2012 - I had Vertical Sleeve Gastric Surgery in October 2012, and this is my journey to push the fat girl aside and start living life without fear of lawn chairs, the middle seat, clothing shops and high heels. Among other things.

2017 - I'm preop for the Duodenal Switch procedure for my sleeve to help me get to goal weight....and to fix another hiatal hernia.

Tuesday, August 29, 2017

VSG Failure? depends on your perspective.

So I've had a lot of time to think about what a revision to my original WLS, vertical sleeve gastrectomy (VSG), means to me.  The word failure comes into mind a lot, and I try and fight that off, since I don't actually see the original VSG as a failure.

If you start looking around at information on VSG failure/regain you will see very quickly that the community really beats up on the person that is not successfully keeping weight off.  Its a pretty depressing situation, and actually, it kept me from seeking help a lot sooner as I did. I bought into the fact that it was me, my fault, my failure, my issues. 

However, when I evaluate the situation, it wasn't really a failure, in my perspective.

I did fail to make it to a normal BMI. 
I did fail to keep off all the weight I initially lost.

Based on those 2 things I am considered a medical failure, and I qualify for revision.

However, I don't see my journey as a failure and I don't see me as a failure.  The VSG has already done amazing things for me and my life.  I made massive changes to my eating habits, my portions, my choices.  100% good, no.  Better than they were before, yes.  

In 2012 I was on a slippery slope, 315lbs and gaining.  With the VSG I managed to get down to 230, and then springboard back into the 240-250lbs.  The surgery halted my upwards trajectory into the super-super morbid obesity and has made me a mostly normal looking, albeit hefty sized person. 

The "failure" comes into play for me in that I am still not a normal BMI, and I'm at least 50lbs heavier than I would like to be (my preference would be to be in the 190-200 range), and 86lbs heavier than a normal BMI for someone my size. 

Current BMI - 38, 250lbs
Normal BMI - 24.9, 164lbs

Hilariously, here I said that if I never lost another pound under 260lbs I would still be happy.  LOL perspective. That was 2 months post surgery in 2012.

I never made it to my goal weight of 190. Perhaps that is because I was comfortable? 

There are a lot of things that I am going to do differently this time as well.  I've been making a list of them and will make another post.  The main ones are that I ate too many carbs too soon, not enough water, and I didn't/don't exercise enough.

Regardless, there are also other things at play. My surgeon said that there are lots of people that VSG doesn't work for, those with metabolic concerns.  My fundus (stomach) is dilated. My normal anatomy might let food pass more quickly through then normal.

I can also say that my mom put me on my first diet when I was 5 years old, and basically I've been chubby ever since. I have lots of food anxiety, stress, and secret eating.  These are things that I have been working on.  I did a great emotional eating class earlier this year that help solidify my position that I should seek to see if there is another surgery/re-sleeve option for me.

So, I'm positive feeling about the upcoming duodenal switch. I am so excited to think about being a normal sized person for the first time ever in my adult life. 

For those that find their way here and are thinking about a revision for lack of weight loss, or regain, I'm with you.

Here is another great article on revisions to the VSG, a very easy to follow along power point from Duke University.

This is a long one, but if you are interested in this material, then you might find it worth reading.  The conclusion is one that is not very comforting, but pretty realistic. 

In summary, SG as a stand-alone operation is gaining popularity among both bariatric surgeons and patients. This enthusiasm, however, has to be balanced against a paucity of data in regards to potential long-term failure rates. Similar to other bariatric surgery procedures, SG failure is likely to be multifactorial and related to a combination of technical, physiological, and psychological parameters. When discussing SG, bariatric surgeons must review these unknowns with their patients to ensure they will make informed, long-term, surgical decisions based on all available information.

Friday, August 25, 2017

Duodenal Switch confirmed!

I originally had my follow up appointment with the surgeon for this coming Monday, however the hurricane in the gulf right now is going to circle around all weekend and make Monday appointments impossible.  I gave the office a quick call and they actually squeezed me in today, Friday, for an appointment before the weather turns for the worst.

