Dances with DS

Sometimes I wish I was not such an internet trawler. Sometimes I think ignorance is actually - complete bliss. But I also believe I should try to take in any info…the good the bad & the downright disconcerting.
There I was last night having a catch up with other sites online when I found this site:

Read it at your own peril. Be warned it is not pretty stuff. (Please pop the link into your browser - it’s not ‘live’).
http://junkfoodscience.blogspot.com/2007/08/was-this-really-proof-that-bariatric.html

Okay - the DS is exempted from that research. We have a little content on it from other sources. That are potentially equally as biased, but to which I unapologetically and pathetically cling.

And - bear in mind that the surgeries that were researched are older versions.  We have more modern surgeries to contend with now. And hopefully greater improvements have taken place. I’d like to think that because it is kind of comforting. But there’s little solid data on our latter day versions too.  And in ten years time I don’t fancy being a negative entity (gulp!) who can’t read about the new improved version of data on this subject.

I had trouble getting to sleep last night, as I was having panic attacks about that treasurable ‘old age’ I desperately feel like reaching so my mate Ken & me can open the worlds first bariatric retirement villa. (Well among other things like holding my grand children in my arms). If you want to spook me just start messing with that dream!

In life my first approach to reading anything shocking that relates to me even indirectly is panic. Blind dithering panic where I lose my grip on my emotions. My mind starts trying to frenetically fit other pieces to the jigsaw. It’s silly really but that’s just how I am.

Once I have exhausted myself, weirdly, I start to think better. So it was that at 2am in the merry morning my poor long suffering hubby, Pete, hit upon the solution for my peace of mind as I ranted on about not being to be able to rely on any sources of research for WLS.

‘Thing is this - she is probably basing her opinion on other research equally subject to other levels of misinformation/bias etc… ‘

That stopped me mid track. But only for a second.

‘So you are telling me it’s all a crock of misinformation, bias and relativity? If so how does research actually benefit us?’

Pete gave me the ‘UmmmHm’ nod which means he is verifying what he said but not wildly confirming it - the cue being that I need to think it through further and reach my own conclusions.

Later pondering further and more lucidly, I thought firstly, that research does benefit us even if we have to trawl several hundred papers to fish a single tiny universal grain of truth-rice out the net.

That little grain of info might make all the difference to us. Some stuff is concrete. Like with the DS you retain your pylorus.

That matters to me.

Some stuff is way more fluffy (for want of a better word). Like complication stats. There are variables. One surgeon might have more than another. It might just be that his patients are generally very high BMI’s though - riskier patients to operate on. So it’s wise to try to get a general figure out of a whole array of surgeons. It might still be fluffy, but it will be more indicative. Unless you are the hapless sod that went to the guy who had lot’s of complications for no good reason…yikes!
It’s a bit like religion - if you cut out all the heavy nets of tradition, conditioning, ritual, pomp and ceremony, you find core truths that are a bit fluffy but kind of shining anyway. And quite often those truths are pretty similar when all is said & done.
When I researched my DS I believe I did find several relevant grains that helped me take that path. And those have proved true in my life.

And so to fully justify (yup - justification is the mother of all invention don’t you know!) the possibility that I’m not going to turn my toes up & keel over in my early fifties - I thought the facts of MY completely biased life are this:

I KNOW if I had opted for conventional treatments of my obesity any longer (I had opted for them 20 years of my life with no success at all!)…I’d be in heaven by now at best. At worst I would be disabled, coping with loads of co-morbs and I’d be so miserable it doesn’t bear thinking about.

Highly relative to me again & most biased - I can’t for the life of me see why remaining being obese (on the slim hope of a miserable longer life)…could possibly benefit me. Here I am and I am loving being in touch with a body that is functional. So if I only get another 5 years of this I’d rather have it this way…and that’s MY truth.
Why - where are the reasons for the deaths? I want them. Now!!!! I suspect a good few of those deaths might have been avoidable by proper management of the surgeries and or proper management of sudden emergencies that relate to the original surgical intervention.

This is an area that needs a lot more study. A LOT MORE. Perhaps our lives do depend on it.

Pre-emptive action. How can we best tackle it? I have seen on forums people with dire & I mean dire problems being held back from an op. Waiting for the op - day in painful day out. When is it an emergency? How do different surgeons cope with these sorts of dire situations - is there a policy? What can we patients do to help each other identify the signs. Where can patients who have overseas patients go for help because tbh many A & E services are just laughable, if not a potential danger to WLS patients. Small insert on it - but a BIG and important thing that needs some real action plans and consideration.
Nearly finally… I realised long ago that I am just DS experimentus. So why get so alarmed? One day at a time is okay by me.

