DS failure and

Grace, I'm sorry you're struggling so much. The DS is a great operation, but even the DS does have a (small) failure rate. No operation is perfect, and every operation requires some dietary modification, though the DS requirements are the most forgiving.
    So part of the problem might be your diet (of course I don't know for sure, but you've already received some good suggestions there) and part of it might be your surgery. I've never heard of your surgeon before, and I've been on this forum a long time now. He may have made the stomach too large and/or the common channel too long, or at least, too long for YOU. 
    As far as revision goes, it's just as well that he blew you off, because he would be a poor choice to do it. Revisions are tougher than a virgin DS and should be done by a very experienced DS surgeon. Your surgeon may be a good surgeon, I have no idea, but he clearly isn't an experienced DS surgeon and isn't someone who should be doing your revision. I agree with the suggestion of Dr. Greenbaum, who proctored with some of the best DS surgeons in the country and is doing a lot of revisions. He could also look at your films from the upper GI and assess the stomach size, and figure out what might help you.
    Best of luck to you.

Larra

I'm so sorry for the disappointment and frustration you have after having your DS.  We go into this wanting to get the weight off and get our health back, and with any luck at all we lose enough weight to fall somewhere in the "normal appearance" category.  It stinks when that doesn't happen.  I didn't lose enough weight either so I feel you on this.

For *most* DSers the surgery alone will take off most of the excess weight.  For *some* DSers a strict diet that is high protein and low or very low carb must be followed all of the time in order to get the weight off.  For a very small percentage of DSers there are other factors going on with our bodies that make it difficult, if not nearly impossible, to lose enough excess weight despite the strength of the DS.  I know this because I fall into this category.

Based on reading the things you have posted I see that you have a slightly longer common channel than most.  This actually may or may not be a problem.  What would be a truer indication of whether this is sufficient malabsorption for you would be to know what percentage of your overall small bowel length your common channel represents.  Also of importance would be knowing how long your alimentary limb is, and how that related to your overall small bowel length.  This all should be indicated on your operative report.

Since you have had an Upper GI you now have quantitative proof of the size of your stomach.  With that image they can measure and approximate the size.  Did your doctor (or will your doctor) give you an idea of how large or small your stomach is now?  If you ever think you might want to seek a revision this might be very helpful information to share with potential revision surgeons.

It's always a good idea to avoid another surgery if at all possible.  However, if you have already altered your diet to eliminate high-carb foods and you stick to high protein, low-carb meals (think meat, vegetables (which are complex carbs), resonable fats for cooking and seasoning (maybe even high-fat); and you have a good exercise plan in place, then maybe a revision might be an option to explore.  The question then becomes what kind of a revision? 

You mention constipation.  This may be related to insufficient malabsorption.  Or not.  However, the first and easiest thing to address with this is fluid intake and fat intake.  Are you taking in enough fluid for your body?  We each have different fluid needs so it's important to find what yours is.  For example, my body requires about 100oz of fluid daily or I will be constipated.  Somebody else may only require 64oz.  Some might need even more.

You have my sympathies with your struggle.  I hope you find the solution. 

 Sandy, I know you have not had the easy loss that so many have had.  Do you know what your common channel length is?  What is your height?  I am short, so this is a concern I have.
Diane

If you would like, you can check out my numbers on the Lab Rat Data site.  There is a link to the site in my signature section.

The short answers are:  I'm 5' 9.5".  My common channel is 100cm. 

I know that it's said that short people lose slower/less and tall people lose faster/more.  I'm not aware of any studies that support this idea at all.  If you look at all of the entries on the Lab Rat Data site, you'll also see that there isn't a correlation between height and amount lost.

Weight loss surgery isn't an exact science.  The doctors can make our stomachs smaller and they can give us a certain common channel length.  They can also vary the length of the alimentary limb and bilio limb.  However, our bodies are still a factor in how this is all going to work and there isn't any way to know that ahead of time.  We can only make the best choices and do all that we can to get the weight off.  The DS gives us the best shot out there (IMO) and for the overwhelming majority of DSers this is sufficient.

 Thank you Sandy!

