shriner37

When I had the sleeve I couldn't tolerate carbonation. I found a way around it, as I learned to pour the beer rapidly into a large mug or cup which released the carbonation into foam and allowed me to drink the beer when the foam settled. Unfortunately this little discovery was the single biggest reason I didn't hit my goal weight. I had a revision to bypass a year ago, and strangely now even though my pouch is supposedly smaller than my sleeve I can tolerate carbonation better. I still don't drink a lot of carbonated drinks, but on the occasion I try it seems to be better now.

Sorry to re-open an old thread but wanted to add some info for those who might search on this topic. I started experiencing this about 5-6 months after a sleeve-to-bypass revision. It's bad enough that my PCP put me on a continuous glucose monitor (Freestyle Libre 3) so I can monitor it and learn my patterns. I'm now 12 months post surgery and the issue is a daily concern. For breakfast I usually only have something light with very low carbs. If I eat any carbs at all at lunch, even a slice of bread, I have a crash about 90 minutes to 2 hours after eating. I've found that if I eat carbs at lunch I can solve the issue if I have a protein bar about 90 minutes after eating. I like the Pure Protein bars with 20g protein and about 180-200 calories, as they work well. I just try to account for these calories in my daily eating plan. I've also used glucose tablets, fruit juice or a piece of candy, but anything high in sugar it just starts a cycle of my glucose bouncing high and low in kind of a ping pong effect. Eating the protein bar settles my glucose and I'm good until dinner. I rarely experience issues after having an evening meal even if it has carbs. This has turned out to be quite challenging to deal with, and is really the only side effect of the surgery that I've experienced. I'm still better off than before the surgery but wish I could find a way to eliminate this issue.

Best of luck with your revision surgery! I did the same thing for the same reasons a year ago. My biggest issue was a hiatal hernia that had caused great pain and difficulty eating. I also had pretty bad reflux. It seemed like recovery was about the same the second time around, although I was seven years older. I did not lose as much weight after the bypass, but probably because I didn't have nearly as much to lose. As has been said, be careful to chew thoroughly and you still might find some foods that cause you challenges for a while. Just go slowly and if something causes issues wait a while before trying it again. The pouch does react differently than the sleeve and it takes a while to learn how to deal with it. Two things that you may or may not experience after the bypass are dumping syndrome (your body reacting to sugars) or reactive hypoglycemia or late dumping (your body overproducing insulin in response to a meal). I was lucky not to experience dumping but do have issues with the reactive hypoglycemia. I noticed that I lost weight for about 3 months after the revision, then stopped. One difference for me this time is that if I gain weight it seems to stay around, where often times with the sleeve I would gain a couple pounds then lose them easily. Not sure whether this means that my metabolism wants to be at a higher set point weight. I didn't really do the revision to lose weight, and I'm still 15-20 pounds lower than when I had the revision, but it is something I've noticed. Also, my experience is that although the surgery helped tremendously with reflux, for me it's still not gone completely. I'm still taking omeprazole daily, and if I eat certain things in the evening I might still have a reflux issue late at night. I can completely control this by not snacking at night.

I was sleeved in September of 2015. Weight loss was moderately successful with some regain. High weight was 300, surgery weight 277, got down to 210 and I'm currently at 233. Goal was 185. I have had some issues with GERD like others. Recently though my hiatal hernia has worsened and I am only able to eat very small amounts of food at any given meal. It seems like I'm back to eating like I did 6-8 weeks after my initial surgery. I reached out to my bariatric surgeon and have scheduled an EGD for next week. From what his PA told me if they do a hernia repair they will want to do a revision to RNY at the same time. He said they do this in most all cases. I was also told that their practice (a high volume bariatric surgery facility) does 80-90% RNY these days with very few sleeves. I've noticed that my type 2 diabetes was initially resolved by the sleeve surgery but my A1C has crept back up to 6.0 and my fasting glucose teeters right around 100. I wonder if the revision will resolve the metabolic issues as well as perhaps helping me lose another 20 pounds or so. Does anyone have any insight into the reasoning behind doing the revision with the hernia repair?

I went through the same thing a few months ago due to a hiatal hernia that had become almost strangulated. The 'reason' for my surgery was hernia repair, and that is what the insurance company approved. As my surgeon said, "we went in to fix the hernia and a bypass just happened".

Thanks everyone for the insights. I've been stuck at about 190 lbs for over six weeks now. Was hopeful to get down to 175-180, so it's very frustrating to be within sight of a goal but not able to get there. I am thinking I'll give it another month or so to see if this is truly a stall. If things don't move I may vary the program (i.e. adjust macronutrient and calorie levels) to see if I can break through it. With regard to the comment about food capacity, I am noticing that I can eat more at this stage of recovery than I could when I did the sleeve surgery in 2015. Even though my sleeve has been replaced by a pouch, I'm able many times to eat the same amount of food now that I could before the revision. Not always, and sometimes I'm still full after an ounce or two, but it seems like overall capacity returned faster this time than before. Could be part of the challenge.

