VSG to RNY

Have you considered DS. You REALLY should research DS.    Schedule a consult with Dr.  Dennis Smith ASAP.

Converting a sleeve to a rny is butchering you!!!  Why would your doctor even suggest doing that to you?    You already have  the sleeve, just have them do the switch.


PLEASE  PLEASE  PLEASE out of love, and concern for your health and safety I am begging you to PLEASE not do this revision until you have given the DS careful research and consideration. 


I would even opt for a band before I would convert a sleeve to a rny, but I'm guessing that's not an option because of the hernia?

BTW you mentioned Dr. Chasen was a great surgeon and works out of a COE?? I am very active on the GA board and am  support leader, and I have never heard of him? Where does he operate?

Did he even suggest the DS to you?   If he did not he is not looking out for your best interest, he is looking out for his wallet!

Trinity Bariatric and Weight Loss Program at Trinity Hospital here in Augusta.  Dr. Chasen was previously in the Army and now he is in private practice with Dr. Michael Blaney.  He is part of ASMBS as well.  Are you near the Atlanta area? Perhaps this is why you have never heard of him.
Also, he is looking out for my best interest.

I came to this board in hopes of  insight about a revision/ conversion from VSG to RNY. I honestly can say now that I have gone to a support forum that instead of support have trampled my and my provider's decision. 

I do understand that there are many options out there and I respect an individual's decision for the type of WLS they have had or wish to have. I think everyone is different in the ways that they heal and of course how they lose weight. The question that I had was simple: comparitively, how would you rate the pain after having a VSG conversion to RNY? I know it is 2 different surgeries with 2 different outcomes, but I just wanted to know a little bit about the pain scale and healing process that those that have had the conversion.

Thank you all for your input. Do not get me wrong, I am grateful, I just feel as if I have walked into an anti-RNY room and it is a little overwhelming.

Warmest Regards,
Sabrina

Sabrina,

Good luck with whatever you decide.

I am sorry that you got the impression that we were anti-RNY. Most of us are not, but we are anti messing up a previous surgery to do an RNY.  That was the whole point.  I personally, find it unbelievable that a surgeon would even advise it, but I guess it happens.

And yes, if I forgot to tell you, I am a revision from a previous 'restrictive only' stapling surgery and my DS was open.  The pain level actually was not bad after the first few hours and the first few hours were not unbearable, maybe a 5-6 on a scale of 1-10. My open hysterectomy was worse as was my first WLS.

I am sorry that I was so flabbergasted at the conversion that I forgot to address your question of the pain.

Best wishes,
Michele

I had RNY for 28 years, so I know what it's all about. Make sure you talk to RNY's that have lived with the surgery for at least 5 years. All the pouch problems  really wear on you after a few years. I was successful in keeping my excess weight off for about 15 years, but it wasn't because of the RNY. The RNY did help me lose the weight, but after about a year, the restriction was gone enough that I started to re-gain so I had to diet and exercise to keep the weight off. The RNY actually made that more difficult because foods that were good for me would stick and I would have to puke them up. I couldn't eat steak or roast beef, no kind of meat that was stringy or couldn't be chewed to mush. I also had to avoid salads and any kind of stringy veggie like sat celery would stick, so would rice. I could eat pizza, mashed potatoes, french fries, pasta etc. any kind of soft carby food would go down just fine. Then there was the dumping; anything sweet would make me dump; even milk would make me dump. After about 3-5 years, it just really started getting to me; all the dumping, food sticking and feelings of deprivation because I couldn't eat like a normal person. I lost control of my weight when I got sick and couldn't exercise and it was just a matter of a few years and I had yo yo gained all the weight back. 

