Revision from VSG..

[perrygirl4ever]

Hello. New to this board (thanks Larra!!). I am calling Monday for a consultation with Dr K since he's the only DS surgeon in network with my insurance. My vsg was done by Dr. Lyass and I love him but he wants me to look I to RNY and doesn't do DS, PLUS he's no longer in network.
Ok on to my question..lol I keep hearing how revision to ds from RNY is so hard and complicated. Is that the same for every revision? Since I already have the sleeve is it still has dangerous or complicated for someone like myself as well? Thanks in advance

[bradleyp]

The reason the RNY to DS revision is so difficult is that it requires reconnecting the stomach to the esophagus...and all of the intestinal rerouting that has to be undone and then redone for the DS. Very time consuming.

The VSG to DS isn't as much a revision as a completion.

Good luck. Dr. K is one of the best. He did my wife's virgin DS 6 weeks ago, and he's doing mine on Monday.


Ask him why he wears bowties!

[bboop]

Ditto what the other poster said .... you will do fine. It is surgery and everybody has risks with surgery but I think you will do fine. It's like completing the remainder of the Ds. Good luck...hope to see you on here more often.

[Girlrocker]

Welcome! I am a Dr. K patient and a RNY revision to DS; basically VSG is 'half' the DS, the stomach part minus the malabsorption. In the RNY your stomach is created into a small pouch by stapling it off, the rest of the stomach remains 'unused' and your small intestine is then connected to the pouch. Has not proven to be so efficient for the metabolically challenged (raises hand) long term. That all has to be undone and then, turned into the DS. You're in great hands with Dr. K and after you meet him in person for your first consult, you'll have a better understanding of exactly what the DS is and how it works.

[bearmom]

Smart move getting hooked up with Dr K. It makes no sense to get the RNY when you have the first half of the DS, which is a superior surgery to RNY anyway. The only time a sleeve is ruined and made into a pouch is because a surgeon lacks the skill to do the DS.

[larra]

Welcome! Glad you made it over here.

VSG to DS is still major surgery, but FAR less complicated or risky as RNY to DS. As others have said, to convert RNY to DS the surgeon has to completely undo the RNY, put the stomach back together as it used to be, and THEN do the whole DS. Not only far more surgery, but involves working in all the scar tissue from the old RNY and stapling across the old staple lines, which can create an area with a poor blood supply that may lead to a leak. You don't have to worry about any of that.

I think once you meet Dr. K and ask him any and all questions you have, you will feel a lot better about your decision.

Larra

[perrygirl4ever]

Thanks everyone for the warm welcome! I'm looking forward to meeting him and getting all the info. If I do decide to love forward I just hope Aetna will cover it. I'm not sure if there is a one surgery clause or not. Guess we shall see.

[Girlrocker]

The DS, this revision is definitely major surgery, as Larra pointed out, just not near the complexity of having to undo the RNY and convert. I would never recommend the RNY, the DS is absolutey the superior combo of small stomach/malabsorption. Which hospital/office are you going through, I'm in Los Angeles and live 20 minutes from Glendale/Verdugo Hills Hosp. Keep us posted; sending positive thoughts for insurance approval.

[perrygirl4ever]

Thanks. I live in Moorpark so it's a little ways but thinking I will go to the Glendale office as well. I'm very anxious and excited to meet him and see what my options are. I admit, as I've told Larra, being obese from childhood I have no idea how to be thin and how to live that way. I need a little stronger tool that's a little it more forgiving than just restriction alone. I'm nervous about going through it all again and upping my vitamins and worrying about protein again but I want to get this weight off once and for all and still later on feel like a "normal" person when maintaining and not feel like I have to eat chicken breast and lettuce 24/7 know what I mean? I still get stomach aches and diarrhea if I eat you much sugar or dairy and I'm actually glad about that because I can't over do it. But restriction alone just doesn't seem to work for me and I gained half of my weight I lost in 2010 and still never even got to goal. Went from 285 to 209 and sitting now at 249 so I wanna get a handle on this. Sorry for the rambling! Lol

[bradleyp]

Ramble on. You're just a short drive from Glendale down the 118. My wife and I did almost all of our preops in his office there driving from Bakersfield, and she had her surgery in Huntington in Pasadena, which I hold in very high regard.

