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!

Edited February 12, 20224 yr by shriner37

Thank you for posting! After reading it, I am very glad I made the decision to go the RNY route instead of sleeve which was my original choice. I suffer from GERD and a sliding hiatal hernia that has me in pain most days. Until the pre op work up, I didn't realize I had either. I had assumed everyone suffered from heartburn. I would usually "just deal with it" without any meds. I made a point to start taking Tums EVERY time I had heartburn and the amount I was taking was quite the eye opener. I am excited to have the operation on March 3rd and get rid of the pain hopefully forever. Good Luck next week!!!

I have enjoyed everyone’s post and all have been very helpful. I especially wanted to hear from someone several years post surgery and this post was most helpful. My surgery is scheduled for March 2. I am having gastric sleeve unless surgeon has other advice. Thanks for your post and God bless!

I am sorry that you have to go through another surgery but hope it helps your problems.
Unfortunately, I have come to realize that it seems EXTREMELY COMMON over the long term that Sleeve patients end up developing hernias and reflux. I suspect that, as we get more info about the long term with this surgery, it will become clear that something needs to change about the surgical technique to prevent this from being such a common complication down the road. Knowing what I know now, personally I wish I had never gotten the sleeve - if I had gotten bariatric surgery, I wish I had gotten the RNY instead. At least the RNY has been around long enough that the surgical technique has been perfected and we know a lot about how people do with it over the long run. I really regret that I didn't realize what I was getting myself into when I had the sleeve. You guessed it - I too have a hiatal hernia and reflux. People need to be aware that this is an extremely common scenario after a few years with the sleeve.

11 hours ago, SleevedK said:

I suspect that, as we get more info about the long term with this surgery, it will become clear that something needs to change about the surgical technique to prevent this from being such a common complication down the road.

... aaaaaand that's why I hope the mini gastric bypass becomes more of a thing soon in America.