Has anyone had their DS revised because they weren't losing enough weight?

Hi all!

I had my duodenal switch done around 5 years ago. I was very strict with my eating the first year+ out and lost about 135lbs but never got down to goal. I went from 320 down to 185 and Im 5"3 and I found that I did not lose as quickly as some others. There were 3 tragic deaths in my family the first year of my surgery so I'm sure that stress didnt help the situation and I also developed hypophosphatemia after getting an iron infusion and was exhausted all the time. Roll forward to 2018 and I have gained 40lbs back and I am now 225lbs and 5"3. It's rather depressing. Some of the weight gain came after I began taking phophorous -not sure why-because it tanked after my infusion and more weight was packed on because I felt defeated and began eating more carbs. I also developed hyperthyroid which caused weight gain-never realized that was a thing but I noticed the weight coming on quicker once my PTH rose. Needless to say I am going to try to get my food in order and see if this surgery works for me but I was wondering if anyone else has gained weight with the DS and if they were able to get it off and how. Also would like to know if anyone had revision surgery to increase weight loss. My surgeon does a one size fits all DS and I remember reading somewhere that this can sometimes backfire for folks that are shorter and that the HESS method is the more appropriate method to go with for DS. My doc did a 5 oz sleeve and 100cm common channel on all patients and did not use the HEss method. Some of his patients do better and others are like me so I think there is definitely something to getting a DS that is not one size fits all. I recognize that my eating more carbs because of my frustration isnt helping so I'm working on that but I was strict as hell early out and I still didnt lose as quickly or as much as expected so not sure what that was about. Trying to figure out if I should have another surgeon take a look at things and see if they can help me. Regardless, I am trying to get my food cleaned up first to see what the surgery can do for me but I'm struggling to get off carbs.

the DS fits all is a disservice. The short older obese female is the one that will have the most problems with a DS that is not tailored. You state you developed hyperthyroidism? Do you mean hypothyroidism? I would suggest contacting Dr Keshishian to help you, give you options, etc.

Hi there. I fall into the shorter older obese category. Yes, I developed HYPERparathyroidism NOT HYPO. From what I have read those with hyperparathyroidism can gain weight also. I'm increasing my D and calcium to help lower my parathyroid hormone.

I think it is more common that people get their sleeve tightened as opposed to shortening their CC. While I think your point is right about the Hess method, a CC of 100 isn't exactly long.

Try getting back to protein first and plenty of liquids, lower carb. Sometimes just getting back to basics can help. You might also want to look at Intermittent Fasting (IF). Some DS people have done well on that kind of regime (still high protein low carb).

Are your thyroid issues straightened out now with medication? Was that the issue with your PTH and not anything to do with calcium absorption from your bones? That is the usual case when we talk about high PTH.

Pete

Hi there. Thank yo for your reply. I am going to try to reboot my eating plan and see what happens. In regards to my thyroid. It has been slightly above normal range 80-90 ( 0-74) for over a year now but in the past 3 months it jumped 50 + points to 147 and I'm not sure why. I had multiple venofer infusions from Dec 2017-April 2018 and that is the same time my PTH jumped 50 pts so I'm wondering if there is any connection. I am seeing an endo tomorrow to try to figure out how to get my PTH down. I am not on any meds for Parathryoid at the moment. DS folks have been telling me to up my vitamin D and calcium significantly and see what happens. I'm hoping that does the job. :(

That does seem to be the answer that helps most people with elevated PTH. Some people do both some regular calcium and the Upcal D instead of just one or the other. You might also look at K2 (different from K1 for blood clotting) and magnesium, both good for calcium absorption into the bones. Good luck with the endo.

People should probably know that you cross-posted this in the Revision Forum and got a few answers here including input from someone who has gone through a DS Revision.

Just an fyi. =)

A 5oz starting sleeve is an awful big start. I can only imagine what you've stretched out to. I started with a 2oz sleeve and a 100cm cc. Today I can eat a 5-6oz steak with a salad and half a potato, easy when going out to eat. If anything, a sleeve tightening may be in order, but I wouldn't even consider it until you really pushed yourself first. Losing regain is much harder than the first year was, but many have done it successfully.

Hi Valerie! Yes, I'm going to try to reboot and see what i can do. I essentially gave up after a while because I was so frustrated but am trying to work the tool now as best I can before I check into other options.