VSG to DS Revision

I'm looking at my third bariatric surgery. :(

I had a Band installed in 2001... removed 2008 and revised to a VSG.

I lost a lot slower with my VSG than most, and not as much...basically losing 50 pounds...BUT my quality of life was 10000% better than with the Band.  I was pretty happy and got pregnant again.  After my pregnancy, I lost another 25-30 pounds. :)  I kept that off for a year (finally a BMI of 30 woohoo!)... but in the past 6 months have gained almost 50 pounds.  My activity level has actually gone up (I track steps)... my diet has not changed.

My revision surgeon says I need a DS.  I had seriously considered the DS back in 2001, and 2008... but my fear of osteoporosis and iron infustions has kept me from it. (My Mom has had major osteoporosis issues...numerous broken bones, etc.)  

I also know that I cannot follow a low-carb diet.... actually I suck at following any diet.  I am, however, great at vitamins. I don't "need" to be thin, but would like to be in the 175-195 pound range if possible, without any serious nutrition issues.

Thoughts/ideas? Have you had a VSG to DS revision?

Sadly carbs cause weight gain with any surgery or without surgery.  However, you will malabsorb about 40% of the calories of complex carbs with the DS. Complex carbs being veggies and the like.

Read over at DS Facts. Google it for the link.

Thanks for replying.  I know all that...all the DS Math stuff. :)  Been on DS Facts and other boards on and off for years. I've been researching the DS since 1999 when I first looked at bariatric surgery.  :)

However, I also know that for some people, the larger issue with carbs is gas/loose stools vs. weight loss.  I can deal with less weight loss than if I went totally no carb.  I can deal with occasionally smelly/stinky stools.  

Things that worry me is zero weight loss...or the whole osteoporosis issues.  I know not everybody gets them, but for the few who do...life sucks.

Well, I was 52 when I had my DS and I am 60 now.  I have the bones of a teen-ager because I got good advice from DS vets and didn't slack with my vitamins and labs. I taught myself how to read the lab reports,put it all in a spread sheet and watch for anything that was trending downward.  I also started with a full regimen of vites and tweaked downward or upward as my labs indicated.  Some people have experienced osteoporosis due to not taking vites or not being vigilant and some were just in the hereditary gene pool and inherited the gene. They would have had it with or without weight loss. In my case I knew that I wouldn't live long enough to have any bone loss so l was willing to trade.

I have never heard of anyone with zero weight loss in 9 years of interacting with DS patients. 

Hi Sami--

First of all..congratulations on the bandster babies and sleeve baby!  That makes me happy!  I had two beautiful bandster babies myself!  :)

I can't answer the DS question because I'm not qualified and don't know the answer...I'm here myself researching because I am a bandster seroiusly researching getting a revision to a VSG.

I guess what made me post is the worry about you saying you gained after 50 pounds after the VSG.  Can you talk a little bit more about that?  I'm freaking out because I've gained 20 (after losing 150 with my lapband..) (I've had it for 10 years..I still need to take off 50..I can't get that off..now it's going the wrong way and I'm gaining..that's why I feel it's not the right tool and I need the sleeve)..but now you have me really worried that it may fail like that band.  I was thinking about the DS too originally..that is what I really want but my husband is so dead set against it so I was trying to compromise.

What do you think went wrong with the VSG if you don't mind me asking?

Michelle
Washington State

People typically regain with a sleeve for two reasons.  If they lost weight and are not metabolically challenged then the reasons are usually two.  One is going back to white carbs.  Another is sleeve technique.  Even with a mega sleeve most people will lose weight, it's the regain that is at issue.  Bougie size does not matter nearly as much as technique.  This is why you need to go to a true revision surgeon.  Especially since you ARE a revision.  The damage from the band needs to be cleaned up, the scarring needs to be removed and then the sleeve.  If someone is not a revision surgeon they are not usually great about cleaning up the mess and the adhesions.  if they don't remove all the adhesions you are left with a huge sleeve.  

It is kind of sad really, people get a sleeve or a revision from band to sleeve and they lose well.  They think they are doing everything right but down the road about 2-3 years the regain starts.  Then they assume since they lost well it must be something they are doing.

Maybe it is, maybe it isn't.  If the sleeve was not doine by a revision surgeon the technique may not be great thus, regain.

The country of Chile stopped doing bands a few years ago and they opted for sleeves.  Bands were too expensive, not working, harming people, etc.  So some surgeons from Mexico went to proctor them in sleeves and they insisted on using a poor technique and a 60F bougie.  Both set the patient up for failure.  So now it's about 3-4 years later since switching to sleeves and patients are regaining ... again.

Your surgeon is a great band surgeon.  But he's not a sleeve surgeon and he's NOT a revision surgeon.  Hopefully your insurance will cover it in the US and he's not an issue.  Just go to an actual revision surgeon.  Swear off 99% of white carbs and you should be good to go!

I think you misread my stats.  My Lap-Band surgeon was known for Bands, yes.  My revision surgeon (who did my VSG), Dr. Roslin, is known for the DS, VSG, revisions, and RNY.  He is not a band surgeon...he was a "real" revision surgeon.

We talked at the time whether I needed a DS or VSG for my revision.  I was leading towards the DS, but he thought the VSG would be "enough" for me.  Unfortunately, I lost weight only for about 3-4 months before I stopped losing.  I was at 220 until after my last pregnancy, where I dropped down more due to breastfeeding.  When I weaned DS, that's when the regain began. I thought I may go back to 215-220 (where I had stopped after my surgery), but it continued.

HA!  Misunderstandings all around!

That post was to Lacey!  ;)  Sorry!

If you are not eating white carbs and you are still gaining/unable to maintain then DS is likely your answer.  If you are gaining because of white carbs sadly, DS isn't going to help you.  No surgery type malabsorbs white carbs.  :o(

I do remember you from the band board back in the day, aren't you a nurse?  I remember your Av, but I also think I remember that you are a nurse??

Thanks :)

Yes, I've been on OH since the late 90s.  I was famous at one time for being the first threatening lawsuit letter that Eric and OH received regarding my review of a potential surgeon back in 1999. For a long time, that surgeon had zero patient reviews.  (It wasn't that bad, I just said that I found a bunch of errors in his pre-op packet, but I thought he was a competent and good surgeon.)

I don't eat white carbs, but do eat carbs. If I use flour, I use either white whole wheat, normal whole wheat, or a blend of Hi-Maize ( a resistant starch)  and white whole wheat.  I do eat fruit.. maybe 2-3 servings per day, mainly berries in the summer.  I'm not a fan of meat, although I eat it, so the traditional low carb diets have never had any appeal to me. 

A few years back, I used to know a vegetarian DSer from Canada, but no idea what happened to her.