DS to RNY - is this possible?

Hi again!
     I suspect you have either been taking either oil based vit D all this time, or an insufficient dosage, or both. The "dry D" just isn't found at drug stores. Check out vitalady's website today, and even write her an email for assistance. She is very generous with her knowledge.
    I'll provide what knowledge I can. 1000 mg calcium citrate probably isn't enough. I take 1800 mg calcium citrate in divided doses and I'm going up a bit even from that as my PTH is still just slightly too high. I was low on vit D at one point, but with the 50,000 units dry D 6 days a week I'm now well into the normal range.
    ADEKs don't help much, if at all. They sound good because they contain the right things, but they contain so little of each vitamin as to be almost useless for DS'ers. We really need to supplement the fat soluble vitamins separately to get enough. I take dry A and dry K in addition to the dry D. The exact amounts that will be right for each person are different, so regular labwork is what will guide you there.
     I'm not sure why you're taking all that B12. Most DS'ers don't have problems with B12, but if you need it, take it.
     And if your original surgery was with Dr. Husted, contact him! He's been in several locations but seems to have settled in KY, and my understanding is that he's good about follow-up with his patients. I met him (once) when he was working in San Francisco and found him to be very knowledgable about nutrition, far more than most bariatric surgeons. Send him an email and I bet he'll help you.
    Reversal of DS - well of course the sleeve gastrectomy isn't reversable, but the switch part is. But again, with the right help, you may be able to avoid surgery altogether.
    Don't give up yet, either on the DS or on yourself. Get ahold of Dr. Husted, I'm very hopeful that he will be able to help you.

Larra

You want to take the vitamin D3. That is the dry form. The prescription Vitamin D is usually D2, which is oil-based.

I would get all my labs together and fax them to Dr. Husted's office. That way YOU will know that he has them and can advise you, rather than relying on your doctor's office to do so. Many of them just don't understand our need to follow up and think that the regular doc can handle things - NOT!

You are right in that a complete reversal is impossible, but that only relates to the stomach part. The outer curvature is gone, gone, gone, never to return again, but the intestines can be put back to the way they were. I personally wouldn't do that, however, as you will simply begin regaining again.

If I were you, I would start with seeking a round of flagyl and/or checking to see if I had C-diff. That is the biggest culprit for terrible gas. Accompany this with limiting your carbs and see how it goes. I would leave a revision of my common channel for the very last option, and that would be if nothing else worked at all.

I agree with the earlier post that IF a revision is needed due to malnutrition it should only be to lengthen your common channel and improve absorbtion.

If you eliminate carb sources and still have serious gas/bowel issues you might want to try alternate brands of vitamins too because some have fillers that cause problems. 

Also make sure that you avoid fat intake in each hour that you are taking your vitamins.   They'll be less likely to malabsorb with the fat.

just my 2 cents - good luck!

Well, I am a long-term DSer, six years out, so I think I am qualified to address some of your issues.

First of all, ALL of these issues are likely to be improved WITHOUT a revision.  You are not doing what you need to be doing on several fronts, but all of them are likely to be fixable to a large extent by stepping back from your current hopeless and helpless behavior and doing what you are supposed to do.

Second, I've never heard of your surgeon being a DS surgeon in nearly 7 years on OH and as an active insurance advocate for DS patients.  I'm not saying you didn't have a true DS, but did you get a copy of your surgical report?  EVERY DSer should have a copy of their op report.  You should know how your DS was constructed; what was the length of your common channel; how long was your alimentary tract; how many cc's was your stomach initially.

Third, are you attending support groups with other DSers?  You should be.  Studies have shown that the average weight loss, nutritional compliance and quality of life is higher among people who attend support groups.  Online support groups such as the DS forum can function as a substitute.  I am frankly shocked and suprised that the DS forum was not your first stop, rather than the revision forum.  You should be trying to work with what you have first, inslead of looking for yet another surgical cure -- especially a surgical cure for what appears to be non-compliance, and a surgical cure that you will be even LESS likely to be able to comply with.

Fourth, holy crap -- what kind of nutritional counseling did you get from your surgeon??  What kind are you getting now??  Your carb intake is OBVIOUSLY a huge part of your weight, gas and diarrhea problems -- did you not know that?  Just because you aren't bothered by SOME carbs (I can eat potatoes till the cows come home without fart or poop consequence) doesn't mean they aren't causing you to gain weight!  A carb is a carb is a carb!  And sugar is absorbed 100%!  And milk products contain lactose which can give NORMIES terrible gas and diarrhea!  You need to get your ass over to the DS forum and DSfacts.com and start learning about the surgery you are supposed to be caring for and start making APPROPRIATE choices, for the sake of your own health and the sake of your family as well!

