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Should I convert my sleeve to the gastric bypass?

jennifer.mcknight12
on 10/14/12 7:50 am - SC
Hello everyone!  I am over a year out from my gastric sleeve surgery.  I have lost and gained since my surgery of course.  My top loss has been approximately 55 lbs.  My start weight was 335 and my current weight is 285.  I am not pleased at all.  The struggles that I had before surgery still haunt me.  I eat whatever I want and have no control over carbs.  I wonder if going to a bypass will help with my restriction.  Does anyone have any suggestions or has gone through this procedure?  Thank you all for your help. 
Julia HasHerLifeNow
on 10/14/12 8:00 am
VSG on 10/09/12 with
If you are going to look into a conversion then I would suggest looking into the DS rather than the bypass. I am too early in the game to give any advice really but the sleeve is a first step to a DS already. The RNY and the DS won't give you additional restriction but will give you a malabsorption component. The deterrent to eat simple carbs with the DS might be quite strong...there is less longer term regain with the DS. However it does require a lot of commitment to your health and monitoring of your micro nutrient levels. Have a look on dsfacts.com or read on the DS forum. It is the Rolls Royce of WLS.

View more of my photos at ObesityHelp.com 5ft0; highest weight 222; surgery weight 208; current weight 120

     

    

Bellaluna468
on 10/14/12 8:16 am, edited 10/14/12 8:22 am
RNY on 10/26/12 with
 I think the defining statement you made is..."I eat whatever I want and have no control over carbs."

Neither surgery will remove the urges or the desire for you.  Perhaps you need to find out why you can't control yourself when you have a tool to help.  The surgery for sleeve and bypass are not going to be the magic and the weight falls off....it will help, but if you put the wrong foods in...it's not the fault of the sleeve or the bypass.

if you go back to basics and eat protein, very little carbs...you can lose weight.

Have you considered therapy?

I am scheduled for surgery soon, but I do know if I go back to eating the foods that I eat now, I have no one to blame but myself.  The bypass isn't responsible for what I put in my mouth and I can 
restretch my pouch.

      

beckyinkc
on 10/14/12 8:18 am
VSG on 07/25/12 with
While a malabsorptive component might help a bit with the loss, because you won't actually absorb all of your calories consumed, it will not fix your compulsions.  No surgery can do that.  I would strongly recommend that you start with a nutritionist and a therapist to help you get through this and get in some good habits.  Good luck!
   
califsleevin
on 10/14/12 8:18 am - CA
Another vote here for the DS as the next step for a VSG that isn't providing the expected gain, or if regain is a problem. Averages suggest that a move from the VSG to the RNY is a sideways move, as both are very similar in their weightloss and regain characteristics - the RNY has a token malabsorption component, but it is temprorary at best, though its' mineral malabsorption is permanent. Further, the RNY is something of a dead end, surgically speaking, as if it doesn't work for you, there is little that can be done to change it - there are minor tweaks they can do like tightening the stoma or banding a stretched out pouch, but converting it to something more effective like the DS is very compicated, a procedure for which very few surgeons are qualified (Gagner is one, Rabkin is another, and there are a handful of others - assuming that there is enough to work with after the sleeve has been cut up to make an RNY pouch. The downsides of living with the RNY and DS are similar, though the RNY is more limited in dietary and medical treatment options (no NSAIDs for pain relief, for example); both malabsorb some nutrients, with the RNY more fully malabsorbing minerals while the DS only partially malabsorbs minerals but also malabsorbs the fat soluble vitamins A,E,D & K. The vitamins are more readily supplemented than the minerals often are, with many more RNY patients subject to periodic iron infusions than DS patients. The main long term malabsorption of the DS is fats, along with some carbs and protein; overall, it typically moves ones' metabolism back to a more normal state and allows for more normal eating patterns. It is not a total solution to your eating weakenesses - no WLS is - but it is more tolerant of them than other procedures.

1st support group/seminar - 8/03 (has it been that long?)  

Wife's DS - 5/05 w Dr. Robert Rabkin   VSG on 5/9/11 by Dr. John Rabkin

 

desertmom
on 10/14/12 8:22 am - Dubai, XX
VSG on 03/13/12
My very close friend had GB 2 years ago and have now regained 25 pounds.She visited me recently and she is eating loads of carbs.She is super defensive about this, as well as very unhappy about her weight gain.

I believe that no matter which surgery we have,we have to make the choices for ourselves and somehow deal with the issues that makes us feel so out of control.

You've still got your sleeve.Start working it again.Protein in good portions first.Veggies second.then if you have space for anything else carbs.

