Confused

Thinking about revision. I went from lap band to VSG. I got sleeved in 2010. I never gained back all the weight but 30 lb. I did. I've been researching revisions and was set on DS until I spoke with my VSG surgeon. I asked him what size he made my stomach. I was told 32. I told him I lost restriction. He told me a resleeve was rare.

He suggested RNY. I told him I was considering DS. He then went on to say that you can't skip vitamins or protein drinks. I told him I knew that. I asked him his opinion of the DS and he told me he compared it to giving someone "a cancer." So now I'm scared I know I need a revision. But don't know which surgery to go with. Can someone tell me what the 'dumping syndrome' is with RNY.

Also what is the basic vitamin regimen with DS. Has anyone had problems with the DS. Now I don't know what to do. I'm confused. 

Vitamins and protein are nonnegotiable but I certainly wouldn't compare it to cancer. You won't find a happier bunch of folks than DSrs.  Good grief that surgeon is a greedy jerk! He's using scare tactics on you. He doesn't want to lose the money you could bring him. He doesn't know how to do a DS. Talk to a real DS surgeon about a DS revision. See the list of DS surgeons on www.dsfacts.com.

Both RNY and DS are malabsorptive surgeries. They both require extensive care. Dumping and reactive hypoglycemia are known issues but not all RNYrs have them. They react to sugar and fats. You can check You Tube for a visual of someone dumping. I think it's pretty darn scary. Why would a doc wish that on anyone?

I haven't had any issues with my DS, and most DSrs don't, but you will hear horror stories of diarrhea and gas. Most people can control that with eating low carb, high protein and taking probiotics. Also, all the calcium citrate and iron we take can counter loose stools. We figure out what works for us.

--gina

In other words, your VSG surgeon doesn't know much about or how to do the DS and he's trying to keep you as a customer.  I'm sure the resleeve is rare because those not happy with results have resolved that the sleeve didn't work and tried another procedure altogether.

With DS or RNY, you will take a lot of vitamins to keep nutritionally healthy.  I can tell you from my own life that protein drinks don't have to be necessary if you eat strategically.  I keep a powder handy at my desk in case I cannot take a lunch break.  Otherwise, I get all my protein from food.

Either way - I wouldn't recommend messing up a perfectly functioning stomach for a pouch.  I'm glad you're thinking this through.

Giving someone a "cancer?" Most will say with the DS, they got their life back!

Ditto what everyone else said. Protein and vitamins are nonnegotiable. Some people choose protein in the powder form and some people choose it in the "food" form. Some do combinations. You have choices on how to do it. You don't have the option NOT to do it.

You DO have to make your health a priority. The DS requires diligence everyday. I think about my food and vites, every single day. But, heck, I thought about food everyday when I was fat! Now, my thoughts are more proactive as opposed to feelings of guilt.

I would never get the RNY. Never, never, never. Too many revisions, dumping, weight gain, etc.

A Ford dealer is not going to try and sell you a Buick. You have the same thing going on with this surgeon. But I do want to emphasize that your post-care will be your responsibility. Don't rely on surgeons or PCPs. They just aren't up to par in this field yet. Good luck!

Get a 2nd opinion! To many good DS Dr's out there to take this guys word for it. I was a virgin DSer and had surgery 2 months ago. I have had zero side effect or issues.  I have dropped weight faster than I thought I would and overall feel healthier than I ever did with any past diet or weight loss... I think all other weight loss surgeries are a temporary fix to a permanent problem... DS is life changing!

I can only second what everyone else has said, but want to add that each and every WLS procedure has it's pro's and it's cons.  Each procedure also has a target audience/situation that it's more suited for.  At extremes, for example, the lapband is a procedure designed for those needing to lose a relatively small amount of weight (50-100lbs approximately) whereas the DS is designed for those needing to lose a much larger amount (in excess of 200lbs typically), though many people who have less to lose chose to have this procedure because they feel the added malabsorption and more correctly functioning anatomy is preferable to other procedures and are willing to accept the greater need for supplementing . . .  It's an individual thing.  First and foremost, you must speak with a qualified, well-experienced "DS" surgeon to get objective feedback regarding it.

