Kaze

I feel that way, too. I'm very underwhelmed with my sleeve's restriction at two years out. While heavy, dense foods are definitely restricted, calorie dense, slider like foods aren't. Only lost about 50 lbs of the 150 lbs or so I needed to lose to be at goal weight so I'm considering revision. I agree with your sentiment...if we could have been this conscientious about our diet before, surgery would be unnecessary if it weren't for the metabolic changes it has which greatly improves diabetes for those of us that had it.

I'll skip the formalities. I had the sleeve in June of 2016. I initially lost a considerable heft getting down to 225 lbs (heaviest was 300). After some time, I gained back about 20 pounds and have been consistent ever since (this past month I've gained a little more still which is severely depressing). I don't feel I eat ridiculously and I did a food diary and my calorie intake isn't excessive, averaging around 1900ish calories which is closer to the goals of a young woman versus a young man such as myself. When is it appropriate to start considering revision? Based on my surgeon's comments, he may not be inclined to do it OR he meant that it'd be nearly impossible to do laparoscopic again because I have previous abdominal surgeries with tons of scar tissue. I am considering a Bypass revision (though I read a source that suggests a sleeve to duodenal switch might be more effective, yet brings more concern for nutrient deficiency) because it should have considerably better results and also I read that bypass can minimize reflux. I still have take Omeprazole and I've only been able to ween myself off to minimum three days a week for it, so that would be a minor plus. I know for a fact I would need to completely rehsape my relationship with food as some personal stressors caused me to significantly lose conscientiousness towards my diet. I know I need depression and anxiety control beforehand so I go in with a better mentality, but I strongly believe I should at least consider revision. I'm still morbidly obese (BMI ~39.2 as of today!) and I'm almost bad enough to bypass the "must have comorbitity" component of most insurance coverage (BMI of 40 or BMI of 35 w/ considerable problems.) Secondary question, does anybody have experience with revision surgery coverage through Medicaid? I had Medicare and Medicaid (though down to the wire of Medicare coverage post kidney transplant) for my sleeve, but I just have Medicaid now.

Will do. I'm still definitely considering it. I've made a few dietary adjustments and my weight has at least trended back down to where I WAS prior to a few months ago which is still ~25 lbs more than my lowest weight. I read some information about revision that confirmed AtlantaRed's comment about the general WLS diet being 800-1000 calories, and knowing I can eat almost double that (though it's probably less since that food diaryhad a lot of less than ideal choices such as fast food, shame on me) which is definitely fueling me to ask about it. I also heard reflux that doesn't go away is another thing to consider getting a revision to bypass for...I definitely still have GERD! Ugh!

Hey Bryn! I was following up to see if you got your revision to bypass! I see you now belong to Gastric Bypass Patients so I assume you did. How are you doing and feeling? Edit: I see, May 9th! Good luck, one week!

It's low (1800 was actually the average) for normal eating circumstances, and I feel 800-1000 is still low even for surgery. Perhaps they meant the first year after? Either way I know I can eat more of "slider foods" than I'm comfortable with but I definitely get restriction with heavy and dense foods.

Yes on the perfect storm! Ugh! Like I said in a reply above my relationship with food is better than before surgery, but somewhere along the track I grew apathetic (probably because of depression!) and I've hit a brick wall since, so I will absolutely be working on that from here on out. Revision would be something I really seek out hard sometime next year if dietary and activity adjustments just don't work. I don't exercise as much as I want to but I'm hoping with next semester I'll have a more structured schedule and I WILL be putting ~3 hours of treadmill every week minimum. Even if it's just walking, it's something! Thank you all for your kind and thoughtful responses! I will definitely be working on the "things I can change" stuff first and foremost and only really go for revision in due time if my weight doesn't see tremendous benefit down the line.