Dr. K is notorious for going into as much detail as you'd like regarding your procedure. He even showed us videos of certain parts of the procedure once at support group---just because I was curious about the mechanics of things.

Remember, you didn't fail. The VSG is to help knock the weight off, the DS is to keep the weight off.

[Deleted]

Dr. K cheerleader here. I drove 5 hours (each way) from NorCal to Delano to have surgery. I also drove the 5 hours a couple of times and flew a couple of times for follow-ups. Totally worth it. He is an amazing surgeon and a stellar human being.
Best,
Whitney

[perrygirl4ever]

I just read the ds facts about the four things you must do. I'm fine with all except so worried about getting in that much protein. It scares me I will get off track and hurt myself. I am good at taking supplements and going to get labs is fine but the protein thing worries me. Don't get me wrong I'm willing to work as hard as I can but I'm human and the unknown worries me I guess. I must sound lame lol

[perrygirl4ever]

Diana do you mean resleeving and that's all or the sleeve and DS all at once? I wondered about that too so don't feel like you're dampening the mood. Lol I appreciate you bringing that up!

[kennyk]

Perry, the things we need to do are doable and this site is like our own scared straight.
I did not get on here( don't think I even had heard of it pre-op) or do to much reading so as not to scare myself out of this. In hind site I am so stoked that I was lucky enough to follow someone into the DS path (she is uninformed and scares the crap out of me!) and then find all the support and friendship that is here. It really does help keep me on track. Support styles galore the message is the same... It works. Don't reinvent the wheel. Follow the path of the people who have gone this way before you and it will be fine, and not necessarily the advice of whomever got you here.

Just my 2¢ worth, but don't go by me I am still a baby at this at 3 months post-op!

[PrettyGirlBounce]

Hi there. I am a Dr. K patient as well. My RNY to DS surgery 4 months ago was extremely complex due to numerous pre-revision complications. Dr. K is masterful in his craft and I'm sure he will do for you exactly what is warranted for success.

I have driven from San Diego to his Verdugo Hills office numerous times for my surgery and follow up appointments and it is so worth it. Heck, my friend Leonie on this board came to him from South Africa and others from all over the US. That in and of itself speaks volumes.

Rest assured that you would be in good hands...and great job for not agreeing to the RNY. Dr. K won't even perform that surgery in his practice because he knows the success rate is low yet complications are through the roof. Thank gawd you are switching surgeons!

Welcome to the board and best of luck to you.

Sent from my SCH-I535 using proboards

[perrygirl4ever]

Thanks again everyone. I'm sure I felt like this before the VSG too. I had cancelled it the morning of originally, just to reschedule three months later. I'm guessing if I don't feel good ill do what I have to do to keep myself healthy. I just know I don't eat as much protein as I should right now but having only the vsg made that very easy once restriction eased up and carbs didnt affect me in a negative way. I know if I get the DS everything will be way different as to how my body works after. I just want to thank you guys for letting me ask all my questions and not making me feel like an idiot or failure like some have on the "other" wls site. Glad to be here.

[Leonie]

Welcome! I am Leonie from South Africa. Honoured to be called a friend here.
Please ask dr K why he wears bowties, and tell me too. I was too shy to ask.

Protein and water and vitamins and poo becomes a major part of life. But as the major reward, LIFE is soooo much bigger and more fun. I climbed a mountain (ok, call it a hill) this weekend, and was not even out of breath!

