Sleeve, stretched with a pouch don't know what to do

Please any advice or suggestions would be helpful... My story, I had the sleeve done 12/09 lost 115lbs. Kept it off for over a year. Got pregnant only gained 30. Lost 10 of it then bam. In 16 months gained 80 back. Not paying attention just dealing with the baby I didn't really think much about it. Then I noticed I was starving a lot of the time. I didn't feel any restrictions anymore. Found a Dr near me and did a swallow test. Found out I have a a huge pouch and my sleeve has stretched. I'm so disappointed but I need to fix it. The Dr I went to didn't sound like he has done many revisions of any. He wants me to be resleeved but I'm not 100 comfortable with him. My original surgeon is out of state. Any suggestions who would be a good surgeon near NM?

I don't know what you mean by having a huge pouch.  With the sleeve you do not have a pouch but your natural stomach only much smaller.  All I can tell you is I understand the feeling of being hungry all the time and at one time I did have a huge sleeve but it wasn't stretched out, it was made too large.  My surgeon said he only removed 50% but I would guess it was even less since I never experienced the feeling of restriction.  My surgery was in 2002 and was not a stand alone surgery but in combination with a very malabsorptive procedure.  My surgeon doesn't like malabsorption so he made the sleeves large at that time to compensate.

If by pouch you mean that a part of your sleeve stretched out and formed a kind of pouch then yes, you should have the fixed.  If you mean the stomach itself has stretched I would want to know exactly how big it is and what the capacity is.  They should have the info if you had a EGD.  If it really has stretched out and you want to consider being resleeved just beware that being resleeved is not a simple procedure and there is a greater risk of leaks and other complications specifically because if your sleeve has stretched then it is much thinner and the original staple line would have to be involved and it just isn't like a first time surgery.  You have to discuss with your surgeon the risks and decide whether or not it is worth it.

Also, my own theory about revisions is that if they are necessary for medical reasons or to improve your quality of life then of course you need to have one.  If it wasn't done correctly or has failed in that it has enlarged or a stoma (not applicable to you) has enlarged then repairing the mechanical failure could be of benefit but first and foremost is looking at behavior changes.  If you are honest with yourself and know that the reason your surgery didn't give you the results you hoped for is because you didn't change how you were eating then all the revisions to all the different surgeries won't help at all.  No surgery allows anyone to eat what ever they want and even the most malabsorptive procedure will not malabsorb simple carbs if that is your issue.  If you don't make any changes to your eating then you are likely not to be happy with the results the second time then you were the first time.

If your sleeve is intact and relatively restrictive then it should work as designed, which is to help you eat less and stick with a healthy way of eating.  Most of us have found that no matter what restriction we may  have, we are able to eat a pretty large quantity of simple carbs like bread and crackers.  Put it this way, if you are able to eat a cup of cottage cheese then you are most likely to be able to eat a cup of cereal and the cereal is more likely to cause you to crave more cereal and eat more.  If you use your reduced capacity to eat things like dense proteins like meat you will find that you aren't as hungry and avoiding refined carbs will help you not crave them.  So if your stomach is still small enough to give you restriction then try using it to the maximum and eat in a way that will help you achieve the weight loss you want and see if it is easier then it was without the sleeve.  That is the purpose of WLS, to help you to stick to a healthy way of eating, not allow you to eat as you had been without the consequences.

at the beginning of the stomach it has stretched out so much it has made a pouch.. Plus the sleeve has stretched out. It looks like a grapefruit at the tip of a large banana. It takes awhile for my food to get into my stomach. I didn't realize this so i was always wanting more food cause my first pouch was seeing the food first and my stomach was still wanting it.

That sounds like what they call a hourglass sleeve.  I've heard it happens when a sleeve is made too tight.  Do you know how big your surgeon made yours?

That is definitely a mechanical failure and one that sounds like it needs to be corrected as soon as possible.  I have no ideas about surgeon's in NM but with a complication like that I hope you find a very experienced sleeve surgeon who has dealt with this before.  As I said, operating on an existing sleeve has it's own risks and you don't want to put your hands in an inexperienced surgeon.  Travel if you must but find the best you can.  If you live near a university hospital that may be a place to look.

Do you know how I would go about finding a good experienced sleeve surgeon for a re-sleeve?

I would go with getting re-sleeved.  I was sleeved in 2007 and my stomach is shaped like yours.  It doesn't seem to be anybody's fault.  It just happens.  If you can get re sleeved, go for it.  I have to have the RNY because I developed severe GERD.  My appt is the 23rd of this month.  I will be praying for the best for you.  Good Luck, and keep up posted.  

Cindy