From a Sleeve to Gastric Bypass

 yes i researched the DS and found there is a higher rate of  Vitamin Deficiencies.. and that you live in the the Bathroom LOL  and the weight loss is much higher and i  do not need to loss that much i have 95 lbs  to go .. I talk to my doc about it and he can do  the DS but for me it was  not the right one ..

If i did it when i was 415lbs  then that would of beed a diff story but  the way we did it was a safer way for me  to loss the weight..

 and nothing came out of my pockit Money wise beside  my co- pay .. i both surgerys were coved under my Inc ....



And, now, if you don't lose the weight you want with the RNY, the ONLY surgery available to you will be the ERNY which creates more malabsorption and vitamin/protein deficiencies than the DS ever would have!  If you are worried about spending time in the bathroom, just wait until you need to get the ERNY with a 50-75 cm common channel - shorter than the average DS!   OMG!!  

This doctor did you a disservice.   What kind of IDIOT surgeon would cut up a sleeve into a pouch?  No self-respecting DS surgeon would do that, unless the patient had something else going on that necessitated it.   In order to get correct, valid information about the DS, you need to go to a surgeon who has lots of experience doing  the DS surgery.   Your surgeon could have re-sleeved you.   Do you know what size your sleeve was made originally?   They can be different sizes you know, depending on the needs of the patient.   Maybe you needed a smaller one to begin with?

You mentioned that BOTH the sleeve and the RNY were covered under your insurance.     Did you ever consider that perhaps the DS would not have been covered and rather than fight for a better surgery for his patient, your surgeon took the "easy" way out and gave you the surgery that he could get approved easier?  

DON'T TRUST DOCTORS!!  THEY ARE NOT THE ALTRUISTIC HEALERS OF YESTERYEAR!   MEDICINE IS A BUSINESS LIKE ANY OTHER AND THEY ARE ALL COMPETING FOR THE SAME PATIENTS!!  WITH THE ECONOMY FAILING AND PEOPLE LOSING THEIR JOBS AND INSURANCE, DOCTORS WILL PUSH WHATEVER SURGERY WILL PUT $$$ IN THEIR POCKETS FASTER!

WOW .. IM SORRY THAT I OFFENDED  ALL THE DS PPL ..with my poor reasearch .. =/  

 when i said my doc was  going to yell at me it was me being silly .. he would NEVER  yell at me .. or  would i let him yell at me .. 


Thanks  to who every said that the revision loss slower. that make me feel better  =)

and yes  the doc my my pouch out of the upper part of the sleeve..




 

You didn't offend the DSers -- what your surgeon did offended and upset us on your behalf.

I was as serious as a heart attack about the possibility of legal action.  You could be saving someone else from a lifetime of hurt by helping to make it clear to all bariatric surgeons that they must give ACCURATE and COMPLETE information about all alternative treatments, and not steer patients to the only surgery THEY are competent to perform by withholding or misstating information about other options.

Whether or not you are happy now, or will be happy in the future with what was done to you, you were not given the opportunity to give fully informed consent if what you said your surgeon told you about the DS is in fact what he said.  That may be actionable.

Nobody is upset with YOU -- we are upset with your surgeon on your behalf, and angry that this was done to you.

Jill,

I can understand how the replies to this post made you feel like you were getting jumped on. I just want to clarify that no one was offended by you or angry at you. This is not about you, personally. Everyone who commented is furious with your surgeon, who did something that was minimally unethical and possibly criminal.

Unfortunately, the warnings he give you about the DS were all lies, either because he is misinformed or because he does not perform the DS. With your already existing sleeve, it would have been both less drastic and more effective to convert you to a DS.  Instead, your sleeve has now been destroyed and you are left with a less effective revision.

With all that said, you have the RNY now, and I am sure you will do your best to make it work. You did remarkably well with the sleeve - all that weight loss is a huge accomplishment. You should really be proud of that. Your last 65 lbs now are the home stretch.

Again, depending on your current diet, you might want to up your protein, and lower your carbs. Be sure you are measuring your portions as well. As Tom said, getting activity in can help as well.

I really do wish you all the best.

Jenna

You haven't offended anyone, but we do all think you were misinformed and uniformed about your surgery.

I'll try to explain it to you.

1.  With the sleeve, you were already half way to a DS.  What your surgeon did was actually take you backwards, and put you at risk for complications and unpleasant side effects further down the road.  And in my opinion, put you through this with little probability of increasing your weight loss potential.   