My surgeon reviewed the results of the endoscopy and the result of the upper G.I. His recommendation is that I convert to the Duodenal Switch as well as fix the sliding hiatal hernia and perhaps some trimming of my current sleeve.

The upper GI showed that I have a giant sliding hiatal hernia  that is obstructing the esophagus from working properly. I'm mildly embarrassed by my own lack of body awareness, I guess I feel like weird feelings in my stomach and throat are just "normal for me ".  He  reassured me that this is in fact not normal.

The only good thing about the hiatal hernia is that my insurance will definitely cover the repair to that and I know that my insurance does definitely not include  any weight-loss surgery.

This means that a good portion of my surgery will be covered and I will only have to pay for the time it takes to complete the duodenal switch. A significant savings, and my work will allow me to go on short term disability to recover. Which is even better, so I don't have to use all my vacation time for recovery and possibly have to return to work sooner than I should.

I actually didn't really know anything about the duodenal switch until my first consult where he told me about it.  I've been reading a lot.  The conversion from a vertical sleeve gastrectomy to the duodenal switch means that I'm halfway done the surgery, all I require is the detouring of the small intestines.  Although he did say there might be some revision to the fundus, stomach, as mine is quite distended.  However he didn't recommend a re-sleeve by itself because they are not quite as successful and just revising the stomach tissue has a higher risk of leakage.

Because I have so much arthritis in my neck, I require ibuprofen on a pretty regular basis.  The other option of a gastric bypass is definitely off the table,  as that surgery is very intolerant too ibuprofen. The good news is that I regularly take ibuprofen and I don't have any stomach ulcers currently, so that is a positive indicator that this will continue to work well for me.

What I'm really happy about  is that all the waiting and wondering about what might happen, what's the recommendation,  which revision is going to be best for me  .... etc etc is over.  Knowing is just so much better, now I can rest easy and do research on my upcoming surgery.

Phew! So happy that I know the next steps.

His office is submitting to my insurance for the hernia fix and is going to get in touch with me with a quote for the remaining surgery that will happen at the same time. Then we can plan a date for the revision - which will have to be in October, I have too much going on work wise in Sept.  I'm hoping for  October 2,  first Monday of the month and almost exactly 5 years to the day (oct15,2012) from my initial VSG.  That will be a good date as well, so I can take almost that whole month off  to recover.

Happy Dance!!

Monday, August 21, 2017

The Waiting Game

It's so hard to wait now that I have all the tests done. I'm impatient and there are so many scenarios that this could play out to, so I keep over thinking what might happen.

The one thing that I need to get done is a check in with a regular GP to have my vitamin levels tested. Putting that on my to do list. I also need to scroll back in my calendar and review all the pre surgery steps that happened and in what order.

I'm struggling with the up down on the scale, as I always do. Weight down = flying high and feeling good. Weight up = angry frustratinion

I wish that I had a better relationship with my weight.  Guess I can file that under things to work on.

I've been doing better at lunch with bringing my pre-made good for me food. We are doing better at night with making dinners and not eating out, which is a huge downfall.

At this point it's just one day at a time and one snack at a time!

Thursday, August 17, 2017

Endoscopy done

You know what doctors of anesthesia don't appreciate, jokes about Michael Jackson when they're going to use propofol on you for your procedure!! Oops!!

All went well for my procedure. I read the report they give after but am trying to not read too much into it, since I don't want to think one thing and be told another when I have the consultation.

I've started prepping people at work that I am going to need some substantial time off for recover from hernia surgery. I did this the first time as well- I am a "secret sleever". I don't want to tell many people about my WLS so I just don't. Especially at the office.

I'm actually feeling very restless and impatient. I have 10 days until my consultation about the tests and then September is a terrible month for work for me, so I'm going to have to schedule the revision surgery for October. Which feels like forever from here.

But I'm sure that it will go by quick!

