LapBand to DS Revision

Hello everyone. This is my first post. I am nearly 7 years out from the lap band
and have not achieved the results I would have likes. My high weight was 377 and
I lost nearly a 100 pounds, However I fluctuate to between 305-325.

I am seriously considering a conversion to the DS and wondered if anyone had any
experience. Likewise I would be interested in feedback from other DS patients as
well.

1) Any recommendations on physicians (I am in Atlanta so Dr. Smith seems
logical).
2) What has been your experience with gas and diarrhea (I recently started
glucophage/metformin to jump start my weight loss. I'm not diabetic. I can't
really imagine how the diarrhea and gas from DS could be any worse. Multiple,
frequent urgent bathroom trips for foul smelling diarrhea and gas. Thanks to the
tips I've learned from this board so far control the smell).
3) It seems that vitamin side effects are manageable but possibly expensive?
4) With the band I am hungry all the time and have 'soft food' syndrome. In
other words, will I be able to eat chicken breast after the DS. Will I be hungry
all the time? With the band sometimes you flat out can't eat. Does this happen
with the DS? It can be embarrassing when going out to eat that you can't eat
anything.
5) In terms of diet what can and cannot be eaten. Are things like cake and ice
cream a no no or is it a consume at your own risk scenario? Is moderation a
factor?
6) How soon were you able to return to work?
7) To be at goal (BMI < 26) I need to lose 140 pounds and anything over that is
gravy. Is this realistic?
8) What is the likelihood for insurance coverage of a revision. I have Humana. I
am still more than 100 pounds over weight but am pretty healthy.
9) How long is your limb and do you think that had any affect on your results
and side effects.

Thanks in advance for the information. I will probably cross post this to other
boards if that's ok. Thanks!

Ann

I have a sleeve so I can tell you that your hunger is likely to go away. The only time I am hungry is if I overdo with white carbs.

Sure, your goal is very realistic.

Ins is changing a lot, many are opting for the 'once in a lifetime' WLS rule. If you still have WLS coverage and they do revisions you should qualify on your BMI alone.

Cake and ice cream, consume at your own risk.

No, an inability to eat (such as with the band) does not happen to sleeves or DS.

Sorry, those are all I can answer.

Ann, you should post this on the DS board too. I do know that there are a lot of former banders who had revisions to DS. I'm sure they will pipe in on their experience.

Maddie

Thanks so much for your replies. I am not so sure our insurance covers surgery but we are up for renewal and I have a say in our carrier and covergae (lucky me). If not I will be a self pay and will be researching doctors like crazy.

I am planning on attending a support group / information session this week to get the ball rolling. Again thanks for the help!

Ann

 
If by some chance you do become self pay I'd be looking at heading out of the country.  Ungson is in MX, there are others but I do not recall their names in other countries.

Thanks I am already researching heading out of the country.  What about your Dr and Dr, M in Brazil?

 
My doc does the procedure but only when Ungson is assisting.  He said that DS is an art and a skill.  He has the skill, he's not sure about the art.  The advantage of using my doc and Ungson is that it is cheaper that going to Ungson directly.  At least it was when my friend just revised to DS recently.  It was $1K cheaper to go to Ungson through my doc.  I know, two docs and less money, makes no sense.  I can only assume my doc isn't charging for his services to get the DS time.

Dr. M in Brazil is great, I know him by rep and research but not personally.

1) Any recommendations on physicians

I don't know for certain that Dr. Dennis Smith does revisions. I think Dr. Hugh Houston in Nashville does, and I woudl recommend Drs. Rabkin and Keshishian in CA, Greenbaum in NJ, Husted in AZ, and Gagner in Canada.

2) What has been your experience with gas and diarrhea.

The only diarrhea I've had was either immediately post-op, when it was a case of liquid in/liquid out, or the two occassions I've had food poisoning. Gas---depands on what I eat. Yes, it stinks. Has since birth. (*grin*)
.
3) It seems that vitamin side effects are manageable but possibly expensive?

Define 'expensive'. I take two multis a day, which cost about $10.00 every two months, one each A and D @$40 every THREE months, lots of calcium @ $12 a month, iron at @12 a YEAR, B complex @$9 every three months, and C @ $3 every two months. My labs are all in the 'normal' range, but I do have to 'tweak' them from time to time.

4) With the band I am hungry all the time and have 'soft food' syndrome. In
other words, will I be able to eat chicken breast after the DS. Will I be hungry
all the time? With the band sometimes you flat out can't eat. Does this happen
with the DS? It can be embarrassing when going out to eat that you can't eat
anything.

I am nearly seven years post-DS, and I have yet to run across ANYTHING I can't eat. And tolerate well. Except too much white flour/sugar can give me excess gas.

5) In terms of diet what can and cannot be eaten. Are things like cake and ice
cream a no no or is it a consume at your own risk scenario? Is moderation a
factor?

See my answer to #4. (*grin*) When I say there isn't ANYTHING I can't eat, I mean it. But yes, moderation is the key. Fortunately, the DS has given me the ability to eat and be satisfied with moderate amounts.

6) How soon were you able to return to work?

My DS was done open, but I was able to work by two months post-op. By three months post-op, I was working in my garden all day sometimes.

7) To be at goal (BMI < 26) I need to lose 140 pounds and anything over that is
gravy. Is this realistic?

Yes.

8) What is the likelihood for insurance coverage of a revision. I have Humana. I
am still more than 100 pounds over weight but am pretty healthy.

I'm totally clueless on this one.

9) How long is your limb and do you think that had any affect on your results
and side effects.

My Common Channel is 90 cms. I don't have the numbers on my alimentary and bilio-pancreatic limbs ready to hand, but these DO seem to be important.

I am NOT a revision patient---just thought you could use some feedback from a long-time DSer.

I haven't heard of Dr Smith on the DS boards.  Are you sure he does DS and revisions? 

Yes he is listed on DS Facts and on his website. Also there are several on the boards that have used him.

http://www.dsfacts.com/North-American-Duodenal-Switch-Surgeons.html

http://www.advancedobesitysurgery.com/duodenalswitch.asp

Ann