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Dr. Josh Roller (Roller Weight Loss) has a GREAT segment on the podcast he’s on going over best surgeries if you need revision. I just finished listening to it. It’s on Spotify (& others) “The Skinny Truth”. I’m set up to get the Modified DS in the next few weeks with him.

Good morning! I am so happy that I found this group! I have been lurking for a month or so. There is a lot of information to be gained here😁. I had VSG Nov 2014 and lost 80 lbs. I was down to 170 lbs. I am 5’9 so I was quite content there. As we all know life throws curveballs and my weight has steadily climbed. I am now 60 years old and weigh 225. My A1c is high and I have been diagnosed with type 2 dm. I have been nauseated for months and last month I had an upper GI that showed severe acid reflux and a moderate hiatal hernia. Omeprazole has not helped at all. I have an EGD scheduled this coming Friday. Revision to bypass has been brought up by the nurse practitioner at the bariatric surgeon’s office. I also just met with my new PCP who gave me a prescription for Mounjaro. Bariatric surgeon said not to start the Mounjaro until we resolve my reflux issues (due to the possible side effects of nausea). I am unsure if I should go with the revision to bypass with hernia repair or just get the hernia repair and hope that fixes my reflux issue and use the Mounjaro to help with weight loss and lowering my A1c. I am not sure if just repairing the hernia will fix my relax issue. I will discuss all these options with my surgeon after the EGD. What are your thoughts/experiences?

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I had revision to rny 4 years ago in May. I have horrible bouts of abdominal pain that has sent me to hospital several times... 2 CT scans, 2 egd and a colonoscopy later...no answers.. I don't see how it can be gas trapped but at this point I don't care what it is I am tired of these bouts that come on whenever out of the blue. It is debilitating. The pain is the worst! I need help.

Short update: I had my gastric sleeve procedure done in November 2019. I lost around 85 lbs and then stalled eventually regaining around 50 lbs back and a horrible case of GERD. I had never had symptoms of GERD before my surgery and about 3 months later, I had to begin taking omeprezole daily to deal with it. If I forget a dose I can tell by the afternoon. During the first year post surgery, I lost my husband (not unexpectedly but it DID happen 10 days post-op for me), moved across country from Florida to New Mexico, bought a new house and started a new job. My daughter is 1 year post-op and lost approx. 150 ibs on the DS. l just started the process to obtain a revisional surgery. Will be discussing the benefits of either the DS or ByPass. I had the upper GI completed which showed a small hiatal hernia with evidence of GERD. It also showed mild cricopharyngeal hypertrophy. Any suggestions regarding which of the 2 procedures would help with the GERD and to help lose the 130 lbs. that I still need to drop to get to my goal weight?

I am just starting Zepbound tomorrow! Ihave had a long journey. I was lapbanded in 2002. I lost 130lbs. In 2014, after not seeing any doctors for 5 years, I went to a local bariatric surgeon just for a checkup. He found my esophagus had expanded. My band was too tight and I was packing my esophagus..didn't even know..no pain. Immediately unfilled and gained 30lbs in a month..eating NOTHING! LIke almost! I was refilled after about 3-4 months and then developed an infection..and to cut to the chase..band was removed in 2018 and revised to sleeve. By then I was up 50lbs. Since then I gained another 50lbs..so the sleeve did nothing. Between covid, bad eating habits and menopause, I cannot get this weight off..I tried keto..lost a few lbs..tried intermittent fasting..lost a few more..but my body just won't move the weight down..so broke down last week and saw my new primary doctor and she prescrived Zepbound..well orginally Wegovy but that is harder to find and Costco had Zepbound. I will start this Saturday.

I can’t tell you how much I appreciate you taking the time to answer me. It’s been over 2 months , so that’s why I’m kinda freaking out (my younger brother died of stomach cancer in his 30s… sooo the thought not getting my erosions to heal and this surgery not having been a success is really depressing me). I have an endoscopy scheduled for 3/15.. I can’t bear the thought of this revision not being a success … thank you , again 😢🙏🏽

MOST bypass patients will not have heartburn, but not all. Occasionally heartburn can happen. Usually it is temporary while the stomach is healing and readjusting itself. Definitely talk to your surgeon about this. If your heartburn was from acid reflux from the stomach when you had the sleeve, the odds are overwhelmingly in your favor that it will settle down soon. Rarely a person can have bile reflux, but this is very different and normally tests are done to make sure it isn't that before revision surgery is done. Also, ask for nausea medication. If you have it and it isn't working well, ask for a different one. For me, Zofran does nothing, but Promethazine is amazing! So you could just need a med adjustment.

