Weight gain

Well, I have put this off as long as I could.  Denial and depression just is not going to work for me!  I had a VBG in 2001.  I was 5'6 and 450 some-odd pounds.  I should have realized that picking a "popular" surgeon who did not even have the scale to weigh me and suggested I go to the vet to weigh was trouble in the making!  I was very successful with my surgery at first.  She told me no foods were off limits as long as they were in moderation.  She told me carbonated drinks were okay as long as they did not make me uncomfortable.  She told a Flintstones vitamin would be all I needed.  I quickly lost weight.  Within 9 months, I was down to 275 pounds.  On my first year anniversary of the surgery, I was down to 230 pounds.  I was feeling excellent, proud of myself, and felt beautiful for the first time in a long time.  I was trying to eat correctly, but anything of nutritional value caused me terrible problems.  I couldn't eat anything green, proteins were extremely limited unless they were fatty, and I had become lactose intolerant.  I had developed IBS but my sleep apnea, hypothyroidism, and hypertension had resolved itself.  I just felt wonderful.  I began to plateau but never gained a pound back for the next year.  I was not really exercising because I had developed a hernia at my incision line due to exercising at Curves.  Because I had fibromyalgia, I limited my exercising to aquatic walking.  Skip to the next 9 months and I began having female problems.  I was in and out of the doctor's office very week, on hormones, and ended up having a very complicated total abdominal hysterectomy February 2003.  The surgery was over 2 hours long and I lost a lot of my muscular tone in my abdomen.  I was extremely anemic and was having horrible, horrible cramps due to vitamin deficiencies.  My orginal VBG surgeon had discharged me because she considered me a "success."  Yep.  After being inactive for 3 months due to the surgery recuperation and anemia. I had gained back 15 pounds. I was heart broken.  My thyroid had begun to malfunction again and I became depressed.  16 months later they found out I had renal cell carcinoma.  I had to have my left kidney removed but the cancer had not spread.  Again, I was inactive for over 7 months due to recuperation, anemia, and vitamin deficiency.  At the end of that 7 months, I had gained back 100 pounds.  Now it has escalated to where I am back to the original weight I was with all the health problems I had.  That "doctor" (I use that term loosely) is gone from here and practicing in another state right now.  The only doctor in my area of the state that does revisions requires you to pay half of the surgery up front because I no longer have the original insurance I previously had during the surgery (my current insurance does not even pay for the surgery).  I am hoping and praying that this upcoming job change my husband is going to make will cover revision surgery.  My question is will it be possible to lose the weight and keep it off?  I let the bad habits creep in after the cancer, but previously I was faithful to eat as nutritionally as I could and exercise as best I could.  I felt I was on the way of becoming a success being I had lost over 200 pounds.  I am just wondering if I am fooling myself thinking I was partially successful.  The stories I have read do not really talk about people losing as much as I lost before regaining.  I know I will be going to UAB in Birmingham, AL as I have heard so many wonderful things about their program.  I do not know.  I am at my wit's end and want to get back to where I was!!

This was my original post on the Revision forum.  They suggested I post over here as at my weight a DS was my best option.  I am scared of doing this again and failing.  I know I can do this, but the fear just has me torn.  I would appreciate any feedback and names of surgeons in the Mississippi-Alabama-Tennessee area.  Thanks!

I think you should revise to the DS.  (Keep reading for a long time on this message board to see if the DS lifestyle is something you can live with.)  I think you should give up the idea of using UAB in Alabama, because I don't think they even do a DS as a virgin WLS, let alone a complicated revision of VBG-to-DS.  Adding the malabsorption of the DS (and modifying your current restriction from the permanent band to a narrower stomach) will help a lot.  Being a revision and at your current weight, it may be more likely that even with the DS you will still end up being obese, but to a much lesser extent than you are now.  Although, ending up with a BMI between 25-30 is not all that unlikely for you, either.  The doctor you should look at the most is Keshishian in California.  He does tons of complicated revisions to the DS.  However, he does have a program fee of something like $4k for revisions that is in addition to your copay, deductible, and what insurance covers. (If your insurance does not cover it, the self-pay cost with him is something like $29k, for the curious.)  We see many of his patients on this message board, and they tend to do well.  (Dr. Rabkin is also very popular for revisions to the DS, but he would cost you more up-front than Dr.K, plus will not be in-network for you.)  You may be able to get the revision to DS in Tennessee with Dr. Houston, but he is newer to doing the DS.  You may also look into Dr. Stewart in Denton, Texas.


