New Forum Member

Hello everyone,

Just wanted to introduce myself. I was on the OH boards a lot when I had my gastric sleeve surgery performed back in 2007 but had not been back to OH in a long time.

Althought I hate seeing the words "Failed sleeve" on my doctor's notes, I guess that is what happened. Details on my last blog post in case anyone is really bored. lol.

Anyway, just had open revision to gastric bypass a week ago and am praying hard that this one works for me.  I look forward to meeting you all and reading of your experiences Do others here feel any of the sense of guilt and shame that I am experiencing from having to do all this again? I'd love to learn some ways to cope with this. Am pretty down on myself right now. :(

Hi Arabella,
I also left the bords around 2007, just a year or so after having lap-band with Dr J.  I have done well, but have been ill all summer, not being able to eat.  They tested me for everything from a pap-smear to telling me I have too much stress.  I now know my band is just too tight, as over the years, my stomach muscle has enlarged.  I now face revision to RNY, or simply have everything removed and pray I dont gain 200 pounds back, which is what I have lost.  So, I am again trolling the bords looking for awnswers.  You are certainly not a failure, as look to build a healthier body.  Weight loss isnt promised to any of us, and regardless of the procedure, it is hard work.  I too am finding it hard to believe I might be doing this all over again also, especially since I am down to goal and was already thinking of plastic surgery.  Would love to talk some time, as we have a wonderful doctor in common!  You are going to do great this time.  I asked him about the sleeve, and what he suggested.  He is the master of RNY chin up!!!

I can relate to how you are feeling but please do not get too down on yourself. I had a lapband for three years. I have never eaten so poorly in my life as I did with that stupid thing.

I had the band taken out in February and the DS done 12 days ago. I feel really committed to making this work but there is that little voice in the back of my head saying "you screwed up once, you'll probably screw up again!" I just try to tell it to shut the fluff up. Surgery is only a tool, but you also don't want to have to cut down a tree with a screwdriver. Now you have an axe.

I read you recent blog post but it cut off mid sentence. I am really curious abou what you were saying because the sleeve is half my surgery. We're you saying water while youneatband carbonated beverages stretch your pouch?? Any other words of wisdom?

Hey Jenny,

Thanks for your email. I love your analogy about having a axe with which to run up that tree instead of a screwdriver. Weird that might blog got cut off halfway through. Maybe I bored it. Lol.

I'm not very familiar with the DS procedure but for the sleeve as well as for the Gastric Bypass it is imperative 30 min before and 30 min after a meal to have any beverage. I complied with this early on but after a few years basically forget all about it. I had been told by the original surgeon that did the sleeve that it was because you will be too full from the liquid to be able to consume the necessary protein and such. So after awhile, I expt merimented and was like "oh-well I'm not too full for the protein so it doesn't matter" Wrong. The  surgeon that just did the revision on Aug. 15 explained it much better. When you have liquid in the pouch and then add the food, the weight of the two combined, stretch out your pouch. I guess it's like filling a ballon with sand. If you then add 8 oz. of water or whatever liquid, it's going to make it heavier and will definitely stretch your pouch. I know realize why i need to do it their way and will definitely do that right this time around. Over the past couple of years I had worried that I had someone broken my pouch but couldn't understand why. I am now positive that not waiting that 30 minutes was a major factor. When this surgeon looked at the xrays, he said my pouch had expanded and was now almost the same size as a regular stomach.  During surgery 1, was told to give up soda and carbonated beverages because it would be uncomfortable. But Dr. J has since explanained that the carbonation also acts to increase pouch size. I had pretty much given up on soda after the first surgery so doesn't bother me to continue to stay away from it. Particularly since now I know it also can cause pouch stretching. But for me, I think my biggest issue was going back to drinkng something with a meal. That might have made all the difference. But once that pouch stretched, once again I was hungry all the time, just as if I had never had the procedure. What  a let down. In a nutshell, over the 5 years since surgery I also got bad about ensuring that I met my protein goals of 60-80 oz. a day. I guess it never really hit me that this would be for the rest of my life not jjust for the first ffew years. It's sometimes hard to get in lean protein when you are constantly one the go. But I will make sure I do it this time. Bought some unflavored whey protein and I can sprinkle that on just about everything.  The other change I am going to make this tme aroud to ensure that this time around I will make sure that I always have ready.  And lastly, thought I did gone see a therapist to address the emotions that caused me to use food to make me fee better. I never really felt that they "got it" and didn't provide me with much help. This time I am researching the heck out of available therapists and will insist on a therapist that is certified in eating disorgers. And if I can find one that specializes in NES (night eating syndrome) I will be very happy. So little is known about NES as it's only recent come into the spotlight and being recognized as a separate and unique condition. Not all food dysfunction was created equal and I really need someone that can help me with this. Does me no good if I eat perfectly all day long and then blow it all 2 hours after dinner when the endless grazing begins. I found a lead on an ED specialist here locally and am going to do some online research and ind out all I can abou her, and then make a appointment to get to the bottom of my uncontrollable night eating.
So my advice would be to ask tons of questions, read books on the procedure and the whys and why nots.  The first surgery I was just anxious for them to fix it-didn' t care how or why-just make me be not fat anymore. This time, I am going to ask lots of questions and make sure I understand so that it works this time.  Ask your doc for literature or sources to make this a success!