Even though you are a revision, your digestive system is still full of swelling and sutures from a major surgery! Hydration is king for the first two weeks, then protein, and both of these needs can be met with fluids... If you are experiencing nausea don't be afraid to ask for meds, it should help you be able to drink more. I agree with the others, sounds like a possible UTI. Best to go be tested at the doctor. Be sure to let your surgeon know approximately how much fluid you are getting in a day. Low fluid intake not only causes dehydration, but it can increase your risk for a UTI, especially in the first few weeks after surgery. ❤️

I'm so sorry you are experiencing this!! This isn't a you problem!! If you aren't losing sufficient weight you are either being given poor advice from your nutrition team, poor medical support from your surgeon, or it is possible your body is under significant stress for whatever reason and isn't losing weight. There are rare cases when someone with a sleeve doesn't respond but often those are people who have low starting weights. If they had a high starting weight and don't respond to the sleeve surgery, these people generally end up revised to bypass or a DS/SADI, and then lose weight, but again, that should be a convo being initiated by your surgeon as a future possibility if food modification and medications don't work. Some people take GLP-1 meds to help jumpstart their weight loss if the surgery hasn't triggered it, but again, at the 6 month mark this should be something the surgeon initiates conversation about. You shouldn't be living in fear of your appointments with them. If you aren't feeling supported you might consider getting a second opinion from another bariatric surgeon in the area not affiliated with this practice. I strongly believe in second opinions when talking things like surgery... It may sound like I'm being harsh on your team, but lets be clear. They made a nice chunk of money off of your surgery. You deserve good aftercare!! Some surgeons, like my own, believe that the best way to lose weight in the first 6 months to a year after surgery is through being in ketosis. This involves a good protein intake (60-80 grams with the sleeve) and carbs below 50 total carbs or 30 grams net carbs. You can get pee strips to test if you are in ketosis. Once in ketosis you should go through regular periods when you lose some weight, followed by periods where you lose none as your body stabilizes from the previous loss and recalibrates. If this doesn't happen, I'd definitely be communicating with the surgeon about it! What dietary advice did your team give you? Hydration is important for weight loss. If you aren't able to eat enough calories or drink enough water your body will go into starvation mode like @summerseeker mentioned. This is a huge stressor to the body!! And huge stress will cause weight loss to stop. Sleep is also crucial to weight loss, often more important than exercise. If you aren't getting regular sleep for enough hours per night, this can stall your weight loss. Physical activity of some kind is important, but it accounts for less weight loss than proper nutrition and sleep. And if you are under calories and under hydrated exercise will just further stress out your body.

I had VSG (2015) to RNY revision on January 18th due to GERD. I also had regained almost 70 pounds from my VSG post-op low weight. I've so far lost about 20 pounds since the pre-op diet & surgery. I need to lose another 20 pounds (for normal BMI) to 50 pounds (for calculated ideal body weight). I'm now on unrestricted food textures, and per my program's dietician, I'm supposed to be on my "maintenance" diet now. However, they refuse to discuss any calorie goals or macros other than protein. I'm someone who needs very clear goals and guidelines (thanks, long-undiagnosed ADHD), and I'm feeling very lost about what my diet should look like moving forward. The lifelong guidelines for my program, as I understand them: 60-80g protein per day Up to 4 oz. (1/2 cup) per meal, consisting of: Up to 3 oz. protein per meal Up to 1 oz. (total) veg, fruit, or starch per meal 3 meals per day 1 snack per day (the program guide I was given says 1-2, but per my surgeon I'm only allowed to have 1 snack per day and it has to be between lunch and dinner) - I have no guidelines for the amount I'm allowed for the snack. I assume it's not supposed to be as much food as the meals, but I don't know. Protein shakes/powders are frowned upon The only sample menu provided in my program guide is as follows: Breakfast: Egg omelet with sautéed peppers & onions Snack: Protein shake OR Greek yogurt with berries [removed per my surgeon's instructions] Lunch: Lettuce wrap with turkey and avocado/cheese [it is not clear to me if the / means avocado OR cheese, or avocado AND cheese, but I assume the former] Snack: Apple slices with 2 tablespoons nut butter OR carrots with hummus Dinner: Pesto chicken with spaghetti squash, sautéed spinach, and cherry tomatoes I plugged this menu into the Baritastic app to try and get a sense of what the calories and macros are supposed to look like. The sample menu gave no amounts other than the nut butter, so I used the 3 oz. protein + 1 oz. veg/fruit/starch rule. With the carrots & hummus snack option, here are the macros for the day: 593 calories 62g protein 32g fat 17g carbs (13g net carbs) 4g sugar 4g fiber And here are the apple & nut butter (I used natural peanut butter) macros for the day: 739 calories 67g protein 43g fat 21g carbs (16g net carbs) 8g sugar 5g fiber So from that, I'm extrapolating that I should be aiming for the following daily: 600-750 calories 60-80g protein 30-40g fat less than 25g carbs less than 10g sugar I have a few concerns... I have already been going well over those amounts at just over a month post-op. I've typically getting around 800-900 calories per day. It seems like a real struggle to get to the upper range of protein daily while sticking to the allowed amounts and without using any shakes or protein supplements. Even then, 80g seems low for a protein goal. I have never been a big meat eater (I was vegetarian through most of my teens and 20s), and I absolutely cannot stand any fish or seafood. I do eat a lot of dairy, eggs, and beans, but it seems like that's not going to do it. The standard daily fiber goal I've always heard is 25g per day. I've been getting about 12-15g per day right now, but knowing that I'm overeating and already having too many carbs means even that's not sustainable. I've struggled with post-op constipation... I have gotten to a much better place recently, but if I need to cut back to 4-5g of fiber per day to be within my other limits, I'm afraid of going backwards. That I'm limited to 1/2 cup of food per meal for the rest of my life came as a shock to me, as a revision patient. I knew that my pouch would be smaller than my sleeve, and like with my original surgery, the amount I'd be able to eat at one time would be very small initially. But with my sleeve (which was done by a different surgeon in a different program), there was definitely not the expectation that the amount I could/should eat at 1 month post-op would be the same as what I could/should be eating at 6 months or 1 year out. My bypass surgeon also told me that she left my pouch a little larger than normal so that I wouldn't lose too much additional weight, so my pouch is already larger than a regular bypass patient's. Do these amounts seem in line with other people's experiences? Or am I way off-base?

