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Considering a re-sleeve in the new year



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I can't decide if I'm embarrassed to write this post or not...So, I'm just going to go for it.

I hit my 2-year mark without fanfare a few weeks back. I reminded no one, and didn't bother taking a picture. I'm completely bummed out and am grasping for...food (was going to say straws, but I might as well be honest). I've struggled - starting with a pretty darn high weight in the first place, having a stupid short honeymoon period, and ending up in November 2015 with so much extra stress in my life that I sometimes wonder how this all happened (this is the "woe is me" part, sorry)...so here I am today, weighing about 15 pounds more than my lowest weight at left (that I hit in May 2015) that I don't seem to be able to shake back off of me, and looking for support.

I'm writing this post because first, I would like to hear from anyone who has actually been re-sleeved. FYI that I am not interested in converting to the bypass, because for probably the rest of my life, I must be able to take NSAIDs for arthritis (and after a bypass, medicating for that becomes tricky and appears to only involve cortisone shots. Yuck, ouch, and no).

Second, I'm writing this as a reality check to myself -- I've written/deleted/rewritten/re-deleted this post a couple of times this morning because as I've typed, I've realized a few very important things I've changed in the past 5-7 months that I need to grab back onto - things that are now contributing to my weight gain and pushing my thoughts toward that 2nd surgery. With as much weight as I still have to lose (50 to 90 lbs), I had already been considering a 2nd surgery, because I felt like I would need one more big push toward goal (at more than 50 pounds away after 2 years). I checked into getting a bypass as a method towards that final push, but that's when I learned about the arthritis meds problem. My recent struggles are just causing the underlying reason for that surgery to change a bit-from a "push" to a "need" (at least in my head :) ). Hopefully that sentence makes sense.

I'm looking for someone who can maybe shed light on what it's like to be re-sleeved (as a "re-do" rather than for actual medical complications, since I have read about those issues on this site), if there's anyone out there who has experienced it. I will be seeking a different surgeon to perform it, and if I end up going this route, I am hoping to do it in May or June 2016. I have faith that some will remind me of the 5-day pouch test, getting in my daily Protein and Water, and other great advice toward getting back on track (that's my plan for the coming week - doing menu planning after posting this). I appreciate this community for its experience and advice! Thanks!

ETA 1: Thanks for the comments! But somehow I've possibly given the impression that I have just 15 pounds to lose. Ah, if only that were true!!! Clarification, my "first" goal weight is 199, and I'm currently 50+ away from that. My true goal is 180, and my reach goal is 160-165. The 15 lb reference is that I'm up 15 from my lowest "current weight" (listed at left in my profile info). In other words, I have more weight still left to lose than some people have when they walk in the door for their first WLS consultation. I've had a number of weight fluctuations in the past 6 or so months, but this is the first time I can't seem to adjust my diet and have that weight go away.

ETA 2: I've had a Fit Bit almost 2 years, and have worked out for the past 15 or so months (per my doc's plan, which is very conservative and geared around losing fat not muscle) until recently 5 to 7 days per week. Where I'm off is on my food intake and choices, which is good to be aware of because I can effect change. The heart of my post is that yes, I can make better food choices and update my workouts (they are boring to me now so I'm less motivated) and could probably get back on track for another bit of weight loss. What I'm considering is whether to do a "drastic" step to get re-sleeved to assist with the large portion of weight still left to lose. And no, this is not a stall - I've stalled any number of times in the past year and a half - this is different. This is more of a meta moment of realization...and I appreciate everyone who is taking the time to read and respond!

Edited by Shells_Almost_There

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I haven't been resleeved, but I have a lot of weight to lose. It is just my opinion, but it seems like a pretty drastic thing to do, especially if you aren't patient enough to use the sleeve as it is designed to be used.

Are you still following your program?

Since I do not know your story, all I can suggest is that you think very carefully about your decision and talk frankly with your surgeon and NUT.

Also, I am posting a link to a thread I wrote a while back that you might find helpful.

I truly hope you find a good solution that is healthy and works for you.

Embrace the Stall!

http://BariatricPal.com/index.php?/topic/351046-Embrace-the-Stall

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I said it in another thread, and I'll say it again.

No amount of re sleeving, banding, revision to bypass, band to sleeve revision etc will help you be successful if you don't have your head in the game. Period.

These surgeries shouldn't be used as a crutch. They should be used as a tool to help you meet your weight loss goals and then maintain the weight lost.