The DS is pretty much the easiest and most enjoyable surgery to live with IF IF IF you follow The DS Rules and make the choices that you need to make.  You seem to be unaware of these Rules.  Non-DS surgeons are unlikely to be able to help you with this -- in fact, many DS surgeons are incompetent at nutritional counseling.

* Protein?  Where is your disclosure of how much protein you eat?  You don't even MENTION the Prime Directive of 80-100 g of protein/day -- this is VERY concerning. 

*  Wheat flour is THE DEVIL!  DItto lactose and sugar alcohols!  Ditch the sugar and most other carbs until you drop the weight you've gained.

* 50K IU of vitamin D isn't unusual for us -- why are you so surprised by this number and think we would be too?  It's one tiny capsule per day (actually, I take only 3 capsules per week). 

* Iron -- there are other forms of iron which are non-constipating.  Do your research! 

*  How much calcium are you taking?  What kind?  How many tablets (the proper dosage [500 - 635 mg of elemental calcium ] of calcium CITRATE, which is what you should be taking, is TWO tabets at a time)?  WHEN are you taking them in relation to your other supplements (you do know, don't you, that you can't take them at the same time as most forms of iron, right?)

* Probiotics -- are you taking them?  WHY NOT??  Don't you know that you should?  You may need a round of Flagyl first to kill off the bad bacteria which may be part of your diarrhea issue, but you should be taking probiotics, e.g., Primal Defense Ultra, ALL THE TIME.

I'm going to stop now.  There is so much more that you need to learn and to be doing.  Come over to the DS forum and post what you eat on a daily basis; EXACTLY what vitamins and minerals and other supplements you take and when you take them; READ READ READ the posts to see the advice that you should have learned long ago.  Ask questions, but mostly READ -- it's all there for you, you just have to step up, learn and adjust what you are doing.

YOU DON'T NEED A REVISION AND YOU DON'T NEED TO BE SUFFERING!!

 Even though I have been an active, compliant, researching DS patient from even the pre-op phase, I am STILL having nutritonal issues.   You have to be able to take control of your labs and your nutritional needs, because most PCP's don't know jack squat about what a DS'er needs.  Hell, not even my DS surgeon's practice has a clue at this time.    I've been on the phone all day today trying to find a physician who will help me tweak my supplements in order to put my labs where they belong.  I'm not happy with my PCP, my endocrinologist or my surgeon's office, so I'll keep looking until I finally find someone who "gets it."  Dr. Husted is a good physician, and as your DS doc, he should be the first person you turn to.  Please, please, please, listen to the advice of Larra and and others on this board.   You should be taking "dry" D.   You know darn well that the gas issues are because of carbs.  Yes, I do have gassy days premenstrually when it seems that even if I subsist on nothing but protein, I still get gas, but for the most part, my gas issues are very dependent on what I eat.   There are lots of "hidden" simple carbs in foods - in gravies, meatballs, cereals.   I am very sensitive to wheat, rye, oats and barley, as they all contain gluten.    Please come over to the DS forum.  There are people there who can help you.   I'd at least give it your best shot before relying on a less effective surgery that is going to create NEW problems of its own.  Deficiencies still exist with the RNY, and if you can't be compliant with the DS, what makes you think you will be able to with the RNY?

I can only speak from my experience, but, my suggestion is this:

RESEARCH, RESEARCH, RESEARCH!!!!!  Here are some useful links for a start:

www.dsfacts.com/

http://www.duodenalswitch.com/

http://www.lapsf.com/weight-loss-surgeries.html

And, Michelle (Vitalady) has MUCH info on RNY and DS vitamin schedules... She had RNY surgery.  But  she is SO AWSOME!!!!
http://www.vitalady.com/

http://www.obesityhelp.com/forums/revision/a,messageboard/bo ard_id,5360/

http://www.obesityhelp.com/forums/ds/a,messageboard/

Check out my profile, ask questions... go to other boards & POST questions!!!!  You have gotten some REALLY GREAT replies, granted, not alot of sunshine & rainbows, but the people who have replied to you DO CARE for you & give a **** about you & YOUR HEALTH!!!!!!

Take Care
-Jamie

First off -- ditto what everyone else said, but I wanted to add about the bowel issues.

Simple Carbs (flours, pasta, and sugars)
Artificial Sweeteners (anything ending in 'tol)
Lactose Intolerance

All of these are known to cause gas and bowel issues.  You can try eliminating one group at a time and see what changes occur.  Ditto on the need for antibiotics.  An imbalance can occur in the bowel with the bacteria.  An antibiotic like Flagyl will kill them off, then you replace with probiotics to restore a good balance.

Ive seen a few re-lose more than what you gained back by simply cutting back their simple carb use.  There's no reason you can't do this, too.  Do come join us on the DS board.  There's lots to learn from many of us who have been there, done that!

Your surgeon does not appear to be a 'real' DS surgeon---first red flag.

You do not seem to know much about the DS---second red flag.

Research, and find a better doctor.