Edited because it cut off my ending sentences about Houston and Stewart.

It still is not showing my last sentences I typed above to start with:  (I had "may" in italics, and it did not post what I typed after that.)  You may be able to get the revision to DS in Tennessee with Dr. Houston, but he is newer to doing the DS.  Also, you may be able to get the revision to DS sort of in your region with Dr. Stewart in Denton, Texas.

Gil, you've been to hell and back!! I started with the VSG in 2004. Lost a lot, gained back lots, and got the 2nd part (intestinal) of the DS in 2010. I'm mortified that you started with a VBG at your starting weight.

The vets will mention all of three vetted surgeons that do revisions. Your revision might not be as complicated as an RnY, depending on how your VBG was done. Some are done with a complete VSG and then banding, others are just done by banding the top of the tummy.  No matter what, you need someone who can deal with all the scar tissue from your multiple abdominal surgeries.

Keep reading about revisions here. You will have to travel to get to a vetted surgeon. There's a good chance your insurance won't pay for it. Also research the vitamins you HAVE to take on a daily basis to keep deficiencies away. If you can't afford them, don't do the surgery.  These are not optional.

Hugs and keep fighting,
Ratkity

We have a vet here that is a revision from a VBG.  They could not give her a DS stomach due to all the scar tissue from the mesh band.  She has lost all of her excess weight and her labs are good. She looks and feels wonderful.  I am not sure who her surgeon was.

Read everything you can get your hands on here and on DS Facts.

I will see if I can find Mary J and have her contact you.

I was a revision from a Horizontal Gastroplasty and other than adhesions my surgery was no problem, but I did not have any kind of a band in place.

Michele

Yup, you are going to have to travel. You have a complicated case and after what you've been through I think you know how important choosing the right doctor is going to be. Let me make it a little easier on you. This is the short list. These are the top three revision surgeons in the country (probably in the world) and if you do this, you should call each one and go with the doc that feels right. 

Dr. Ara Keshishian, Glendale CA (LA), Phone: 818-812-7222
Dr. John Rabkin, San Francisco, CA, Phone: 415-668-3200 or 1-888-848-8446 toll free
Dr. Mitch Roslin, NYC, NY, Phone: 212-434-3285 or 1-888-949-9334 toll free

I was a self pay with Dr. Keshishian and the price I saw in an earlier post wasn't even close to what I paid but I was a virgin DS. Perhaps that price is more in line for a revision. Call the office and find out what the self pay price is for your particular situation. There is no $4K program fee for self pays.

Please, if you are going to do this, you must go to a very qualified surgeon. You were burned once using the wrong doctor; this time the results could be so much worse if you go with an inexperienced surgeon so take our advice and use one of the above surgeons. They are very experienced with the difficult and complicated cases and your situation is complicated.

PS

Mary will check in after work.

Hopefully there are others that revised from a VBG that will chime in also.

Great advice already provided by others, I'll just mention that you didn't fail, the operation failed you. The VBG is barely even being done anymore due to the high failure rate. Just a handful of older surgeons who haven't moved on to the more modern operations still do it, and it is no longer recognized as a standard of care operation by the AMSBS. It's even possible that you have a staple line that has fallen apart, causing loss of restriction.
     You will need your old operative report, and also some assessment of your stomach pre-op to help guide your surgeon. And, if your VBG has fallen apart, this would be a mechanical failure that might help you get insurance coverage for revision surgery. Hey, it's worth a shot!
     So get on the phone with the revision surgeons, don't waste your time and energy on the local group, and best of luck.

Larra

You've been given the list of surgeons.  No one in or near Alabama can help you.

I wish you all the best.  The DS is a great surgery.

~Becky