Revision condundrum and DS question

I am really struggling trying to decide on a revision course.  I had the VSG in 2010.  I had diabetes, high BP, high cholest, and PCOS.  My doctor tried to talk me into RNY, but I was to chicken about the dumping and so on.  Recently testing has shown that my sleeve has gotten alot larger.  I originally lost 50 lbs that was the most I capped out at from the VSG I have kept 40 of those off for three years.  I need to have a revision as my BMI is still around 42 and of course my diabetes is not relenting.  I am scared about the DS, but since I already have half of it, it would be easy to just get the other half and tighten my sleeve.  I have had alot of people tell me the the DS malnutrition can be hard to manage as time goes on.  I know keeping up with your labs is important.  They also tell me that RNY is better but I did see that the benefits "wear off" after the honeymoon phase with diabetes not really being controlled 2-5 years out.  Frankly alot of my friends have gained back weight with RNY and I like having my pyloric valve, but worry I will nose dive on the iron or calcium with the DS any comments, suggestions would be great appreciated.

Thanks

You have diabetes and you have proved you need more than restriction.  To me just the diabetes alone would lead me to consider only the DS.  Managing obesity and diabetes as you age would be a whole lot harder than managing the DS.  I had surgery the same time as a bunch of my coworkers.  Most were RNY and 1 band.  They have all gained back every pound plus 10 years out.  And they still dump and throw up too.  The worst of both worlds.  And you have a more than 95% chance the DS will cure your diabetes.  I can't figure out why you would seriously consider anything but the DS.

You've seen the pitfalls from the RNY yourself. This can happen with a DS just not very often. I chose the DS because it gave me the best chance to maintain the weight once I lost it. It doesn't happen for everyone but I went home from my sugery no longer needing 1000mg Metformin a day and no longer needing two shots of 75/25/ insulin a day - 85 units each. So far the malabsorption has lead me to be slightly anemic and low on Vit K and zinc. A trade off I gladly make since I can just tweak my vits.

You can be a success with either. There are plenty of them. I think the DS offers you the best long term solution.

Best wished for your decision.

Your reasons for not having RNY to begin with were sound, and nothing about them has changed. If anything, you have learned more about the longterm failure possibilities with RNY for both weight loss and also for resolution of type 2 diabetes.

It doesn't surprise me that VSG was not sufficient for you, given that you clearly have metabolic problems that it could not possibly correct. The DS will give you by far the best chance of resolving these problems, and your diabetes along with them. As far as the nutritional issues go, deficiencies are a possibility for both DS and RNY, but in both cases are almost always due to noncompliance. In other words, the nutrition is largely within your control, whereas the problems with RNY are largely NOT within your control.

Does that help put this into perspective?

The DS has the best statistics of any bariatric surgery for weight loss, for mainenance of that weight loss, and for resolution of almost all comorbidities, including and esp type 2 diabetes. You already know this. You have seen people have problems with weight regain, and you knew enough from the first to appreciate the value of maintaining function of your pyloric valve. If you get to know a bunch of people with the DS, by and large you will find a pretty happy and successful bunch of people.

Larra

PS lots of good info on the DS at dsfacts.com

Malabsorption can be worked through and NOT become malnutrition.  It takes close monitoring and tweaking of supplements.  I am 8 years post op, and so darned healthy that my life insurance sent me a partial refund check because they were overcharging me.