Hey Chantrel,

Thanks for the welcome. It's nice to meet a fellow patient of Dr. J's. He is not the same same doctor that did my sleeve back in 2007 but I was recommended to him by my pulmonolgist when they figured out my year long bout with chronic pneumonia was from GERD (caused by sleeve). I am a lot more impressed with Dr. J. His office gives a lot more thorough information and I was impressed that he does some things differently from other doctors when he does the RNY Gastric bypass. I thought it interesting that he also wraps a band of some sort around the pouch during surgery which helps keep it from expanding afterwards.  My surgery was done rather quickly as an emergency because I was so sick with the lung thing so I didn't go through the normal process and education that most of his patients do but he brought me a nifty little DVD that was great. It had him explaining the procedure again in detail, the dietician, the nurse and is a nice thing to have. They overload you with so much info it's hard to remember it all so I lovedf having the dvd to watch as a refresher.
Would love to talk some time. Do you go to his Ocala or his Orlando office? I am in Orlando and saw that they have a group support meeting on Sept. 4 at 6 pm at ORMC. I was thinking of attending. Do you think you might come, or have you been to any of the others?
Arabella/Kim

Hey Kim,
I live about 45 min west of Dr. J's Ocala office, so I see him there, and used to go to meetings all the time for almost 2 years.  I would really love to talk to you though, as I have forgotten things, like how long that tube stays in, the amount of vitimans and such we are to take daily, and do we drink protien shakes after that FOREVER?????  I thought the sleeve would be a really great solution, RNY seems like so much, for someone who has already reached goal (within 20 pounds).  I must admit, being totally unfilled right now has once again brought back my appetite with a vengence.  I can easily see how eating things I have not had in years is way too appealing.  The band really kept me full...that is to say, not hungry and grazing all the time.  I liked the feeling of cooking for my kids, and not thinking in the slightest that I was missing out.  so hard to explain.  gotta run now, but really would like to talk soon.  Thanks for writing back!!

Hi Chantrel,

I emailed you my phone # so feel free to call. I think Bariatric offices should consider offering a 1 year out and 2 year out "refresher" information center to go over the basics again because it's so easy to forget some of this stuff, or figure out what was just for the immediate time pre and post op.

What I have found out since I started the revision process-and that I had forgotten and was not doing was:
The protein shakes aren't forever, but the getting 60-80 (what they told me I needed-yours might be different) g of protein IS forever.  I didn't get that part and wasn't really making sure it happened. When my hair started falling out again about a year ago, that should have tipped me off. I have since found out that it was from not getting adequate protein. I find that protein also helps me feel fuller so I am going to do my best to make sure I comply with that part of it going forward.  There are other ways besides protein shakes-unflavored protein powder can be added to all sorts of things-scrambled eggs, soups, peanut butter, whatever! 
I think you are right about the RNY being too much for someone that close to goal weight. It is a big deal operation. In my case, the only reason I did it was because it was the only way to divert the stomach acid away so that it stopped infiltrating my lungs.  Noone had ever told me that GERD can be a side effect of the sleeve. Shame on me for not researching. 
I also found out that the not having a beverage 30 min before and 60  min after a meal is forever. Guess I thought after a while it doesn't matter. Apparently it does. The vitamins are also forever.

So I plan to continue to educate myself by picking the brains of all you wonderful people as well as reading all I can so that this time, the weight stays off! 

You all know what it's like when you are obese. People judge you in public, don't take you seriously and tend to look right through you. I always felt guilty when eating in front of anyone feeling that they were judging me. "She doesn't need to he eating bread." And then when I lost all the weight, that all changed! It was so wonderful. Hard to describe to a person who has never experienced the hatefulness that overweight people experience. But after gaining 50 lbs back, attitudes towards me by strangers have changed back again. Bah.  Oh well. We all shall overcome.

