Sleeve or DS - low BMI

Hi...I'd like some advice.  I have a low bmi  35, plus several comorbidities.  At 5'1" I weigh 185.  I have had a lapband since 2003 (which got me down to 140 ), but beginning in 2007, started gaining ever so slowly - til now I am almost back to where I was.  I'm going through all the hoops to get a revision approved, but my doctor is totally against the duodenal switch procedure - says I will lose hair, teeth, and be hospitalized with every flu.  Scare tactics, for sure.  He says the sleeve will be sufficient. 
However - and this is the biggie for me - I have been tested twice and have 33% of what my basal metabolic rate should be at the age of 58%. Of course, I could have told them that without a test, but at least now it's in black & white.. To maintain my weight, I cannot eat more then 1000; to lose weight I must eat no more than 600 calories a day - this is WITH walking 1-2 miles a day.  It's been this way for about 10 years.  SO, the way I see it, the only way to permanently fix the problem is to have the DS procedure: then because of the malabsorption effect , I will finally be able to eat a healthy 1200-1400 calories a day - and not gain weight.  HURRAY!  With the sleeve, what I eat will still be absorbed - and, though at first, I won't have much of an appetite, eventually (like the band) the stomach pouch/sleeve may stretch & can gain weight again. I know exercise is the only way to raise the metabolic rate, but with bad knees & a back injury, anything more than a daily walk is not possible.
So I really would like advice on this. I have about 70 lbs to lose: is the DS overkill, and stick with a sleeve - or is the DS the REAL and only solution to my low basal metabolic weight??  
Thanks for listening - and for any advice!

Giina (Major Mom) will probably  come on here and address this, but there is also a DS lightweights board on OH that you might want to visit.

Good luck with your decision!

Thanks - hope to hear from Major Mom soon! I'll go to DS lightweights board too.

Hi there,
I agree with you that another restrictive only WLS is not going to work well for you. The DS is a powerful surgery but you can be healthy if you follow some smart recommendations of folks like Vitalady. Also, please check out www.dsfacts.com for a list of vetted DS surgeons and speak with a couple of them. 

--gina

i PM'd you, but also had Ortiz for my lapband in 2005, went for revision to DS w/Ungson in Feb 2011 this yr, but woke up w/a VSG due to heart complications.. i am down from 49 to 33 BMI in 7 months w/sleeve alone, tho due to my concern abt regain & maintenance, am communicating w/ them again to see if they can complete my DS for me (also having paid for the full revision to DS pkg self-pay!), we'll see what they say.

good luck w/ ur decision!

You are all so AWESOME!! I never expected to get so much help...thank you so much for validating what I already thought!  The only thing I have to wait for is the insurance to approve revising my lapband...problem is they will NEVER approve a DS - at least I don't think so.  Maybe it would be worth getting the revision to sleeve here in NY - all paid for  (if approved) - then going to Dr Ungson, or Dr Gagner (I tracked him down in Canada & spoke with him) or Dr. Greenbaum in NJ for the duod. switch part.  Any one know what the cost is for just getting that done, afterward?  If it is close to what it would be for a total sleeve with ds to start with, then I will just bite the bullet & get some financing.
And you're right...my doctor here does NOT do DS...only bypass, lapbands, and sleeves. 

Okay one more question: THIS doctor said it is much better to get the lapband out, let the stomach heal for about 2-3 mos, then proceed.  He said doing the removal of band & revision at the same time results in a bigger pouch over time.  Is this true??  When I talked to Dr. Ortiz, he said it is easier for him  to do a sleeve, if the band is removed at the same time.  (he does not do the DS however)  I will not be going to him for that reason.

Thanks again - you have no idea how grateful I am.  :-)

I hope some of the folks with revisions will chime in on some of your questions. I've just heard my own surgeon say that taking the band out is difficult due to the scar tissue that has to be cut through to remove the band...difficult, but that's all. I would think getting the revision done all at the same time would be better than risking multiple surgeries.

--gina