Question:
I don't know where to start.

I had RNY 6 years ago. I had lost about 110 lbs and have since gained back about 65 lbs. My surgeon no longer deals with this surgery. Should I try to get a revision? Should I do the 5 day pouch test? How much calcium should I be taking now and how many vitamins? I have to get a B-12 shot each month. Should I take B12 sublingual too? Please help......    — Kittylover56 (posted on July 4, 2008)

July 4, 2008
If I gained back more than 10% of my weight loss I would be contacting my sergeon, but maybe he is out of business. I have o assume that a revision would greatly assist you in losing your weight and with the right surgeon, you would allso get an opportunity to be beter educated. Today they send us to class and make us study before surgery. I don't know where you are, but in St. Augustine Florida there is a great Bariatric Sergeon that does revisions, but he does require you to take at least a day long class a few weeks prior to surgery. I know there are people that come to him from out of state as he has done more than 6000 WLS. His name is Dr. Robert Marema, and he is on this web site. He is with US Bariatrics, see www.usbariatrics.com or www.flaglerhospital.com. While he has several locations in FLorida, I know he personally only operates from this hospital, and his associated do the other hospitals in FLorida that are listed on their site. Best of success to you.
   — William (Bill) wmil

July 4, 2008
There are some great surgeons in the Northern Va. area. I had my lap band done in Reston. My Dr. doesn't do RNY any more but Dr. Robert Pinnar in Reston does. Also, there are doctors in Winchester and Hagerstown now that perform bariatric surgeries now that you could check out, they would be much closer given where you live. Best of luck to you!
   — HBSantis

July 5, 2008
Grace, weight gain is such a discouraging thing, and it happens all too fast. 6 years goes by pretty fast. I think Grace, that you need an evaluation. A revision will not help you lose the weight, if you are not willing to work at it now. If you are not taking calcium and vitamins now, you could have damage that is not reversable. I take 3 calcium chews (GNC or Walmart) and one multi vitamin every day, it is important. It is also important to exercise, diet and drink water. If you neglect these three things and your vitamins you are putting yourself at risk for problems, and that should like what you have done. I really encourage you to begin a walking routine, stop all fluids but water and milk, much more water than milk, and cut your portions in half or better, concentrating on lean protein first, then fresh veggies, no treats or snacks, and go to the vitamins once or twice a day and 3 calcium chews. Once you start this, find a surgeon that will give you an evaluation and see where you health is. Once you get yourself on track again, then see if you need a revision. The thing about a revision is people think it will help them lose weight like before, the truth is that is NOT true at all, many people go through an additional surgery and get so discouraged when the "surgery" did work for them. It is not the surgery that works, it is you that works. So if you get to work now on your health and weight, you can probably skip surgery again altogether. You can do it girl! You CAN do it! Patricia P.
   — Patricia P

July 5, 2008
Well, first you need to figure out WHY you gained so much of your weight back. Likely it was that you slowly began breaking the rules, one at a time, over a period of time. It is so easy to become relaxed once you are at your goal. We get braver and braver and push the rules and eventually fall back in to our old habits. The first thing that I would do is do a liquid diet for a few days and then start fresh with a high protein diet and eliminate ALL the bad carbs. Eat small portions of food and eat often like you did in the months after your WLS. Make sure you follow the basics; drink lots of water (64 fl oz) every day. Carry a water bottle with you wherever you go. Buy a bigger purse if yo have to. Never leave home without your water. No liquids 30-45 minutes before or after your meals. Get a minimum of 60 grams of protein each day (80-100 is better). Find a protein supplement that you can become friends with (which is pretty challenging, I know) because it is almost impossible to get all you will need from food due to your restiricted volume. From all I have been reading, protein in critical not only to your health but also to your successful weight loss. You also need to become "in touch" with your body again. The pouch-tool is still there and you can and must use it as it was intended to be used. Do not overfill it. You will need to rethink the whole satisfied vs. full thing. Eat to live instead of living to eat and eat only what is healthy and what your body needs. Not to say that you cannot enjoy food but the focus must be on feeding your body not your appetite. Also like the others said, you need to get back on a vitamin-mineral and calcium regime as soon as possible. I take atleast 1800 mg of calcium every day. Oh and I almost forgot, you have to eat slower and pulverize every bite of food again. I know it has gotten easier to scarf down my food and I am constantly having to remind myself to SLOW down and even set my fork down between bites if I need to. YOU can totally do this! You did it once and you can do it again. Don't get discouraged and quit because you will not see the same dramatic weight loss like you did inthe weeks and mnths after your original surgery. YOur body has adjusted and the malabsorption will not work now like it did in the early months after the WLS but you can STILL lose weight. According to my surgeon and nutritionist, we will always be able to lose easier than regular stomach folks so you will have an advantage. I would start right away getting a new routine established and then find a bariatric center or doc that has a qualified nitritionist that you can work with even if you have to pay for the service it is worth it. I would do this before seeking a revision. So many people think they have ruined the pouch but it is never ruined (unless it is anatomically no longer in tact) and can always serve you. Yo have to use it. Weight loss and maintenance after WLS takes discipline and a burning desire to be healthy and thin(ner). You have the discipline there you just have to cultivate it as you once did. Try all the bariatric basics for at least 6-12 months and see how you do. I think you will be surprised what you body and spirit can accomplish together. Best wishes for your success! I hope this helps you in some way.
   — ChelleBelle

