Revision from Loop to Traditional DS

I currently am working on getting my Loop DS revised to a Traditional DS. I have a long, sordid story but here's the shortest version I can muster.

• I had the LapBand in 2012 at 500lbs and took 1+ year to lose 100lbs. Gained it all back and then some.
• Was a guest on a TV show. I went to a fitness camp for 6mo. Worked my a** off and lost 125lbs "naturally."
• I was given the opportunity to have free surgery (in exchange for show publicity) to remove the band and revise to any other surgery I wanted. I asked for Traditional DS.
• Surgeon wanted to do it in 2 steps - Had the LapBand removed and sleeve portion completed in Sept. 2018 at about 390lb.
• Then, the surgeon refused to completed the rest of the DS. After much arguing with producers and whatnot, they sent me to another surgeon who only did Loop DS. Settled on the Loop (as it was my only option) in March 2019 at about 340.
• Got pregnant unexpectedly weighing 270lbs in December 2019 - Healthy, normal pregnancy, baby & delivery in Aug. 2020. Weighed at 300lbs at delivery.
• Severe case of post-partum depression/anxiety, hospitalized several times after delivery. Lost 60+lbs in the first 2mo after delivery as I wouldn't/couldn't eat due to symptoms. Got to 240lbs in March 2021.
• Several months and medications later, doing better. I've since regained back to 290lbs+ and now after really watching diet/exercise, I can't get weight below 270lbs or so.

All in all, from the time I had the "Loop" part of the DS done I've only lost maybe 70lbs - Almost 20 of those pounds I've been able to maintain of that weight loss was from skin/fat removed during a Panniculectomy I had done in 2020.

Here's my dilemma: Even with consistent & restrictive diet/exercise regimen in place, I can't break through this barrier. I've never once had any issues that people talk about. (Diarrhea, malabsorption, etc.) Which is great, but I went through the most of the last few years without taking any vitamins and my numbers are perfect...And my weight doesn't budge. I also suffer from extreme reflux - The primary reason I sought revision in the first place. This tells 2 BIG things - My surgery is no where near restrictive enough for my body. And 2, I really need to commit to my vitamin regimen..

I have Medicaid right now and they have approved revision, but I believe that was to gastric bypass. My surgeon declined surgery at all, saying I've already had 3 surgeries and there was nothing more he could do...And my tests to view the damage from the reflux (even though I aspirate frequently and have thrown up in my sleep) weren't bad enough to warrant any changes. He also said a bypass might make me gain weight.

I want a 2nd opinion and I want to go to traditional DS. My common channel is 300cc and I feel like I'm still always hungry...And I've always been able to eat more than I felt like my other sleeve or DS counterparts could. I remember eating my first solids and crying, because I set out my portion and I was still hungry shortly after...It was like the band all over again. I have been so blessed to come this far and TONS of doctors say, "You should be proud of how far you've come. Most people your size don't make it this far." But going 2/3 of the way isn't good enough for me and I know in the depths of my soul that this isn't working the way it should because it wasn't as "aggressive" as it is meant to be. I'm upset because I didn't get what I asked for in the beginning and not am being punished for having too many surgeries. I understand the risks and I don't want someone to go in and hack away at whatever is left...What I'm asking is someone to go in and consider what I'm telling them - My body needs more restriction than whatever has been done before and perhaps more than "average." I really think my genetics are playing a huge role. I mean, I'd be a GREAT candidate for surviving a long winter & I would have been quite the catch a few hundred years ago, but it's not serving me or my family right now.

My biggest question: Does anyone have any information on revision from Loop to Traditional DS? Has anyone had this revision done themselves? Anyone know of a good surgeon I could reach out to that would be willing just to give me encouragement? The surgeon I had basically told me it was all behavioral. I have a counselor, I'm tracking all my food/exercise and will continue to press forward regardless...But I want a second opinion. I just have this gut feeling there's more to my inability to lose.

Thank you for taking the time to read if you made it this far!!

In would recommend you consult with Ara Keshishian. That is my best suggestion. Google him. Very well known and respected. He takes the tough cases.

I don't mean to sound condescending but I don't believe your identifying the problem correctly. Based on the info above, you could have started with the DS and you'd likely be having a myriad of issues now including excess weight. You should consider if not taking required vitamins means you were never really ready for wls, and reconsider excellent advice from your doctors about being a live fat mom vs a dead skinny one.

I've been living with the SADi DS for almost eight years with the same 300 cm length cc. It works extremely well and I have zero excess weight eating virtually anything. My challenge is being responsible about health reasons for eating but not weight gain.

Getting an expert consult is a good idea but you should be sure the surgeon is a true expert on all wls options, and maybe a therapist to help you evaluate the risk of another surgery for you and your family.

I appreciate and respect the honest response and have considered all of the things you've mentioned. I have been working with a therapist consistently and my primary doctor to identify the root cause of the issues, both physical and mental. I am currently looking into finding a naturopath to hopefully help me find some other solution that my other providers and I have not yet thought of...Or at least do in conjunction with what I'm already trying. (I'm starting to wonder if there is a hormonal imbalance, especially given my challenges post-partum.)

I should also add that the reasoning behind the vitamins has more to do with the reflux itself. I've tried all kinds of brands and versions (especially while pregnant) but the flare they caused in my GERD symptoms were intolerable most days. My PCP recommended we focus on symptom management for now and monitor vitamin levels frequently until a GI specialist or surgeon was able to evaluate me...And here I am. (I still try to supplement calcium, iron and vitamin D at the very least.) Since my surgeon denied the revision, I am still awaiting contact from the specialized nutritionist to discuss how to tailor my diet to fit the needs of my DS but also curb some of the reflux issues. Trust me...I'm willing to try just about anything at this point - I'm just admittedly frustrated.

The only thing I can say for sure is that no two people are exactly the same and that is why there are so many surgical options out there still in existence. Some people who have had the same surgery say they eat everything they want without gaining a thing, others say they can't eat indulge in most anything without all day trips to the bathroom. I just can't envision myself continuing down this path without at least another opinion of someone more familiar with this kind of case.

I agree and wish you all the *******so apologize if I sounded like a jerk. It's a hard path with a lot of obstacles but still well worth it.

yes you can revise from SADI, loop to BPD-DS. I will send my a PM

Can you send it to me too?

Have you been diagnosed with Lipedema? It's a fat disease that makes it hard for people to lose weight. I would try to do some research on it. Some insurance companies are now paying for liposuction for people with this diagnosis.

I was given the loop procedure when I had asked for and paid for the traditional.

I also had reflux but because the loop was done incorrectly, I also developed bile reflux, which is different. From what you are saying, it sounds like you are also refluxing bile.

I ended up paying to revise the loop to a traditional DS snd the bile reflux went away. I still have some acid reflux but not the bile.

So, yes, it is possible to revise but make sure you have a surgeon who knows what they are doing.

Thanks for sharing