My relationship with food, I'd say, is infinitely better than it was pre-surgery, but I won't kid myself and claim it's where I should be. I definitely will pursue a therapist for that after I find a doctor to address anxiety and depression. I also will consult with my nephro docs because malabsorption did worry me as far as medication, so I'll see what their input is. My WL surgeon did affirm that medication absorption is rarely effected by bypass or the duodenal switch, but when I pursued my sleeve I just was too worried about it. If I pursue and go forward with revision, I will be in the highest plane of vigilance this time around because I'll go into it with side factors (like stress, anxiety, etc) dealt with or under control so I don't slip. I'm only in the preliminary stages of considering it. I might seek a second opinion from another weight loss surgeon at the hospital I work. On a positive note, I did an assignment for one of my classes where I had to keep an extremely detailed food diary and I did make several adjustments because of it...whole grains as much as possible, more vegetables around, I'm going to invest in some fish (though I don't like it blech) and other things to boost healthy categories. I get a considerable amount of my daily calories from fat which I'm sure isn't helping even though my sum total calorie intake isn't terrible.

Quest bars are good and have decent protein content. I tried the new Beyond cereal bars (part of Quest's stuff) and it was really good and decently dense and well restrictive. Certainly a good choice for grab and go over any other junk food. I just wish they weren't so expensive.

I sympathize entirely with your experience. I, too, have stalled on weight loss because I've been eating like crap (while I can attempt to justify it because I've relapsed on my depression and my work schedule isn't helping me much, I won't tackle that here). Note that I'm sure you'll notice that if you eat very dense, good proteins (or dense foods in general) your restriction is still in tact. Your stomach at 6 months and beyond is usually just free from all of the surgical inflammation. You'll never, ever revert to anywhere near your normal stomach size. You can however revert back to an emotional tendency to food. The reality is, unfortunately, our brain is separate from our stomach. Slider foods are called that for a reason...they literally do not hold in our stomach very well so with a brief break and a sip of water, we can go back to gorging on said foods. I won't tell you how many times in a while I've eaten entire bags of chips since surgery. Hint: it's sad and more than I'm proud of. But as others have pointed out, your restriction is here to stay, and while it's never going to be like it was post surgery and for the first about six months, it's just knowing what foods will be restricted. The honeymoon period right after surgery and the following months is known as such for a reason...restriction is painfully strict, weight loss is rapid and cravings are basically nonexistent. Once we start getting out there, it gets a little easier to binge again and I think it's best if we can acknowledge that, not beat ourselves up over it. Just start being stricter with yourself, as I'm trying to do for myself. I'm looking hot and heavy for a gym to join and I'm trying to find replacements snack items that would be more protein rich (there's protein chips now! weird, right?) and satisfy my cravings. Do not beat yourself up and don't think you've done irreparable damage! That'll just hurt your attitude and not feed into productive use of this assessment of your habits!

I had to adapt to swallowing uncomfortably large pills the next day since I'm on an immunosuppressant regimen for transplant. At first it was extremely painful and nerve-racking, but I think by day 2 it was just tedious having to do one at a time. Now, 7 months out (and I could probably do this at about 2-3 months out) I can swallow all of my horse pills and gulp some water down no problem.

They say nay, but I'm a daredevil and I love gum. Do at your own risk. The complications are just that it can be really hard on your new stomach to digest (since gum is already hard to digest) in the off chance that you swallow it, and since you have a staple line, it can get stuck and it's probably not a pretty picture, but I don't routinely swallow gum and I'm not sure of anyone who does.

Hello! So, if you've happened upon a post I've made before, I've made it no secret I'm a kidney transplant patient. It's the main reason I'm both pursuing and fretting the sleeve. On one hand, I need, need, need to lose weight to give this little bean the best possible circumstances it can have but I also have concerns regarding meds and fluids, but many people have reassured me in the department. So my next, well hurdle if you can call it that, is my doctor. Let me give a little background. I'm 19 years old. I've been going to this particular nephrology practice (at Children's Mercy Hospital in Kansas City, MO for those curious for whatever reason) since I moved to Missouri from Cali when I was like 18 months old. I was born with chronic renal failure secondary to posterior urethral valves. It wasn't until 2010 that I finally had to go on dialysis about a month after my fourteenth birthday. Since then until June of 2013, I had battled to be put on the transplant list and for a majority of circumstances, my weight was the biggest inhibitor. My doctor has always been skeptical about my persistence. I'd suggested the Lap-Band about two years into dialysis and he shot me down...and hey, at 16 what could I do? Later on down the line, I got my transplant after getting sick and losing 25 pounds (only time I've ever lost a large amount of weight). Skip a year and I was suggesting it again. I was 18 at the time and he was still super skeptical, but he finally heard me out (well kind of). I asked him to give me his suggestions for places to go. His suggestion, which took well over six months to get to me, was a program that was now defunct. Lol he tried. So I personally sought out Saint Luke's myself. Cut to March of this year, I was diagnosed with diabetes and most of my doctors actually REASSURED me that weight loss surgery would be good! A few months prior an hepatic endocrinologist wanted to see me to discuss elevated liver enzymes indicating possible fatty liver tissue. He was the first one to go "Uhm, that's actually a really good idea???" and he was shocked to hear when I told him I'd been suggesting it for some time and didn't get the support I needed. He's the one who pushed my doctor into the right direction. Now, to get to the point of this My surgery is happening on Tuesday. A three year battle is coming to an end, albeit with one detail changed (not Lap Band but sleeve ). On August 9th I have my next follow up with my renal doctor (3rd with my Endocrinologist). That's about a month and a half and a smidgen. I'm not looking for concrete estimates as I know everyone is different, but I'd love to know your experiences. At about 6 weeks post op, how much weight had you lost? I'm hoping I can kind of wow my doctor and (respectfully) tell him "I told you so".