July 7, 2008
As far as vitamins and minerals is concerned, it should be a "liquid" vitamin and mineral. You only absorb 10% of tablets . VEMMA is a good one to try. Go to TrySomeVemma.com to check it out.
   — [Deactivated Member]

July 7, 2008
Grace..I hear revisions are not a cure or even a big help at all in the long run. It's not easy losing weight once the honeymoon period ends. I see it all too often on the Grad's forum. Many people are working on losing their gains...Much of it comes from becoming complacent and not following the pouch rules. Many are getting back on track with the rules, taking their vits, getting their 100 oz of water and 100 gs of lean protein, starting exercise and getting rid of bad carbs and replacing with fresh food carbs (good complex carbs) No sugars too! Don't drink calories and cut back about 200-500 calories and you will see a slow weight loss. Add exercise and it will go faster...But expect to only lose about 1-2 pounds a week this way...I lost 10 holiday pounds in about 3-4 months by first doing the 5 DPT and getting back on track, cutting carbs not drinking with meals and drinking much more water in bewteen meals. That helped...But then I found out I was malnurished because I had almost quit taking my vits regularly...When your body thinks it is starving...it holds onto fat and utilizes calories as a shield since you are not getting the proper vitamins! Ahhh! So I started vits and that helped me get healthier again too! Gave me more energy and I got it back together...You can do this if you realize that your tools still works, and that you've only found a way to eat around restriction with carbs that don't keep you full but keep your intestines very happy! The 5DPT helped me realize I still had restriction and got rid of a chocolate Kisses habit I began at mom's at X mas time! UGH!!!! Now when I want chocolate, I have a low carb protein bar...WLS candy! LOL ( I order OH Yeah Wafers) They are sooooo good! But I have to watch those too...Moderation is a hard habit to learn and so easy to break! You can do this...Count your calories and figure out where you can cut back daily 200-500 calories...Then start taking more steps...Take the stairs...Walk up escalators...walk the long way...mow the lawn once a week...Join a pool...Walk the dog..Take a walk with 3 lb hand weights...Little things add up to loss...Sugar is the most wasted useless calories...Eat fruit for sweet. Come on sweetie...You can do this! Vits: Your B-12 shots wshould be enough.... Iron: Carbonyl Iron (easy on body, highly absorbable after RNY) must be take with Vitamins C as ascorbic acid (Copper and Vitdry Vit A helps Iron absorb too) Multi-Vits: ADULT CHEWABLES! (or liquid) (childrens do not have all the vit adults need such as Vit K and selenium as well as a few other minor but important vits and minerals) Calcium Citrate: with D3 and magnesium (Don't take calcium carbonate unless you want to risk gallstones and not even absorb the calcuim as well as citrate) NOT!!! All the fat soluable vits should now be take in DRY FORM NOW!!! These vits are Vit A, E, D and K...You can no longer efficiently absorb fat soluable vits since fat is malabsorbed after RNY...Sugar and calories are NOT malabsorbed...So you can gain weight and still be malnourished! Take the right vits and that alone will help you in energy and health. Good luck!
   — .Anita R.