Revision to ds after vsg?? why?

Hello Everyone! I am curious to know , as i decide my best route for wls, did anyone have a revision to ds after vsg??... if so why??. What did you find was your reason for failure with the sleeve??.. any regrets of not having done ds to begin with. I am dead set on the sleeve but since i have a bmi of 50.7

Ooops, didnt get to finish.. so im wondering basically if i should go all out with ds te first time , or go with the least invasive procedure and keep ds in my back pocket for later down the road incase i cannot lose enough with sleeve. thanks for reading!! Brooke

Nothing is "least invasive".  They have to cut you open for any surgery.  Don't go into WLS thinking, 'well, I'll just revise later if it doesn't work'.  The problem with this thinking is that we are seeing more and more insurance companies move to a 'once per lifetime' WLS.  That means you can only have ONE WLS per lifetime, no matter what insurance paid for it the first time.  Your insurance may not have that now, but if they change to that in the future, you are going to be screwed.  You'll have to pay out of pocket.

With your BMI....the DS would more than reasonable.  Do you have any comorbids?  The VSG is a great surgery but is only restrictive.  Some find they can eat more down the road and it can be harder to maintain after that.  The weight loss is not as great with the VSG.  All you can do is weigh the pros and cons of each.  

Chances are a purely restrictive surgery won't really work for you.  And honestly you want ONE surgery, not multiple procedures.  The biggest difference is diet and long term results.

The VSG is only restrictive.  It is a diet with help from a smaller stomach.  You will lose weight but over time your stomach will get bigger and you can eat more.  Your diet is low cal, low fat, and low calorie.  You will take vitamins/supplements for life but not as many as with the DS.  It's not too likely that you will be able to keep off more than 50% or so of your excess weight.  You will probably still be 'fluffy'.  And that's if you work hard at it.

The DS is restrictive and malabsorbtive.  It has the best results of ANY WLS out there.  Our diet is high fat, high protein, and low carb.  We can eat like a normal person after a while.  The DS cures type 2 diabetes over 95% of the time.  You do have to take a lot of supplements and vitamins for life.  This is your best chance to reach a normal BMI.  Many lose all the weight but there is a minority *****ach the overweight category and just stay there.

When you are doing your research, remember to seek out people who are years postop.  Every surgery has a honeymoon period where you will lose for a while.  It's the long term results that count.  Pick the lifestyle and body image you want and you will know what surgery to have.  Best of luck.

I replied to this question on a different post awhile back. I hope this link works. http://www.obesityhelp.com/forums/revision/4607877/Who-has-a-sleeve/#38211808

Basically, my BMI was around 50 when I was sleeved. After some loss and some regain, I am now scheduled for the DS.

Good luck with whatever you decide. It's a very personal decision.

With VSG every calorie you eat is still absorbed.  You must be mindful of this.  Yes, your stomach is smaller, and yes, you will have a reduced appetite.  But every calorie is absorbed.  You cannot leave the diet mindset at the surgery table.

With DS you have the benefit of malabsorption.  So if you're eating 1000 calories of protein, your body is absorbing only 50-60% of this -- 500 to 600 calories.  If you're eating 1000 calories of fat, your body is absorbing only 20% of this -- 200 calories.  If you're eating 1000 calories of complex carbs, your body is absorbing only 60% of this -- 600 calories.  Given the above scenario, you've ingested 3000 calories but absorbed 1400.   

Read more about DS Math here:  http://www.dsfacts.com/ds-math.html

Metabolic testing will tell you how many calories per day your body uses at a given activity level.  Mine was a very efficient 1137 calories per day!  In order to lose 1 pound per week, a person must reduce intake (or expend through exercise) 500 calories per day.  So to lose 2 pounds per week, in a doctor-supervised weight loss program, I had to eat around 500 calories per day AND do aerobic exercise at a minimum of 60 minutes per day AND log 10,000 steps per day on a pedometer.  AFTER losing the weight, I could never go above 1137 calories per day.

I cannot stress enough the freedom that the DS brings from that kind of dietary stress. 

Just for clarification when i said " least invasive" i was refering to in that my intestine would remain intact. The only reason i mentioned havong the ds in my back pocket for later is because my surgeon and various others here on OH had suggeted that. I am 20 years old and i am wanting the surgery that would have least complications such as chronic diarhhea,

And nutrition issues as i will have to take SEVERAL vitamin supplements for the remainder of my time here on earth 50, 60, 70 years.. however long the lord wants me here.. i also do not want to look malnourished.. i wouldnt mind being "fluffy", but i have seen several post dsers here and vsgers tooo who just look wayyyy tooo thin for my comfort. thank you all for your input it is greatly appreciated!! Brooke

P.s my metabolic rate is 2160 calories

Hi, I was sleeved in 2009, and just revised to a ds 6 weeks ago. I have not lost any weight though. I revised because my sleeve was stretched, be careful not to stretch out your sleeve! Regain happens! Well I am still waiting for this ds to start working and trying to be patient. Sleeve will be fine as long as you do not eat too much often. That is hard to do, I over ate many times and barfed, stretching every time. If I could turn back time I would have done a virgin ds the first time.