Tuesday, August 15, 2017

Another Hiatal Hernia... Good News, Bad New

Bad news, I have another hiatal hernia... Good new, that means that my insurance will cover the part of the surgery to fix that. 

Side note... barium is about as yucky as I expected.  When you have not had anything to drink in 10+ hours you would think that drinking anything would be awesome... yeah, no.

The curious part of me is wondering why I have one again.  I imagine that its a combination of genetically having a big hiatal hole (hahaha!), and being overweight with the majority of my weight being carried in the front of my abdomen. This creates more pressure on the organs and could be forcing the stomach up. 

Anyway... all problems that can be sorted out.

Onwards to tomorrows 5am wake up call.  At 6am I have my endoscopy to have a look see the inside and I'm guessing I have ulcers again. 

Regardless, it will be a day off after conscious sedation, so I'm going to turn my work phone off and rewatch Game of Thrones last season and this season (if I can stay awake), and snooze with the dog.

I'm super curious to see what the doctor has to say about my sleeve and how it looks and his opinions on how to move forward from here.  

Monday, August 14, 2017

Upper GI X-rays Tomorrow

Tonight at 10pm, nothing more by mouth for my upper GI tomorrow morning.

I've only had barium once before, post first VSG, to make sure there were no leaks. Or, at least I think it was barium... pain meds make things fuzzy.

Very excited to kick this off again. I've also started an instagram account: TammyTake_2 if you want to link up where the "kids hang out"!!

This morning I was down on the scales again, which is great! But then I get wracked with guilt... am I just not trying hard enough? Can I do this without another surgery!? Ug, such ugly feelings. I have worked hard and I never came close to my goal weight, so I know that this is the right decision. I have to keep reminding myself that.

I've struggled for three years and done nothing but creep ever upwards. This is the right decision.

I found my 1 year pictures from 2013 and I'm excited to see the next phase of progress!

Saturday, August 12, 2017

Duodenal Switch

I had a good 24 hours to think on everything the doctor said about the re-sleeve and duodenal switch, which he thinks is the solution(unless the testing reveals another story), and I had gone into the appointment thinking that re-sleeve was the only option for me because I didn't want to have my intestines altered.

I have done a good bit of reading and soul searching... the husband and I talked about it and we both agree- whatever he recommends I will do.

We went and bought a bullet mixer so I can get through my pre op and post op liquids and puréed phases making my own baby food. I want to be sure to eat more protein this time and less pudding and cream of wheat. I also got some more small containers for food prep and some mini popcile maker for frozen yogurt pops of my own design.

My new passion is riced and mashed cauliflower!! Which will fit into the puréed phase and beyond. Tonight we had it with sautéed shrimp as the grits replacement- Devine.

All in all, I am feeling happy and now comes the long wait to testing, results, and scheduling. It would be great if they kind of find something else to fix in there that my insurance will pay for to divide out the costs, but I don't suspect so and that's fine. Husband is on board and I have a month of vacation time saved up so I will schedule my time off via that.

Feeling positive

Weight today: 248.2

Friday, August 11, 2017

Re-Sleeve Consultation

I had my re-sleeve consultation with my surgeon this morning. On the drive out there,  I started to get more and more worried about my middling success with my first sleeve and what he might say about it.

When you've been fat for your whole life and you're used to being blamed for it - I suppose it's a natural reaction that I would feel that this doctor, like all my other doctors, would be judgemental about my "success"  and question my every single behavior.

Of course, he wasn't.  Not that I still didn't get emotional talking about it, which I did, but I managed not to cry. He reassured me by saying that VSG doesn't always work for everybody especially if there are metabolic concerns. He also said that RSG (re-sleeve) is not very common and he would usually recommend either gastric bypass or a duodenal switch- DS. However,  reality is is they need to take a look inside to see what's going on before he can make a decision.

 I have an upper G.I. scheduled for next week Tuesday and an endoscopy scheduled for next week Wednesday.

