Do i do the duodenal switch after getting sleeved?
I had gastric sleeve surgery on 4/4/16. I have had no problemsor complications since the surgery and i feel great. I went to my doctor today for my 4 week Post-op appointment. My doctor recommends that i get the duodenal switch surgery in about 4 months. I hadn't really thought about this surgery before talking to him today. He thinks that it will be better for me in the long term to do the DS surgery and give me the most weight loss success. Before surgery my bmi was 54. I have lost 44 pounds since surgery. I have until July to decide if i want to get the DS surgery. I would greatly appreciate it if anyone thatbhas had the DS surgery can give me helpful advice, tips and information on this as it is a very big decision i have to make. Thank you!
And another thing, I find it highly suspect that the Doctor told you after you had your VSG that you should get the DS. The DS is a sleeved stomach with intestinal bypass, for a virgin DS it is done at the same time. The fact that the doctor split it up and only told you about the DS after, is unnerving. I know sometimes for the super obese they do it in two stages, but a BMI of 54 doesn't seem that high to me.
If you are asking is it possible for you to have the rest of the DS after a sleeve, yes, of course. In fact, we are seeing more and more people revise from sleeve to DS all the time because the sleeve alone didn't get them where they wanted/needed to go, or because of weight regain - but people are usually at least 1 and 1/2 to 2 years post-op and often more.
The real question is, if your surgeon thought you needed the DS, why didn't he discuss this with you BEFORE doing your sleeve? You must have had a consult, waited for insurance approval, etc, so there was time for that discussion. And unless there is something medically wrong with you that your bmi does not indicate, there was no medical reason to break it into 2 operations, and even in that case he could have discussed a 2 stage DS with you instead of just doing the sleeve.
Will you need the DS? I don't know, and at only 4 months post-op you probably won't know either. There are some people who are very successful with a sleeve, though it does take more effort that with a DS. The other issue is going to be insurance approval. They just approved your sleeve, why would they approve a second bariatric surgery without knowing how you will do with the first one? If you had been approved ahead of time for a 2 stage DS, that would be different. Many insurers have different criteria to meet for a revision, and some won't approve any revisions at all, with "one bariatric surgery per lifetime" rules. I personally believe that should be legal, but I don't rule the world (yet).
Larra
Larra the doctor and i talked about the types of bariatric surgeries when i first met with him. At that point i told him that I wanted the gastric sleeve surgery. He agreed with me that that surgery would be very good for me and i would have great success with it. Fast forward five months later to my surgery for gastric sleeve. Between our first consult and surgery day he never mentioned anything more about the DS. On my two week post-op follow up appointment he did not say a word about the DS. He told me i was doing great so far. Then i go on today for my 4 week follow up and he starts saying that we had discussed the DS surgery but we didn't discuss it. And that's when he went on to say that he thinks it would be better for me to lose the most weight and keep it off long term. That's why I'm a little confused on what i should do and what's going to be best for me years down the road. I have so much thinking to do.
Michelle, I agree, you have a lot of thinking and probably more research to do, and looking to the long term is what all of us should do when considering any bariatric surgery.
The DS has the best statistics of any bariatirc surgery for percentage excess weight loss, for maintaining that weight loss, and for resolution of almost all comorbidities. Both the DS and the sleeve avoid many of the nasty side effects of gastric bypass, including never being able to take NSAIDs again, possible dumping, possible reactive hypoglycemia, and such. The DS does require a lifetime commitment to taking a host of vitamins and minerals, and plenty of protein. You have some requirements with sleeve and gastric bypass, but more with the DS. They are crucial and not optional, but really not difficult. They become a part of your daily life, like brushing your teeth. You need to adjust them occasionally by following your labs.
I hope you will do more research about the DS, and while I personally love my DS and have absolutely no regrets, I would never want to see anyone rushing into it without understanding what it involves.
Larra
I would agree what some of the others had said. 4 months is hardly enough time to see how well you do with the sleeve. I would get a second opinion and wait to see how much more weight you lose.
I am 5 years out of VSG and I have gained back 40lbs of the 90lbs I lost. I am considering the DS but I am very nervous about going for another surgery. I want to know more about people who are considering this option as well.
I am trying to do it on my own right now but it is very difficult.
Regardless of any decision you make, think it through & Good Luck.
