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Hi Laura, thanks so much for replying to me. I forgot to mention I am only 5 feet tall so my 200+ pounds equals a lot more than it does on someone of average height ?. I have decided to convert my sleeve to a gastric bypass but with less intestine bypassed because I don't eat animals and my surgeon said that should eliminate nasty effects of too much carbohydrate. Although he did say complex carbs like legumes shouldn't be a problem with a normal bypass. It's the simple carbs that cause the problem. My surgery is set for April 21st. I'm excited. But isn't it a pain in the rear that our eating disorders make us undertake such drastic actions? ?
Great answer! I second that noting that Dr. Ungson will also revise your sleeve during DS operation if needed.
I know when I went to see about having surgery the BMI had to be 40 or above to qualify. I'm sure it has changed over the years but unless you are considered morbidly obese they most likely will not do any type of weight loss surgery. You will need to consult with a surgeon to see if you to qualify. I think it is a little lower if you have several co-morbidities, like diabetes, sleep apnea, etc. Find a BMI chart and see where you are so you can get an idea of whether you may be in that BMI range.
Thank you so very much for all of this information! I will talk to the surgeon again! My fear is regaining weight again. With the gastric bypass, it is very possible but with the DS it's less possible. That is why I want the DS but I also want the resleeve so I'm nervous.
thanks again! Wish me luck!!!
When I had my VSG, I talked to Dr. Rabkin on this subject - the prospect of revising to a DS later as a "plan B" for regain, and he noted that their experience on the matter is that it works best if you catch it early, before substantial regain occurs. A parallel note is that in the support group meeting descriptions, they presented a semi-rule of thumb that with the DS, it is the sleeve that gets the weight off, while the switch keeps it off. That may not be 100% correct, but call it an 80/20 proposition. So, look at the switch part as more of a maintenance tool than a weight loss tool.
As to whether your sleeve should be revised along with a switch revision, IIRC Keshishian noted in some of our group meetings that when he does the revision, a resleeve is a sometimes proposition, depending upon the condition of the sleeve. Given that there were quite a few wonky sleeves done in the early part of this last decade when it was new to most bariatric surgeons ("twenty years of doing bypasses and they think they know how to do a sleeve...") then there were quite a few that had to be resleeved. As others have said, I would be inclined to get a second opinion and maybe get an upper GI done to get a look at what shape your sleeve is in.
Historical note - as the story goes, the DS had its origins with procedures developed in Europe to treat diabetes, to which the VSG was added to make it a weight loss oriented procedure. These days there are several implantable devices in development that seek to emulate the what the DS does for diabetes by blocking absorption in the upper intestine (things like endoscopically implanted sleeves) so the idea is still active, but being explored in a different form.
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