And finally - at last : As for the truth…who knows? Nothing is uninfluenced by other things on this earth. Perhaps bias is inherent in absolutely everything. Perhaps bias is the only truth?

Enuff …enuff already! Get me out of here. Think it’s time for a cup of tea now!:-D

Recently have been mulling. Mulling is a favourite past time of mine - I do it in the bath, I do it while I strip furniture, I do it while gardening and painting.

Current top mull is about this blog. I know I wander off into all sorts of topics nowadays. It used to be about my weightloss - plain & simple. My whole focus rested there on that fine happy pinnacle of experiencing a huge physical and mental adjustment as the weight fell off. I lived weightloss surgery bigtime. I blogged it, wrote threads on WLSinfo -1000’s of them!, I was very concerned, I’m embarressed to admit but chiefly with ME.

Looking back I suppose this narcissistic time is par for the course. It IS a time of mega changes. I felt at times that I was in a weird sort of centrifugal machine that sucked off my fat and deposited me each day in a slightly different body. Some days the body did not play ball. Some days it would alarm me. Naturally I focussed on it. Now I have become blase really. It has a wobbly I just get on and fix it. No problem no fuss. It needs something - most times I hear what it needs and it gets that. Then we have peace again.

It’s like having a baby. You read about it, buy the books on parenting and furnish the nursery. You decide just how you will rear your little angel. Then it arrives and all logic goes on standby as you realise that this wee thing has a mind of it’s own. Later on, when you understand your baby better you relax more. You can pre-empt it’s needs and you know what to do in a given situation. Much the same with WLS.

Then there comes a time of letting go. Some people get to my stage and they fly into LIFE. Overnight. On the forums they go from a few daily posts to nada. Sometimes it’s because they are facing a difficulty silently which always upsets me because I worry about them and I also then feel the forum is failing them in some way…but very often it’s just that they are forging a different life that no longer is anchored in obesity. Off they go - into new jobs, new relationships, new interests. I love hearing from these high flyers that once had such cropped wings. I think they have such courage.

My letting go has not been sudden - it’s been an accumulative process. My memory of younger DS days started to fail me. I forgot what it was like to wake up after surgery with a bowel that was frankly most odd! At the time. Over the years the bowel has adjusted and I don’t remember what a normal bowel is like. This one that I have now is normal for me. It’s all relative. I cannot forget what it was like to be morbidly obese though - that stays with me. Perhaps because it cut so deep over so many years. But I do forget specific incidents related to it.

Just yesterday an old friend of mine who has witnessed my ride, recalled a past event.

‘Remember when you went to the companies Christmas party. Everyone had to stand up to introduce themselves. And you could’nt get out of your seat. I felt so gutted for you. Remember how you came here and bawled your eyes out afterwards? ‘

I had forgotten. But the tale is true and as the memory came back to me I felt the same horror that I felt trying to fumble my large body out of a particularly squishy sofa infront of a whole bunch of people very important to my husband. I remembered how I went into a mind funk about being spotlighted. And the terror of the person standing upright beside me because I knew I was next. And then the moment of horror when my body could not get out the seat. How I tried to do that little thrust that we obese people do to get the front bulk to push me forward and how because the sofa was soft my bottom was caught in the dip and I just could not get momentum. How I tried several times feeling wretchedly embarressed. How I then grabbed the arm of the sofa and pulled myself up using it. By that time dripping perspiration & red faced. It was just ghastly. I felt utterly floored.

I’d forgotten because it’s been several years now that no sofa, no chair with arms, no small space challenges me. I slip with ease past tight corners. My body is no longer in my face…literally.

I’m not alone. Just today I came accross an old DS blogger who has closed shop. In fact recently several of the longerterm DSers have moved out of WLSworld to take up residence properly on planet earth.

It made me think about my own WLSworld residence.
Looking through years of writing it’s clear to me that recently my blog has sometimes lost focus. My life is very multifaceted now and I find myself mithering on about things other than my DS/obesity very often. When I started blogging this was the only idea…I had but one topic!

