Starting journey for revision from RNY to DS - help!
I had RNY in 2008 and lost 110 pounds. In the last three years due to a number of reasons including medical and emotional I have gained and am only 40 pounds shy of where I first started this thing! I never reached goal weight but have to say that I felt fantastic. And now, not so much. I have plenty of comorbidities so that shouldn't be a problem. So depressing! I had a consult with my surgeon, the same one who did the RNY and I do the psych eval next week, etc. Gotta go from there, get insurance approval etc.
I have been reading your posts today and am worried now. I know once I'm there it will be fine just as the RNY was but.... you all talk about eating so many calories! And it seems more bathroom issues than RNY. All those calories in have to come out somehow! It sort of freaks me out! Probably fear of the unknown verses what I've already experienced with RNY. I'm okay with all the vits, already doing that although I see that I may need more. But eating constantly all day??? Whew! A bit overwhelming. It does seem like most of you are pretty happy with the surgery though and would do it again, yes?? It also scares me that there is no dumping syndrome to keep me from eating all the bad stuff. That was certainly a big deterrent for me. Well that's not much to go on, but any thoughts or wonderful supportive ideas?? Thanks! Mary Ann
Most bariatric surgeons don't do the DS, and even most who do the DS don't do RNY to DS revisions. It's a very challenging and complex surgery that involves undoing the entire RNY, putting the anatomy back to where it started, and then doing the entire DS. You will need to go to a DS surgeon experienced in this specific revision. Luckily for you, 2 of the best are here in CA - Dr. John Rabkin of Pacific Laparoscopy in San Francisco, and Dr. Ara Keshishian, who operates in both Delano and Glendale. There are others further away. Despite what the previous poster claims, I have never heard of any surgeon in Mexico doing this type of revision. There is an excellent DS surgeon in Mexico, Dr. Ungson, but he does not do RNY to DS revisions.
As far as calories go, no one is required to eat 3-4000 calories/day. Since we only absorb about 20% of the fat calories we consume, we can eat fat freely, but it's not a requirement. We absorb about 40-60% of the pretein we eat, so we do need to eat plenty of protein, but again that doesn't require huge numbers of calories. And we absorb carbs well so it's best to keep carb intake low. Can you eat lots of calories and get away with it? Yes, if those calories are fat and protein, but you don't NEED to eat all that fat if you don't want to. And while snacking is ok, again, it's not a requirement to eat all the time.
Larra
Larra, we were told when I had RNY that we wouldn't absorb all the calories either and now years later, I am reading that after a time we start to absorb the calories....this seems to be one of the big draws of the DS, is it's suppose to take care of that ..seems to me that most of the drawbacks to DS slso come with the Rny...and at my size it was the only option available at that time...of course my main drawback is to find a surgeon to do a revision and for me to be able to make the best decision for me...I am happy for you that you had the opportunity to have the DS as your only surgery.
Andie, there is some malabsorption of calories with gastric bypass, but it's minimal even at the start. The operation works mainly via restriction (which also doesn't last forever, at least not completely) and in the longterm via behavioral changes once the severe restriction is gone. For some people, who can sustain the discipline and diligence required, gastric bypass works well. For others, who either can't sustain the behavioral changes or whose lives change (can't exercise any more, other medical problems, medications that cause weight gain, physical or emotional trauma, and so many other reasons), the weight loss is temporary. The failure rate and incidence of weight regain with gastric bypass are significant, and we see more people wanting revision all the time. It is my personal belief that we would see even more people looking into revision if they knew it was possible, and if they could get insurance coverage for it.
You are right, I was very, very fortunate to have the DS as my first and only bariatric surgery. I am more grateful for this than I can say. There are some surgeons who do RNY to DS revisions, but not many because it's a difficult and high risk operation. But it can be done, and I hope it will become available to you as well as to the OP. You would need to travel for this, which many revision patients do, so the surgeons who do these revisions are accustomed to working with people who come to them from across the country. I will also send you a pm with more info.
Larra
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I am older and was wondering if you feel like it was worth it to get your Rny revised...I lost about 230 and have regained 60 and am considering it...my husband doesn't want me to go to Mexico... Michelle, when you get better, maybe you can tell us about your experience...thanks to all of you that post so we can get more information