Your mindset need to be right or it just won't work. Start by deciding what exactly your weight loss and fitness goals are, then put a solid plan into place. Get back to basics like when you first had surgery. Protien first, then veggies, and lots of fluids. Move more. Take it one step at a time if you have to until you feel you're back on track. Then just keep up the momentum. Make small goals along the way to keep you motivated.

It's not easy, but I've seen people as far out as you get back on track and stay the course and lose the weight. I know you can too.

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I thought that with the sleeve the surgeon removes between 65-85% of your stomach... so how can a person be "re-sleeved" when there's hardly any stomach left to be removed?

I'm just curious as I've never heard of this.

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I've never heard of a re-sleeve, and I certainly wouldn't consider surgery for 15 pounds.

Go back to what you know. Replace some meals with Protein Shakes.

You can do it!

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First of all I know you must feel awful, but 15 pounds is not that much and I am certain you can lose it again since you have already been successful and know what you have to do to make it work (even though I know sometimes that's easier said than done)

Second, I haven't been resleeved so I can't speak from a personal experience. However, I have a close friend who has been resleeved. She is actually the bariatric coordinator for our hospital and surgeons office program. There are two surgeons in our program. After about two years she was talking to the other surgeon and said that she felt she should have lost more weight and didn't feel like her restriction was what it should be.

He did some tests to look at the size of her stomach and told her he felt that the other surgeon did not make her sleeve small enough. He offered to re do her sleeve and she agreed. She had the surgery and did just a great with the second as she did with the first and went on to make her goal weight.

I don't think it's that common but it does happen. Good luck with your decision. In the meantime take a shot at going back to basics and doing what you can.

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I think one of the first steps should be to get an endosocopy to see just how big your stomach is. Stomach sizes vary depending on the surgeon so this should be your first place to start. If it is indeed to large; consider revision. I revised from sleeve to gastric bypass and I am very glad with my decision. One other poster commented on the 15 pound gain; if I am correct you currently weigh 240 pounds at 5' 4". It does seem like you have alot more than 15 pounds to lose. I think revision is a great idea; yes it is just a tool but sometimes it is that extra push you need to get the rest of your weight off and stay there.

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@@Shells_Almost_There -

I'm not sleeved, but I stopped at your topic because it may come to be. From what I glean amid all the detail, you're considering revision surgery to achieve a smaller stomach than you have now? To curb your appetite and decrease the stomach's capacity?

If so, it sounds that you want to rely on surgery to lose weight for you rather than doing the mindful work and making sound choices for yourself. It sounds like dismal choice. We are separate individuals, certainly. From my perspective, admittedly one with little knowledge of sleeving, I'd feel lesser as a person. I don't want to give up autonomy and personal responsibility; I want to earn the satisfaction and pride of achievement.

Your regain is 15 pounds from your lowest, post-surgery weight. No one wants regain, but 15 is not uncommon and nowhere as high as it could be, obviously. Consider whether the amount is really so overwhelming that going to the OR makes any sense. If you don't want to recommit to your original goal and want to evade doing the work for yourself, it's likely that you won't get where you say you want to go. There's something called "eating around the band," i.e., eating things that go down easily and never give satiety (anything sugar and most things crunchy, such as chips). I understand that there's an equivalent for sleeve people. If you don't know that full routine now, you're sure to find it.

You've lost weight before. You can get back to it, maybe with a therapist who has experience with WLS people, eating disorders and all that.

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After actually reading your post, and realizing how much weight you have to lose, and where you are, it raises some questions that need to be answered before anyone can give you any kind of honest answer to your question. The first is; why have you not lost more weight? There are in the grand scheme of things two possibilities, one, you are not eating properly. Two; your surgeon failed to make your stomach small enough. On the outside there is the possibility that you have stretched your stomach out and are eating too much due to that, however, that is pretty rare. So, if you are not eating properly, you could convert to a bypass and lose a bit of weight but you would gain it back. If your sleeve is too big, it needs to be fixed.

Here is the second part of my post, and one I read far too little about on these and similar forums. How much do you move a day? Are you wearing a Fitbit (or similar device)?

Weight loss = Burning more calories than you intake. Period. You could gain weight eating 1000 calories a day if you only take 500 steps a day. Move more, eat less, and better.

Embrace the Stall was a great post. I am stuck in a stall now, and it's driving me crazy. But...... I stick to the program knowing this will pass. It has too. My caloric deficit for last week was 24K calories. My body will get with the program and yours can too.

