Need revision from VSG

[lornadoone]

::)Hi Folks, I am on a sleeve forum. To make a long story short, I had been a bandster many, many, years ago. After 10 yrs. of multiple complications I converted to the sleeve.

Before any of my WLS I was at most 225lbs. with a 5' 4" frame. Be that as it may, I haven't weighed that much in years as my bariatric surgeon converted me to sleeve straight from the band. After sleeving I went down to 140 lbs. About 6-9 months out I hovered around 150-155 lbs. I was sleeved in 2010. I was able to hold that weight until last year. Since last Spring I have been steadily gaining. I currently hover around 165-170lbs. and am not pleased as my clothes are getting tight. Up until last year I was able to eat in small quantities with satisfaction. Now that no longer seems to be the case. I don't think I'll balloon back up, but I wish I was back down again.

I discussed it at length on my sleeve forum and they suggested I go back to liquids, then soft foods, to see if I can take off the weight. I do have restriction, however not as it was. After surgery, my doctor did mention that a few years out after surgery, some sleevers do start to regain as the stomach heals and many times will go in for revision surgery. I am reading up on it. Apparently sleeving doesn't keep the weight off permanently. I did read that the DS procedure does. So I would like those who have converted from sleeve to DS to give me some feedback. I'm not morbidly obese, I guess I would be considered a "skinny-fat gal". Has anyone in my shoes converted. If so, tell me about your experience. I have heard I could either be re-sleeved or convert to DS. I had my surgery in Mexico and probably would go back there for revision.

I wouldn't take the conversion lightly and would think it over carefully doing more research and taking my time. I believe sleeving is 1/2 the DS procedure and I would only have to go in for the 2nd half of the procedure. Also, I would like to know does everyone get loose bowels and smelly stools. Has any sleever converted with minimal side effects. I had terrible dizzy spells for about a year after surgery, due to low blood sugar but now that experience is practically nonexistant. I look forward to hearing any replies.

Thanks to Larra for suggesting this place.

[CVHarris]

Hi Lornadoone. I love those cookies. I just revised from a distal RNY TO DS. I have no advice to give just wanted to welcome you.

[Deleted]

Hi there. At 170 and 5-3, you're not going to get any insurance coverage for this revision. That's a BMI of just over 30, I believe, correct?

If you have the means to pay cash for a revision, then it might be an idea to consider, since we all know the outcome of this story. The scale numbers just keep going up .

[Deleted]

I don't mean to be negative here, but you need to REALLY think about the risks.
With each surgery, your risks for complications increase. You haven't said that you are dealing with any chronic health issues.

I would not want you to go through what I am going through just for 40-odd extra pounds. Also, revisions can be tough to come back from even if they go well. That's why I appreciate the "think twice, cut once" philosophy on this board.

Please don't get defensive and read my tone as mean. It's because I care that I'm speaking up and you are free to blow it off. I wish you all the best, whatever you decide.

[Deleted]

^^^What she said. Lornadoone, please read proteinsnob's posting history. Another one to read is Karen aka Feeder-Something (numbers that I can't remember, but her name is easily identified). Karen is suffering extreme excessive weight loss and malnutrition so severe that she cannot risk an intestinal revision. She has been trying to get well enough to withstand a revision surgery for quite some time now.

This third WLS would be a VERY VERY big deal. Others will be along who will state this even more starkly, but I urge you to read up on what CAN happen and decide whether or not you're ready for that kind of risk.

[larra]

Hey, Lorna, glad you found your way here. You will get honest answers, and I hope people who have revised from sleeve to DS will chime in.
I would just add that your thinking may change as your situation continues to change. By which I mean, while you aren't MO now, thankfully, if you continue to see the scale going up despite your efforts with the sleeve, you would have more justification for further surgery. The bottom line is that, after doing all your research, the decision will be in your hands, since you are lookings towards self-pay in Mexico and not to having insurance pay.
I hope we help you find the answers you are seeking.

Larra

[lornadoone]

Dear Folks, For those of you who are suffering severe weight loss and malnutrition. I am by no means an expert. But I can tell you that I have read if you make it past the first 2 years of surgery with the DS your body will adapt and your intestines will loosen up and start absorbing nutrition. Often times those who are too tight go in for the 3rd surgery to loosen up and find they've been made too loose and start regaining.

But of course, you know what is best for your body as I have not undergone any revision as yet. If I go, I suspect I will go to Mexico and pay out of pocket. Since I am a lightweight I will ask the doctor to customize the switch to by body type. I'm doing a lot of research as I did with the sleeve. My doctor did tell me out a few years from the sleeve it's very common to regain and loose restriction. I spoke with a doctor in Mexico who told me he would not revise my sleeve, only give me the 2nd half of the surgery.

