sleeve to ? revision advice

I had VSG done 8/2010 and lost 78 pounds in first 10 months but since then no loss and not only have I not lost any more weight, ive gained 23 pounds effortlessly. I'm looking into my options and trying to decide which way to go. I know there is a surgeon in NJ who will do a sleeve to DS revision and am going to see my prior surgeon who will do a revision to RNY. I appreciate any advice on insurance approval or which revision would be better, DS or RNY. I cuurently have bc/bs but have open enrollment at work and have aetna as an option and am not sure which plan might be easier to work with in terms of revision. :)

*I* think you'd be better off with the DS. For one, you already have the stomach portion of the DS, so there would be less surgery to undergo. For another, the DS has the VERY BEST long-term, maintained weight-loss stats. And, while I know nothing about your general health or family medical history, the DS also has the best stats for resolving or preventing co-morbs like diabetes, insulin resisitance, and high cholesterol. Also, keeping your Sleeved stomach and your pylorus will allow you to take NSAIDs as needed. At your age that may not sound too important, but as you get older---well, most days *I* wouldn't be able to function without my Aleve.

thank you so much for your reply. with my family history all of these could potentially be issues for me. I talked my Dad into having DS in october so was kind of leaning that way anyway and really appreciate your input. thank you!

I have n't had either done but from reading the posts on these boards for awhile I agree that is seems like the DS is better. One thing you should know about the RNY (I had one) is that if you are wanting to rely on the dumping to be your slap on the wrist for eating the wrong things, that is may not. Not everyone dumps. Not everyone has a reaction to fats and sugars. (I did not). I could be wrong but I am under the impression that with a revision surgery the weight comes off slower and less of it. So how much and how slow would a revision to RNY be for you?   with RNY even a 50% EWL is considered a sucess with the first surgery (before a revsion). Your body may begin to heal itself and where it would malabsorb when first done, after about 2 plus years it will begin to heal itself (not all people of course) and you will absorb your foods like before. With an RNY you must use the initial opportunity to learn to eat correctly so that when (and of course if) it happens to you, then you will already be eating correctly. Your stomach will stretch over time and you will be able to eat more. But you must learn not to. And if you are one who dumps, your body will (not always of course) heal itself and you will be able to eat those sugary, fatty things but you must learn not to. If you choose to go to an RNY and it doesn't work out well for you and you at a later date want a revison, your choices will be very limited. Finding a Doctor to do a DS revision from an RNY is a major deal, and you would have to most likely travel out of state or cross country to get it, giving you the added cost of Hotel stays, Food, rental car etc.
If you go with the DS revision you can find a surgeon almost anywhere who can do it. If you choose a DS and later want a revision you can find a doctor to revise to an RNY alot easier and most likely local. I had an RNY proximal and desperatly want revised to a DS but alas travel is not an option for me and I will have to settle for a proimal RNY to a Distal RNY (ERNY). I so wish I could have chosen a DS in the begining. (didn't know of it). Do some reading on this board and do some Archive posts as well. Not sure about your insurance but if you post your insurance in the headline I am sure you will get the answer you are looking for. Good Luck.

wow. that is a lot of really helpful information. as I said above, i talked my dad into having DS in october and hadnt known about it when I was sleeved so I was kind of leaning that way and now with the input from the 2 of you, I definitely am. I am extremely appreciative that you took the time to share such valuable and insightful info. Thanks so much!
Tracy

Hi Tracy,

Dr. Irgau did my Band in 2006 which I'm about to have revised to a RNY in 2 weeks by Dr. Wasser in Jersey.  He is Dr. Greenbaum's partner (I am assuming since he is the only DS doc in NJ that is who you are referring to).  

I didn't go back to Dr. Irgau because they don't accept my insurance.  Your best bet would be to call Dr. Greenbaum's office (they have a website too if you Google Dr. Greenbaum it comes up) and you can talk to Tina.  She can answer any and all insurance question you have, and probably just about anything else you want to know.  I know they take BC/BS and unless your employer has a weight loss exclusion, BC/BS usually covers the revision surgery if you meet their criteria.  Tina can tell you all about that kind of stuff.

I wanted the DS but I have health conditions that preclude that as being a good option for me so I am having the RNY.  You can go to one of the support group meetings up at Virtua in Mt. Holly or at Virtua in Voorhees and you can really get a lot of information there and you have an opportunity to speak with Tina and the doctors in person.  

You've already gotten the first half of the DS; I would imagine it would be easier to just get the second part rather than revise to a RNY, barring any reason why you couldnt, of course.   You can post over on the RNY and the DS boards too and you may get some answers you're looking for. 

Good luck with whatever you decide to do!

thank you. this is so helpful. dr irgau did mine as well and Im having trouble getting them to answer any of my questions whereas Tina has been answering all of my questions so I think Im definitely going to book my appointment with dr Greenbaum today. I have BC Bs now but was thinking of switching to aetna since i heard it may be easier to get them to approve it. Thank you for your help. My dad had Ds surgery done by dr greenbaum and is doing great. they are a great practice! Good luck with your revision. keep in touch and let me know how it all goes!

Thanks for the well wishes, Tracy!  They are much appreciated! 

I love Dr. Irgau and Dr. Peters, but my experience with Dr. Greenbaum & Wasser's office has been absolutely wonderful.  I have been amazed at the level of Customer Service/Patient Care that I have experienced there.  Tina has smoothed out any wrinkle (seemingly effortlessly); she is awesome!!!! They really DO have an awesome practice and I feel very lucky to have them as my surgeons. 

I'm glad to hear about your dad and how well he is doing!  Keep us updated and let us know how you make out and what your final decision is. 

Take care!

I agree with the DS recommendation. Your pyloric valve is the way your body best regulates food flow. An RNY is just a hole there that can stretch - and revising from an RNY is a very difficult surgery.

Sleeve to DS is essentially just the intestinal portion of the DS.

thank you so very much. all this advice is making this very easy for me. so appreciative!