I finally got a revision to DS on Sept. 17, 2008 and it was a very tough surgery; it actually took two surgeries because of all the adhesion's, scar tissue and damage from the RNY. The first surgery took 8 1/2 hours and the second one three days later took 41/2 hours. The recovery was also was also a lot more difficult than I had anticipated but after a couple of months I started to feel pretty good and things just got better and better. Now, it's like I'm in heaven. I eat like a normal person, I've lost all my excess weight and I feel great; I'm 57 but I feel like I'm 30 again! It's wonderful. Check out my profile and you can read all about my experiences living 28 years with RNY and see what I'm doing these days. There's lots of pictures there and it's all public.

I'll tell what, knowing what I know about RNY and living with a pouch for so long I would never allow my stomach or sleeve to be cut up and turned into a pouch, no way; no way in hell would I allow that.

It's your life and you have to live with your decisions for the rest of it, so what ever you decide to do doesn't matter a bit to me. I Just know what the difference is in living with a sleeve and a pouch and there is no way I would ever let anyone turn my sleeve into a pouch, no way, no how. I can't imagine what you hope to gain by revising to RNY, but like I said, it's your life.

Good luck,

Kerry 

Thanks for clarifying the info on your surgeon. You're right.  I am in the Atlanta area, so I am not familliar with the Augusta surgeons. 


BTW I am not anti rny, but I am pro COMMON SENSE!   converting a sleeve to a rny when you could have an easier, and safer transition to a DS is just plain foolish. 

I am not calling you ignorant, because you are not a medical professional and are following your surgeon's advice, but I am calling your surgeon foolish, selfish, and irresponsible if he did not at least suggest the DS as an option.

Dear Sabrina:

I am a VBG revised to an RNY and I will give you my story, unbiased opinion, good and bad from all procedures I've been through as I am a 3 time Weight Loss Surgery Patient...

Procedure #1 in 1979 a VBG or Gastric Stapling as it was called then...Surgery was mostly uneventful but recovery was horrid and I didn't eat for almost a year...Nearly starved to death. By about 1.5 years after this procedure I began eating better but had lost 130 lbs and began loving life...At some point about 9 years out I began eating much larger amounts and began regaining weight...I went to my Surgeon and they did an EGD and found out the stapling had come apart and I would need a revision...10 years almost to the day I had a revision to RNY...surgery was difficult as I had major scar tissue and damage from the stapling which had opened but actually the recovery time and pain I experienced was practically nothing...I did exceptional and lost 100 lbs of what I had regained in less than a year...I returned to work in two weeks after surgery...I loved my RNY...I maintained my weight loss from 1989 through 2005..But I experienced very low Vitamin B12 and Iron issues which required IV Iron infusions and B12 shots..

.The reason I regained again was me, I got lazy, began eating irratically and I moved in with my Mother and Grandmother who were both ill and needed full time care and meals made 3 times a day...I ate like there was no tomorrow and I gained like there was no tomorrow.

The reason for researching and getting a 3rd Revision surgery was me and only me I have no one else to blame...Yes, I have a streched stoma, but my pouch isn't streched my mouth just got to big and I over ate my surgery, plain and simple..

So last May at 214 lbs I had my 2nd Revision to an ERNY I have lost 50 lbs to date...Definately not the speedy weight loss I had become accustomed to but it's been slow and steady and probably better as I haven't noticed any hair loss or some of the horrible side effects of fast weight loss and protein loss...

Now for what's going on now...I was just told that my labs are very low on the vitamins ADK...Although I feel good...I did a ton of research on my surgery decisions but especially on this 3 surgery I just had and honestly if I had the insurance and/or the money that would have covered a DS I would have gone for it without thinking so much as twice about it...It just seems to have the best long term outcome from what I have researched...Not to say that RNY doesn't give you a good outcome because it can and it does...Unfortunately it doesn't seem to be long term (anotherwards over 10 years) and this is because we folks who overeat and are over weight don't change our habits in our heads we still like to eat and over eat we still do even with RNY and we do that by snacking on hundreds of little meals all day and this over a prolonged period of time will stretch the pouch and stoma...Plus our miraculous little bodies have a way of compensating over time the bypass portion of the surgery as well...Soooo...this is my story I hope it has been helpful...To answer your question about pain...After surgery you don't even think about it I don't believe it really bothers you other than getting up and down...

