Decent news! Kinda

I got an email from the NP at my surgeon's office this afternoon saying they are fairly certain they can revise me to a sleeve gastrectomy and get my insurance to pay due to medical necessity.  We'll talk more about it at my appointment on Thursday.  I'd prefer a DS, but I'm thinking the problem may be lack of experience with this type of surgery, although I know the dude I'm going to see is their main revision man and has been at it for a long time.  At any rate, it's better than living in fear of everything I put in my mouth and passing out as a result of eating the wrong thing.  I know nothing is certain till insurance gives formal approval, but I'm feeling hopeful!

Here's hoping everything goes smoothly for you and the insurance is cooperative. Best of luck to you!!!

I understand your surgeon is experienced with RNY-to-DS revisions.  Hopefully he will revise you to a DS rather than a VSG.

Could be that the NP is not real familiar with the DS.  I know that the 2 NPs who were there at the time of my surgery no longer work at this clinic.

Hey Vicki!!  How the heck are you?  I knew that Dr. D was their main revision man.  You may remember that he did the revision of Kim's mini gastric bypass that had her so malnourished.  I know he restored her health and people seem to really love and respect him.  The NP is the one who has worked with my surgeon, Dr. O'Rourke for the past several years, so I think you're right -- she's probably not aware of all of Dr. D's areas of expertise.

How have you done with your DS?  Have you lost all you wanted to, and do you feel your health is good?  Any complications?  I'm just so excited to have someone ready to talk seriously with me about this instead of sending me to yet another endocrinologist who will misunderstand what I want.  I think they all just think I want to lose more weight -- which I DO, but that's not the major issue here.  I want to be able to eat like a normal WLS patient -- most food groups with a minimum of refined carbs.  I'm a little sick of tuna and salad!

I have done very well with my DS.  I have lost significant weight but not all I wanted.  I want to lose another 40 pounds; 50 would be good.  I haven't had any significant health problems related to the surgery.

I haven't had any complications from the surgery itself.  My gall bladder was left in during the DS surgery, and I was given a six-month prescription to prevent gall stones.  However, it became necessary to have my gall bladder removed via lap at 19 months post-op. Dr. D did the surgery, although any other surgeon in the clinic could have done that.  Good thing was that I had lost a lot of weight, making the surgery a lot easier.  I spent only 28 hours in the hospital and went home and ate as if I hadn't had surgery.  I was out of work only 11 days post-op and was very tired the first few days I returned to work.

My taste buds have changed significantly since surgery, as many foods taste different from before my surgery.  I no longer tolerate sugar alcohols but I can ingest sugar with no problem.  I don't tolerate many refined carbs either so I try to avoid them.  Sugar tastes a lot different now than before surgery so I don't need to consume sugar if I don't want to.  I eat most protein from meat, fish, eggs, and full-fat cottage cheese.  There are days when I feel like I can eat all day; others when I feel like I can eat only a little bit.  I got full very easily the first year; now I get full when I have had enough.

I take acidophilius with psyllium as probiotics every morning as well as 500 mg of calcium citrate, Vitamins A, E, and D3.  I take another 500 mg of calcium citrate at least two hours later and another 500 mg of calcium citrate another few hours later.

I can now fit into most armchairs, which I couldn't do when I was so big.  In fact, I bought a newer model of car two years ago, and the driver's and passenger's seats are about a couple inches narrower than the ones in my previous car.  Good thing is that I can still fit into them rather than have my body hang out of the seat.

I think you may be very happy with a VSG.  Depending on your situation it may be all you need.  In hind sight I would have probably done great with just good restriction.  I would like to be at least 10 lbs heavier but I have been unable to gain any weight in nearly 2 years.  I know people have no sympathy for me but believe me, I would rather look healthy then be too thin.  If I had it to do again I would have gone for a small sleeve with no malabsorption but back when I had my first WLS, in 2002, the sleeve wasn't even being done as a stand alone procedure or I would have most likely gone with that.  At least with the VSG you will be able to eventually have a revision to the DS down the road if you find that you need the malabsorption.  And most important, your symptoms should go away and you can live a more normal life.

