So here I am...

Where do I go from here...

I am a band to sleeve revision, 4 years out and I have gained back most of my weight. I had only lost 70 pounds. (HW 304/SW286/LW238?CW280) Long story short, I still have a great tool. It hasn't stretched out. I still eat small amounts. the weight I have gained has been from my own doing. I have been in therapy for the past year and a half to work on that part of the issue.

Now that i have that part under control and some understanding why I sabotaged my revision, which is what I did, and I am eating healthier than I have ever eaten I am trying to figure out what to do next.

Because of my past and history with food, I don't like feeling deprived. I don't eat diet food. I do best eating whole foods, higher, good fats. Fruits and Veggies. I eat whole grains but kept to a minimum. I like to eat good, real food. I can't go back to carb master yogurt and sugar-free fake stuff. I just can't. I will end up binging on doritos. If that doesn't make sense, I will explain it to you in a separate email, but I didn't really want to go into all my junk here.

 I can lose weight doing what I am doing now. I still have a great tool. Eat real food. I have had a challenging year with injury so I have not been able to move. at 45 I have to move in order to make the scale go down. I had 2 tears in my left knee meniscus in March, followed by finding out I had osteo-arthritis in both feet, they have flattened out. My left foot has achilles tendonitis and I am now wearing two inserts in my feet. I am currently in a boot in my right foot due to a stress fracture probably because of everything that went on with my left leg. So....needless to say. Exercise and moving has been a challenge all year. My meniscus was repaired in March.

Of course my knee and leg issues are all due to a lifetime of obesity. Before my miniscus tear I was in a bootcamp 3x a week and should have been doing more modifications but I didn't. The point is, I was active. I have been active. I have been fighting the weight gain since year two. 

My question is: Since I still have a great tool, I have been working on my head stuff, can I do this with support and healing of my leg and moving without malapsorption? I have been considering DS but that surgery scares me, just the poop and gas, the board people don't make a big deal about it, talk about it like something you get used to but, really, there can be some serious side effects. Even my therapist, who specializes in eating disorders talks about having people come in who have had DS and how miserable they are. However, if people eat the way they are supposed to eat then there shouldn't be bowel issues.

Or, should I do RNY? Less invasive but comes with its own issues. Small pouch, going back to more restrictive eating.

I do have issues with acid reflux. I have a physical scheduled on the 22nd and I will be discussing all of this at that time. I'm still taking PPI's and I was under the assumption that after 6 months I would be off of them but I have tried and can't. When I was abusing food I could understand why. Now, I don't abuse food, over stuff myself, but I can't seem to get rid of the acid reflux.

Because of my surgery and arthritis I have been on Celebrex since March. That concerns me to.

So, I guess I am a mess. All of this has been going around in my head. Do I keep on going on (which is extremely frustrating but at the same time I want to do it) or do I need the next step, which is malabsorption.

Man, I hope this makes sense. It feels good to put it in writing. Any input is welcome and I will answer any questions. I wanted to keep it short and sweet.

Thanks!

Susan

I would encourage you to first try being very mindful and diligent about how you are eating with your sleeve, focusing on the healthy foods you mention and on portion sizes that are only as large as you need to get your protein in.  See how much weight you can get off with your existing tool before considering another revision.  

I, too, try to eat as many unprocessed foods as I can, and even with a RNY, I prefer a smaller amount of a sugared item than a larger amount of a SF, chemicalized version, so I completely "get" you as far as food choices (and the Doritos binge if you feel deprived!).  I think that if you are really committed to healthy eating and portion control, you can lose the regained weight without having to resort to getting yet another surgery (which insurance might refuse to cover).

As you said, the restriction on NSAIDs makes it a far less than ideal fit for you, and the significant lack of vitamin absorption and bypass length with the DS also can come with significant issues.  (Not everyone has gas, diarrhea, etc. issues after DS, but of the DSers that I have encountered in real life, more of them have such issues than do not.)  Since there is no way of knowing how your body will react, you have to be willing to take the risk of being one of the ones who does have them.  (I wasn't, so I chose RNY instead (VSG was not available 7 years ago)).

