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I will pass that along about a second opinion, which are hard to come by where were at. It's cool Dr. K Skypes, this might help her make up her mind. I personally feel the DS is the way to go but $ is always a factor.
Thanks,
Larra
WOW! That's incredible!! I'm so happy for you! Thanks for answering my questions and your offer to continue to answer them. I have my consult Saturday, and I have a lot of questions for the Dr too. Thanks again, and wishing you continued success! ;)
Thanks for the update and keep up the great work! You got this! 
HW: 398.8 SW:356 GW: 175 CW:147
Thanks so much for asking! I'm doing great, as long as I remember not to compare myself to anyone else. I can tolerate pretty much any food, which I realize could get me into trouble if I choose the wrong things, and I will admit to making the wrong choices a few times. The only foods I absolutely cannot stomach are anything with sugar alcohols. Absolutely disgusting.
It took about 3 months for me to hit the recommended 64 oz of water per day, but I do a lot more than that now.
I'm a week shy of 6 months and down 162 lbs. (I count from my highest weight) I've shaved more than 20 points off my BMI and I've lost 20 inches around the widest part of my body. My doc says if I was losing any faster, I'd probably be doing damage to myself. I'm losing steadily about 5-7 pounds per week. It's definitely tapered off since the earliest days but it's still steady, so I'm not worried.
I would absolutely 100% do it again. I wish I hadn't waited so long.
HW 525
SW 492
CW 363
Good luck and please feel free to ask me questions!
*Edited because I reworked the math on my loss and realized I overestimated my weekly average
Hi Miss Maggie,
It's been a few months since your last update (on this thread at least), can you tell me how you're doing almost 6 months post-op? I'm considering a DS (revision from RNY) so I'm very curious how things are going.
Thanks for sharing!
Looch
Best advice, she needs the problem solver, Dr. Keshishian in California.
You already know this but you need to tell her the sleeve failed her. The sleeve is just another diet with a smaller stomach. She should have had the DS from the get go and the surgeon who sold her the sleeve is the failure. The DS is still her best hope to get down to the weight where she can get her knees replaced and get her mobility back. If a panniculectomy will help her, perhaps it can be done with the DS. Ask Dr. K.
I wish there was something better than the DS. A pill would be great. But there is nothing else out there that will give her a better chance. There is one non-surgical option I can think of and that would be Medifast/Optifast till she gets down to a weight where her knees can be replaced. BUT once that's done, there is a very good chance she would regain.
I can understand a pouch hybrid if she was having significant reflux problems such that it would be desirable to go to a "low pressure" system (sort of like a higher restriction/lower malabsorption Scopinaro procedure) that would also avoid the extreme NSAID intolerance of an RNY, distal or normal. But I don't see that a pouch is significantly more restrictive than a properly done sleeve as the RNY and VSG overall give similar results. As you say, he may not be a big fan of resleeving, and that may just be a preference; revisions, even fairly straightforward ones like a VSG/DS "completion" are more complicated than virgin procedures, so styles and preferences between surgeons, even amongst the group of long experienced DS guys, can vary quite a bit. I'm a fan of getting second (and third) opinions, particularly when dealing with less than textbook cases such as revisions, so it is good that she is proceeding in that direction as well.
Likewise, I think that it would be a good idea to consult with another of the legacy DS guys; I know Dr. K does quite a bit of consults via phone/email/skype, etc. so it doesn't have to involve a lot of travelling, at least for the initial consult, and it's a pretty easy way to get some diversity of knowledgeable opinion.
Good luck....
1st support group/seminar - 8/03 (has it been that long?)
Wife's DS - 5/05 w Dr. Robert Rabkin VSG on 5/9/11 by Dr. John Rabkin
That's what we were thinking or hoping but Anthone isn't a fan of resleeving, to many risks apparently. He would just do a roux-en-y pouch.
Different DS surgeons have different theories about what is most important in a DS. Some go for more restriction (i.e. a narrower sleeve) and less malabsorption, others think a larger sleeve is ok as long as you have really good malabsorption.
It's certainly possible that the initial sleeve was not done as well as possible, but also possible that the original surgeon was being careful not to make too narrow a sleeve, which can cause serious problems with reflux. The size of the bougie doesn't tell the whole story, as it also depends on how tightly the surgeon stapled against the bougie.
So, given that none of the above options sounds great, I would recommend a second opinion with another DS surgeon, and the one I would recommend is Dr. Ara Keshishian in Pasadena, CA (near Los Angeles). He does a lot of revision surgery, and his philosophy goes more to the larger sleeve, more malabsorption end, which might be just what your sister needs. Though of course, if the sleeve is truly malformed, she may need a re-sleeve, but this is something to discuss with him. Given that your sister is going to be self-pay, she may as well pick the surgeon that suits her best.
Larra
If he wanted to do anything on top, I'd ask for a tighter sleeve.
HW: 398.8 SW:356 GW: 175 CW:147