Oddly it’s just as I wanted it when all those years ago I embarked on WLS. I wanted to be able. Physically able first and foremost so that I could partake in life and not just be a sideline observer. From this perspective it’s really a dream come true for me. What I hoped for has worked for me. I’m healthy (if a bit of a skinny ninny!), I am not gaining weight, I am living a full happy life. That full happy life keeps beckoning me to really leap into it. In some ways I already have. In other ways I must ask myself if I want to shut the doors on the Jane that was. Do I quit everything to do with that life, posting on various forums, this blog, my website?

Or do I move into other directions?

These are complex mullings. It all looks simple written down. On the small level I would close up shop I think. Make a complete break.

But the bigger pic is always my bugbear. LOL. And the bigger pic is complex. Or maybe it is so clear & simple I tend not to get it!

I ask myself somewhat rhetorically: Have I achieved what I wanted all those years ago - to help bring the DS surgery into the UK’s awareness in some small way? Because I believed and still do not only in the surgery, but also that people needed to have awareness of all their WLS options. I hope so, I think so.

I recall when I first realised others needed to know of the DS. I was going to support meetings etc and finding that more than just a few people had not heard of the DS, except after getting other surgeries and now wished they had known prior to their decision. After my website went live I had a flurry of e-mails from people asking me to please tell them more about the DS. I figured it was important for me to not only speak out of my experience of the DS but I needed to do more. Patients needed after support - some nutrition guidance at the very least, which I felt I should extend to other WLS patients too. (Those days most RNY patients never even knew they had to get a bit more protein savvy and calcium was a supplement far from many minds.) I look back and it makes me smile…little did I know the hornets nest that ‘nutrition guidance’ could be! And I knew patients needed lot’s of TLC. Aside from a few good mates at the time I had my surgery, there was no one to turn to. I was scared a lot. I was very alone for a long time & I didn’t want others to feel like that. I felt DSers needed reassurance that the first year as rough as it can be, does evolve in most DS cases, to a surgery that ultimately is not difficult to live with. So that’s what I did the best I could.

Now dynamics have changed. There are many DS patients in the UK now & much to my joy, I am no longer the lone dog! Some of these patients fill me with pride because I witnessed that first root of their enquiry into the DS through the uncurling leaf of their journeys at newly post op to great big flowerings some years down the line. I love their enquiring minds, honesty and compassion. They are informed people. They know the ropes well. I feel I can leave the role of awareness with them…they will help others on the DS path now.
So in my mulling I come to cusping on the fine lines. This or that? Where do I place myself now? Can I be of any further benefit to others?
No doubt I’ll be cusping for a while yet. It’s a strange place to be but then again I always knew that in any ending there is a plethora of new beginnings. It’s just a matter of choosing the really relevant one’s…both the relevant endings and the relevant beginnings.

Here’s the thing.

Imagine you have lost ten stone. That’s a kind of magic figure, the kind of figure that holds great promise for undaunted bliss and happiness when one is dreaming of fitting back into the skinny jeans one wore in 1981 and the sweet groove of life. Sometimes it’s not jeans, sometimes it is pants. I had skinny pants. Just after my daughter was born I lost a lot of weight by eating almost nothing daily for 3 months. I worked it out and ate just enough to produce milk. Three months later I blew the budget (and all the money I saved by barely not eating for so long) on a gorgeous pair of skinny pants. I pulled them on and I was no longer leaking titty mummy I was suddenly frigging gorgeous if I say so myself. Glam mummy. A desirable object - at least in my eyes. I forgot the starvation, the grinding hunger, the real mcoy.
Ten stone loss is like a beacon of hope, a milestone of promise for some of us. I remember drooling over the prospect when the fat became sheathlike and I was reduced to a permanently slightly sweaty sticky embarressment in my own eyes.
So surgery beckons. Hopefully for reasons way bigger than the above, like your health. I’m being serious health is important and health is numero uno. It’s got to be top of the reason list for undergoing a surgery that will reroute your guts so much it will almost certainly surprise you - even if you are very well researched.

But deep down those skinny jeans will be beckoning and luring many women into taking the first wobbly steps into WLS. Deep down if we scratch a little those skinny jeans are all metaphor. Skinny jeans remain more than just jeans.

If one always battled obesity they are the stuff of holy grail. If one had a time when indeed one was out there with perfect skin and hair, pert booty tucked into those little tight marvels, the memories never fade. Never mind one was 16 years old at the time. Never mind you did not have to worry about the kids, the mortgage, the dogs errant behaviours, your mother in law. Hope judders in one’s heart that one day, one blessed fine day, those jeans will slide on without having to suck your stomach into your ribs. Or worse, find they only fit one leg approximately. Those days when one was carefree and so darned happy one could weep with remembrance, reappear each time the desperately faded pair tucked way back in the wardrobe appear during the seasonal wardrobe clear outs. Like a little thorn of crowns they represent what was, and much much worse they represent what is. Exactly.

