Trying to decide on which type of revision

Hi All,

I originally had a band for about 10 months back in 2010 but after no success, I converted to a sleeve. My starting weight was about 205 and I'm 5'3". I had both surgeries performed in MX by two different surgeons. I did this as it was quick, inexpensive and I was a single mom at the time and the timing just worked well. I also knew there was no way Kaiser was going to approve me at the time for either.

I got down to 128 very quickly, had some stomach issues, had to get my gall bladder out at about 6 months after surgery. Then my weight slowly crept up to about 138 - which was a nice weight for me. Well, I got remarried and had a baby. My husband insisted I eat, eat, eat and I gained 30 lbs during pregnancy bringing me up to just under 160. It was odd but around month four of pregnancy, my capacity increased significantly. 

After having a healthy pregnancy and healthy baby, I lost the first 20 lbs quite quickly. I was nursing my baby and had the strongest craving to drink juices and sodas. I think my body was craving the sugar and hydration to help nurse the baby. Well, now 14 months after giving birth, i'm back up to 160 lbs and am considering a revision.

I spoke to my sleeve Dr in MX, Dr. Rodriguez, and he is suggesting the RNY. I've gone through BeliteWeight and the coordinator stated that he would have to be strongly persuaded to do the DS as he is concerned with the malnutrition piece. She also said that given my current weight, even with the RNY, I might go below what I am wanting.

My insurance does NOT cover bariatric surgery as well, but was thinking of getting a US opinion as well.

So... I'm seeking input from the community. I've been off the boards for so long, can't even dig up my old password to log in.

Any input is appreciated.

I should also mention that I already deal with dumping and I get some nasty diarhea if I eat food that is too fatty. For example, ANY time I go out to breakfast - even if I just order eggs and bacon with tomatoes, I'll be in the bathroom mid-way through the meal. I've also become lactose intolerant.

None of of this makes sense, other than the fact you have a RNY surgeon that doesn't do the DS, and they NEVER send away a paying customer. You need to get unbiased advice from a surgeon that actually does the DS as well. He is a "bait and don't switch" surgeon, meaning he says he does the DS, then if anyone actually tries to get one, there are always reasons, even if untrue, than they can only get RNY.

You have the first half done, of a superior surgery. The malnutrition part is BS as well, when the RNY which is suggested as you malabsorb nutrients for life with that as well. If that's a worry for you, learn how to get by with the sleeve. 

If you think dumping is what you have going on, study the purpose of the pyloric valve on the bottom of your stomach and how cutting that out of commission and instead poking a hole as a man made "stoma" can only make that worse - so much worse. 

I had insurance that would pay for RNY or band, and I chose to self pay for DS. I too went outside of the country for budget reasons, but you can get a top notch surgeon in MX. If I knew everything then that I know now I'd have likely gone to Ungson in MX. 

I'm worried you are going to get your sleeve butchered into a pouch, end up far worse off, and your stomach will have been cut so drastically several times you will have no chance of a future revision for the possible reactive hypoglycemia and dumping that the RNY is known for.

  The gastric bypass is a good tool for weight loss and in certain cases it is  the surgery I recommend to my patients, in cases like extreme acid reflux  for example the bypass is the best option, but the bypass will not take care of your dumping and it may make it worse.    The DS would be the surgery that I think would work best for you.  You already have a sleeve so the natural progression is the DS.   Both the DS and RNY have the malabsorbic component so  you still have to deal with that, it is easy to prevent malnutrition if you supplement properly.  Your surgeon may also adjust the length of the limbs to give you a not too aggressive DS if you do not need to lose too much weight.   The Ds has the best long term results for weight loss maintenance.  In the end you need to decide which surgery will work best for your needs.

Dr Ungson