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

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.

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.

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

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.

Date	Weight	Lost	BMI
Start	301		45.8
6 month	240.8		36.6
12 months	236.4		35.9
18 months	234	-67	35.6
19 months (low)	232.2	-68.8	35.3
24months	240.6	-60.4	36.6
36month	247	-54	37.6
48months	247.4	-53.6	37.6
57 months	251.4	-49.6	38.2

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.

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:

	wgt	Lost
Start	301
6 month	240.8
12 months	236.4
18 months	234	-67
19 months (low)	232.2	-68.8
24months	240.6	-60.4
36month	247	-54
48months	247.4	-53.6
57 months	251.4	-49.6
	Average lost	-58.9

Check in...

246.2

Back to logging and prepping meals.