Hello Sleevers- A few questions from someone who is about to be revised

Good Morning Sleevers!

I am going to be undergoing a revision to a sleeve (from a RNY) in a couple of months.  I have had absolutely no surgical problems relating to my RNY and have lost all of my excess weight.  I'm 2 1/2 years out from my RNY.  The reason for my revision is that I suffer from severe hypoglycemia now in spite of following a very low carb diet, so I'm revising to put my pylorus back into the picture and hopefully to get the hypoglycemia under control. 

I go to my sugeon next Wednesday for a preop appt to schedule my surgery and talk about any questions I have and am wanting to know what other questions I should ask besides what I already know....

Still be on Low Carb/High Protein (I'm already doing this)

Vitamin Supplements (I'm already doing this for my RNY, but would I be able to cut some of the supplements down because I'm going to be losing the malabsorption piece once I'm revised to the sleeve?)  My labs have all been great with my RNY so far. 

What exactly do you guys mean when you say that your sleeve is "oversewn"?

How many grams of protein do your Dr's recommend after a sleeve?  My Doc said at least 60 with my RNY, but I find that if I don't hit 100 then my hair falls out.  Hopefully that will improve with the sleeve since I'll be losing the malabsorption piece.

What other stuff do I need to know about the "sleeve" experience?  I would assume that I may experience more heart burn, and that I would be at a higher risk for strictures since I'm going to be having my stomach put back together and then recut in a different place. 

Am I missing anything else?  From reading this forum it doesn't seem like you guys have a lot of "issues" with your sleeves, or is that just my impression.  I'm interested in hearing the good, the bad, and the ugly.

Thanks Everyone!

hyp"o"glycemia or hyp"er"glycemia? cuz if ur hypo, u should actually increase ur carbs/not be on a low carb diet...

In many RNY patients carbs may  cause "dumping" one of the symptoms of this is actually RH  reactive hypoglycemia...so adding more carbs esp simple ones can have  the  opposite effect.....need to eat low carb with small amounts of complex carbs to keep an even baseline with blood sugar.

gotcha! forgot all about that... thx!

Yep, you're right.  My hypoglycemia is reactive.  BTW...Way to go on your weight loss.  You're right, your sleeve does kick ass!!  I'm impressed. 

Yep, it's hypo, not hyper.  I produce too much insulin when I eat even very small (grams in single digits) amounts of carbohydrates, regardless of whether it's complex carbs or highly refined carbs.  And to complicate matters sometimes I can eat something and be perfectly fine, and then the next time I eat the same exact thing in the exact same quantity and I'll get low blood sugar.  It's like that saying from Forrest Gump "Life is like a box of chocolates, you never know what you're gonna get"

 Wow, that' s interesting...I've seen a lot of bander revisions to VSG, none of RNY....
I hope it works out for your problem...

As far as my sleeve experience, it has been great...no complications...no real issues...The hunger greatly diminished. The weight loss has fallen off pretty easily....my cravings for bad food lessened. My energy returned and I feel fantastic. I'm off all prescription meds and am healthier and skinnier than I have been my entire adult life!

Minimum protein is 60 gms for my plan....I sometimes fall below this on a day, but then I get more on some days...I did lose a lot of hair in the early post op days, but is coming back in now...

I do have heartburn, but it was way worse before surgery and before all the weight lost....I used to take 40 mg Prilosec pre-op daily...now I frequently miss days on end before an episode.

I love my sleeve, and am so glad that I went ahead with WLS, best decision ever!

Good luck! :)

Good luck with the revision...It is rare for RNY to sleeve......is your surgeon a "revision" savvy doc?  if so....how many RNY--->VSG have they done?  Just pick an experienced surgeon is what I'm saying....good luck.

Hey there. Good luck with your revision. I do know you have some risk factors we don't have, but we have many revisions on here from band who've done great.

I actually take a bariatric vitamin, calcium and iron. I've personally added B12 and D3, but mostly because I was low on those pre-op and now that I'm eating less...Doctor's recommendations for protein on this board seem to be all over the place - some as low as 60. So I'd check with your doctor. I do over 100 grams a day.

My biggest concern for you is that early on while they're swollen, healing sleeves are tiny, tiny, tiny. It may be difficult for someone who is at goal to avoid losing some weight during this period. Once your sleeve is completely healed, you will see capacity increase somewhat with time (mine improved gradually until 3 months, stayed stable and then I saw a slight increase at month 9).

Also, some folks sleeves are sensitive to certain foods, especially at first. Example: a lot of people have trouble with scrambled eggs early on, or white meat chicken. Me, I have a tiny sleeve of steel - there's no food that ever disagreed with me, and I've never had nausea or vomiting. Some folks do.

Do RNY patients get foamies? That's a common one for sleevers who eat too much or too fast or don't chew. I managed to give myself foamies from eating too fast just a week ago; only the third time I've done it but proof that some people never learn.

Reactive hypoglycemia seems to be a real bear and I hope the surgery resolves it for you.

Again, good luck.

Edit to add: no heartburn here as long as I don't eat within an hour or so of bedtime. I took a PPI on surgeon's orders for 60 days, then nothing since.

Has anyone warned you about the noises? Sleeves do tend toward tummy rumbling/gurgly noises (which some people have had trouble with because they interpreted them as hunger noises). Sometimes I have to remind my sleeve to use its indoor voice.

Thank you for your reply.

Your vitamins sound a lot like mine currently. I take bariatric fusion, citrical, B12 and D3.  So far my iron has held out really well.  Probably because I've also had a hysterectomy.

RNYers do get foamies if we get food stuck.  It's only happened to me once though, but yeah it can happen and it's not fun.  Oh, and about the noises, RNYers get those too.  It's really weird, but my old stomach makes tons of noise when I've just eaten.  I think it's possessed sometimes . hahaha

I expect that I will lose some more weight initially and that concerns me too.  One trick I learned as a RNYer is that if you water your protein down a lot (like to the consistency of OJ) you can get a lot more in than if you blend ice into it, so that's worked for me in the past.  It may not work with a sleeve though because I'll have my pylorus back.  I'll just have to see.  I'm going to be really good about getting my protein in right before the surgery to kinda "stack the deck" in my favor and maybe eat some more too just to get some calories in before I take the big dive again.  Maybe I can stave off some hairloss.