Good luck to you and I think if you can just start again,you'll be so glad not to need another surgery!

  

    

    

    
PoohHag
on 10/14/12 8:58 am - TN
VSG on 06/11/12 with
 See a therapist.  

Your sleeve hasn't failed you.  You're failing your sleeve.  If you really want to lose weight, you'll follow your nutritional plan.  There is no magic weight loss surgery.  It's work, plain and simple.

        

soon2b20
on 10/14/12 9:09 am - NJ
PoohHag...  you said what I was thinking.

I would not be where I am without going to support groups and seeing a therapist.  

    
Crabadams72
on 10/14/12 10:16 am - Silver Spring, MD
No surgery will work with a non compliant patient. Point blank period.

Even with a DS you have to watch your carb intake and be on top of your vitamin intake. Get in touch with your bariatric team. I'm sure they can help you be successful.
VSG 6/10/2011  Dr. Ann Lidor BMore MD 5'5 HW-247 SW-233 GW-145 CW-120
        
http://www.youtube.com/user/72Crabadams   Me rambling about my journey : )

Ms Shell
on 10/14/12 10:26 am - Hawthorne, CA
The struggles that I had before surgery still haunt me.  I eat whatever I want and have no control over carbs.

Well this right here is a BIG problem.  Please research your options and get soem therapy about your HEAD because no matter the surgery you can and will find a way around it if you don't.

Ms Shell


"WLS is only for people who are ready to move past the "diet" mentality" ~Alison Brown
"WLS is not a Do-Over (repeat same mistakes = get a similar outcome.)  It is a Do-BETTER (make lifestyle changes you can continue forever.)" ~ Michele Vicara aka Eggface

blackegi
on 10/14/12 10:48 am
VSG on 08/07/12
 I'm 2 months out and already feeling your frustration. And while many responses here are chiming on the  fact that you said you "eat whatever...and have no control over carbs", I noticed that you loss approximately 55 pounds. Which says to me at some point you did try to follow the diet guidelines and that's how you lost the weight you did. I suspect that once your weight started to slow , there was less incentive to stay on track. Thus came the RETURN to old eating habits. You're gonna get a lot of responses about "get your head right", "your sleeve didn't fail you" , "you have to have will power" blah blah. But in the end, you chose the surgery because trying to do all those things before  your surgery, just didn't work. And when you realized that  following the surgery guidelines still doesn't get you anywhere you need to be, unfortunately it is easy to fall back. I'm sorry, but if seeing a therapist and nutritionist were such great problem solvers post-surgical, then it would be problem solvers before surgery and you wouldn't need it. 

I think Drs, healthcare professionals, and yes even us patients, need to be more upfront and vocal about the fact that for many people, WLS of any kind just may not fully resolve longterm obesity. Yes you hear how common failure is AFTER an initial amount of major weight is loss, but rarely do you hear about those that struggle to get to goal. And that's a major disservice. I'm learning that those of us who voice concerns about our slow weight loss during the first months are often "yelled at" as being stupid wimps who can't make this thing work. My stand is if we paid $30k for anything less than a major surgery, and didn't get the results we were sold (let's be real that WLS has no become a big marketing ploy with DRs) then everyone would be up in arms to help us get it right! I mean women can pay $10k for fake boobies and if one of them is lopsided, droopy or whatever, rarely does anyone blame the patient-instead it's the surgeon's fault.

Okay that's my vent for the day. I just had to say "I feel your pain" before everyone else cause you more. If i had a vote, i'd tell you to research DS for all the reasons that others listed. 

Best wishes to you in whatever you choose! 



~Regena from SC: /Surgery Weight 317/Highest Weight 321
               

louisamay
on 10/14/12 12:09 pm
VSG on 04/27/12
I followed this site for only a few weeks before getting my sleeve, and I saw it repeatedly stated that the sleeve is just a tool and you will have to make the choices to eat the right things in the right quantity for the rest of your life or the weight won't stay off (or come off).

I'm not sure how anybody could miss that memo.

I do think it would be easy to ignore it and focus on the posts that talk about only being able to swallow a few spoons of food, foamies, etc.  But even then, people are warned that this doesn't usually last and eventually you will be able to eat what you want in most cases.

My surgeon told me that in my case (since I started out with a goal of losing 80 pounds) the sleeve would take the weight off, what happened after that was totally up to me. My PCP told me that weight loss surgery of any type only worked if the patient was fully committed, and told me that one of his patients who had a gastric bypass never lost his weight at all--he just drank shakes all day long and his caloric intake stayed the same.

