Considering Revision LapBand to DS....scared of failure again!!!

I am new to Obesityhelp and from the many, many, many post I have read, it has been so helpful in my research on revision surgery from LB to DS.

My obesity journey has been long indeed.  I have been obese 38 years of my 40 years, with the exception of the times my fad, starvation diets helped me lose 40-60-80 lbs, but never to keep it off. To this day it still baffles me at such a young age, how I was obese when I ate what my family ate, obviously child portions, and they are not obese?!?!?!?!?!? I was seriously thinking back of my diet/weight history and this is my story:

-1st grade wt 100 pounds (age 5 or 6)
-3rd grade visited with the first registered dietiitan and started a life-time journey of dieting (age 7-8), oh and at some point in that year weight was 147 (imprinted in my brain)
-7th grade joined weigh****chers for the first time (age 12-13)
-Freshman year of college strated with the "pill mill" fat doctor (what I call it), where you go to get appetitie suppresants.  Continued this on/off for about 15 years until I decided on lap band ........

June 2006, lap band surgery.  It took me 3.5 years to lose 75 lbs.  I was a very slow loser and in my greatest times of loss it was "starvation" and tons of exercise.  But I managed to keep it off until I had the ULTIMATE BAND FAILURE.  I had a life-threatening complication with my band that took 9 months to diagnose.  It started in March 2010 with severe reflux.  My doc and I thought it was due to stress because at the time my father was dying.  And this is the first time in my life I could hardly get food down.  So I started drinking milk shakes, prot shakes, anything (usually bad) that would go down. I gained 25 pounds during these 6 months. I totally own it!!!  Oct 2010 I had a complete unfill under fluro becuase we thought I may have had a slip.  No slip.  Next day presented with classic gallbladder attacks.  All test (ultrasound, hida scan, blood work) normal ....gallbladder was perfect. And yes I gained some weight after unfill.  Jan 2011 had emergency surgery for small bowel obsturction (necrotic bowel).  This was all due to the cather of my band somehow coming lose and wrapping around my small bowel 5 times.  Since surgery, I breathed in air and gained weight.  I was 210 at this surgery and now struggling to stay at 235 (meaning not gain).  So I have gained all the 75 pounds back that I had lost. 

I have never had restriction with the band from day one....even with max fill. I have been filled since 2011 surgery and I fight everyday just to not gain weight.  Its so frustrating!!!! 

So long story, long .....I am scared to death that DS will not work for me.  I just want to be "normal", meaning I can eat a meal with my family and not gain 2 pounds while everyone else stays the same.  For the most part, I eat healthy.  I am actually one of those rare birds that enjoys the protein shakes and has one a few times a week for breakfast.  We all have our bad  eating days and I would be lying if I said I didn't.  I love to walk and hike so I am capable of staying active.  I've researched and  understand how the DS works with fat malabsorption and offers restriction (esp at first).  I guess I having a hard time trying to understand how the DS will work in and for me since nothing else has  helped long term from the age of 2. 

I would really appreciate any input from people with similar journeys.

Thanks for listening

OK I don't know alot about the DS but I do know that it can be very successful. Just like any surgery you DO have to follow a diet of sorts to succeed but the DS diet is easier to follow from what I understand. It does require considerable vitamin supplementation but if you can handle that it should be very successful. Just because the band failed you don't expect the same from the DS. The band fails nearly everyone that gets it. I firmly believe the manufacturers flat out lied about how effective the band was. It has failed too many people to just be a coincidence. I suggest you go to the DS forum and ask them what their lives are like and what it's like living with the DS, I'm sure they will be glad to help.

 hi, i too had band issues and had mine removed after 2 prolpases.  anyway, im donsidering a sleeve and im wondering what made you decide on the DS?  just looking for info.

dawn

I was banded in 2006 too!  Lost 100 lbs, started with horrendous acid reflux, and am now scheduled for a revision surgery at the end of May to a Bypass.  I get why you're nervous and afraid the revision surgery won't work for you; I had similar concerns that my surgeon talked me through. 

When discussing my concern for failure, I was told "this a different surgery altogether; your body will react differently", and that the band failing was NOT my fault, that "some patient's just develop reflux, some don't; it is a known and very prevalent complication with the LapBand".  My reflux actually started after I had plastic surgery, 2 years after I had my band. 

I was given the options of the sleeve, DS or GBS for this revision surgery.  After discussing it in depth with my Surgeon and my GI doc, we collectively decided the GBS was the better option for my particular health issues. 

Same goes for you; you had a complication.  The band failed, YOU didn't.  By having the DS you are having a restrictive AND malabsorptive procedure.  This is your opportunity to kick butt with weight loss!!!  The malabsorbtion alone would cause you to lose weight, but add in the restrictive part as well?  I think you are going to be VERY pleased with your results; and you will be amazed at how little food you actually need to eat to be healthy!

Keep coming here for support; it will help! 

Best of luck to you

 
Almost Thin,

Your doctor does not do DS!!!!  Please, Please, Please use this time before your surgery to REALLY reseaerch the DS.  You owe that to yourself!!!!  I revised to DS from RNY.  I had RNY almost 10 years.
My RNY failed me!!!!

These links below...... lead to so MANY informative links to read & ponder:
http://www.obesityhelp.com/forums/ds/4280788/Repost-Request- Advi/#4280788

http://www.obesityhelp.com/forums/amos/4454843/Considering-the-RnY-Please-educate-yourself-These-threads/



Here is one website for you:
http://www.dsfacts.com/

SmileyJamie,

I appreciate your concern and thank you for the links.  I have been on the dsfacts. com site; my surgeons office gave me that one and several others.  I have spent many hours researching DS and RNY. 