Good Morning!!!
I will take you up on the phone call.  My little one had a sleep over last night, and now are in the pool, whooping it up.  So I will wait untill I think I can get a few minutes of quiet before I dare touch the phone.  I have been reading the bords like a nut for the past few days.  All so interesting, and I learn so much.  I truly never thought about the pouch being streatched if you drink before and after, rather, with the band, I would consider it liquifiying the food to a point that it would not properely fill the pouch, as it would 'drain' to fast, thereby defeating the purpose and never feeling satisified.  In fact (for what its worth now), with 'perfect restriction', when I would eat a meal already feeling a bit tight, I would drink a cup of coffee, or tea.  Something hot to 'lube' me up.  This would help open my band area and ready me to eat, without the chance of having a 'stuck' episode.  worked like a charm.  I never drank with meals, and did wait as long as possible afterwards, because keeping the food in the pouch will streatch the top of the stomach, hitting the vegas nerve, which sends the signal to the brain that tells us we are full.  Drinking would lesson my solid protien etc. similliar to eating cereal, or having soup.  Which is a band 'no-no'.  Food goes through to fast.  So, having mastered my own band, I now seek info. on RNY.  Just cant wrap my head around it yet.  Having no tool at all just scares the wits out of me.  Taking out the band for a wait and see period scares me even more.  Then I face a second surgery, and insurance, and anisthesia, and tests and on and on and on.  So confusing.  Really glad this board is here.  I am remembering why I was online all day now!!!!!!   Call you soon, and Thank You

Hi Kim,

Thanks so much for all the info. It is funny, so much of what you say about pushing the limits with the sleeve is similar to my experience with the band. I never thought much of drinking with meals, eating as much as I could etc. Perhaps because they just give you these rules without much explanation. I also went in without having done enough research, overconfident that the band would just fix everything.

As much as you feel guilt and shame for the sleeve not working, I wonder if somehow this being our second (or third) time around we are at an advantage. We know that the rules are there for a reason, and that we just can't become complacent. If you had learned nothing from your past experiences and just blamed it all on the procedure you'd be no father ahead, but you have learned so much.

I'm also a night eater. I would sit in bed and consume anywhere from 500 to 1500 calories easy. I'm curious to know what you learn about yourself.

Have you read the book "Women, food and God." It actually is not really religious, it just deals with a lot of the emotional eating stuff. You might find it interesting if you haven't already read it. It really resonated for me.

Good luck on your journey, but I don't think you need luck. You already have what it takes.

Good Morning, Jenny,

I agree that we do have an advantage having done this before in terms of knowledge that we gain and tricks of the trade. One thing I forgot to tell you about the "tips and tricks" which I did not know the first time, was do not drink with a straw. This introduces air into the belly and makes you feel fuller and then somehow you eat  more. Not sure the exact mechanics of why that is, other than don't do it.

I am somewhat irritated and cynical though about the lack of pre-op education that is given to most bariatric patients. I am so glad the second doctor has been a lot more forthcoming and goes into more detail about WHY not to do or do certain things so that I understand the process a lot better.  This is really your only opportunity to learn this stuff because as you may have noticed, other doctors know less than we do about bariatric surgery. Sure, one can be proactive and read, research and hang around forums and boards like this one. OH has been a great help, both times. However, I am pretty ticked off at the first surgeon who essentially told me nothing. Some general guidelines but no real explanations. Bariatric surgery has gotten HUGE (no pun intended) and these guys are racking up a lot of money. Most insurance companies do not cover this so the doctor's collect a big fee-$15-30k up front and then run the patients through the system like an assembly line.  My first surgery was out of pocket because my company is self insured and has a rider that specifically states it does NOT cover bariatric surgery. That one was elective and I just paid it myself. This recent one, as it was medically necessary and for my lung issue with the weight loss being an awesome side effect, they DID pay for after a brief battle with Cigna. I was surprised and pleased that the battle was so short. I had imagined it would take weeks...months.
When I was at my last pre-op appt, I jus****ched the proceedings. The place was so jam packed with overweight, desperate people that some had to sit on the floor. (not me-I would not have been able to get back up!). Then you file in to talk to nutritionist, to dietician, to financing lady. It's a very efficient and profitable system.  The first surgeon also required that you speak to a shrink first and get cleared. In that situation, I got the sense that she was not really interested in me or my emotional eating issues. It seemed more of a situation to make sure I wasn't likely to go nuts and sue them.
It's great that they have such an efficient system even if it is somewhat assembly line but I feel that these guys are making tons (again no pun) of money off of us by doing what in most cases is a very simple procedure. Run 'em in and out. That is fine, but there should be some sort of standard to make sure that we get the information we need to be successful. Surgeon 1 seemed to be more interested in his bottom line. Surgeon 2 seemed to actually care.
We do have to be proactive to educate ourselves but most of us (certainly me the first time) don't know what we don't know.  I am very pleased that surgeon 2 takes more time to educate his patients but had I known a lot of this the first time, I don't think I would have regained 50 of the 90 lbs. I lost. I also think part of my irritation stems from the fact that I found out much later that surgeon 1 is affiliated with the bariatric vitamin company he encouraged us to buy from. Aren't they supposed to disclose that sort of thing?
Thanks for the book recommendation! I have already downloaded it to my Kindle and will start it this morning.  I'm not allowed to do much as I recover because my surgery was an open one so this will be a great way to pass the time and learn something.

I'm sure the education will improve as this surgeon becomes more mainstream. Maybe they will look upon all of us on these boards as pioneers!  Thanks for the encouragement and I feel you will do great also. Keep in touch.!