2.  With the sleeve, you HAD a fully functioning (albeit smaller) stomach, with your pylorus intact.  This is a very important point for you to understand.  The pylorus is the natural valve at the bottom of the stomach that passes your stomach contents to your intestines.  As your body's natural and functional valve, the pylorus is able to relax and contract on its own to regulate the passage of food.  With the RNY, the surgeon actually bypasses the pylorus, rendering it useless.  The RNY uses an artificially created stoma (hole) created in your stomach that empties directly into the intestines.  Big difference here!  Because this stoma isn't able to naturally contract and relax, you get dumping (sickness when you eat the wrong things), and also things can get stuck. 

3.  You have incorrect information about vitamin deficiencies.  RNY'ers can have vitamin deficiencies, tool, just different ones.  Yes we have to be vigilant about our supplements but most of us are just fine.  He could also control this by giving you a longer common channel.

4.  You have incorrect information about bathroom issues.  No DS'er that I know of is "in the bathroom all day".  I am a recent pre-op and go once a day.  Trust me, I asked and asked and researched the hell out of this one.

5.  Your surgeon most likely gave you incorrect information by saying he is able to perform the DS but chooses not to.  The DS community is a close knit one, and we all know of the names of the surgeons performing the DS in any reasonable numbers.  It is a much more complex surgery that requires specialized training and experience.  Not something a surgeon will do "once in a while".  What is very common is that a surgeon says he "could" do it, but doesn't recommend it.  We call this "bait and DONT switch" surgeons.  PLEASE - if any preop is reading this, when you consider the DS make sure you get the facts from a true DS surgeon (list on www.dsfacts.com).

6.  Your surgeon gave you incorrect information about not needing the DS to lose only 100 pounds.  Especially since you started much higher than where you are.  Lots of DS'ers have 100 lbs or so to lose.  The DS can be customizable by patient by changing the length of the common channel.  

7.  Since now you are into your second surgery, if you still fail to lose your excess weight any revision  for you will be much more complex, if it's even doable at all.  I shudder the think of your sleeved stomach cut into a pouch.

8.  Although there aren't many long term studies on the sleeve, most show that the weight loss is similar (or only slightly less) than the RNY.  So, basically you could have gone through all this for nothing.

So yes, there are many of us upset at your situation (not you), and I hope this helps you understand why.  I wish you the best of luck on wherever it is that you go from here.  If you feel like you want more info, you should come visit us on the DS board.

Jillian,

Let me add my voice to the others in saying that no one is angry or upset with you; we are all furious on your behalf at your "surgeon".

You now have RNY, the best thing you can do for yourself is to learn all you can about what you have and what the consequences are for what you have. Then start working your RNY as best you can. It can be done, there are many successful RNYers, I was successful with my RNY for 15 years before losing control. Hopefully you will be more successful than I was.

I wish you well; just hope your "surgeon" is disbarred so he can't do such a thing to anyone else.

Kerry

Thank you all  for your Post ... I was  the one that read up on the DS and  got the wrong info from a diff site and from diff ppl   .. 

well i bumped up my working out and  and watching my card  intake and meats and veggys .. and ill see my doc on the 22  ...


and  thank you all for all the new info  that i have leared and i will talk to my doc about it when i see him

Jillian

Sorry that you are having a difficult time Jullian.  I hope it all works out for you.

I don't understand why docs are doing a sleeve to RNY.  The sleeve is the first step to the duodenal switch.  Oh, wait a minute, these docs don't know how to do the duodenal switch !

Best,
Leila

As a future RNYer, let me chime in here.  I am relatively new to all of this and have not yet had my surgery.  I have done hundreds of hours of research.  I looked into DS even though I only had about 100 lbs to lose.  DS can cause vitamin deficiencies but so does RNY.  Perhaps RNY is less but since you already had the VSG I can't understand why he advised you to do what he did other than financial considerations.  I ultimately decided on RNY due to my age and other factors. I do believe the other posters are correct.

It's not a matter of upsetting those who have undergone the DS.  The bottom line is that the doctor did you wrong--he probably can't do the DS.  He should have had the ethics to refer you to a DS surgeon who could have offered you the best options for success.  What he did is beyond belief.

I wish you the best.  Hang in there.

I know a lot of people start the 5 day pouch test to reduce carbs and get back on plan - it looks like this:
http://www.5daypouchtest.com/plan/theplan.html

Days One & Two: Liquid Protein
low-carb protein shakes, broth, clear or cream soups, sugar-free gelatin and pudding.
Day 3: Soft Protein
canned fish (tuna or salmon) eggs, fresh soft fish (tilapia, sole, orange roughy. 
Day 4: Firm Protein
ground meat (turkey, beef, chicken, lamb), shellfish, scallops, lobster, fresh salmon or halibut. 
Day 5: Solid Protein
white meat poultry , beef steak, pork, lamb, wild game

So your plan to reduce carbs seems good.  Make sure you hit your protein and water targets as well, and some exercise and hopefully things will start moving again.