You are correct, my surgeon does NOT do the DS.  However, his partner, Dr. David Greenbaum, who I also consulted with, DOES do the DS as well as other extremely dangerous/difficult revision and conversion surgeries, and the RNY and sleeve.  (I did not think to mention that in my original post.)

I initially leaned heavily towards the DS, which is what Dr. Greenbaum suggested due to my diabetes being so out of control.  Dr. Wasser is more concerned about the damage being done daily to my esophagus from the unending reflux, as is my GI surgeon.  Dr. G and Dr. W each strongly advised against a sleeve for me.  Both doctors gave me the reasoning behind their suggestions, and allowed me to make the decision on which surgery I wanted.  

One of the things we discussed in depth, is that because getting a sleeve is part of the DS, there is a very good chance that my acid reflux will not be cured as for lack of a better explanation, there is no re-routing done and my "stomach" would still produce the acid and shoot it into my esophagus.  With the RNY the re-routing that is done puts the acid straight into the large intestine at a lower attachment and there is no more acid in my stomach to cause any further esophageal damage, which is why RNY is the gold standard for curing reflux in obese patients. 

With getting the RNY, I also still have the option to convert to a DS in the future if I need it.   Of course, I am not anticipating that that will happen, but it is good to know that I still have an option available if I need it.  

Right now, I need to get rid of this reflux, get this weight off and put my diabetes in remission, in that order.  Everyone's medical history is very individual and what works for some does not work for others, which I completely understand.  I trust my doctors and surgeons and their knowledge of my list of health issues, so I am very comfortable with the decision I have made to have RNY at this time, and not the DS. 

Thanks again for the concern.  I'm sorry to hear that RNY failed you but that you were able to convert to a DS, that is great!  I am very glad that it worked out for you.  

I can appreciate the RNY surgeon's concerns about your reflux. However, I would look at your indivudual situation slightly differently, in that it sounds like the band is causing the severe problems with reflux, as it is known to do in some people. Getting the band out, which would be done with either RNY or DS, should improve your reflux greatly.
    I also agree with everyone who said the sleeve was not your best choice. This makes it sound like Ds would not be great either, since the sleeve is part of the DS, but there is a big difference: with the sleeve as a stand alone, the sleeve is often made very narrow in hopes of preventing weight regain. This is because with the original VSG patients, who had the larger sleeve that is done with the DS, there have been significant problems with regain after 4-5 years. Whether the narrow sleeve will prevent this or not is not yet known. What is known is that it can cause bad problems with reflux, much like the band does.
     Since Dr. Greenbaum could make a more generous sleeve for you with your DS, esp since he knows your history and your concerns, and with that damn band being removed, it is much less likely that reflux would reman such a problem for you.
     Is RNY the best choice for severe reflux? Yes. BUT - that statement doesn't take into account that you are not someone who has never had wls with severe reflux, you are someone with a band that is CAUSING severe reflux. Remove the band, and your situation changes greatly.
     Is it also well know that the DS is the best choice for type 2 diabetes, esp when that diabetes is difficult to control? Yes, and that applies even more so if the weight loss from the band didn't control your diabetes, since it tells us that you need the metabolic changes that the DS will give you to get your diabetes controlled. RNY does confer some metabolic advantage, but not as much as the DS.

One last thing, and this concerns me - at the end of your post, you stated that if the RNY didn't work out, you could convert to the DS. You make it sound so easy! RNY to DS revision is in reality the most complex and high risk bariatric surgery presently being done. It is NOT always possible. And even if possible, it can be extremely difficult, maybe impossible, to get insurance to pay for it. It is ironic that you and Jamie are conversing here, as it took her several YEARS and a huge insurance battle to get her RNY to DS paid for, and she had a serious complication even in the hands of one of the best revision surgeons in the country.
     Do you really want to even think about a THIRD wls? DS isn't intended as the fallback for when all else fails, it is a great primary wls. Obviously you are already in revision territory, we can't change that, but with all due respect I really don't think you have thought this decision all the way through.

Hi Larra,

Yes, you are correct, the band is absolutely causing my reflux even though my band has been completely empty for 2 years now.  I've been on daily GERD medications for 3 years, and the acid still breaks through.  I also have a lot of scar tissue that has developed under my band, unfortunately.  With the band being emptied, that should have resolved my reflux, but it didn't. 

The problem for me with having a bigger stomach/pouch is the damage to my stomach from the diabetes, which has also affected a lot of my blood vessels.  So, the goal is for me to have a small pouch (GBS size) made with the "good" stomach tissue that I have left. 

Believe me, we went round and round about DS vs GBS and the pros/cons, long-term success, failures, and pretty much everything that you can think of, and we keep coming back to the RNY.  Just the fact that the DS would cure my diabetes is a HUGE discussion that I had with all 3 surgeons (2 WLS + GI surgeon).  They all think my diabetes will go back into remission with the RNY as long as I eat what and how I am supposed to.   

I was off all of my meds with the Band, and my diabetes was under control with my diet.  The reason its all over the place now is because of how much weight I gained back after they emptied my band a few years ago.  For some reason I just can't get it stabilized, even with the meds.  Until I gained the weight back, my diabetes was in remission.  When the weight came back, so did diabetes and he brought a few of his unwanted friends.  

>> One last thing, and this concerns me - at the end of your post, you stated that if the RNY didn't work out, you could convert to the DS. You make it sound so easy! RNY to DS revision is in reality the most complex and high risk bariatric surgery presently being done. It is NOT always possible. 

** sorry if this is repeated, it is cut off in the other message I sent **

Okay, is it just me or is the whole second half of my message missing ?!?!?