how to start over???
I hope your test results are helpful to you.
I personally don't think 40lbs in 8 years is seriously indicitive of a mechanical failure, but I am certainly not against ruling one out.
In my experience, my pouch can be as loose or as tight as my habits make it be. I know how strange that sounds. But when I'm on track, my pouch is still a very effective tool. I have restriction. My hunger and fullness follows exactly how it should. When I am not on track, it's amazing how much I can eat and how much I can graze all day -- and what calories that adds up to! I was not aware that 1/4 cup of roasted sunflower seeds was 400 calories for instance! You know how fast I can down 1/4 cup of seeds and not feel one iota of satiation?! An average REAL meal is 300 calories for me. For comparison!
I hope you get an appointment with the nutritionist while you're at it. Or even a local WLS support group might help. Getting back on track is 80% psychological and your body will make up the rest just fine.
The cottage cheese test is ridiculous. It's a slider food. Maybe it'll work with newbies and maybe it won't, but it really, really won't work for us. I could probably sit there and eat a whole 16oz tub. IF I liked the stuff and I do not!
Everytime I have done the dense protein test, I have been fine. In reality, I'm only comfotable with 4-6oz of protein and that's with no other food at all. With other foods, it's more like 3oz. That's totally normal. I don't get the fullness I did the first year or two, and I don't stay FEELING really full for hours anymore but not alot of people do this far out. You have to look more for feelings of satiation than fullness. And you do have to weigh and measure and plan and get a schedule down. The surgeons know about regain for us grads, that's why they push that so much in the beginning. Learn it then, and you won't have an issue later. In reality, most of us get at least a little lax. Some of us have more consequences for that than others.
I've also learned hunger isn't a desperate as I once thought. It used to be the world's most uncomfortable feeling and I'd feel a desperation to grab something, anything! to stop it. Pre-op, that meant cramming as much down my throat as I could to make the feeling stop. I've learned with sit with it and just let it roll on by without judgment or attachment. It's my emotional interpretation of the feeling of hunger that makes it so overwhelming. Even if I don't eat a protein-dense meal an end up hungry, I can wait until my next meal. Starvation is different and unless you go more than 8 hours without food, you won't truly feel that.
I hate to say this, but I am right there with you on having to, or at least, feeling like I have to start over.
I am 10 yrs post op and during that time I lost 150lbls, gained 30 back, dropped that 30 and then another 30 more, and now I have ballooned back up to over 200. The level of shame I feel is almost unbearable. 
This month I joined a new gym - one that focuses on cardio more than anything, and HOPE it kick starts my metabolism again. But like some others have posted; it's time to get back to basics. Higher protein intake; lower the carbs; increase the water; make sure to add in good vitamin supplements; and get active!
Miss Anita - You were strong once before when you made this life choice. I have no doubt you will find your inner strength again and beat the fat back into submission... just like I'm going to do ;-)
Melissa 
Hi Anita.
I too had my surgery in 2003 as well. I had shed 152lbs within the first year. At 124lbs I felt too smalland unhealthy eventhough the books claimed I was at goal. I tried and achieved getting to 140, a size 8 which I was more than fine with. However over the last two years and much added stress ( I am a stress eater) I have lost sight of protein first and fallen for carb securuty. With this I have gained 28lbs and hate every lb. I am a firm 10 which I know is not large, however I feel unhealthy and it is time to regain comtrol. I went back to the backs and last week lost 2lbs. It isn't a lot but I've got to try. I know that WE can do this, we did it before and it's always easier the second time around.
proteins first ALWAYS! One thing my nutritionalist once told me was if you ever eat more than HALF of a happy meal YOU are FAILING your TOOL, your TOOL is NOT FAILING YOU! That has stuck with me...
Good luck.
Trish
My heart aches for you guys!! Besides the great diet advice given, support and motivation are what you need. Have you visited the site www.300poundsdown.com ? It's a blog by a woman who is on the same journey and has had wonderful success and relapses, and boy, is she inspirational!!
My sleeve procedure is Feb 12th and this pre-op diet is the pits!! But my motivation is so high right now and I feel like I can do anything!! My biggest fear is that "someone" will turn my motivation switch to "off" again and I be right back where I was. I don't know the secret to keeping the switch in the "on" position, but inspiration is helping more than anything. Good luck to you all; if you did it before, you can do it again!!!
Hi there!
I am 3 days into "starting over" !! My surgery was 2/5/08 and I had lost 130 lbs. I have gained back about 30lbs and I don't like it either! So what to do what to do!?
Here's the short version of what I am doing (and I'll be very detailed in a bit)
1. MyFitnesPal app on my phone for a reasonable outline of food intake
2. Syntrax Nectar protein powder
3. Mild exercise (I am 9 weeks post-op from a major foot surgery - so when I say mild, I mean MILD)
It didn't seem reasonable to go back to the immediate post-op diet as I know I couldn't handle doing that just yet. Not saying that anyone here is wrong for giving you that type of advice. I have GIVEN that advice myself to "other" people but the thought of how restrictive that is, has put me into a procrastination mode for the couple years. It's not that I am gaining... I am managing that 30 lb increase just fine.
I may actually go back to a modified version of the post-op diet if I can stay on this for at least 30 days. By that time, my mindset will be different.
My Fitness Pal: (Android and Ios)
What it does: Daily allowance of calories based on weight, amount wanted to lose, and accurate nutritional intake (broken down quite extensively)
This smart phone app was a real eye opener! I had no idea how much I was consuming and how little water, protein and vitamins I was getting. One example is I like decaff coffee in the morning, no sugar, half-and-half. My half-and-half consumption for the day was 160 calories!!!!!! JUST the half-and-half!
So I am now very conscious of what I am eating every meal because I know what I just ate and how many calories I have left.
Protein powder:
What it does: Increases protein intake, decreasing overall appetite, heals muscle, bone, etc. V. important in WLS (as we all know)
The thought of chalky Vanilla and Chocolate protein shakes made my stomach churn so I found that Snytrax Nectar whey protein isolate mixed with zero calorie flavored water was the perfect option. I bummed a bit when I realized it had 100 calories a serving but after three days of having protein powder for lunch, I found I wasn't hungry until dinner time.
Mild exercise:
What it does: Gives me more calories to eat (yum) and increases endurance, strength and improves my mood. Also, skeletal exercise is needed to protect bones from Ca loss, which is a biggie for me, being 47 and menopausal.
Like I said: MILD. I am barely walking without the CAM boot yet from foot surgery on June 20th. Before that I was in pain since October and barely walked either. SO many people would say "well, you can lift soup cans" and I wanted to smack them in the face. It was DEPRESSING to not be able to walk and even go on an errand to the grocery store.
So I am able to walk my dog 2 blocks right now. (Note: not AROUND the block -- a straight line of 2 blocks) It takes me 15 minutes. I also have to do knee bends, balancing, isometrics and strengthening exercises to allow me to walk better. That takes about 15 minutes. So that is 30 minutes a day of MILD exercise.
