Revision from DS - Pregnancy

Hello, I had DS surgery 6 years ago, and lost over 145 lbs. I have always struggled with vitamin deficiencies - primarily D and protein, even though I religiously took vitamins and supplements. I have also struggled with excessive weight loss. I became underweight with low BMI, and look like I have escaped some concentration camp...

I am 5 months pregnant and was recently diagnosed with iron deficiency anemia, high deficiency of D and protein again, as well as hypoglycemia or low blood sugar... Surgical revision during the pregnancy is out of the question, I know - but does anyone have any advice for me? I would consider revision after delivery, has anyone had revision from DS? What's to be expected?

Oh, I am 35 years old. 5' 7" tall and currently weigh 132 lbs, 15 of which I gained since becoming pregnant.

Thanks all!

Alysa

I'm of no help, I just wanted to say congratulations on your pregnancy and I hope it's all smooth sailing.

i think ladytazz on the rny board revised from a DS to rny- I'm pretty sure though not 100%.

What EXACTLY are you taking for vites?  If your iron numbers are really low, get in to a hemotologist.  They can look at getting you an iron infusion.  It is not uncommon for us to not absorb iron from supplements and instead need to have occasional iron infusions to tank us up.  I get an iron infusion about once a year.

You D....you should be taking dry D3 50,000 unit capsules.  You can get these from Vitalady or from Amazon.  They are produced by BioTech.  How low is your D?  With the D deficiency, you should probably start with at least 100,000 units dry D3 per day.  How is your Calcium and PTH?  What else are you taking? 

BTW--congrats on your prenancy!  Those little ones don't help a bit when it comes to our vite levels, lol.

I too am wondering what you are now taking, as those decencies should all be treatable.

Has there been any mention of a digestive enzyme like Creon to boost absorption??? The more information you can give us, the more we can help.

My sister was at the same place nutritionally and deficiency wise.  He doctor wanted to revise her.  She didn't understand what he wanted to do.  So she lost it and refused and asked for another option.

All he was saying was he wanted to go from DS to VSG and he was right she should have.  She thought he meant to put her back where she started.  Which isn't possible as the DS left her stomach a sleeve.

The option they chose was to forcible over eat to stretch her sleeve.  Keep in mind the sleeves were a 60 back than not the 32-38 of today. 

Revising to a sleeve after giving birth may be an option for you. I also read about different routing but sorry I don't remember just what they said.

(My sister is still to thin but, she thinks she is fat)

I was revised from a DS but not for the same reasons.  Long story but in spite of a lot of malabsorption I managed to regain most of the weight I lost (due to terrible eating) and had issues with deficiencies and chronic bacterial overgrowth of the intestines.  I wanted a reversal but I was told that I could only be revised.  My common channel was lengthened to 200 cc from 100 cc.  That solved all my problems.  My sleeve was made way too large and I had no restriction and was always hungry, hence the large regain.  My surgeon advised that I have it revised to a RNY pouch, which I did for fear of gaining even more weight after losing so most of my malabsorption.  I was told I probably wouldn't lose any more weight but would hopefully not gain any more, either.

Anyway, in hindsight I would have done great with a longer common channel and smaller sleeve.  Now, due to a lot of restriction, even with reduced malabsorption I have managed to lose all the excess weight and then some.  I have no more deficiencies and feel 100 times better.  And all my intestinal issues are completely gone except now I deal with constipation instead of constant diarrhea.  Do you know how long your common channel is?  You may need to have yours lengthened.  I guess because of all the variables of peoples different lengths of intestines that there really isn't a one size fits all common channel length.  The Hess method takes into account the individuals total intestinal length and divides things based on that.  Obviously my surgeon didn't do that.  I have no idea how he measured or what he did but things seem to be working okay for me now.

If your surgeon isn't helping maybe it's time for a second opinion.  I don't know where you live but if I knew then what I know now I would have gone to see Dr. K in California as he is the expert in DS revisions.  He could probably fix you right up. 

congrats on your pregnancy. not knowing any personal info like limb length, vitamins etc this will be general info.   I understand your fear, but let me give you a few options before revision to your DS  What you are experiencing is not unique....for iron deficiency get to a good hematologist for iron infusions.  For your vit D deficiency go to an endocrinologist that understands what is going on with a ds, or if not ask to be treated as a short gut patient or find a nautropathic dr  there are different ways to get vit D, I take injections, yes the dr has my vit D compounded for me and I get one injection every 12 weeks, pretty easy,  the protein is a little more difficult.  try eating more protein foods if you can. What about Creon for a while?  if you are trying to gain a few lbs, increase your good carbs, not to the point that you get GI distress.  If a revision is what you are really looking for, look to extend your common channel and not have your DS completely reversed.  good luck to you and your baby.....