I have seen it done on rare occasions where the DS misbehaves or was not done correctly in the first place. I can't comment on whether the RNY is any more resistant to a hiatal hernia recurrence - they both have a small stomach that seems to be prone to being dragged up out of the abdominal cavity. I would certainly get a second (and possibly third) opinion on it. Is the doctor whom you're consulting your original DS surgeon, or someone else - those that don't do the DS can often be quick to ditch it as they aren't that familiar with it (or often, the sleeve itself.)

I understand the concern about minimal weight loss with the change, as the RNY is a metabolically weaker procedure than you DS. Something that might be considered is the uncommon distal (or long limb) RNY which has a weight loss and nutrition/supplement character similar to the DS. It isn't usually covered by insurance as a primary WLS but is when appropriate as a revision. It doesn't have a great reputation as it tends to be troublesome, but I suspect that much of that is because most treat it the same as the standard proximal RNY rather than a DS, and that leads to long term nutrition problems.

Yeah, personally, I've learned to stay on top of things by getting regular blood tests to see where my levels are at. It's like my own little health checkpoint. Chatting with your doc about specific tests or their take on managing calcium and vitamin D could give you some solid guidance.

Take a look through the various articles and blog posts from Dr. Keshishian at https://www.dssurgery.com/articles/ . There is likely something in there covering your concerns, as it is something that would come up from time to time in our support groups (before covid halted them.)

It is likely something that you need to see an endocrinologist about to see what's happening - thyroid possibly? If you are just now seeing low levels in your labs, it may be something that has been going on for a while as the body works to keep serum Ca levels constant - by using your bones as a reservoir - so certainly something to get on top of. Have you had bone density scans lately? That's something that should probably be routine for anyone with a malabsorbing WLS.

the body tries to adapt to the malabsorption caused by the DS over time do I wouldn't think the absorption would get worse over 30 years, but I could be wrong.
good luck with your search for answers.

I read that but there are several different kinds of calcium. Some are better absorbed than others. Look on the packages at the labels to what kind of calcium is in them.