But Sabrina it's really important to know all your options...everyone on this board truly means well, sometimes we don't want to hear what others have to say about what has worked for them but honestly if it's working for them how can we dispute it...I still see a complete DS in my future if needed and yes would I go for a 4th surgery you bet I would...I don't like being heavy and don't intend to be heavy also I am still technically an RNY and I don't absorb B12 or Iron the way I should I don't think that would be as big of issue if I had a fully functioning stomach also, I had a scary thing happen as I was experiencing pain and no one could find out what was going on and the scariest thing in the world to me was when I realized the Dr.'s couldn't do a simple EGD on me because of my closed off pouch which means if you have cancer or a tumor or something like that they can't always find it because they can't get to it without doing full blown surgery...With DS your stomach is open and it can be scoped and treated as a normal stomach...Just something else to think about...

One more thing and that is depending on how much you need to lose if you are having RNY sometimes having a Distal not a short cc but maybe 150 cc can help you to maintain your weight loss and help you from regaining...But that also comes with it's own set of problems...Just please do your research and if I can be of help in any way, please feel free to PM me I would be happy to tell you all the good about RNY and how it helped me for almost 16 years.

Janie

The DSers were HORRIBLY mean to me in the beginning.. called me stupid... said I was going to fail the VSG.. blahblahblaah... BUT.. if the time came.. and the VSG and I didn't have a successful partnership.. there's NO WAY I'd go to the RNY..

I would fight my insurance... or do whatever I could in terms of loans.. to go to the DS...

I don't need it now... I'm loving my new lifestyle... but if the VSG hadn't suited me.. my body is already set up for the DS.


Do you know what Bougie size your doc used? I've never seen such low weightloss on the VSG in recent times.... Do you think he maybe used a 48+? Older sizes? How much can you eat? If you've got a Dr. that's already using WAY WAY WAY too large of sizes... I wouldn't be taking his suggestion on the next step...

Unless you're eating Ice Cream and not working out... I'd imagine the size he put in you to begin with is the culprit...

especially if you can eat a lot more than other VSGers..

So why go with him again?

Hi Sabrina.   I am a revision from a VSG to a DS.   I kind of had the same history with the VSG as you.   I think it's a wonderfuls urgery if a restriction-only surgery is what you need.   I lost 30-40 pounds something like that.   I'd have to go look it up to be more specific.   Basically I lost a couple of pounds on the preop diet and then a couple of pounds and then I'd be the same weight and then I'd lose a pound and then I'd gain a pound....   On like that.

I had the DS for a bunch of reasons.   It was the WLS that I wanted in the first place, as I had a hunch that restriction wouldn't be enough for me.   Not that I didn't give the VSG the really good try that it deserves!   My doc asked how much my stomach would hold and I honestly had no idea, because I always weighed out whatever I was going to eat and when that was gone, I was done.   The VSG made it much easier for me to restrict my calories - I didn't have the huge hunger that I'd had before that.   But I was never comfortably full, either.

I didn't consider the RNY because I wanted to keep my pylorus.   Sounds selfish - heh.   But I've been diabetic for quite a while, and dumping sounds way too much like a hypoglycemic episode feels, and I don't want to sign up for that!   Also RNYers (at least what they were saying when I was doing my research) tended to constipation.   Since that had always been a HUGE problem for me, I went with the surgery that was going to cure that.  