Lora

However, if people eat the way they are supposed to eat then there shouldn't be bowel issues.

I just wanted to make a comment on this statement.  I also had a DS and I was also miserable, completely due to my own bad choices.

I just wanted to say that if I could have eaten the way I was supposed to I wouldn't have needed WLS.  Believe me, I have an addiction and when I am in that addiction there is no deterrent, not foul gas and diarrhea, not dumping, nothing gets between me and my drug of choice when I am practicing.

However, with some time not practicing my addiction I do think clearer and I can choose to not eat those things with help from a deterent.  But when I choose to eat those things and awaken my addiction there is nothing, probably not even threat of death, that can stop me.  Believe me, I know and I paid the price.

So it is essential to work on those issues, even if you do choose to have a malabsorptive procedure because if you are like me, the consequences are not enough to stop me from my self destructive eating.

Yes!  We have had quite a few people here over the years who have tasked about how they will still eat something even though they know without question that it is going to make them sick! 

Thanks! 

And yes, that is what the therapy has been for to treat the disordered eating so that as long as I am making better choices, not feeling deprived, eating good whole foods 80/90% of the time with allowances for this thing called "life" and really learning what that looks like then keep moving forward. Giving it 'one more try' as my therapist says. It's worth it. I'm worth it. 

I knew there were whole food eaters on here and I think there is  a forum or group and would love to get hooked up with them for support because not everyone understands that way of eating. I totally respect people who eat SF stuff and eat low fat if that works for them. For me, it leads to deprivation effect and I rebel and will binge or snack all day on junk. Which equals failure. I've figured that out.  If you have had a procedure where you have no choice in eating SF, good therapy can help you come to terms with that. (believe it or not, I am a licensed therapist myself) I think even eggface discusses not being ready for the psychological aspects of changing the way you eat forever when you have a malabsorption procedure. I believe that process of WLS is greatly overlooked and hopefully getting better, helping people get their head stuff straightened out before surgery. 

Anyway, thanks for your responses. Support if definitely an aspect of this journey that never goes away. I will post later for help in finding the right group to get plugged in with...if you all know of any whole food eating groups on here pass them along. Or starting over groups....whatever is out there.

More input welcome. 

Today I am prepping meals for the week (very important to keeping me on track)

walking and doing my PT on my left leg. woo hoo!!!

Journaling

And, just living one day at a time....

Thanks!

I definitely think that you have to concentrate on healing till you get to the point where you can be more active again.

You really have to dig deep as to why you're not losing weight with the vsg alone b4 you go to the malabsorption route, exercising helps in weight loss but according to these boards the weight loss is 90% dieting, exercising helps to keep it off. So you'll have to look at what you're eating more so than the exercise you can't do right now., also can the meds you're taking affect your weight loss?, stress?,water retention?, lack of sleep? There's a lot that can make your weight loss go from a sprint to a crawl. Keep in mind this would be your 3rd wls, ins might not cover it, check into that.

You'll lose weight faster with the malabsorption, but is the problem with weight loss due to the rate at which you're losing it?, or are you in a stall & want to break out of it. It sounds like your body is dealing with a lot right now, so that might be why the weight isn't coming off right now.

I think the good news is you still have a tool that works.  Since you still feel the restriction, I assume your portion size is no more than 8 oz per meal.  I too am a clean eater.  Whole foods only is what works for me.  Are you losing weight?  I guess I would track my food and try to eat 3 meals with a snack if you need it.  Some medical issues have sidelined my exercise at times, but I have been able to maintain my weight loss.  I think if you give yourself a timeframe  with your sleeve to see if you can turn things around, you will be able to make the decision as to whether you want a revision.  I think it is great that you have the awareness about what happened and are getting the support you need.  I wish you well and hope you continue to come to the boards for support.