[ladylucky]

I was a VSG (12/7/10) to DS (6/19/13) revision. Mine was an actual revision because he had to redo my sleeve since it was not the correct shape, partially due to stretching but mostly because of an error with my original surgery. I'm sure the surgeon will want to do a test to see what your current sleeve looks like. That will tell him if he needs to redo that while he's in there. Yes, that makes it more complicated because that's where you will have scar tissue. But fixing the sleeve (if necessary) and rearranging your intestines to complete the full DS would all be done at the same time. My surgery took a bit over 4 hours because I had a decent amount of scar tissue around my stomach area.

If you're good with supplements and labs, you're off to a good start. But the supplements are substantially more - maybe 2 dozen pills per day or even more. Be prepared for that. And, not to scare you more, but you are right to be scared if you can't get in the protein. You must find a protein drink/shake that you can tolerate. That's what I see the vets still doing to get in their protein several years out. I pushed myself to try more than 50 samples from VitaLady, finding only about 3 that I could even tolerate/keep down. I stuck with one (Isopure Vanilla, 30g) and now it actually tastes okay when I hide it in my iced coffee every morning. Then I sip on Isopure RTD throughout the evening, giving me an extra 20g (1/2 bottle). As I drink those I keep reminding myself that I only have to worry about getting in another 50g in food. That has really eased my worry about protein. As for hair, I know I will still lose a decent amount. My body doesn't like the shock of surgery no matter how much protein I get. But remember, it's temporary. Almost everyone has had a bad perm or dye job they had to deal with. I'm thinking of it that way. Stay positive! But be proactive in your planning. You can do this if you put your mind to it. Good luck!

[ladylucky]

Oh and what I've discovered is that since I was already sleeved I seem to be able to eat and drink more than those getting the full DS from the beginning. Even though my sleeve had to be redone (mostly the bottom half), I have been able to tolerate a wide variety of foods and even big drinks. I sipped at first for fear it would hurt. Then I accidentally discovered I can drink like I did with the VSG, nearly gulping. That's been a big help in getting in enough fluids. But everyone is different so just wait and see how your body reacts. The nausea pills have also been a big help these first few weeks. If my protein drink isn't settling, I take a pill and that feeling is gone in minutes, allowing me to finish my protein drink. They are pills straight from God himself. :-)

[larra]

Regarding protein, not everyone uses protein drinks/supplements. Keep in mind that your protein options will be much more varied with the DS since you don't have to stick with only lean protein, like chicken breast. Since we only absorb about 20% of the fat we consume, we can eat lean or fatty cuts of meat, dark meat chicken, all kinds of cheese, pork, bacon, any type of fish, etc. You can also cook with fat, not just broil everything. It's much more freeing, and that makes it a lot easier to get in the required protein.
But I agree with everyone about how very important the protein is, and that you can get into trouble if you skimp in that area, so if you need a protein supplement, use one. There are lots of different ones out there, and again, you don't need to worry about the fat content.

Larra

[perrygirl4ever]

Larra, thank you. You're right it should be easier to get in protein without having to watch the calories so closely. I have a very good friend with Crohn's disease and she was talking to me about it. Because of her colon being so inflamed and recently having part of her intestine removed, she too has to take many supplements a day, throughout the day, and is very skinny as her body doesn't absorb calories and nutrients the way it's supposed to. She also has to get labs done very frequently. Kind of puts it in perspective knowing that you just do what you need to, to be healthy. And that it can be done.

[Girlrocker]

Hi there, you're not going on too much at all, that's exactly what this place is for, asking questions, getting information, lots of support of all kinds. I'm a Dr. K patient as well and I live in LA, in Hollywood, so if you ever want more in-person angel support, let me know, you can message me here. Protein and supplements are really key for us, and you don't have to worry about fat anymore which is still amazing to me 19 months after my revision It's my choice to use protein shakes still as a supplemental boost, I eat plenty, I do it for my overall levels, because I've been anemic in the past. Fat keeps us moving, everyone is different in how much or how little, as someone here notes, if you can't go, or it's too solid, up the fat, if it's too much, too lose, lower the fat.

Sharyl

[kennyk]

[perrygirl4ever]

Thanks Kenny lol