It’s the precision that is killing. I used to hold my skinny pants up to my hugely expanded waistline (not that I had one but I was unwilling to accept that really. Accepting no waistline was scary so I just pretended I had one where it used to be. But those skinny pants would not allow for fantasy in the now. Only fantasy in the future.

I had surgery - drastic et al. (We’ll beat that ‘drastic thing’ out later ). I feel shallow admitting it, but the truth is just before I had surgery I sat on my bed skinny pants in hand and I wanted to be back in a time when life was roaring through me and I was out there feeling I could achieve anything. Those skinny pants symbolised me back in the swing of things, me healthier, me happier.
Some years ago I phished those skinny pants out of the demented heap of clothing my wardrobe is. Somewhere between sizes 12 and sizes 26 I spotted the white and black design of my beloved pants. They slipped on like butter. Perfect fit - well near perfect as a saggy double bum effect can be but ignore that!. Okay a little baggy on the thighs and there was a mothhole but nothing that could’nt be fixed. Why spoil the joy? I had euphoria. I mirror gazed for almost 20 mins I think. It had happened!!!! WAYHEY!!! YAHOOOOOO!!!!

A great flurry of activity followed. I think it unleashed all my shopping demons. I could wear ANYTHING from ANY shop! By gods I was going too. My first thought was to grab the old credit card and get my new size 12 bod down to Monsoon (which was my other holy grail). This time I would be in the store scanning the rails. No more greasing the window with my nose pressed up against it, wistfully wishing I too could join the steady stream of gorgeous women perusing rail upon rail of stunning stuff. Nah, I was going IN. At last. Baptism. Baptism into the whole promising world of slimhood.
I remember that day well. It was beautious. I can’t find a better word. Even the pale british sun was shining. I sailed through the doors of the store and beelined for the trouser section. Then it all went kooky. I found myself at the larger end of the rail. Worse I found myself in the changing room trying on a size 18 top. Even worse I thought it looked nice all baggy and loose and flowy. I was’nt sure about size 12 anymore…it might look all tight and clingy and show up my double bum sag. I knew it was ridiculous but I couldn’t help it. I tried to analyse it. What the hell was going on?

The thing is and was this: residual head fat.

Long time ago when I could not define it plus other stuff I called it ‘headstuff’. Now I’m thinking it might help to get more specific and start unravelling the generic ‘headstuff.’ The surgeons can’t undo this unfortunately and most of us just go along without any psycho help. It’s probably irreversable but then again it might just be me. I can’t seem to shake it. I think sometimes my current weight that teeters on the brink of ‘too thin’ is partly connected to it. I have bad days with it, on & off. I cathart them here from time to time.

On bad days I didn’t see myself as size 12. I saw myself much larger. I go quite blind in some ways and mirror gazing does not help. Squeezing into a tiny space is much better for it - it wakes me up a little. Measurement is better than sight which might explain part of the skinny pants scenario. You KNOW you are size 12 when you are standing in those jeans. It’s not negotiable.  Feeling slim & being slim are two very different things, I have discovered. At size 8-10 residual head fat is not such an issue for me . But then - health is. I know it would be good to get back to that size. It would most likely be healthier for me.

Oddly, size 8-10 has nothing to do with feeling wonderfully able and wonderfully in control and wonderfully wonderful allround. Standing in size 8 skinny pants, life is just that - life. Some days are crap, other days are better and life itself does not give a shennanigan about how small I am. It still deals me blows and sometimes I get a little ticked off that the dream of perfect life simply does not exist. Relationships still need work, I still feel huge stress sometimes trying to get my head around all the things I have to do, sometimes my kids still worry me sick. Sometimes I have panic attacks about potentially having to mess with Creon. Size 8/10 does not bestow glowing happiness day in and day out nor do I feel like a hugely desirable diva day in and day out.

It’s been a helluva journey so thank heavens I did surgery for other reasons than only wearing skinny pants in the literal sense, because if that had been my sole motivation, I’d have been catatonically depressed by now.