I had a good cry in the car on the way home, I'm pretty sure after my first consultation I did the same thing (except I had a dozen donuts after),  and thought about how I judge myself just as harshly as I think other people do for being overweight.  I thought about all the things I could do better, I thought about all the times that I could work harder on my diet, all the moments of weakness and over eating and not following the rules.  It was exactly the same kind of conversation I had with myself before my first surgery, how I could exercise more eat less, blah blah blah all the same shit .  The problem I guess is with me and it's hard to fully except that I'm flawed in this department and I'm so flawed that I can't even manage to have surgery work for me.  At the same time I have to remind myself that I'm not the only one and that I should be allowed to solve this problem,  with freedom from judgment even my own judgment.

 I'm not keen on a DS ,  but in thinking about the doctors comments about being metabolically challenged I think that probably applies.  When I stick to anything over 1200 cal I struggle to lose weight.  Even after this surgery now sticking to 1200 cal is difficult for me.  Over the last week I've had between 1800 and 2200 calories a day and I've gone to bed hungry each night.

I had a good long argument with myself about surgery and in the end I realized that I'm going to eat a cookie the day before I die and I'm going to feel guilty about it.  So if I want surgery now who cares it's for me to decide it's for me to choose I'm still accountable but there's no shame in admitting that I need help.

I'm going to do some research on the duodenal switch and go for my appointments next week I have a follow up appointment on the 28th to review my results and I guess I'll know after then what can or can't happen.

Thursday, August 10, 2017

Looking Back

I spent some time last night and read through all my first 2 years worth of posts.  It was a delightful and terrible walk down memory lane.

I can see all the errors that I made back then, things that I wouldn't do again. 
  - too many carbs
  - too much sugar
  - no exercise
  - always attempting to eat too more

I also see just how far I have come from and I'm still proud of that. 
Changes that I have made:
  - no soda
  - no booze (not that I was a big drinker anyway)
  - generally make better food choices, more protein
  - 50lbs gone and to be fair, I was headed to 350+, which is not my reality anymore

I feel like this surgery was a pendulum swing for me. I was so far to one side (binging and eating amounts) and the surgery swung it way to the other.  The final result was that I settled in the middle, which is still too many calories to get to where I want to be. I can and do eat 1700 - 2200 a day and I am hungry several times in the day. 

If I get approved and have surgery to re-sleeve myself, then the arc of the pendulum will be so much smaller this time, that I think the final resting place will be more reasonable than 250lbs and more like 1195/200.

Directly after my first surgery consultation in 2012 I went to Shipley's donuts and bought a dozen donuts and ate 11 of them in my car.  The week before my pre-surgery diet started I ate three full sized bagels and a tub of cream cheese.  I also used regularly eat a whole large pizza, followed by a pint of ice cream and a liter of soda. I never left anything on my plate.  

I feel that the mental leap from eating 4,000 calories in a sitting to ~1,000 calories a day was so huge that I couldn't even grasp it.  It was actually mentally impossible for me to see that I need so little food that I could get by on a 1/4 of what I had in a single sitting.  I couldn't conceive of a meal that didn't have a starch of some sort - WAS it even possible to HAVE A MEAL without carbs?

I do a lot better now, I eat better, more protein and actually follow the diet guidelines, +100g protein a day - but the issue is how much I can eat. 
I've read this a few times and I don't like how it sounds, but there it is.  Looking back through all my other posts it was nice to have a few that were stream of consciousness - much like this.  So, posting these thoughts for my own good.

Wednesday, August 9, 2017

Re-Sleeve Thoughts

I was correct in thinking that people don't really blog that much anymore about this, or .. not that I can find on google anyway.

I have found a few re-sleeved people on Instagram.  Most of the accounts were private, understandably, as its a platform for sharing photos, so I totally get that (I would likely do the same).  There were a couple of accounts that were open and had some good positive data on being re-sleeved and did a little poking around on their posts to see what they thought and how it went. That was a positive!

