc.  The last several days, I've been eating about 300 calories 5 times a day.

Yesterday I went to church and had two people tell me that I look like I've lost weight.  Part of that is that I've started a workout with weights -- a high circuit workout DVD with Cathe Friedrich.  A friend saw me and told me, "I don't care if you say the scale isn't moving, you MUST be firming up!"

Since I've started eating more -- I'M HUNGRY ALL THE TIME!  But I think that's a good sign.  I wasn't really all that hungry before.  Now that I'm eating, I'm burning!  That means the pilot light's been turned back on!  Secondly, after I thought my monthly was over, it came on with a vengeance yesterday.  My body's systems must have been unable to function just simply because I wasn't eating enough.  But I couldn't figure out or maybe really didn't understand how I was supposed to be eating.  I thought I was to be eating like Atkins, but now understand that I need to eat a balanced diet with high-fiber carbs.

I may actually have to take up my calories closer to 1800, because no kidding -- I'm waking up in the middle of the night STARVING!  Last night I ate a low-carb quesadilla with whole wheat taco-size tortillas with 2 oz of chicken and cheese.  At least I made it through the night without waking up hungry, but at  6 this morning I was ravenous!  You'd think I was pregnant or something, because that's what my body did when I was carrying children.  I ate nearly 1700 calories yesterday in healthy foods, and dropped .7 of a pound this morning.

Here's the other thing -- if I eat 1000 calories a day, where do I have to go once my caloric needs lessen?   What's going to happen once I get to 200 pounds?  Do I eat 800 calories?  And THEN what happens once I reach goal?  I can't live on 500 calories a day!

The thing that threw me off about this is that I was losing on 1200 just before surgery, so I thought that's what I was supposed to be eating after surgery.  But then I thought about it -- I got to that number GRADUALLY.  They started us off at 2000, then 1800, then 1500, and then 1200.   They did that because we would be eating only 300 calories immediately after surgery, and they didn't want us to go from like 1800 calories to 300 and go into shock.

No one ever told me that I should still be striving to eat about 1500 calories a day after surgery, though!  Everyone talked about using small plates and small meals, etc., so I'm thinking I'm supposed to be eating like a bird with meals of nearly all protein!

A lot of people talk about how they're eating LOW calories now, and increase their calories to stop losing weight.  I seem to be the opposite.  I have to start HIGH and then work my way down to a calorie level where I'll maintain.