Thanks! I'm glad I could help with relevant information! It was difficult to find information specifically regarding a transplant patient do maybe we can talk amongst ourselves? Anyway, I am down to 256-258 pounds making my total loss about 40 pounds thus far. My doctor was certainly impressed. Sent from my iPhone using the BariatricPal App

Yeah, I'm on a PPI and have been long before surgery. I have chronic heartburn. I was off my Omeprazole one day and it was back...was hoping the surgery would cure that for me but alas, I am one of the unlucky ones who gets to keep GERD. I don't think it's made restriction more noticeable because I concur with the above commenter that restriction was felt around dense purees and not liquids. Sent from my iPhone using the BariatricPal App

I've been able to drink pretty decently since surgery. I can't gorge Water like I used to in one sitting, but I have no problem gulping a reasonable amount, waiting a couple minutes and gulping again. My Fluid goals are increased (128oz ideally) because of another procedure. I'm still working on it but there's no restrictive reason I can't achieve it, I just need to think about drinking throughout the day. When I eat, drinking can make me feel bloated if I drink too soon but it also eases a few minutes later which is probably a sign that it's flushing food out of my pouch which is not a good thing because at week 5, I'm noticing minor hunger...so I might be fueling a fire by drinking too close with meals (although I don't particularly have meals, I just have Protein sources right now like cheese, deli meats, yogurt, salami, stuff like that).

Heh, so I've noticed I have a habit of making posts where the title is literally just one food item and I just know this will garner a discussion on several foods that are related, but yeah, there's my little introspection for the moment. Anywho, my guidelines say at week three I can add in crackers, but it specifies non-seeded crackers and non-grains. It suggests saltines and melba toast as examples. What exactly constitutes a "grain" cracker? Would wheat thins fall into that? I'm not a huge fan of saltines but I would like to find some good crackers to have some guac and hummus with. I like wheat thins but I know they run rather salty and I'm not entirely sure if wheat is what they mean by grains. In my mind, I was imagining things like shredded wheat and really fibrous type crackers, but I'm not sure. Any thoughts? It also suggests corn/flour tortillas and baked tortilla chips so I might try those as well.

I tried the ricotta bake the same time as you, a day before starting soft foods. My only gripe was the mozzarella topping was very chewy and it made me stuffed and uncomfortable so I told myself if I do it next time, instead of making it a topping, I'm going to mix it in.

I agree! I was a Cheezit fool! You know how they put on the back of the boxes "Get your own Box".....I think they wrote that for me! haha. Sadly, I will never be able to have Cheezits ever again.....but that's my own rule for me. ImageUploadedByBariatricPal1468692642.374290.jpg here a cool thing I found to make your own cheezits! Sent from my iPhone using the BariatricPal App I'm going to have to try that! Sent from my iPhone using the BariatricPal App

On my plan, it was OK but check with your NUT. If you do, try and remove as much of the stringy bits on the banana before you put it in as you can. Sent from my iPhone using the BariatricPal App

Not to mention 222 is a fairly low starting weight (not sure of your height?) so you will generally lose a little slower because there's less to lose (I would assume). Sent from my iPhone using the BariatricPal App