On 2/15/22 I underwent revision from VSG to RNY due to hiatal hernia and reflux issues. My surgery weight was around 230 lbs, actually a few less due to three days of liquid diet. In the 5 months since revision surgery I've lost about 40 lbs, but have been at a steady weight for over five weeks. I'm currently around 15 to 20 lbs away from my final goal. I had a post surgery follow up with the surgeons office and they just suggested I try to stay closer to the dietary guidelines. I probably was a little short on protein but in the couple weeks since have worked diligently to increase protein and reduce carbs. Yet the scale hasn't moved. Looking for experiences from others who had revision without a large amount of weight to lose. How did it go for you? Is this just a stall or my new normal? Should I expect to continue to lose, or am I pretty much at my new set point after five months?

I never had one before, but since I've slimmed down overall the lack of one isn't quite as noticeable as it was. I've always said I had a case of "noassatall".

I had the sleeve in 2015. I lost about 90 pounds from my highest weight which was still a ways from goal, but over 7 years managed to gain back about 25 pounds. Early this year my hiatal hernia worsened and because of that and GERD my surgeon told me I really needed revision to bypass. My revision surgery was three months ago. I've done well with recovery with no complications. I've lost about 33 pounds since surgery and am about 19 pounds from goal. I will say that weight loss for me has been slower with the revision, possibly because I didn't have as much to lose. The surgery did take care of my hernia and GERD issues. I have not pushed the envelope with high fat or very sweet foods to see if I have any issues with dumping, but I'm told only about 1/3 of bypass patients do. Because of the change in the way your pouch works (less stomach acid and such) I have experienced a couple issues with dry or very tough foods causing what is called frothing or 'foamies'. It's very uncomfortable but passes in an hour or so. All in all I'm glad I had the surgery. I was having significant issues from the hernia and really didn't have a choice, but it's nice to be down in a weight range I never made it to with the sleeve.

Tomorrow I will be three weeks out from bypass surgery. For the past six days my surgeon's diet program has had me eating soft, moist proteins, with a target of eventually getting to 3oz per meal before adding in non-starchy vegetables. I'm really surprised at how sensitive my stomach is to food capacity. Sometimes I can eat 2.5 to 2.75 ounces of food and feel fine. The next day the same amount makes me feel awful as though I ate a pound of food. It's really something how sensitive my new stomach is as it heals and how even 1/4 ounce of extra food can create all kinds of discomfort.

I think it really is more a question of whether your stomach is healed enough to tolerate alcohol. My surgeon advised to wait two months before consuming alcohol as their belief is that the stomach should be completely healed first. That being said, I did start drinking again a few months after my sleeve, which I believe was one of the reasons I never reached my weight loss goal. I was in a similar situation to yours in that alcohol was a part of my social scene at the time. Along with drinking came poor nutrition decisions and between the two I stopped losing weight 30 pounds short of my goal. I'm two months post revision to bypass and haven't started consuming alcohol again yet. I'm determined to get to my weight loss goal this time (only have about 25 lbs to go) and have now adapted my social scene enough so that alcohol isn't such a big part of it.

My program advised as soon as you could consume 3 oz. of solid protein at each meal to discontinue the shake. Once you are able to do that you can start adding cooked vegetables and then some limited carbs. If you have room. I'm at right about the 3oz. stage now but haven't cut the shake out yet. Probably next week.

What worked for me after some regain was to combine 'time restricted feeding' (i.e. intermittent fasting) with a low carb/low insulin diet plan. I skipped breakfast and only ate two meals a day, at Noon and by 6pm. This let me 'fast' for 18 hours per day. I ate about 3-4 oz. of protein (beef, chicken, fish, etc.) and green vegetables such as green beans, broccoli, salad, etc. for each meal. I was able to drop close to 20 pounds doing this in a couple months. The basis of this is the insulin control program developed by Dr. Jason Fung. You can search his name on the internet and find a lot of useful information. He is the author of the book The Obesity Code.

Sorry to hear of your loss and challenges. We all deal with stress differently, so the thought of seeking assistance with that is good advice. I will say from the weight perspective, I was six years out from my sleeve and had gained back about 45 pounds. I found that what worked for me was to go on a 'time restricted feeding' schedule, and to eat a diet that was generally keto when I did eat. I skipped breakfast and only ate from Noon to 6pm. For those two meals I would have a serving of protein, and a green vegetable or salad. I was able to drop about 20 pounds in a couple of months. I stopped because my hiatal hernia had worsened enough that it had to be fixed with revision to bypass, but the diet program was working well. There is a nutrition doctor named Dr. Jason Fung who develops programs for insulin control diets, which is what I based my program on. You might want to Google him and check out his information.