I took guts to write your post for the whole world to see. Now finish it. Solve the riddle. Are you logging your food? I log everything I eat. Get a fitness tracker. Figure out where you are and establish a baseline, then improve. If you are already doing all these things, eating right, exercising, tracking movement and food, then, you may have a valid question in regards to your sleeve.

You were honest in your initial post, now it's time to get REALLY honest and personal.

You can do this.

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Thanks, everyone, for responding and sharing your thoughts. I updated my post a bit, since I had edited out all the exercising, etc, that's happened in the past 15 or so months after I had an important knee surgery - that was HUGE for me and some awesome physical changes that were related solely to working out, not losing pounds on a scale. I don't want to minimize how important that has been. I'm not in a stall, but anyone above who has posted about my needing to question my food choices, etc is exactly right. Thank you! i know there are a number of things that only I can do to change this circumstance.

Shell

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Excellent question, as I hadn't heard of it either until a friend mentioned it -- Here's one resource on the topic:

https://www.google.com/url?sa=t&rct=j&q=&esrc=s&source=web&cd=5&cad=rja&uact=8&ved=0CEkQFjAEahUKEwja2NOhiobJAhVQ32MKHTlyA6o&url=https%3A%2F%2Fwww.tijuanabariatrics.com%2Fblog%2F2014%2F06%2F20%2Fsleeve-gastrectomy-revision-surgery-why-145250&usg=AFQjCNHPrKz4tFDkt1fBWrquG0sR6j_Rmg

I thought that with the sleeve the surgeon removes between 65-85% of your stomach... so how can a person be "re-sleeved" when there's hardly any stomach left to be removed?
I'm just curious as I've never heard of this.

Edited by Shells_Almost_There

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Thanks for the reply - I absolutely agree about the endoscopy. I have wanted to do one since about 9 months out due to some weird pain/cramping in my large incision area but I had insurance problems at that point and finally gave up on the idea. In 2016, I think it's where I will start. Thanks!

I think one of the first steps should be to get an endosocopy to see just how big your stomach is. Stomach sizes vary depending on the surgeon so this should be your first place to start. If it is indeed to large; consider revision. I revised from sleeve to gastric bypass and I am very glad with my decision. One other poster commented on the 15 pound gain; if I am correct you currently weigh 240 pounds at 5' 4". It does seem like you have alot more than 15 pounds to lose. I think revision is a great idea; yes it is just a tool but sometimes it is that extra push you need to get the rest of your weight off and stay there.

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Please don't take this as judgemental, only that it seems prudent to explore all non surgical options before resorting to another modification of your body.

Have you worked closely with your nutritionist?

Have you tracked your food intake (using Sparkpeople or Myfitnesspal)?

Do you have any WLS support group meeting in your area?

Do you have the means to work with a trainer at a gym?

Have you thought of working with a psychologist?

Have you talked with your doctor about another surgery?

As most people on here have said, this is only a tool, and sometimes it can be ineffective, but you have lost 100 lbs. so we can safely say it works, so what has changed? I have no idea of your health or your circumstances but a 100 lbs. is a lot of weight, most importantly, how do you feel? Maybe that's where you are or maybe it's how you're handling life, are you happy or sad? Is your problem emotional, or are physical problems holding you back?

As far as additional surgery, I only know what I have found during my research prior to my surgery, I learned about the good and the bad with all WLS options and I chose the sleeve. I actually didn't know there could be such a thing as a re-sleeve, but why not? One of the complications of any sleeve surgery is complications caused by scar tissue, the thicker it is the more chance for complications, additional injury to the same area would increase those risks. I would weigh the potential of the benefit vs. risk very carefully before committing to another sleeve surgery especially because there's no reversing it. You have other options if you go surgical, through lap band and duodonal switch. You had better be very careful to thoroughly research your options. Good luck!

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The re-sleeve idea is one of many things I'm exploring because of where I find myself with my previous procedure and how far I still have to go. The intention of my original post was to receive support, because that's what this community is about, and also to see if maybe there was someone here who had done a re-sleeve. There doesn't seem to be, though, which is why I plan to work closely with a surgical team to learn about options and risks, plus focus on my day-to-day routine to get the extra pounds off slowly -- just as I tried to do for many years before I ever considered a body-modifying procedure in the first place.

Edited by Shells_Almost_There

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