My doctor said that after my gastric bypass (revision from gastric sleeve) , I should not have any acid related disorders or heartburn, but I definitely still have it ..also in the middle of the night I feel naseau that comes and goes (can go a way if I change positions) … is this true that bypass patients have zero heartburn?

Gastric bypass revision from sleeve. I am doing liquid IV and trying the best I can to drink shakes and eat mush food. Not working out well. I am drinking. Still nausea. Is this the usual for a lot or am I in a bit of trouble. I was at er for urinary issue and they did scan said all looked good. Still going every ten minutes and just a little comes out. I guess it’s time to call doc. It’s a bit overwhelming. Praying for best outcome

I had a revision from sleeve to bypass, but it was due to complications, not for weight loss. When you have a revision, the amount of weight you lose is a lot less than the original surgery, and tends to come off slower, as well. For example... with my initial sleeve, I lost 103 pounds the first 8 months. Since I've had my revision (and it's been 8 months) I've lost 57 pounds. I'm not complaining, by any means, but it comes off a lot slower and you definitely lose less. Also, with the initial surgery you tend to lose the most weight in the first 6-7 months. With the revision, I noticed it was the first 3-4 months. In no way do I regret it (as I said, I had some pretty gnarly complications, so a revision was a must) but it's just something to keep in mind when looking at a revision for weight loss versus because of complications.

I’m doing ok. I had revision and it’s definitely not the same as I expected. It’s slow weight loss but at least it’s going down. Body take longer to heal compared to before. Over all can’t complaint. Thanks for asking!

I had GS nine years ago. Lost a lot. During lockdown I transfer addicted to alcohol. Now I'm sober, but, transfer addicted back to food to get there and have regained over half my loss back in the last year. So, what to do? I'd appreciate thoughts from those who got revisions and how they think it has helped them. Thanks.

Had my revision to gastric bypass two days ago. I did so well they let me go home yesterday. Today is a different story. The pain has definitely increased and I am having trouble urinating. It trickles out of me and not a lot. Has anyone experienced this? Thanks so much!

Can you elaborate on your "My sleeve caused lot's of medical problems) about to have revision from band to sleeve. Thanks

Thanks for sharing your experience. I'm just over a month post-op from VSG to RNY revision and feeling kinda lost. Do you track calories and/or macros? If so, what are your daily goals? Is your pouch normal-sized for a bypass, or did your surgeon leave it larger like mine did? How much food per meal are you eating at this point?

That's interesting... I had revision surgery the day before you, so we should be on the same stage, but even over a week after you posted this, I'm only allowed 3oz protein and 1oz veg, fruit, OR starch. 4 oz. total, with no indication that these amounts will ever change moving forward. And I'm being told that I should not be using protein shakes anymore if at all possible. I'm struggling with how to consistently get 20g of protein per meal when I can only have 3oz. at a time. If I could just eat plain chicken breast for every meal, sure. But I'm not cleared for unrestricted textures yet, and canned chicken breast is only 15g protein for 3oz. The dietician also REFUSES to give me any guidance on how many calories I should be aiming for per day and says that I shouldn't be "restricting," because I'm in my "maintenance phase" now. Which I am extremely confused by, because according to their plan, I'm still on "soft foods" until Monday, 2/25. And I have 25-50lbs to lose, still at the high end of the "overweight" BMI range.