I am 4 1/2 weeks out from a sleeve to RNY conversion due to hiatal hernia and GERD. During the 7 years I was sleeved I never encountered any issues of foods I couldn't eat except for carbonation. Last evening I had around 2.5 ounces of beef brisket, which is listed by my NUT as being something that is allowed at this stage of recovery. Within an hour I was feeling miserable, with fullness, high chest pain, and major discomfort. I originally just thought i ate a bite or two too much, but soon began to have my first experience with frothing (or foamies as it's called on here). It was not a pleasant experience. I am hopeful this was just because the brisket was too dry or too firm for this stage of my recovery. As a person who owns a smoker and frequently prepares BBQ brisket it would be pretty devastating if this was no longer a food I could tolerate. Does tolerance for dry or firm foods get better over time after an RNY?

Yesterday my surgeon did my hernia repair surgery to repair a substantial Hiatal Hernia and to do a revision from Sleeve to RNY. What I found out after surgery was there wasn't actually any hernia repair completed, just the revision. I was told by the surgeon's PA that conversion from sleeve to bypass pretty much permanently resolves most potential hiatal hernia issues. Recovery and first night seemed very similar to what I underwent with the sleeve in 2015. I do believe I am more sore at a couple of the incision sites than I was the first time. The most painful was where they had placed a couple of surgical drains which were removed this morning before discharge. Relaxing at home this first day isn't really relaxing, as almost any movement, and certainly getting in and out of chars, causes significant discomfort. I'm not one to usually take serious pain meds, but I did start using the Oxycodone that was prescribed to help reduce the pain. But other than incision pain the process was flawless. The surgery center specializes in bariatric surgeries so they have the routine down very well. There were only six patients in the center yesterday, and with three nurses working each had two patients. Great responsiveness.

I was sleeved in 2015 and just went through the revision from sleeve to bypass about 3 1/2 weeks ago. So as I'm still in recovery mode I can't really provide a full answer all of your questions. 1. Reason for conversion: I developed a hiatal hernia where part of the sleeve had slipped up through the opening of the diaphragm into the chest cavity, which was causing chest discomfort and only allowing me to eat a couple ounces of food at a meal. After doing an EGD my surgeon was concerned enough to schedule my revision within a week. He said if they just fixed the hernia there was a high likelihood it would recur with the sleeve. If he converted to bypass he said there was a very low likelihood I'd have any further problems. I also had GERD issues from the sleeve which I wanted to address. 2. Post-op period: I'd say for me it was essentially the same. I had the same surgeon and facility which were both great. Recovery plan is the same for both surgeries (clear liquid, full liquid, puree, soft solids, etc.) I had a bit more pain with the bypass but I'm 7 years older than when I had the sleeve. 3. Best and worst part: Can't really answer this yet, except to say it's nice to lose some additional weight (I never hit my goal with the sleeve) but it's tough to have to start over with the recovery. 4. Dumping: Haven't experienced it yet, but I am just up to about 2 to 2.5 oz of soft protein so I have not been able to even try anything that might cause dumping. My thought on the revision is if you are experiencing significant GERD it is definitely worth considering. GERD can cause Barret's esophagus and ultimately lead to esophageal cancer if not kept in check. Having had a relative who died of that cancer in her early 50's I was concerned enough to want to solve it if I could.

This is good advice. I've experienced it a couple times already. The past two days at lunch I have had more than I should have, even by a couple bites, and the discomfort was intense. I realize I'm still healing but I'm also trying to learn the feelings and signals that go with this new pouch. They are different from the sleeve. Today at dinner I was very mindful of my current capacity, and stopped eating at the first flash of a full feeling. It worked as I was comfortable after my meal.

My gastric bypass was revision surgery from a sleeve due to hiatal hernia and reflux. Since I had the sleeve first, most of the hunger hormone (ghrelin) producing cells were in the part of the stomach they removed. I rarely got really hungry with the sleeve, so perhaps that might carry over with the bypass as well. I know my remnant stomach is still there, but it's a sleeve, not a full stomach so it won't produce the hunger hormone like others. That being said, I do hope after time I can end up eating more reasonable portions. After a year or so with the sleeve I was able to eat 3-4 oz of solid protein with 1/3 to 1/2 cup veggies and a little starch. I am hopeful for similar capacities with the bypass.