So I had the DS finished up in February of this year, and I've lost well over 100 pounds in almost 10 months.    The second surgery was very easy for me, because my stomach was already well healed and used to the new dimensions and all that.   It somehow kick-started my metabolism, and it's left me a much happier person than I've ever been, as far as I can remember.  I'm also happier because I'm never hungry.   I don't eat a lot at one time.   I feel very ladylike when I eat now, very dainty and rather picky.   But when I get hungry again in a couple or few hours, I eat again.   I have the soul and mind of a pea-counting nurse, but I've been able to leave a lot of that behind because my life is so much easier!   If it's protein, and I'm hungry, then I eat it.   I don't have to make a production out of my meals, I don't have to take teeny tiny bites and chrew for three minutes.   I don't wolf my food down, but I don't have to concentrate on every bite, either.   I can eat socially, if you know what I mean.  I'm a Social Eater now!

My VSG was done lap and the DS was done open.   I have a hernia issue as well, but I didn't have it addressed during the surgery.   I'm kind of hoping to never have to deal with it, but who knows.   The open surgery was no more painful than the lap.   I was up out of bed the day of surgery.   Of course, I was first on the schedule and had the rest of the day to recover.   I got rid of my IV and the IV pain pump PCA the next day because I could.   My doc let me get up and take a shower - he was my hero!  I took some pain meds on the way home, I think, but by a day or two home, I was off all pain meds.   I have kidney failure so I can't even take Ibuprophen.   I'd say the discomfort from both surgeries was pretty much the same.   I had two C-sections and that's the only other abdominal surgery I'd ever had.   That's really a painful recovery and I was pretty nervous about the DS.  

Of course, since you're having your hernia surgery done at the same time, I have no idea about pain levels for that.   I have to say as a nurse who has taken care of a LOT of postop patients from various procedures (not bariatric), modern pain relief techniques are very good.   If you're having pain, take the medication!   It's not good for you to suffer after surgery.   You'll need to deep breathe and walk around and all that kind of good stuff.   You'll find that it's easier to take your medication in a scheduled way, rather than let the pain build up.   Much better to keep it at a lower level than to fight it down when you're really in a lot of pain.

I can't think of anything else to say from my own personal expeience.   I don't post much on this board, even though I guess I'm a revision.   I really gave the VSG a good run and I would never have regretted having had it.   I'm especially glad that I had it done before I had the DS, as I'm pretty old, and I was pretty sick before surgery.   Anything to make things easier on me, I'm in favor of!

Feel free to PM me if you have questions or think I could be of help to you.

Dennie

I am a revision from a band to DS.  And I am sorry if you feel like we are all anti rny.  For me, that is true, as I have medical knowledge of complications that I have obtained behind the scenes at a bariatric clinic.  But, I think the biggest concern from the DSers is that you already have 1/2 of a DS and, to me and others, it would be less taxing on your body/health/pain level if you only did the intestinal part and not the whole pouch/intestine surgery.  Plus you would have a better quality of life afterwards.

From what I posted, and what other DSers have posted we really hope you get a second opinion.  Or, at least talk to your surgeon about doing the intestinal bypass only and leaving your sleeve alone.  There is no reason to convert to a pouch with all its complications/risks/side effects when you already have a sleeve.

If you are set on the RNY, then go for it.  But a second opinion from a qualified DS surgeon would not hurt you in any way and may save you some time and pain in the long run.

And just an FYI:  My first surgeon told me that I would not be a canidate for the DS because I had surgery on my stomach at 6 weeks old and that I could only get the RNY.  As stated before I did not want the RNY and the DSers pretty much told me that  the surgeon lied to me and to seek another opinion.  When I got my second opinion, I found out that the surgeon did lie to me.  Don't know if he knowingly lied, but it was untrue all the same. 

It takes twice as much time and skill to do a DS.  Surgeons can do 2 RNY's to 1 DS, pretty much... so they go for easy to make money.  Now, I am not saying that your surgeon is doing this.  From what I gather you trust him 100%, and that is good... but another opinion would not hurt. 

IMO leaving your sleeve alone would be best, just add on the intestinal bypass RNY style or DS style so that you can avoid all the pitfalls of a pouch.  And there are many...

Good luck.