I personally don't get the "cancer" comparison.  In my experience, my body reacts to food the same post-op as it did pre-op . . . only magnified . . . ooooohhhhh, about a 1000 times!!  For example, ice cream always gave me a touch of gas . . . but post-op, it's a nuclear meltdown.  Certain hot things always irritated briefly upon exit, but now if I indulge too much, I'm shooting like Smaug (not to be indelicate).   Ultimately, the choice is yours, but you must find a very experienced surgeon who has proven knowledge and experience in whichever procedure you choose.  Wish you the best.

I'm a lightweight. I previously was over 200+ lbs. I had the lapband for 10 yrs. I started having problems with it so converted to sleeve. The doctor told me I may have some weight re-gain 3-4 years out. So now I find myself at 170 lb. I'm going to take my time thinking it over but if I start to see more excessive weight regain I'm going to think more serious about revision. Right now I'm scared and don't know what to do. A few doctors have told me not to re-sleeve. You can get resleeved if you were sleeved years ago when the sleeve's were made excessively large but mine was made at 32 which is the going average size. To go in and recut it to make it smaller would be useless and dangerous possibly leading to leaks. That's why most VSG revisions can only be RNY, or DS. I don't like the thought of destroying my sleeve or cutting the valve and the dumping that goes with RNY. Then I read you can have gall bladder issues after any bypass surgery. I know I would have to be on major supplements too. Right now I just do a multi and calcium. Some days I have skipped vitamins but I know you can't do it with DS, so I would have to keep a pill case in my car and house because I'm frequently on the run. I know you can't skipp with DS. I'm going to hold off on revision for now and keep reading up on DS. Than if I gain more and know I have to revise I can make the best decision. But I'll keep reading this blog and learning. If I need answers to anything I'll ask.

Thanks All.

 

Your specifics really give me pause. I have never seen someone at 170 lbs seeking the DS. How tall are you? I was a lightweight at 5-7, 240+ pounds. I have seen a great many people end up at 170 after their DS, and they are thrilled.

Are you a cash pay?

I understand your frustration, though. If you are gaining and can't get it under control, you want to solve the problem before it gets bigger.

I was originally 225 lbs. I had the lapband for 10 yrs. and then took it out and revised to sleeve. I went down to 140lb. and then back up to 170lb. I need a revision of some kind. If you're sleeve fails your two options are either DS or RNY. I spoke with 2 surgeons and was told a sleeve revision is usually not done with the new sleeves because of the risk of a leak. If you had an old sleeve done years ago you can be resleeved because back then they only removed 50% of you stomach. Now they take out 75-85% and to revise the new ones is very risky. My sleeve surgeon recommended RNY but I'm leaning more to DS. I really don't want my sleeve hacked up and I don't want the dumping issue. 

I've heard from other people who were second stage DS'ers and they told me the surgery went well because 1/2 the procedure was complete and done and over with. I'm thinking to convert in the next year or two but I don't want to rush. Taking my time and reading up on it. I'm 5' 4".

This surgeon has really gone out of his way to misinform you.

First, while VSG works great for some people, as people get further and further out more of them experience weight regain as the sleeve inevitably stretches out. The fact that your sleeve was made with a certain size bougie is irrelevant, first because it also depends on how tightly the surgeon stapled against the bougie (this varies - a lot) and also because by now your sleeve is not the same size that it started at, and knowing where it started doesn't tell you what size it is now. Bottom line, a substantial number of VSG patients are now looking at revisions of various sorts, and more will in the future.

Next, the DS is not cancer. As others have already said, it gave us our lives back, rather than taking them away. I'm almost 8 years post-op and living very well with my DS, thank you. I don't even want to think about what my life would be like by now if I hadn't had the DS. For someone to say that to you IMHO was very irresponsible.

You are doing the right thing by taking your time and doing your research. If you want more info about the DS, you can find it at dsfacts.com.

Larra