The only rationale for a shorter person losing weight more slowly is for BMR, correct?  Basal Metabolic Rate (BMR).

For instance people will NATURALLY Burn more calories if they are:
1.  Male gender
2.  Taller
3.  Younger
4.  Higher weight (needs more calories to maintain a higher weight)

The BMR formula uses the variables of height, weight, age and gender to calculate the Basal Metabolic Rate (BMR). This is more accurate than calculating calorie needs based on body weight alone. The only factor it omits is lean body mass and thus the ratio of muscle-to-fat a body has. Remember, leaner bodies need more calories than less leaner ones. Therefore, this equation will be very accurate in all but the very muscular (will underestimate calorie needs) and the very fat (will over-estimate calorie needs).

THIS IS WHY:
Once we lose 100 pounds, and are in our 40's, and are female, and are LOWER WEIGHT NOW:  We will automatically require less calories than we did 100 pounds ago, or 80 pounds ago. 

The way to change this is ONLY:
1.  Decrease calories
2.  Increase exercise

As we cannot change age, or gender.  It's simple math that was applicable prior to having DS Surgery.  The surgery does NOT take away the math.  The surgery alters the way the math goes.  We can decrease calories DIFFERENTLY Now, by low carbing and EATING fat and protein.  However, we cannot surgically repair the exercise piece. 

:o)  

So, this is why I know:  Due to BMR; the things I can change are low low carbing it and increasing exercise. 

Any disagreement ?  Comments?

FOR EXAMPLE 
My BMR to maintain 273 pounds is: 
You have a BMR of 1969.45.
My BMR to maintain 173 pounds is:
You have a BMR of 1534.45.

A difference of:  435 calories

This all being based on HEIGHT 5'7" age 40 gender Female, not considering exercise level (I am fairly sedentary). 

So, while I was immediate post operative, it was quicker and easier to have a larger caloric deficit.  As, I am 1 year out, and can consume more food at once, I can create LESS of a calorie deficit (at 173 pounds).

That is why weight loss slows.  I believe.  So, low carbing & adding exercise are the ways that a DSer can create a greater caloric deficit resulting in further weight loss.  This is THE BEST OPTION, as RNYers or Lapbanders would be required to JUST Low calorie which in essence (for those of us who calorie counted our entire lives) means LOW FAT.  At LEAST we can eat ample amounts of fat and protein. 

The other issue is our common channel length which varies and I don't know that they have proven that differences from 50 cm to 75 cm to 150 cm makes that much of a difference?

Kathy

I've never heard of your surgeon, which gives me pause. You're consulting with Dr. Greenbaum in New Jersey, right?

Would you care to share with us how you usually eat? We might have some suggestions you could try in the interim while you're exploring the revision options.

I'm in the same boat as Sandy.  I never lost to goal, but I'm only 8-10lbs from a normal BMI so it's ok.  My first stall was at 5.5mo, didn't lose any weight for 4mo, then dropped another 10lbs.  That's where I've been for the last year.  Granted I generally eat what I want, but I always get in my protein, water and vitamins.  I am more active than I was before, but no constant exercise.  Both of these set points 150 & 140-142 were long-term weights for me before gaining my weight.  I'm not complaining, I wear 9-10 jeans, M-L tops.  I have a very big muffin top, pooched out by my bellybutton, and lots of sharpei skin, but I'm healthier than I've been for several years.  My body loves the vitamins the way it hated the prescriptions.

If you've gone back to basics and I mean basics, protein, limiting carbs and adding in exercise and still no weight loss you may need a revsion, but I'd try everything else first.

My stats - 5'1", 100cc, and started out with a 3oz tummy.  My starting BMI was 39, now 26.?  But my diabetes is gone, bp is normal and cholesterol still working on, it's not high, but went up.

If I were you, I would try to add a bunch of fats in there. Like bacon?  Seriously. It might help, especially in the poo department. If you still can't get moving, then you need to add in a couple of stool softeners both morning and night. That's the only way I can keep from being constipated myself.

What you're saying about it "taking a lot of food to fill you up" says to me that you might not have as small of a stomach as you need. I mean, you're eating things that would fill me up right quick. I hope you get some answers!