Why do you suggest a different surgeon?  I never had any problems with her 11 years ago.  Is there something I should know about her or her practice now?

Thank you so much for clearing up the difference between the BPD and the DS.  Please keep in mind that I had the surgery 11 years ago...before the DS was the way to go.  At that time the BPD was in its infancy, and I went to the best doctor in the field at that time that was one of the only doctors doing anything other than the RNY.  My surgeon was Dr. Christine Ren (Now Dr. Christine Ren-Fields) located at NYU in NYC.  I had faith in her then and still do.  I think she gave me the best advice given the time period.  I looked at her sight yesterday and it is updated for the DS.  She doesn't even do the BPD anymore.  I am going to make an appointment with her to discuss "fixing" my surgery.  Perhaps she is one of the surgeons that can turn this BPD into a DS and fix the stretching I have done to my gastric pouch.  At least I hope so.  

I understand what you mean about doctors not knowing enough about our surgeries to maintain our health afterwards.  I recently became so low in Calcium that I have been placed on Calcitriol.  I had been going to a doctor that had the RNY and so I thought he understood what my medical needs were.  He was doing all the testing that the surgeon had told him to do every six months, but he wasn'****ching closely enough and as a result I ended up with tetany.  I went to a new doctor who sent me to an endocrine doctor who is now helping me get all my numbers back into wack.  Part of it was my complacency for not following up, not getting copies and being knowledgeable enough myself, and for non compliance on taking my vitamins and minerals and such.  In any event, I have taken control of my health again and am much better...taking all my meds and being proactive about my blood tests and health in general.  

I appreciate your candor and information.  Thanks so much for sharing!  :-)

Primarily, it's a quality of life thing. And, your surgeon might not have been comfortable with his ability to sew duodenal tissue---I've heard it compared to sewing wet tissue paper. Here's a comparison pic:

If you really have a Scopinaro BPD, you have a very large pouch, distal RNY. It looks like this:



A true DS (sometimes called a BPD with DS/duodenal switch) looks like this:

Well, I have the BPD-DS (also just called the DS), so my knowledge is limited about the Bpd, but I can tell you that the DSers in general are more knowledgeable about supplementation, so hopefully you are getting really comprehensive labs each year (use Vitaladys list, or one similar) and Vitalady, or many of the DSers can help you decipher them. Our doctors often don't realize something is heading out of bounds on our labs, until it is way out of line, and then much harder to correct. 

It's not you - don't get down on yourself about this. One difference between the bpd and the bpd-ds is that the bpd-ds has a sleeve stomach, whereas you have a pouch. If your pouch or stoma are stretched, then that could be the issue for your gaining, but a surgeon would have to evaluate you to see.

I would NOT NOT NOT go to the same surgeon that gave you the BPD - they are not up to date in either information, or SKILL! I'm angry that you were mislead by them, and wouldn't trust them any further than I could throw them. Many of the problems that result from the pouch are because the pyloric valve is cut off the bottom of the stomach with PBD and RNY (sleeve and DS retain the pyloric valve) and the surgeon makes a stoma instead. Having a manmade stoma in place of your pylorus causes issues like dumping syndrome, reactive hypoglycemia, and regain. 

There are a few surgeons that can reverse the pouch to make a DS or sleeve. I don't know what part of the country you are in, but if near CA I'd have Rabkin or Kesheshian evaluate to see if they can help you. Where are you at? There are a few other surgeons in the US that can to that reversal, but you will almost certainly need to travel. 

At the very least, following some of the early DS eating rules, like high protein, low carb, may help you re-lose that gain, but you have likely lost the caloric malabsorbtion you once had, which will make losing and maintaining much harder, which is why I think you may want to talk to a surgeon that revises many pouches due to regain and other problems.

I don't know of any surgeons, particularly in the US that still do just the BPD (well, I know of one where there was an accident during surgery and part of the stomach couldn't be saved) and am wondering who your surgeon was. 

BUMP