Hi everyone, Just checking in to see how you are all doing now that we are 8 months on from the start of July surgeries? As I posted before I had a terrible time with complications; leak, pancreatitis, allergic reactions, abscesses and infections, I even had to be transferred to a hospital in another country for a procedure to stop the leak! But most importantly I made it through and got home from hospital the start of November. I am only starting to get my energy back now and find an interest in doing more than just coping /trying to get through the day, can see small improvements each week. My weight loss has slowed down over the last few weeks but my body, and mind, have been through a crap fest the last few months so not surprised, it will happen when it happens. I still can't always hold food down and get bad pains in my stomach at times, have refulx but it is all an improvement from a few months ago. So far I am down 38kg / 83lbs which is good going considering when in hospital I was on a feeding tube for quite a while and my weight went up due to the nutrition I was being pumped with. I may have to get a revision to bypass if the leak doesn't heal (won't know for another month or so if the treatment worked) but I'll cross that bridge if and when it comes. I hope everyone is doing well.

Sleeve in 2017 to revision Gastric Bypass Aug 2023 - Update Hi All! I can't believe how fast time has gone! I will be going to my 6 mth check up tomorrow 2/20/24. Everything is a lot better! As of today I am 173lbs, I'll update my ticker it's still at 183. I am able to eat more varieties that I cook at home. Can't tolerate beef to well but I was never a big red meat person. I am still on the fence with salads/raw vegs though I can tolerate raw onions and tomatoes. I CANNOT eat take out! Purchased chinese for my son as he was going back to college... tried a little and was bringing it back up the rest of the night! If I eat out it has to be at a place that actually cooks food like salmon, veggies, no added anything. Food prepared at home is MUCH beter because you know what's in it. I am not doing too well with my multi because I purchased capsules that I open to put in my protein smoothies (Unjury Vanilla) which I don't take every day anymore. I just purchase the multi-vitamin patch from the bariatric store, I'll update you on that later My food is mostly a diet consistency of pescatarian due to the low cal/high protein and the ease of my system digesting the food. I would occassionally eat chicken as well (ground, poached breast etc), turkey hardly ever because the meat is not as soft as chicken. My veggies are fine steamed, some legumes & beans (occasional), as far as grains or potatoes etc I try to not do carbs at all or keep them at a bare minimum (jasmine or basati brown rice) with an occasional meal...I've really gotten into sweet potatoes as I didn't eat them a lot before. Swelling is gone, skin is good, and I can visually see the difference in pounds and inches loss especially from a side view lol. I still have work to do (vitamins, eat more, move more) and I am working on it. BTW!!!! I am back in the health & wellness field as I start my new position next week. I took a pause last summer. Now as I am on my health journey I'll be helping my patients with weight loss and adopting healthier lifestyles. My goal is to lose 13 more lbs and as you all know after running so long and you can see the finish line in sight....your legs get weary and that last sprint is the hardest. It is good to move from "morbidly obese", to "obese", to now "overweight"...do you guys feel the same? Let me know how you all are doing!

I'm not sure, since I had an incredible amount of polyps that had to be removed, as well. Those were caused as a result of being on 80mg of a PPI everyday for an extended amount of time. I had 4 endoscopies just to remove polyps. 8-10 were removed each time. The first time, my esophagus was stretched, as well. I ended up needing to get a revision to bypass because the GERD caused, not only the polyps, but also gastritis and esophagitis, as well. And even with the 80mg of Nexium daily, I was still getting break through GERD that required Pepcid, which didn't always help. I also never had any kind of GERD or reflux before the sleeve.

TORe is a relatively recent revision for RNY. Essentially, they go in through your mouth and esophagus and stitch your pouch and the opening to your pouch back into the tight little basket It was when you first got gastric bypass. I’m looking into it as I was very successful for 20 years, but regained most of my weight in the last three from life, stress and menopause. Has anyone had an experience with this?

I'm curious what they told you to expect in terms of weight loss, as I've heard revisions for that purpose don't necessarily produce large weight loss (but do help with issues like GERD). I'm afraid I don't know much about gastric bypass and IBS. That's quite a bit of fruit and veg they have you eating preop. I wish you luck, though, and hope you can get answers to the questions you have!