I'm sorry to hear of the problem you're having.  I have had friends who could not gain and I know it's an awful problem, even though some of us dream of having such a thing happen to us.  I am thinking that I may just go with the sleeve.  Part of the problem on this journey, as they tried to help me malabsorb carbs, etc., has been horrendous gas, which I understand can be a real problem with DS.  I don't want to be out of the frying pan and into the fire.  Right now I worry about restriction alone not being enough, but when you have hypoglycemia to the degree I do, you're nearly constantly hungry and you crave carbs.  I've been having such a hard time holding the line on my weight, but I'm managing.  I truly believe that, if I get the endocrine crap under control, I can deal with restricted eating.  Also, it will be nice to be able to burn calories more normally instead of having the out-pouring of insulin try to store everything I eat.  I'm wearing the soles of my feet out walking 5-6.5 miles a day.  Plus, I'm so very tired.  I wish you eventual success in getting your weight up some.

I had Dr. D, too, and I believe he knows what he is doing.  I can tell you that since my revision nearly 3 years ago I rarely get hungry and have to schedule my meals or I may go all day without eating.  I get full very easily even now.  Sometimes I wish I could eat more but most of the time I am happy being satisfied with what I can eat.  I know before this happened with me I assumed that all people who couldn't gain weight were eating the way I used to.  Now I realize that for me, anyway, that I just don't care as much about food as I used to.  Even though I know that I can eat anything I want (except things with sugar and gluten) I just don't care about it.  I throw out food all the time because it sounded good to me at the time but then after having a little I don't want any more.  I am not kidding, I have at least 4 or 5 half gallons of sugar free ice cream in my freezer because it sounded good but then I forgot I had it and now I have to throw it away.  

I hope you are approved very quickly and have a great surgery and recovery and have great health from now on.  Before my revision I was very sick and it took me a long to finally get back to normal but now that I feel better I am so grateful I had the revision.  Even with my problem I feel 100% better then I did 3 years ago.  I just look unhealthy ;)

What was your original surgery, and what were you revised to?  Dr. D has a really good rep among the people I know.  He's saved at least three friends of mine, particularly one who had a mini GB in Las Vegas and was starving to death.  The woman was nothing but skin and bones and was being fed by a tube.  Dr. D restored her health.  I felt very comfortable with him today.  He asked good questions, I think was impressed that I had done my homework and knew what I was talking about.  He was happy that I had brought him the reports of a recent abdominal CT and my bloodwork.  I also had my glucose meter for showing how my blood sugar drops when I eat.  Since OHSU is a teaching/research hospital, he sent a medical student in to talk with me first.  She was actually really good.  I think she is learning from the best, and that helps!

I had a DS back in 2002.  Maybe he didn't have a lot of experience with them at that time but I had nothing but problems, many due to my own making.  I really had no idea that eating refined carbs would lead to constant diarrhea, bloating and gas.  I also had chronic bacterial overgrowth in my intestines.  Plus I continued to overeat and eat the way I had been.  For the first few years I lost weight in spite of that but after a few years the weight started coming back on, so much so that I had regained 100 lbs by the time I had my revision, although truthfully that is not why I had the revision.  If it was only weight regain I never would have had a revision because I knew that I was the problem, not the surgery.  But I was so sick and miserable that I begged for a reversal.  Dr D told me that it couldn't be reversed but he could revise me so I wouldn't malabsorb so much.  That did solve my problems.  The day of my revision was the last day of my intestinal issues but I also changed my eating and gave up sugar and gluten.  Dr D also recommended that I have my sleeve made into a RNY pouch.  I agreed because I never felt any restriction before so I assume he made my sleeve very large, probably to compensate for the malabsorption, which he really doesn't care for because of so many vitamin deficiencies due to lack of compliance.  That may be because they really didn't give very good post op instructions back then.  All I know is that they had a lot of issues with many of their DS patients and last I heard they no longer offer the DS routinely.