Today is two weeks past surgery. Recovery has gone well with no complications. My surgery was a revision from sleeve to bypass for hernia and GERD issues. I've dropped 10+ lbs in the two weeks which seems right in line (I was only at 227 on date of surgery). Per my surgeon's plan today we could progress to soft solid proteins, so it was great to have an ounce or two of sliced deli meat for lunch. Only downside is that they do an internal stitch to hold things together and that pain is real. I'm told it'll go away 4-6 weeks following surgery but until then it's the only downside to an otherwise good recovery so far.

Thanks. Have had no GERD issues since surgery but then again I've been on a liquid or pureed diet until today.

More like thinly sliced roast beef or turkey.

I began my WLS journey in 2015 with gastric sleeve surgery in September. My starting weight was 301, which I had managed to diet down to 285 by the time I was approved for surgery. Surgery weight was 277. Surgery was uneventful and I was back at my normal activities within a couple days. My goal weight was 185, but I only managed to lose down to 210. I believe this was because I made the mistake of continuing to drink alcohol after surgery (although less than before) and still ate too many snacks and slider type foods. Over the next several years my weight gradually increased until it settled in at about 230-235. Then the pandemic occurred and that added 20 pounds, so I was back to 255. This is when I learned what I felt was a good method to handle regain - I combined time restricted feeding with keto dieting... I only ate between Noon and 6pm, and strictly limited carbs. Doing this for a couple of months I was able to drop from 255 back to 235. I had issues with reflux before the surgery, and they continued after. They seemed to worsen as time passed. I learned not to eat at least 3 hours before bedtime, and still sometimes I'd end up sleeping in the recliner for several hours when the reflux was particularly bad. I also had developed a hiatal hernia (which a CT report said was small). Then in January of this year something changed. I started having issues where I could only eat a couple ounces of food without feeling severely overstuffed. This plus some bouts with chest pain prompted a couple of ER visits for cardiac workups. Finding no cardiac issues my doctors determined the pain was likely the hernia that had expanded. I also started experiencing symptoms that seem to be consistent with "silent reflux", such as throat, ear tube and sinus issues. I scheduled an EGD with my bariatric surgeon who found a 3cm hiatal hernia. He is going to repair it this coming Tuesday, and to prevent recurrence of the hernia as well as to resolve the GERD issues is doing a revision to RNY. I'm not happy about having to start over with the healing process, but am excited to finally lose the excess weight, correct the hernia and GERD, and get a chance to do things right the second time. So, here are some lessons learned along the way. If they can help someone else then this post is worth making: 1. Listen to your surgeon. If they recommend one procedure over another, there is a reason why. I probably should have done the RNY in the beginning but opted for the sleeve even though I had existing reflux issues. 2. Follow the dietary guidelines. They are there to assure the most successful weight loss. Unfortunately I 'taught myself' how to overcome the carbonation in beer and continued to drink it after recovery, which is a large part of the reason for lack of loss and regain. I wasn't addicted to either, but both were present in my social environment. I have now determined that alcohol and junk food are poison to my system and have resolved to be diligent in avoiding them. 3. If you do experience regain, get on it quickly. I found that time restricted feeding along with a keto eating plan worked wonders for me. I was essentially following the insulin control program established by Dr. Jason Fung. I quickly dropped close to 20 lbs using my sleeve along with this plan. 4. The sleeve, or bypass, is a tool that is given to you for life. You have a great window of opportunity the first year to lose weight and correct health problems. Make the most of it. Even though the tool is still there in later years, it becomes more difficult to lose weight after your system is fully healed and settled into normal life. It's possible, but harder. Make the most of the "one year honeymoon" window!

I'd also tell him about the hernia for sure. I went back to my surgeon 7 years after my sleeve with severe hiatal hernia symptoms. He did an EGD, and as soon as I woke up told me he saw the hernia and had scheduled my revision surgery for the following week. Hernia and GERD are two very good reasons to revise to bypass as it should help with both. As others have said though, don't expect as much weight loss with the revision as with the original surgery. One other thought, I had great luck using my sleeve with a combination of time restricted feeding and keto. I only ate between noon and 6pm (lunch at noon, dinner by 6pm, no snacking) and generally followed keto guidelines. This is the insulin control diet regimen recommended by Dr. Jason Fung. I dropped 20 pounds in a couple months and found it was easy as since my sleeve I didn't have a great deal of hunger.

I had my one week post-surgery follow up with the surgeon's PA today. They removed the staples and put on steri-strips (told me to leave them in place until they fall off by themselves after showering). They told me it was safe to sleep on my side, that the sutures were healed enough to be safe and it was a matter of tolerating any pain. I'm not really having any incision pain so it shouldn't be an issue.