Residual head fat is really about fear. It’s fear of going back to being size 26 and expanding as rapidly as a black hole in space. It is the protective barrier that lurks in the size 8 body, it’s the ‘just in case’. It’s not logical either. It’s erratic, it’s unrealistic and it is given to suddenly diverting one to the ‘larger size’ clothes rails just when one should be celebrating ones good fortune to no longer be battling obesity.

I live with it. I know I can’t let it rule my life, I watch it spin on it’s own little wheel & I cathart it when I can, even if I don’t understand it.

But some days it slips out from it’s undercover position and get’s in one’s face. I’m not alone. I read a report on suicide after WLS - it was shocking. I wondered if residual head fat is a little responsible. Of course there are other factors, but I just wonder if residual head fat doesn’t spill into things like a poison sometimes. Part of it is expectation based. How do we cope when we still find ourselves hemmed into a stressy life despite our weightloss? How do we cope when friends we love turn away and isolate us, when family structures start to alter because of our loss, when people around us sense we are well enough to take charge of our own lives and expect us to get on with it doublequick? And how do we cope if we regain? It’s horribly hard, I know this from reading about regains of other patients and from the times my own weight went up post surgery. I often feel bad that I mither on about stuff like this post at my size. It must look completely preposterous to someone struggling. If I was regaining I would kick my own arse, reading a post like this. In my defence I must repeat: I know logically it is ridiculous. I don’t have an excuse for it, but sure as little red apples grown on apple trees, it’s currently part of my life. Maybe this is what saves me. It is only PART of my life. But I fear it can become rampant and potentially dangerous.

All sorts of things can happen on account of it. I recognise it sometimes when I read on forums that a person feels they just don’t want to eat anymore, for example.

Not long ago at a support meeting I listened to a slim young RNY patient recount how she exercised around 7 hours a day! 7 hours! I was thinking that’s like losing the life we so desperately want in an effort to get it back. A sort of cancelling out. I know one could have a field day trying to analyse it, but looking at  her beautiful slim body and knowing that she herself could not embrace that, made me feel sad. For both of us really, as there are times I can’t embrace myself as is either. I also knew then there are times residual head fat will stub out the small quickening heartbeat of life that is ours to claim - no matter our size… it will twist the truth.

What’s the truth? To be frank I’m not sure. I’m trying to explore it. Does residual head fat exist before stress or is it stress related? What triggers it for others? Has it got anything at all to do with skinny jeans practice? If you know please share.

Where does time go? I can’t keep up with it! The days fly by and I sometimes don’t even know the date!

Needless to say I am busy. Busier than busy. I’m still renovating my house day in & day out. I had to laugh the other day after a long days graft when I emerged in my bathroom face paint spattered - hair brittle with sanding dust, with the sweet toxic tang of thinners still wafting through my breathing system…where the hell is the glamour dolly I once dreamed I would be when I was slim?

I had idea’s in the days of the fat prison that I would emerge and find glamour in my life. I would have a body wearing monsoon day & night (maybe East) and my nails would look the part. I’d sip tea in London with friends and my image would at last be intact. Yep right! Instead at night I gaze on my dusty face and my nails sport multi hues of enamel (paint that is - not nail gloss!). I’m not far off from a bag lady in my oversized baggy work clothes. And tea is a hurried affair between coats of drying paint. No biccies or scones. Just tea…strong & sweet. London - where is that? I am ensconced in surrey suburbia in a room that shouts at me to finish it!

Meanwhile the rest of the house falls apart…furniture removed from one room spills into other rooms. The dreaded ironing builds up. The radiator sprung a leak allover my recently painted floor. My family subsist on toasted cheese sarmies. Mayhem & chaos are my morning buddies. But Jane dreams on. And on.

My plans always start small. I will just paint the walls. But then the skirting looks grubby so I do that. Then the fire surround looks tatty - so we tile it in slate and I get the brilliant idea that somehow I will fox the eye and make the tiles look like slate slabs by filling the gaps and using slatey colours to get the effect of a slab. Omg. Where was my head! NEVER never again!

The answer to the title question is probably slate is all 3 colours and more, plus light changes it’s intensity - so try painting that!

The chap at our local hardware tried hard not to sound patronising when I nipped in yet aggggain to pick up more filler. Not finished yet then? he asked innocently. I subjected him to half an hour speech on just how frikking difficult it is to make slate tiles look like REAL slate slabs. Poor man. But I had him right there behind the counter and I needed to vent. Pete is unavailable for my venting - he looks at me & the room and knows whats coming so he beats a retreat to computer land where all is safe and known.

