Considering revision, need advice

Hello everyone!

It's been a long time since I've been here, but now I could use some advice, and I know this is the best place to go!

I had my DS with Dr. Anthone at USC in May 2003.  I had no complications, did very well, and went from around 420 to a stable low of 205-210.  But after several injuries (knee, back and hip, and more recently, foot and ankle) I have basically stopped all forms of exercise - and gotten back into bad eating habits (carbs, carbs, carbs).  So, over the last 4-5 years, I have gained back 100 lbs. - and I am completely horrified, depressed and angry with myself, because I swore I would never get this big again.

My orthopedic surgeon will not do surgery on my bac****il I get down to around 250, and I'm sure losing weight would help with my knee/foot/ankle too.  My PCP suggested it, because I have been doing a very low carb diet for the past 3-4 months and have only lost about 15 lbs.

So...where do I start?  I'm in Southern California - are there any good revision surgeons down here?

Any help/advice would be appreciated!

Jennifer

Wow!  I totally get the movement issues with injuries/pain or whatever.  The thing is you got the biggest and best WLS already!  You had a great surgeon!  Would it really be worth it to tighten your sleeve (dangerous) and shorten your common channel (more chance of deficiency issues and more) when you know that you are/were doing absolutely everything to have a 100lb weight gain in the first place.  Carbs, carbs, carbs that is a NO, NO, NO and they must make you feel awful too - so you punished yourself.  Why do we do that!

It sounds like you are heading in the right direction doing low carb . . .  but are you really doing a clean low-carb?  We must be absolutely honest with ourselves.  You are losing and that is amazingly fantastic.  Just do you best and ride the train a bit longer.  You have a good surgery to work with.  Go back to the DS Forum - put yourself out there.  Don't hide, don't feel angry at yourself.  Forgive yourself and start from here and now.  There is a back on track forum here but I think it worth it to go back to the DS Forum here and post a how to do or get back to DS basics.

Hug yourself friend and give you a chance.  You can lose your gain if you just decide.

Best,

Layla

What Layla said, you already have the best tool there is and IMHO you are the only one who can fix it. The only way low carb works is to go inder 20 carbs per day and that is total carbs not net carbs because I feel carbs are carbs. No white flour, sugar or other carby products during the weight loss phase. With the DS you can have fat for flavor so super low carb shouldn't be too bad. Losing the second time around always seems to take longer so just be patient.

I would also strongly advise you get into some counceling to find out why you keep sabatoging yourself. Most people with weight issues tend to have a psychological component to it, whether you realize it or not. It sometimes takes a great amount of work to discover what the root of the problem is so don't expect a quick fix.

If you do both of these things along with support from the DS forum you almost have to succeed but the one thing I wouldn't do is look for an easy fix with a revision because as we both have said you already have the gold standard surgical tool. Best of luck to you and keep at it, don't give up on yourself. If you slip up, just forgive and get right back up, don't wait till tomorrow to get back on track do it the minute you slip!

Nothing really to add to the above 2 posts except to say they are right.  I regained all of my lost weight because I sabotaged myself and then gave up.  Now, I am having the band removed and going for revision after my tummy heals.

I really don't think you should look for another surgery, just yet anyway.  Go back to your plan and stick with it!!  DO NOT GIVE UP!

Good luck!!

My sister had the DS and actually lost more than they wanted and they had her over eating to stretch the sleeve and stop the losing.  She had her's in '06.  She is now 7 years out and she has only regained 20 of the almost 200 she lost.  She eats a lot of carbs.  She thinks she doesn't eat much but to me she eats like a pig.  She still doesn't regain.  She also over the last 7 years spent a lot of time in a wheel chair with knee replacements and feet rebuilding surgeries.  She was in bad shape from the years of extra weight and mal-absorption from the DS. But the DS is the surgery with the best long term weight loss.  There isn't anything to revise to.

The only thing I can think of was to sit down and go over how they decided how much to by pass and if it may not be the right amount for you.  I know when they did my sisters she had to do this whole big family history including all our medical history and removed ALL her intestines and measured what she had to determine how much to by pass. I don't know if they still do that any more or not.  Talk to your surgeon and a therapist.

The problem is that no surgery can help you if you eat carbs. We all absorb them just fine.

You already have the most effective surgery available, so all they could do is possibly shorten your cc, which would most likely add problems like diarrhea. You've gotten good advice. You need to focus on getting rid of the carbs, and what you should do, since you may have gotten careless in the years you HAVE been eating carbs, is re-learn where they are. You know, the sneaky ones in sauces or coatings or as sides. 

The only way to lose weight is to take in less calories than you absorb and burn.   You non-surgery options are to go to extremely low carb, which will be very difficult since you have been eating carbs now, or to start tracking food and counting calories.  I think that fifteen pounds in three or four months is excellent.  It is about one pound a week. 

If you start careful tracking, you should easily be able to up that to two pounds a week.  There is a program called If It Fits Your Macros.  It will let you calculate your protein, carb, fiber, and fat needs to lose two pounds a week.  In your case, you might lose a bit faster due to malabsorption of fat.  Start using that program to set your goals and My Fitness Pal to track everything that you eat. 

Be realistic and give yourself a year to lose 100 pounds.  As others have pointed out, further surgery now might result in constant diarrhea or too much malabsorption.   Before pursuing something like that, work with the If It Fits Your Macros Program