Usually, the shape of the sleeve is fine it's just loosened up a bit.
Since I already have had the 1st half of the surgery I may not get as sick from the surgery as a person who is going in for both procedures. I did spring back from the 1st procedure very well,
had minimal pain and was back on my feet in no time. I do know I have to do something eventually if I want to retain my weight loss. I do know right after my surgery I took my vitamins twice daily as opposed to once a day and felt a lot better. I no longer have to do that now since I lost some restriction and am eating better. Anyhow I suspect to see more sleever's in my predicament . Good luck to all.

[kennyk]

I second proteinSnob here.
This is a hell of a lot of recovery and risk to lose some weight with out extreme reasons.
I believe this extended my life and gave me much more quality of life in the future.
8 months in? It is a living hell with NO COMPLICATIONS. Sorry just my 2¢ worth it.
To save your life? I could not recommend it higher. To look a little better? Screw that
Kenny

[Deleted]

Dec 28, 2013 2:06:47 GMT -5 lornadoone said:

But I can tell you that I have read if you make it past the first 2 years of surgery with the DS your body will adapt and your intestines will loosen up and start absorbing nutrition.

WRONG. WRONG. WRONG. Micronutrient malabsorption gets WORSE, not better, even if some caloric absorption improves.

If I go, I suspect I will go to Mexico and pay out of pocket.

Good plan as long as you go to Ungson or Aceves. Life-threateningly stupid to use anyone else, k? Those two guys know their stuff .

Since I am a lightweight I will ask the doctor to customize the switch to by body type.

Um, this *could* be a useful thing, but it depends on what you and/or the surgeon mean by that. Not changing your stomach size should be the major factor in helping you not lose too much. However, giving you an extra long alimentary limb and/or common channel might mean that you remain at higher risk of regain, which would leave you with a variation on your current problem of regain.

PrettyGirlBounce is someone who had the DS revision at a NORMAL WEIGHT as an almost-emergency surgery due to complications that resulted from her first two WLS procedures. Dr. Keshishian gave her the same kind of configuration he would have given a still-MO person. She has pretty much just maintained her already-normal weight. She had a hell of a time recovering, though. It was a tough ride for her.

I'm doing a lot of research as I did with the sleeve.

Excellent! Just be a cautious consumer of information. That's why I hopped on your assertion above about starting to absorb nutrients. It's really NOT very accurate.

My doctor did tell me out a few years from the sleeve it's very common to regain and loose restriction.

Yup, it seems that way from the evidence that has been published to date. Remember that when we look at published evidence, we have to read the statistics carefully, and we need to look at both averages (means) and ranges. Mean %EWL maintained with VSG seems, thus far, to approximate that of RNY, which means IMO, "Not horrible but not all that great, either," especially compared to the DS.

I spoke with a doctor in Mexico who told me he would not revise my sleeve, only give me the 2nd half of the surgery.

That's good, but which surgeon? See above.

Since I already have had the 1st half of the surgery I may not get as sick from the surgery as a person who is going in for both procedures. I did spring back from the 1st procedure very well,
had minimal pain and was back on my feet in no time.

Every surgical procedure, regardless of what kind of procedure (could be an appendectomy, hernia repair, anything) is a new roll of the dice. You could suffer godawful *surgery* related complications from any of them. You can't assume anything based on your previous experience.

But the risk of perioperative and postoperative troubles is a whole different animal from the risks (and benefits) of living with a DSed small intestine. Just to be clear on that--they are two completely different subjects .

I do know I have to do something eventually if I want to retain my weight loss. I do know right after my surgery I took my vitamins twice daily as opposed to once a day and felt a lot better. I no longer have to do that now since I lost some restriction and am eating better. Anyhow I suspect to see more sleever's in my predicament . Good luck to all.

Yup, I think there are quite a few sleevers in your boat, too. I think there's more to it than losing restriction and being able to eat more. I think that too many people opt for the VSG without understanding what their real problems are that caused their obesity--by which I mean metabolic problems. If you're cursed with a super adaptable metabolism, the ultimate SURVIVOR body *g*, the VSG will eventually fail you because the severe restriction makes you automatically starve yourself, further wrecking your metabolism.

It's the metabolic transformation, not just the malabsorption, wrought by the intestinal bypass, that does something "magical" for people with these kinds of troubles.

I hope I've been clear that I in no way want to talk you out of getting the DS, as long as you really, really educate yourself about what you're getting into, and as long as you commit yourself to being connected to fellow DSers as you learn how to do your long term aftercare YOURSELF. You cannot rely on doctors for this, because they just plain don't know the stuff.