Considering a revision to a DS-Looking for info

I am cross posting this here and at the revision forum. :)

I had a VSG in October 2007. I lost an initial 80lbs, but at 6mnths out-I stopped loosing and felt the restriction slip away. I have gained back half of what I lost and feel like a  complete failure.

I am now pretty committed to a revision procedure so I am back at square one: research!

I am not ruling out an RNY, but since I have the first step of DS, I want to get some info on that firstly.

I also have psoriatic arthritis, so the ability to take NSAIDs is important and I know that is not possible with RNY. For the record, my oldest sister is just a year out of the RNY so we have been supporting each other in our journeys. I know many people with successful RNYs, so I believe I am extremely educated on that. Its the DS that I am unsure of.

Since I think (don't know for sure) that my sleeve is stretched, do surgeons tighten it back up during the intestinal part 2 step? My surgeon used a 32 French.

I am open to all comments and thoughts because this is my life and health and its important to hear all sides.

I thank you in advance for your input.

-Jessica :)

Some surgeons will resleeve your stomach.  I really think it depends on the surgeon and his preference/ estimation on how much tissue is left to do so.

The metabolic portion, or switch, of the DS is incredibly strong in terms of losing weight & keeping it off.  The switch happens in your small intestine, where you absorb nutrients.  Your body will adapt to the reduced nutrients it receives and responds by increasing the surface area (elongating the villi) of your small intestine so that you absorb more food.  This also happes with the RNY.  It's a byproduct of reduced nutritional absorption in both surgeries.  I think it's important that you know that, due to this adaptation, it is estimated that that approximate average of 15% of the small intestine that is bypassed with the RNY and the malabsorption that occurs from that original 15% is essentially gone after two years.  Since the DS bypasses an average of around 75%, after the intestinal adaptation phase, you STILL malabsorb A LOT . . . and that is why the long-term stats of keeping the weight off are so much better for the average person than any other type of surgery.  It's why regain far, far less.  Most people regain around 10 - 15 lbs from their lowest weight.

i like dsfacts.com, a lot of info on the ds.  i like the idea of keeping my pyloric valve, so for me sleeve and ds are the best.  having to take nsaids i would stay away from rny

if you get the ds the surgeon can evaluate your sleeve size, the ds tends to be larger than the sleeve stand alone size, so you may not need to be resleeved, again the surgeon can advise.   there are people on this site that have had the vsg and then the ds, hopefully they will also chime in, good luck with your revision, whatever you decide....

If what you need is to add malabsorption why not add the malabsorption that you will be able to keep for the rest of your life rather than malabsorption that will end in a few years?  You would be right back with the weight gain again.

I wouldn't loose my pyloric valve for any reason.  And there is no reason to anyway.

If you need NSAIDs it just seems a no-brainer to me.

~Becky

Thank you all so much for your replies. I thought this part of my life-and WLS journey-was done. But here I am again, researching!

In a perfect world, yes the DS is a no brainer. However, I am uninsured and without many options. I am just starting a great new career, but there are no health benefits as I am technically a contracted employee. (I'm a grant writer) I'm counting my blessings that I was able to get hired with a company before I technically have my degree! So many of my classmates have been out for a couple semesters and cannot find work.

So, I have been looking into purchasing my own coverage. I have an application out to United Healtcare for One and am waiting for a reply. Financing this on my own, at least in the near future, is not an option.

When I was sleeved, I traveled to Mexico for Dr. Alvarez. I do not regret this decision at all. However, I was able to get a credit-based student loan-with a cosigner-to pay for everything. This was right before the economy collapsed. The program I utilized is not even available anymore. My credit stinks and I am toying with bankruptcy so that when I graduate in December, I will just have student loans to worry about. With all that being said, travelling to find a doctor who does the DS is highly unlikely. I am established with the Cleveland Clinic and would really like to stay there. (I have multiple specialists and its wonderful that they all have access to my records with the click of the mouse.)

This is why I am on the boards again trying to make the best possible decision for myself. Its all still in the hurry up an wait stage, so its not like I have to make a decision immediately. However,  I don't want to go forward and have another surgery, and find myself yet again failing.
The next surgery will be the last as I can't keep altering my insides. Whatever decision I make I have to live with.

So again, thank you all so much for the input. I have a lot of thinking to do and hopefully I will soon have health insurance so that I can at least start getting consults  under way.

Take care!
Jessica

Hello.  I read your profile, and man, do you remind me of myself (sorry, lol). 

I do have a few thoughts I wanted to point out.  I am pretty sure the Cleveland Clinic does not do the DS (or, if they do, they do very few, because I keep watch of the DS surgeons people list here, and don't know any from there).  There are not a lot of surgeons who will do it, but it is worth it to travel if that is necessary (and, it may not be very far -- there are some in Ohio, plus others in the midwest).  Also, with the health insurance you have applied for being an individual policy, it will be unlikely that it will cover any WLS.  So, really, it seems to me your only problem is money!  That does bite indeed!  I had to wait several years to get WLS, since what I had, Blue Cross/Blue Shield of Kansas, had (and still does, I think) a total exclusion on all WLS, and I definitely could not afford to self-pay (and, in fact, I declared bankruptcy in 2005).  My life deteriorated to being on disability for my mental problems (including the ones you mention in your profile),  and then waiting long enough for Medicare to kick in, which covered my DS.  I think it will still be some years before you will be able to get the DS.  That totally stinks, but just keep the faith that some time cir****tances for you will change.  Although, it is kind of ridiculous for me to be saying that to you, since you have been a member of OH since freaking 2001!  I wish you some big windfall of winnings or an insurance with DS coverage.

No need to be sorry! I am glad that there are people who can understand where I am coming from.
I would travel a short distance for the surgery, like you mentioned. But travel abroad or cross country isn't an option.

I hope I can find a good self-insurance option, but I am realistic about that too. I still need to be covered in general, so I am going to proceed with that.

Thanks for the good wishes, I truly appreciate it. :)

Well, If I already had a sleeve, there's no way I would get an rny, especially if you need nsaids.

I was also self pay, just so you know I researched and it took 3 years for me to figure out a way to pay. So keep researching and keep your options open and hopefully you will figure it out.

But this is your one and only body, don't settle for a surgery you may regret.