DS or RNY

Hello everyone. I am new here. I had the RNY in August 2013. I lost 100 pounds only to gain approximately 150 back. I honestly feel that my medications in part contributed to the regain. I can pinpoint to approximately 2016 as to when my regain started. My mother passed away after sitting in the hospital for 3 weeks waiting for her to pass. I was traumatized by this. I am a RN and have been a nurse for 21 years but had never had anyone that close to me pass or been in the position of waiting. I had always been the healthcare professional. If that makes sense. Anyway I started to have panic attacks and was started on Buspar and abilify also got with my antidepressant Effexor. I have had adjustments made with increases in the meds since then.
Anywho I am looking to get a revision but am uncertain which would be best for me the DS or have the RNY revision. The program that I would like to use does not offer the DS. This program is only an hour away. The program that does offer it is approximately 2 1/2 hours away. Any suggestions?

I am sorry for your loss and for what you went through. About 50% of people who have weight loss surgery and loss 100 pounds gain back at least 50 by the end of five years. I worked for a while with a psychologist who specializes in weight disorders, and she told me that being on those medications is almost a guarantee of weight regain. Is it possible to get off of that medication?

An RNY reversal is not going to make any noticeable difference in your weight. Average loss with an RNY revision is 20 pounds. Investigate the DS program carefully. Ask to speak to their patients who have had long term success with a DS revision and don't be too surprised if there are not any. You may have to keep searching and travel to find a program that will help.

RNY to DS is a complicated procedure and there are very few surgeons who do that. There are various modified DS procedures. Do a lot of research and chose carefully. I hope you will post again and update us on your progress. Wishing you the best.

Distance means nothing. It?s not uncommon for people to travel thousands of miles for surgery. Surgeons are cutters. After you heal from surgery there is seldom a reason to see them again. Very few surgeons have an aftercare program worth attending. I can only think of 1 exception. There are probably others but for most surgeons it is another revenue stream they use to push bariatric products. And usually, poor nutritional advice.

What?s important is to get the right surgery for you. And be sure you know what you are getting. A real traditional DS is a 2 anastomosis surgery. And you want a relatively short CC(common channel 100cm or so). There are lots of procedures the surgeons are calling a DS that are not the same. Look up SIPS/SADI/LOOP. Some people say they are just as good. But one surgery has already failed you and if I was in your place I would want the real thing. Anyway, educate yourself on what?s out there and question your prospective surgeon. Next learn about our protein and supplement needs. If you are not willing to take the pills and eat properly the DS is not for you.

RNY to DS is a big surgery. There are not many surgeons who do it. Make sure yours really does! Do they leave you with a pouch? Or do they give you a real stomach? Is your pyloric valve still there? Learn.

RNY to me is synonymous with failure. 20 years ago when I had my DS, I was one of 10 women I worked with who had surgery. 1 band, 8 RNY, and 1DS(me). Today I and 1 of the RNY people are normal weight individuals. All the others are bigger now than when they had the surgery. A standard proximal RNY bypasses so little that the body has usually adapted by around the 2 year mark. That's when the regain begins. There is nothing available today that is better than the DS. But it?s not effortless, you still have to do your part.

Best of luck!

Sorry for the strange question marks. It is not me.... I edited and took them out several times and they won't go away!

Thanks for the replies. I have made an appointment for a seminar with a doctors that does revisions close to my home. Today I called St Vincent in Carmel to see what they have to offer. A nurse is going to be calling me back. Dr Inman is the physician that I would like to see. She does the DS. Actually she was supposed to be my original surgeon but at the time she decided to only be affiliated with one hospital and it wasn't the one I had to go to. Even though it is a drive I want to talk to her and see what she says. As for getting off my medication for anxiety and depression I have no idea. I don't see a specialist. There are none around me. Just my PCP.

In your situation, I would certainly strive for the DS, as what revisions that are typically done for the RNY are minor tweaks - installing a band over the bypass or one of several stoma tightening procedures, none of which seem to have a very good track record for stimulating much additional weight loss.

I don't know if Dr. Inman does the RNY to DS revision - that is a complex revision that is another level above the basic DS, and few surgeons do it - but she would be a good start. I know that Rabkin and Keshisian out here in CA do them and I believe that Roslin in NYC has done them (and there may be others in the NY crowd who do them) but you usually have to cast your net wide in finding the right doc.

As Patty noted, worry more about getting the right procedure for you than how close the surgeon is. Most in the DS business are used to dealing with travelling patients and doing their pre op and post op care and longer term sustaining care remotely. I travelled to SF from LA just to get my VSG from the Rabkins because there was no one in the LA area at the time who had much experience with them, and they had been doing them for around twenty years by then, via the DS. So, it is certainly worth travelling to get what you need, if you can swing it.

Another option that some will promote in your situation is to convert your standard proximal RNY to a distal RNY, which combines your RNY pouch with the greater malabsoprtion of the DS. This tends to be a fairly problematic procedure and I suspect that the main issue is that the surgeons rarely do them, and don't really appreciate the different nutritional and supplement requirements, and their patients suffer as a result. Most practices that do the DS do so as their primary or preferred procedure, so they are well versed in its requirements and whats needed to keep their patients healthy in the long term. My wife has been on some of the meds that you mention and they haven't been a problem with her DS; there might be adjustments to be made, but between the surgeon's experience and that of other veteran post ops in the practice, they are quite manageable, as the knowledge base is there to draw from.

Hello I had the RNY 2002, lost 85 lbs then gained all but 16 back.In 2017 I had the DS. It's not perfect and not the speed loss that people with WLS are used to but it works for me. Occasionally I do have increases but for the most part I lost about 50 lbs first 2 years and about 10-15 lbs each year since (COVID doesn't count does it?). I also found that the wasting isn't as bad as the RNY. I was also on Buspirone but it is an appetite stimulant so I have made the choice to take it on days I know will be stressful. My DR. also prescribes phentermine, which I only take on work days as that is my food trigger place.