Sadly, all the WLS/Obesity forums I've found on re-sleeving revision have been almost unanimously negative towards the person that is asking about getting it done. 

Its one of those strange things about WLS surgery, there is a sort of hyper-competitiveness over how it has worked for some people, who is "doing it the best", etc.  Mostly I've noted that if it is not working for someone - there seems to be a significant amount of finger pointing to the person that is not successful. 

I was laying awake last night thinking about what the surgeon might say to me on Friday about not being as successful as I could have been  and what level of "disappointment" he is going to have. I was already lining up a bunch of excuses, but the truth is....

This is hard.  No matter if you have surgery or not.  If I was able to control this myself, I wouldn't have been in for surgery in the first place.  

I thought back to my first meeting with him and remembered how NON-judgmental he was.  So I hope that I get met with the same amount of care for my feelings again, and then I can move forward with finding out if I meet all the right criteria.

I did find another great medical article on the Re-Sleeve: Better Results in Weight Loss after the Second Gastrectomy in Re-Sleeve Gastrectomy

Very promising material. Here is a nice graph that shows the results.

Weight today: 250

Tuesday, August 8, 2017

BMI Progress (2012 to 2017) and ReSleeve article

The best article I've found so far is here: Re-sleeve Gastrectomy for Failure of Weight Loss After Primary Sleeve Gastrectomy; 3 Cases

Its a very interesting read and of course, they use BMI as that is a better indicator for research than weight, due to variation in body size etc.  I do feel that some BMI is bullshit, since I really don't even want to be 175lbs, I want to be 195lbs and all the rest of the usual argument, muscle mass etc. 

As a result of reading this article I had a look at my BMI changes to give me an indication of my progress.






6 month


12 months


18 months



19 months (low)












57 months



So I lost 10 points off my BMI score, then gained back 3.  I would love to lose another 10 points off this BMI of 38 down to a BMI of 29 (190lbs) or 31 (205lbs).  This is the range that I am shooting for anyway.

I have started to track my food again, and make better choices for the interim and "work my sleeve".  As I said - I am not good at this, and now I am often hungry and don't feel full.  Which is my kryptonite.  Last night I was hungry after dinner (6oz of beef and 1.2C of veggies).  So that is a problem for me.   This morning since breakfast I've been thinking about food nonstop except for the 45min meeting that I was in.  

I have 10min before I can eat my lunch, countdown is on.

Monday, August 7, 2017

2017 update - revision/resleeve - 5 years later

Does anyone even use blogs anymore?  haha!  I think all this sh*t is done on Instagram now, but whatever.

I have updated my weights page and am back here because on Friday (august 11) I have a consultation to see about being "re-sleeved". 

I have been searching blogs to see ... has this been done? are there people out there that are talking about this?  What are the results?

Mostly I've only found medical articles, most of which are promising.  I'm not sure if that is because this is too narrow a search, or I'm bad at "googling", or if people are just not talking about this.   Regardless, I'll consult with my physician on Friday to see if I am a candidate. he has done and does do this procedure, so I'm cautiously optimistic.

I'm currently stuck in the 240-250 range.  Back to battling the same 5-10lbs over and over and over again.  I spent 20 years doing this pre sleeve, and now... I just don't want to waste time again.

I want to knock another 50+ pounds off and get a tummy tuck. I also want to do that before I'm in my late 40's instead of my early 40's. Since I was 43 last month, time is a wasting.  

I have also spent a good deal of time re-reading my early entries and wish wish WISH that I had paid attention to the bloggers that talked about the honeymoon phase and to use it to lose as much as possible. Anyway, certainly there are things that I could do better, and things that I would do differently this time around. 

I certainly do not regret getting the surgery, I would do it again in a heart beat and I hope to get a second swing at the plate as well (pun intended).   If I was good at losing weight and managing my eating, then I wouldn't be here.  So, we will see what the doc says.

Small recap:

6 month
12 months
18 months
19 months (low)
57 months
Average lost