DS to RNY - is this possible?

Sorry, I do not have any experience.... but, Can I suggest a second opinion??

Maybe a visit to a nutritionist??  **Remember, protein first!!**

Take Care!!!
-Jamie

You shouldn't have any WLS if you can't be compliant with the rules. You are not compliant with the surgery that has the fewest eating restrictions, so I don't know why you think having more food restrictions and bad consequences will improve things. Carbs will give you digestive issues and cause weight gain, and sugar will cause weight gain. With RNY it will happen faster, and with more issues. There is less weight loss, and more regain with the RNY.

You also need to have your labs checked frequently (like every 3 months!) to tweak the supplements and only move it to annually when your levels are all good, which it sounds like you didn't do. The RNY will require supplements too, but slightly different ones.

You need a magic wand, not WLS.

I'll tell you how she will be holding up in 6 years --- very well, or fighting to her death to do so.  She is proactive about her health, here almost everyday offering advice to pre-ops & newbies, and learning herself.  She doesn't take her health for granted.  She is educated about her anatomy and aware of  what that means.  She listens to her body.  She knows that she cannot rely on doctors to read her labs --- she does it herself and understands not only what the results mean but trends the results against previous draws.

We don't deal well with excuses here.  We'll help you find answers, but not bother if you aren't going to be start being proactive.

I have learned more here, especially on the DS board, than from my surgeon.

One big thing I learned before getting the surgery, is that most pcp's don't know squat about the DS, and many surgeons are familiar with RNY, so give out RNY advice and nutrition guidelines. That has been true of my surgeon as well.

I also learned to find a pcp that was open to working with me (she was not familiar with DS either) and stick with her. I dumped one Dr that supposedly worked with WLS people, but did not listen to me, and insisted on calling another misinformed RNY doc to consult about me. I'd rather have a clueless doc that wants to learn, over a doctor that THINKS he knows, but insists on bad information.

I got the list of labs here, from more experienced DS folks, and gave it to my new doc, and said "this is what needs to be checked, XX often..". I think she assumes it was from the surgeon, and I'm not going to correct that, because the surgeons list was for RNY, and doesn't even cover the fat soluble vitamins like we need.

From the other DS people who have gone before me, I learned that I really have to be an advocate for my own health, and not let things get too far out of whack before correcting them, and to INSIST on the proper treatment. I'm pretty quiet, and not very confrontational, so this does not come naturally or easily. You didn't have much benefit of following those before you when you started out, so I will suggest you go to the DS board if you haven't already, since there is almost always someone there that is familiar with whatever you are dealing with.

Aside from the diet issues, you likely need a round of antibiotic, as it sounds like you may have some bacterial imbalance in your gut. The bypassed intestine can get some overgrowth in it. A short round of Flagyl should fix that, and then a daily dose of probiotics can keep things in balance.

I really hope to see you on the DS board. Your problems aren't normal, and should be fairly easy to resolve.

Sounds to me like you could use a round of Flagyl, to start with.  Then a better place to get supplement/nutritional information - try the DS forum here on OH for starters.  Then, if you're still having issues, find a better doc.  The one you're talking to now is apparently a quack.  Why the hell would anyone revise your STOMACH for intestinal issues?  IF and I say BIG IF, you need a revision, it would only be to lengthen your common channel - that's all the RnY is going to change to help your gas/diarrhea issues.  I still don't think that has anything to do with it, and a revision of any kind, let alone to an RnY is waaaay putting the cart before the horse.  Weight gain with the DS is the carbs, that's straight forward and simple.  Go back to basics and eat protein, if the weightloss is going to return.

I don't mean this to sound harsh, but have you seen a therapist or pyschiatrist? It sounds like you have some underlying issues that need addressing. Don't get fixated on the fact that some days you can eat carbs without seeming ill effects. If they're causing you problems (like regain, and gas/diarrhea), you really have to avoid the problem carbs and not gamble, or you will be miserable, as you are now.

Please, make a therapy appointment. It's a much easier thing to do than a revision surgery. I'm not going to address the wisdom of a revision surgery, because I'm sure you'll get lots of comments about that. I would just echo one of the earlier posters and point out that the DS allows the most normal eating, so a revision would be setting yourself up for further failure.

You need to discuss your issues with a DS surgeon.  Surgeons who specialize in RNY are not going to have the level of knowledge you need about the DS.

Red

    I can't answer all your questions, but will try to help a little.
First, I don't know who did your original surgery, but would suggest that you consult either with that doctor or with another experienced DS surgeon who might be able to help you get things straightened out. Most people who have problems with diarrhea and/or gas after the DS find that they can greatly improve these problems with dietary changes. Another potential problem might be bacterial overload in your colon, which could be improved with a course of antibiotics.
    About PTH and vitamin D - many DS'ers take 50,000 units vit D daily, or more. You are not unusual in this regard at all. But if you are taking the prescription Vit D, it won't help you. This is because it's oil based, and since with the DS we don't absorb much fat, you won't absorb this vit. D either. What you need is "dry D", which is not prescription but can be easily purchased via the internet either from the manufacturer (bio-tech) or more cheaply from vitalady at vitalady.com.
    Michelle (vitalady) is a wonderful woman who had RNY and knows a lot about the nutritional needs for both RNY and DS patients. She would be very helpful for you with suggestions regarding vitamin deficiencies.
     Also about your PTH - the normal level is 10 - 60 or so, depending on your lab, NOT 8 - 10. So your PTH is high but not as bad as you thought. It's the calcium level that is about 8 - 10.
     Are you taking the right vit D? Are you taking the right calcium, and enough of it? Calcium carbonate won't help you, you need calcium citrate, and probably several doses daily. Check the label on the bottle - a "dose" often consists of 2 pills, not one. Don't be deceived by a normal serum calcium level - your body maintains this by stealing calcium from your bones,which it does by raising PTH. So you might not be getting enough calcium along with the insufficient vit D.
    Bottom line, I have never heard of anyone going from DS to RNY. I'm not saying it couldn't technically be done, just that it would be exceedingly rare. And if anything, you would probably have more problems with weight regain with RNY, not less, as there is so much less malabsorption with RNY. Vitamin deficiencies also occur with RNY, so with either operation, you need to get some assistance getting more information and taking the RIGHT supplements. And bad smelling gas - yep, happens with RNY also. And diarrhea. Or constipation. Just as with the DS, the gas and diarrhea issues are usually diet related, so if you continue to eat the foods that set this off, you will continue to have this problem with either operation.
    Worst case scenario should be a revision of your DS by lengthening the common channel, rather than switching to RNY, but with proper supplementation even that usually isn't needed.
    Come on over to the DS forum and ask more questions about the vitamins and such. There are a lot of well informed people who can help you. Jumping straight to any kind of revision surgery usually isn't the best approach.

Larra