Sleeve to DS - List of Questions for Doc

Just thought I would share my list in case it might help someone else.  Feel free to share anything I might have missed.  I also welcome your answers and feedback if you've already been through a revision or have a DS.  I'd love to have a robust list before my consultation.

Surgeon
How many surgeries have you preformed?
How many Sleeve to DS revisions have you done?
How often do you perform the DS?
Which surgery option do you perform most?
How many two-stage duodenal switch procedures have you performed?
When is the second stage typically performed?
How many laparoscopic DS procedures have you performed that needed to be converted to open? What were the reasons for that?
How many DS procedures have you started but were unable to complete? What were the reasons for this?
 
Complications
What percentage of your revision patients had complications?
What are the possible complications?
What is the most common complication?
What has been the worst complication with your patients?
What do you think caused these complications?
How many of those patients died due to post-op complications?
What can I do to help avoid complications?  Lose weight pre-op?
How many patients of yours have needed follow-up surgery to help with the complications?  

Costs
What is the estimated cost?
Do you have financing for any portion of the expenses that insurance will not cover?
Do you require a deposit? If so, how much?

Procedure
If a liver biopsy and removing the gallbladder is not approved by insurance, will those need to be done anyway?
How will the incisions be closed (staples, stitches, glue)?
Do you stitch over the stomach staples?
Can you possibly go in through the same spots from my Sleeve procedure?
Is there a weight loss unit at the hospital?
What size is the stomach with the DS compared to with the Sleeve?
How do you determine common channel length?
Does the length have an impact on GI issues?
How do you determine alimentary limb length?
What pre-op and post-op tests do you conduct (leak tests)?  

Surgery Options
How many pre-op appointments are required before surgery?
At what point is it truly necessary to consider a revision?  And the DS in particular?
Does my non-surgical weight loss affect your opinion on me needing the surgery?
Which surgery would be best for me (why, laparoscopic)?
What is my normal weight range and what is the expected weight loss?
When will the weight loss start?
Why don’t you recommend the other surgery options for me?  

Post-Op
What happens to the unused portion of the intestine?
What is the best thing for dehydration?
What can help with bowel issues (probiotics, avoid carbs)?
What percentage of vitamins, protein, sugars, carbs and fat are absorbed?
Will the hospital staff give me something for nausea after surgery?
Will the scars be any worse than the ones from my Sleeve?
What are the details of recovery compared to the Sleeve (time, pain, etc.)?
How often and what type of follow-up care will there be (labs, doctor visits)?
What are the long-term medical needs (vitamins, medications)?
What percentage of people regain weight?
Is there nutrition, psychological, exercise, etc. support after the surgery?
How long should I avoid pregnancy? Should caffeine be limited post-op after the healing process?

Vitamins/Medicines
Will I need to crush my vitamins and medicines at first?
When will I start the vitamin regimen?
What are the most effective birth control methods post-op (depo shot, a ring)?
If my gallbladder isn’t removed, will I be on Actigal post-op to help prevent stones?
Do iron levels drop post-op?
What helps prevent or slow hair loss?

WOW!  With all those you should be covered.  You
may not get thru the list in one visit though.

Hope your consultation went well. I had my revison on 7/23/12 sleeve to DS. My doctor did an endoscopy first to see what my sleeve was like. I was little over 3  years out and didn't do so well with it. A different doctor did my sleeve. I also lost my mom shortley after getting my sleeve. I only lost about 50 pounds. In hindsight, I had to forgive myself as we didn't know how sick she was and that she was going to die within like 2 months. I still lost weight. And then like 6 other relatives died that same year! I really had a hard time comtemplting bypass surgery. I have a sister who is 13 or 14 years out in keeping 110pounds off! So I know it can be successful. But every person is different. I also had to decide about my job at that time, you know insurance. I got approved for my revision with the new insurance this year. I thought I had asked all the questions. But until I actually got the switch done, I had more questions. My surgery went well. I only had a complication with my stoma not closing and had to be off. Again every ones body is different. My gallbadder was removed. ONly issue i have is dumping. TMI diarrehea. The endoscopy showed my orginal sleeve was in excellent shape. So it was not redone. Only the intestinal rerouting. I get the hic-up as usual when it is full. But something "extra" when eating things that don't agree with the intestines. I keep a new running list. I cannot have plain protein shakes. They have to be smoothies with fruit. NO noodles, pasta,rice,chips. No fried fast food like McDonald(neverliked their bugers anyway),Whataburger etc. They deep fry their burgers with too much grease.I cannot do KFC or POPeyes fried anything. Too much grease. Greasy foods make me very ill. I can do burger king. Otherwise everything I eat is at home or I stick with salads,grilled chicken.shrimp etc when eating out. It is a big change from the sleeve. Some people don't have drastic bowel changes. Some do.  It is a day by day journey. I pray that things go well for you.

Sally, if you have a DS, you don't HAVE a stoma. Therefore, you should NOT have dumping, either. You say that your SLeeve was in good shape, so it was not redone, just the intestinal portion added.

The intestinal portion is why greasy foods aren't sitting well with you, YET. Your DS causes you to malabsorb 80% of the fats you eat, so in the early months, fatty foods are going to go through you quickly. (Later on, you may find that you become constipated when you don't eat ENOUGH fat!)

Come on over to the DS board, and we'll help you get your issues under control. Who did your DS?