had revision consult, now confused!!

i met with Dr. G at abington Memorial on Friday. I have the sleeve and went to him interested in revision to DS for many reasons. Dr G said that the DS would be his 3rd choice for revision. he didnt say that he wouldnt do it but said that he thinks its a bit too agressive. I lost about 80 pounds with the sleeve initially and in the past 6 months have experienced a 25 -30 pound weight gain which is why I am seeking the revision. in august it will be 2 years since my initial surgery. Dr G said that his 1st choice would be to re-sleeve me with a tighter sleeve, 2nd choice would be RNY and the DS would be last. He said if he did it he would do a modified version where he would -attach a bit higher than in a traditional DS. He said that because I have no co morbities the benefits would not outweigh the risks and that mal nourishment is too high of a concern with the DS. I was so dead set on the DS for many reasons.  I dont want to end up with any of those co morbidities, i have regained too easily with the sleeve & never even got to my goal weight and know that the success rate with DS is much greater. I am 40 years old so definitely no spring chicken but hopefully I have many years left. what would you do? I appreciate any advice or insight! tracy

Hi Tracy!

I am going to revise from a Lapband to a DS. Surgery will likely be this fall.

I'm sorry you are dealing with a regain -- that is so frustrating! But, kudos to you for taking steps to do something about it.

I was faced with a similar situation. I have a band and my body is already accustomed to eating small amounts of food and lots of exercise. I stopped losing and started gaining without increasing calories (band is also causing damage so it for sure needs to go whether I revise to another wls or not).   I ended up deciding to go with the DS because clearly just eating less food was not going to cut it.  If you are regaining easily with the sleeve, just think what it will be like a couple of more years down the road when your body is ultra used to the small meals -- even harder. It sounds like you need something to help with the metabolism too.

Best of luck to you!

thank you so much. this is exactly what I was thinking so it helps to hear someone else agree with me. I think I definitely need that major malabsortive component and am much more comfortable with the mechanics of the DS than the RNY. I think Ill push for the modified DS. I dont think he will do a true DS on me.Good luck with your revision. keep me posted!

Go to a different surgeon. 

please get a second and maybe even a third opinion.  A RNY revision is very serious and should be done by very trained dr whether you choose DS, redo the sleeve or RNY

To me it makes better since to do the DS if you are already gaining.  I mean the DS is the second part to the sleeve. has he done any exams to look at your sleeve.

i really would think he would need to do a MRI or some kind of pictures before he should be making this kind of decision.  If he's not experienced I would not let him touch me with a 10 foot pole. 

Please go see a different doc for another consult.

This. is. YOUR. life.  >>>>> Your. body.

i originally had an appt with dr greenbaum who did my father's ds. I cancelled and went to Dr G because greenbaum will only do the procedure as an open procedure and i really wanted it done laproscopically. i appreciate all the advice and will be calling to reschedule my greenbaum appt tomorrow. thanks everyone!!!

Don't let open-vs-lap be a deal-breaker for you. I had an open DS, and then a lap hernia repair---and I swear the lap hurt just as much as the open.

You said he did not say he would not do the DS so I would pick for sure the one you want and go back to him and tell him you have decided to go with _____ and let him formally deny you before you switch surgeons. Unless you are unhappy with him. I would recomend you not get the RNY. You have gained some weight back with the sleeve and you do not want to go with another WLS that shows regain. I have an RNY, regained and would prefer a DS but I am not able to. If you get an RNY your choice of surgeons to revise to a DS later is extremely limited. I would check if you could get a DS common chanel re elongated if you needed to later. You should know that RNY malabsorbtion ends at around 2 years and then you have a mature pouch which can hold a "normal size meal" (not all people though) and the malabsorbtion goes away and you will absorb all your calories. This is where the weight regain comes in if you are not Nazi about what and how much you eat.

Hi!  Is G as in the famous ADHD Gagner?  If so probably not so gung ho on the DS for you because he does not stick around long enough for paint to dry let alone the  long-term after care all of us post-ops need.

What is your stats anyway.

All best,
Leila