At what point would you get a revision - knowing you will GAIN WEIGHT?

People who malabsorb...RnY and DS patients...have to be concerned about how they absorb ANYTHING, including medications.

True, but a lot of chemo is administered via a vein or in a muscle so it's not an issue. It's only an issue for the kind that is administered via pills.

 i know im experiencing it first hand right now with the absorbtion of my Lexapro. Apparently it isnt working in my body correctly when i cru**** so the doctor said to swallow it. I havent swallowed a pill in 3 weeks since i was pre-op so im so nervous

I've decided I'm terrified of surgery. My most recent back surgery left me freaked out for three weeks, afraid of dying.

Having said that, if my doc said to me, "It's in your best interests to get reversed" and the insurance would pay for it, I'd be there in an INSTANT

Health first.... I got the surgery for my health, I'd UN-get the surgery for my health. No hesitation. My surgery WAS too aggressive for me. Should have had a V8 (VSG)

Wow, osteoporosis.  You  know how to hit close to home, don't you?  lol

I'm watching osteoporiosis cripple my mother.  She has had three back surgeries and every time she THINKS about moving she's at risk for another compression fracture of the spine.  She's on 25mcg of Fentanyl every three days and that **** makes her so loopy that we can't tell how much of her cognitive status is due to the drugs and how much is due to dementia.  And worse than that, she has breakthrough pain that also needs to be treated.  So she takes enough ibuprofen to tear up her stomach.  And she needs meds for that, too.

I suppose that if I were unable to supplement enough to overcome the calcium malabsorption that the DS provides, I'd seriously have to consider having the DS taken down.   I'd end up in a wheelchair either way, because weight is not good for arthritis.  But the pain my mother is in is really something...and I'd probably want out.

 I have already considered reversal in the off-chance it might stop whatever is wrong with me.  

I have had neurological problems since 2006 and seizures since 2008, and I still seize now, at least once a week.  I will be seven years post op on 4/5.

The few bariatric surgeons that I have discussed it with have said that it's unlikely I would gain massive amounts of weight back at this point, because I've maintained my loss for seven years.  One said that it's "all up to me at this point anyway."  Of course I don't believe that entirely, because I am quite a slave to my pouch limitations, and I do pu**** all the time.  I could very easily gain weight, I can do it now, with the RNY.

But, I sit in limbo, because I know the reversal surgery is risky, and worst case scenario?  I have the reversal -- and I'm an obese woman WITH worse neurological symptoms and no relief.  

" know the reversal surgery is risky, and worst case scenario?  I have the reversal -- and I'm an obese woman WITH worse neurological symptoms and no relief.  "

Good point ... surgery is risky. That's why normally they don't take down RnY unless it's very, very serious.

In my case, my surgery can't be reversed. And, yes, you can have malabsorption and nutritional issues even with a "restrictive only" surgery. It's much rarer and tends to be less serious but the risk is there.

In fact, osteoporosis is a known side-effect of all partial gastrectomies, which is why the experts push the calcium so much. It also runs in my family. So it's certainly something I thought about pre-op. I decided the risk was worth it though as long as I was willing to do all the proactive things I could do in order to prevent osteoporosis. So I take my calcium, I lift weights and I get regular DEXA scans.

When a significant amount of certainty could be made that would guarantee relief of said complication--say 75%+, AND I'd already tried everything.

The aspect of this question that is the most difficult one for me to consider is not so much the short-term, life-or-death question (oral chemotherapeutics, e.g.) but where on the continuum of declining health does one make the decision?  It is a very difficult question, I think, with multiple concerns and considerations.

Obviously, there are a LOT of ways to address various forms of malabsorption, just as there are multiple treatment modalities.  Osteoporosis, for example, can be caused by (1) calcium malabsorption - for which there are mulitple options such as calcium source (citrate vs. carbonate vs. apatite vs. etc. etc.), timing of taking calcium vs. other supplements and food, perhaps other things; (2) vitamin D malabsorption (D2 vs D3, dry vs. gel, adjusting the amount, injectable forms); (3) inadequate magnesium and other associated cofactors (balancing the timing and amount with the side effects). 
So of course you would want to try all of your non-surgical options first - that is obvious.  But when do you throw in the towel?  Again, focusing on osteoporosis, although there are medications that promise in normal people, to regenerate bone in those with osteoporosis, I don't know if they work on malabsorbers.  If you are progressively losing bone, and breaking bones, leading to irreversible problems - when do you say "enough?"

I recall a case a few years ago in which someone was having issues with protein malabsorption, who was struggling with trying to fix the problem - but in doing so, passed the "point of no return" - and became too malnourished to safely have revision surgery.  The patient survived the revision surgery, but it was touch and go for quite a while.

Timing is everything.  Unfortunately, it seems more often than not, the timing issues are best determined after the fact, when you have the benefit of hindsight.  "I should have done X at time Y" is often something you say with regret.  The question is complicated by the weight gain factor, which I think ends up getting undue consideration in the mind of the patient who has to make the choice - it is such an emotional issue that complicates the calculus of what is the most important issue to address.

I don't have any answers, I am just posing the question.  And I'm very glad that so far, this isn't at ALL about me.

 When you say you've tried everything, did you take the prescribed vitamin dosages?  Still problems with osteoporosis?