Had VSG in 2010 and now considering DS

I did very well with the VSG but never quite made it to goal for several reasons. In the past year I've regained about 35 lbs. I expected some amount of regain and I'd be ok if I had done that from goal weight...but not from where I was. So to get to my goal weight today I need to lose about 65-70 lbs. 

One of the biggest issues or me is the inability to do ENOUGH exercise to truly make a big difference.

I went for a visit with the surgeon who did my VSG last week and while he wants me to "get moving" and see his nutritionist, which I will do, he said my surgical option would be the DS. So I've been doing some reading up on it. 

So a few of my questions are:

if I decide to go this route, I will have to self pay again as my insurance doesn't cover WLS at all. Because the DS is a much more expensive surgery than the VSG, I've been considering Mexico. Who's the best DS surgeon in Mexico and does anyone have any idea what it would cost given I've already had the VSG?

Do you think someone 4.5 yrs out from VSG can have success with the switch at this point?

I've read all about the commitment and importance of taking vitamin supplements and monitoring labs frequently. That's not a problem. I just had a full work up done and my levels are great with the exception of vitamin D and I'm now on a 12 week course of prescription D. 

Are there any foods you can't or shouldn't have with the DS? Is it really any different than the VSG?

Is there anything else I should know or consider in making this decision?

Thanks so much!

The best MX surgeon and one of the top in the world is Dr. Gilberto Ungson.  I wouldn't expect many discounts, since the DS part is the most complicated.  Expect to spend around $15k total, including travel, lodging, etc.  What's nice is that his staff makes all the arrangements there for you once you get to MX. 

The big difference about DS is getting used to eating fat, and shrugging off the old "fat is bad" thoughts that continue to creep into your head.  We don't count calories at all.  We eat hight protein, moderate to high fat, and low carb.  Some actually count carbs - I just kept mindful about them, not worrying about the veggies, but not going butt-wild on the simple carbs.  Protein becomes the superstar in life - and if you can eat it with real food, all the better.  Pasta is pretty much gone from my life, except for a bite or two.  I find other things to do with the sauce and meats...if only on some mashed potatoes.

Vitamins are a big importance.  With the sleeve, you weren't eating enough to sustain nutritional health, however your body was still whole and working as designed.  Some multi's and extra calcium were necessary - maybe a little more than the average normie, but not a huge change.  Now it's like a race to load up and absorb before they leave your body.  You monitor your levels a little closer, but your PCP can definitely do this for you at home.  Just get a complete list of labs you need.  I do my annual labs with my annual physical because my insurance covers physicals each year with no copay or anything.  My extensive labs slide right on through the system with no additional cost as "preventative care". 

If you've not found it yet, check out dsfacts.com for more information about the DS and some long-time vets that shared their experiences and useful tips.

Thank you so much. 

I keep reading about artificial sweeteners being bad....does that mean no Splenda or crystal light? 

That would probably be the hardest thing for me. I'm a big coffee drinker and I use Splenda and adding crystal light tea is the only way I can drink water. I really need to work on cutting back on the coffee...I've known that for a long time. I was sick for a year being super anemic and I was freezing from the inside all the time and I got hooked on drinking lots of coffee to try to warm up. That habit has stuck. Ugh. 

There are some neurological effects that some (nno wls related) encounter with splenda and aspertame.  For other artificial sweeteners (those that end in "tol"), it causes horrible gas and bloating.  It's just something to be mindful of

The DS is very different from a stand alone VSG because you will be adding both malabsorption and some substantial metabolic changes to having just restriction. There is a lot of great info about the DS at dsfacts.

As far as Mexico goes, the only surgeon there that most of us would recommend is Dr. Ungson, who is very experienced with the DS and has an excellent reputation. You don't need to use a medical tourism service, just contact his office and his staff will give you all the info you need. They can also tell you costs.

And work on your Vitamin D now, because it's one of the fat soluble vitamins that is poorly absorbed after the DS, along with A, E, and K. We need to take the "dry" forms of these vitamins, and the prescription form that you are using now will not work well after your DS because it's oil based (oil = fat). You can purchase the dry vitamins either directly from the manufacturer or from Vitalady, whose prices are usually the best.

Larra

Thank you!

Is there more than one kind of DS surgery? 

I keep seeing all these different initials and words in front of DS on different sites. Like BPD/DS or Sadi-S?

BPD/DS and VSG/DS both are the DS.

SADI is an entirely different animal, in the experimental stage, so far looking good.

Had my VSG in 2010 lost around 50 lbs that was it, fast forward four years and a lot of the last two researching the DS.  Had my re-sleeve/DS on 10-06-14, I am already down 32lbs in That short amount of time.  My original sleeve was too large and had to be trimmed.   I will admit at first you are taking a pill or vitamin every little while but now it is getting more routine.  So far I have no regrets my diabetes is in remission and hoping cholesterol/ sleep apnea will follow.  Also as a note I started off a lightweight at 240 felt like the DS was maybe overkill, but I'm glad I took the leap