I do think it's possible to go into this having read all of the facts and experiences and still think you can handle it, and having a rude awakening when you find out you can't, but to say it hasn't been acknowledged is strange to me.

The reason why counseling and such may help AFTER the sleeve when they didn't before is because the sleeve removes the hunger issue and leaves only the emotional issues. It CAN make a difference.  But MANY of our successful vets have posted time and again that they couldn't have lost their weight and kept it off without counseling and/or group meetings.

Good luck!

[I'm not gaining weight. I keep lowering my goal!] [I LOVE MY SLEEVE!]

                  

    
Carmelita
on 10/14/12 1:13 pm - Four Corners, NM
 
From the Movie Benjamin Button:
Benjamin Button: [Voice over; letter to his daughter] For what it's worth: it's never too late or, in my case, too early to be whoever you want to be. There's no time limit, stop whenever you want. 
You can change or stay the same, there are no rules to this thing. We can make the best or the worst of it.
I hope you make the best of it. And I hope you see things that startle you. I hope you feel things you never felt before. I hope you meet people with a different point of view. I hope you live a life you're proud of. If you find that you're not, I hope you have the strength to start all over again.

Its never too late to start all over Jenn!

I don't know if your less than stellar weight loss is cuz of YOU or cuz YOUR surgeon. Im thinkin it can't ALL be you.  Do you have a copy of your med records? if not l
ook into gettin a copy (pathology report % & dimensions of exised stomach ) and a copy of your leak test (radiology) to see if your sleeve is anatomically correct.

With your follow up surg visits ...3, 6 month post op visits...and your annual...what did your surgeon & nut say about your poor weight loss? 

Maybe take a look at these posts I wrote to other VSGrs contemplatin a revision from VSG (links below).....
Do the two tests.....tools available to us... would be the most telling if its YOU!! Can do both in 5 days!  
Check your restriction (5DPT) and
capacity (CCT)..to see exactly where you are at.
 If its YOU or if its sumthin up with your sleeve...capacity/restriction. 

maybe you DO need malabsorption! Can eat a crapload of calories n absorb just a fraction of em! You'd be surprised how many peeps do give VSG a shot but it doesn't work for em!!  Mostly ALL revisions from VSG go DS, a couplea of REsleeves...but I don't read of many VSGrs that go RNY by CHOICE. They're usually FORCED into it because of some medical problem like ulcers, bile disorders (DBR), Barretts or whatever. 


If I had my ruthers I'd check out DS vs. RNY. Ya got the stomach already. I could never give up my pyloric valve. That is MY dealbreaker. With both RNY n DS you must take a crapload of vit$ n min$ everyday cuz of malabsorption...ya MUST be able to AFFORD DS not only in daily vits n mins, lab work (4 first year, and 1 every 6 months I think) for life
, cuz if ya don't the consequences can be dire. DS would give ya the dramatic results you seek..but Jenn ya must take it serious!
Nothin remotely close to VSG...the way we sleeve n leave... DIY n ***** about the last 10 pounds, re-gain!

Check out the DS Forum talk to em...much improved! Also check out dsfacts.com  for surgeons that specialize in DS n revisions. Wouldn't hurt to consult w/ some surgeons!  I betcha ya qualify too.  Chin up Jenn...the answers will come, they always do!!



http://www.obesityhelp.com/forums/VSG/4559122/Has-anyone-eve r-had-their-sleeve-made-smaller/#37790639
  

http://www.obesityhelp.com/forums/VSG/4568027/Stomach-Streac hing/#37863514


lucy2e
on 10/14/12 1:24 pm - Laurel, MD
VSG on 06/01/11 with
I agree with some previous posts - you need to work with a therapist to get your carb/food addiction issues under control.  There is no surgery that will defeat all food addiction issues - you will find a way to eat around a sleeve, RNY, DS or any procedure if you don't get your head in the game.

I'm sorry you have struggled - I think that if you do get your "head" issues under control, you can still use the restriction that your sleeve procedure has given you to succeed.  You can get back to basics, eating protein first and filling in with veggies... but therapy should be your first step in my opinion.

Good luck! 

Lucy  (Imma Loser!)
  LilySlim Weight loss tickers                  
HW 335 SW 311 CW 181.2 -- Goals:  Twoderville - 6/7/11, 280 - 7/1/11, 260 - 8/1/11, 240 - 10/30/11 Centry Club - 11/22/11, 220 - 12/27/11 Onederland - 5/25/12, 180 - , 170 (surgeons goal) -  
We shall see where this leads...