Question for the Veteran DS'ers

These smileys are great!

In 2000, I had the vetical banded gastroplasty (used mesh for stoma). Very soon after my surgery, the staple line broke down. I went to a few doctors later on and they said a revision to rny could not be done (Alberta does lap band, sleeve and rny). Fast forward 10 years. My barium test indicates that me staple line is completely broke down - with just the mesh remaining somewhere (was not evident in the tests so far would need further testing). In speaking with my doctor, he recommends doing the bottom portion of the DS and leaving the stomach as is. My question is not about surgery choice.

My question is: in your opinion (S), what do you think I should be prepared for with having the intestinal part of the DS without change in my stomach? What do you think I would have to be careful about in regards to eating? Any suggestion about recovery and eating would be most appreciated. Any weight loss predictions would be nice too. Please keep it as constructive as possible - we are in this battle together.

Thank you so much,

Shawna

I have read that the sleeve helped get the weight off but it was the rerouted intestines that KEPT it off. So while you may not eat smaller meals than now, you will still have the malabsorption to help...

Also they ARE doing the switch part in Europe with success on "smaller" individuals (those under a 35 BMI) leaving the stomach alone.

Yup, the switch is being done in Europe for diabetes and from what I've read it works great for the diabetes but not so much for the weightloss.

You would have to do more research to find out if it would be worth doing.

I would also consult with another surgeon on the stomach part, but then I don't really know anything about the VBG that you had.

Good Luck

Hopefully PattyL will chime in here. Her husband had just the Switch done, for his diabetes. He was about 30 pounds over weight. His surgeon told him he'd lose 30 pounds and his diabetes, and that's exactly what happened.

I'd be getting a second opinion about the stomach. I'm really afraid you won't lose much weight still trying to satisfy a big stomach.

MsBatt said it all - yes, it can be done, and is being done (in other countries) for people with severe type 2 diabetes. They lose a little weight, but not that much. It seems like the metabolic changes and malabsorption created by the "switch" part of the DS need some degree of restriction to effect significant weight loss.

that said, I have heard of people revising from vbg to a full DS. The vbg is rarely done anymore because of exactly what happeed to you - the staple line falls apart, leaving the patients with, well, nothing to help them at all. However, this type of revision, really anything that would involve operating on your stomach, is challenging because of scar tissue from the prior vbg and most esp because of the mesh. If you are at all interested in having this done, make sure you go to a very experienced DS revision surgeon. Probably the only one in Canada would be Dr. Gagner in Montreal.

Larra

Thank you for your replies!

Larra - my doctor is Michel Gagner. Honestly I am nervous about him having to fish out a piece of mesh that has grown it and take out the lost staples and the reconstruct my stomach. It can be done.

Ive been doing a bunch of research about the intestinal piece of the ds - research is saying individuals lose a percentage of excess weight rather than a certain amount. I am very interested in reversing my diabetes and sustaining weight loss as I lose - it will likely be slower.

Shawna

Shawna, I'm glad you have already found Dr. Gagner and hope he can help you. I totally understand your concern about having any surgeon working on that mesh. The mesh is designs to promote tissue ingrowth, which is great if you want it to stay put and bad when it needs to be removed. But as they say, that ship has sailed.

We've encountered some patients, with both Dr. Gagner and other surgeons, who had had such bad scarring around their stomachs (not always from vbg) that the surgeon has ended up doing something other than a "true" DS. If you do go to surgery with any surgeon, I would recommend having a frank discussion beforehand about what problems might be found, what options exist if the DS can't be done, what would and would not be acceptable to you, etc. Much better than waking up with a "surprise".

I think the intestinal portion of the DS would most likely help greatly with your type 2 diabetes, though not everyone gets a full resolution. But as to the weight loss, I'm much less confident.

I have also sent you a pm.

Larra

Thank you so much for your very quick replies. I have a great deal of respect for you all. I am so grateful to have my "peeps" to ask questions of because nobody else would have a clue. I've tried explaining it - I was referred to a psychic today lol in hopes of me deciding against having a surgery at all. As all of you know - this has been a very exhausting lifetime battle. It affects my family and their activity level - my 8 year old son is overweight.

The last 6 months I have been foggy brained and tired - due to the diabetes. I know this will be motivation for me to get my butt in gear. In fact I am going to start exercising this weekend - I want to be healthy and strong for surgery.

With regards to recovery what do you think I should be prepared for with having the intestinal part of the DS without change in my stomach? What do you think I would have to be careful about in regards to eating? Any suggestion about recovery and eating would be most appreciated.

thanks

Shawna

I had a 2 part DS, so my stomach wasn't touched either. I was in hospital for 4nights/5 days. The day of surgery and the day after were both nil by mouth (I was still very sleepy the day after). In hospital I had just broth or a yogurt (1 yogurt for the entire day), so in effect I had a 5 day pouch test (and yes I know I don't have a pouch).

Anyway, my surgeon wanted me on liquids and VERY soft food for a month. I had scrambled eggs, yogurt, runny chili, fish, etc. Try and get your vitamins lined up pre-op - you'll still probably want chewables for the first month and Vitalady does such a pack for DSers.

I had 6 weeks off work as it's still a major surgery and I wanted to have my bathroom routine together before going back. Plan your recovery as if it were a full DS and then hopefully you'll just be pleasantly surprises. Introduce foods slowly as you don't know how your reconfigured intestines will react.

WRT loss it'll be slow, but the longer you can stay on the Atkins wagon the better.

BTW I lost 100% EWL but I was a lightweight.  My common channel is 75cm as that's the length that my surgeon does (he only does 2 step DSs and he doesn't believe that any longer will work for 2 steppers).

Do you have any restriction with your VBG?  My surgeon was prepared to re-sleeve a little if required but when he opened me up he said it was OK.