Anyhow it is done. I now have slate ’slab’. I also have a bad temperament and a crikked back and a heavily wistful loss of glamour ideas. On the plus side I have neat little arm muscles. I thank my DS for a physical life everytime I am balancing precariously on the top step of the ladder. But still, I have decided reality is a barstard. The dream of a slate slab is one thing. Getting it done is another thing entirely! But enough of that.
Inbetween - I have had some fun days. On Sunday we went out for a ferret on the Dorking car boot. I bought some very old antique Indian boxes with elaborate inlay & carvings for the princely sum of 3 quid. I found some early 18th century Chinese embroideries for 4 quid each. Petal & Zenni each got a squeaky dog toy. Later we went for a carvery at my fav Inn on the Hill in Haslemere. My plate was a DS dream fulfilled. Lamb, beef AND Pork. Apple AND cranberry sauce. Glazed carrots and roast tatties. I was in heaven. The plate was HUGE. A mans serving. I thought I would test my physical capacity. I managed the LOT. I certainly have capacity I just find in my daily life I seldom eat to it, so it was interesting to rediscover it.

Sometimes it is good to know I can still eat for sheer pleasure.

My mum is braving a trip here in Dec. She is still frail but thinks she can cope. Part of me is worried sick but the other part knows that for her resuming travel and living life is a must. I am taking her to Edinburgh for a few days. I know she will love it. I have plans to take her to Oban as well but we shall see how strong she is closer to the time.

Petal has grown so fast…she’s a wee gem of a dog. A dear loving dog who still makes me laugh everyday with her quirky behaviour. Zen is accepting her better now but still has days when her puppy exuberance is too much for him.

I found homes for all the baby mice & mum. I still have two - Mimi & Smiler, but they were original rescue mice. They are dear little creatures and I am sorry mice have had such a bad rap. They are both very tame and come for treats when I call them.

I’m hoping to upgrade my website sometime. It needs overhauling and to feel a more modern edge. I look at my old photo’s - I have moved on from them quite a lot. I recently read a very interesting article that gave DS percentage EWL over 5 years. Very fascinating as they said the weightloss actually can continue way past the ‘window’ theory. (please key the link into your browser as it is not live on here.)

http://www.weightlosssurgery.com.au/p28_Biliopancreatic-Diversion.html
I’ll quote the paragraph:

In one study of 125 patients, excess weight loss of 74% at one year, 78% at two years, 81% at three years, 84% at four years, and 91% at five years was achieved’

So there we go. I would like to see more studies but this pretty much aligns with what I see on the groundfloor of forums, peer interaction etc. I think we had originally based the window theory on RNY stats - but the DS is proving an entirely different creature. I think DSers must give it more time than they think to reap the full weightloss benefits. We all fear regains but ultimately the reality might be more weightloss. I think we see a rebound around year two & then provided we eat correctly, this might well be followed by later weightloss. For example, when I talk about eating correctly it is not just about protein intake either. I strongly believe that there is a ‘volume’ connection to this after about 6months to 18months or so. More (quality food)is better (for a while.)

So I am wrapping my thinking around this and toying with how best the bebe DSers can utilise and increase efficiency of their metabolisms so that they can optimise these new developments.

I was thinking last week in my own biased way, just how good the DS is as a surgery all round. Certainly it has exceeded my own expectations by a long margin. Sure year one is rough - of course it is. It’s big stuff and it can be a horrible shock in some ways. But what would be seriously rough is significant late regain, constant dieting etc. It’s always a case of trying to look at the bigger balance of things. I’m not saying some patients won’t struggle in this arena for multi reasons - but I do feel there is this quite unique longerterm opportunity given by the DS surgery that might outweigh the enormity of such intense surgery ultimately.

I think too - we might be pushing the boat - other surgeries such as reconstructive, might be better off waiting a wee bit longer as the DS runs it’s course. If I had done reconstructive at 18months it would have been a waste of my time really. I’m significantly smaller now.
Regains at around 18months to 2 years out, might be worth monitoring for 6 months to see if things settle down & loss starts to re-occur, before diving into revision. I know in my case and many others there was rebound, it is frikking scary. Even more so based on the old pattern of how our obesity just increased year by year. But often it seems temporary and it comes off plus some. Maybe we need to relook our old RNY based ideas about the DS….maybe we need to allow time to offload it’s bigger pic on us. Just my thoughts. Imo - the longerterm picture is holding up really well.