New Here, Need Help

[Larra]

@Band07Sleeve13 you say something about the SADI "should I want to go to a malabsorptive procedure". You also say, in your response to (I think) EN that your metabolism is broken and you are struggling just to not gain weight at present.
Put those thoughts together, and it's apparent that unless you want to continue to struggle (which you clearly don't) you NEED a malabsorptive procedure. A third restrictive procedure will only lead to continued struggle. And keep in mind also that gastric bypass of ANY kind is mainly a restrictive procedure as far as calories go. There is so little small intestine bypassed that there is very little malabsorption of calories, just malabsorption of important things like iron, calcium, and B vitamins, esp B12.
It's your decision of course, as you are the one who will live with the consequences of this decision, but don't you think it's time to go with the procedure with the best results, documented with over 25 years of experience in the USA alone? Instead of something which has NEVER been considered standard of care and which one doc says he has some kind of "special" stitch that he does to prevent a complication you wouldn't even have to worry about if you don't have his not so tried and true operation?

Some people do well with the sleeve. Others struggle. You are one of the strugglers. I say this with absolutely no blame or judgement attached, it's the nature of the operation. In addition to doing your research on various operations, take a good, hard, honest look at yourself and determine what operation will actually work for you, and what will leave you continuing to struggle.

 

[Band07Sleeve13]

I no longer have sleep apnea and I'm not depressed about anything but the fact that I'm gaining weight. If Elizabeth in fact was in that position why would she say I'm crazy to want to do anything I can to not get back to that place ? Yes I said 150 is "ideal" but that is just where I could be happy I feel though at 150 I'm still technically "overweight" by a doctors standards. I would ask anyone here have they read everything that has ever been written about MGB ? Have you reviewed the articles ? Can anyone tell me one negative with the exception of risk for bile reflux which has now been significantly decreased by slightly changing the procedure ? I have obsessively researched for months and I have talked extensively with long term (15 plus years) patients of the MGB who have maintained their health and their weight loss. Yes I asked for the opinions of others, I would just also appreciate evidence to support them and not being called crazy, desperate maybe, but not crazy.

 

[Band07Sleeve13]

@Band07Sleeve13 you say something about the SADI "should I want to go to a malabsorptive procedure". You also say, in your response to (I think) EN that your metabolism is broken and you are struggling just to not gain weight at present.
Put those thoughts together, and it's apparent that unless you want to continue to struggle (which you clearly don't) you NEED a malabsorptive procedure. A third restrictive procedure will only lead to continued struggle. And keep in mind also that gastric bypass of ANY kind is mainly a restrictive procedure as far as calories go. There is so little small intestine bypassed that there is very little malabsorption of calories, just malabsorption of important things like iron, calcium, and B vitamins, esp B12.
It's your decision of course, as you are the one who will live with the consequences of this decision, but don't you think it's time to go with the procedure with the best results, documented with over 25 years of experience in the USA alone? Instead of something which has NEVER been considered standard of care and which one doc says he has some kind of "special" stitch that he does to prevent a complication you wouldn't even have to worry about if you don't have his not so tried and true operation?

Some people do well with the sleeve. Others struggle. You are one of the strugglers. I say this with absolutely no blame or judgement attached, it's the nature of the operation. In addition to doing your research on various operations, take a good, hard, honest look at yourself and determine what operation will actually work for you, and what will leave you continuing to struggle.

Thank you Larra ! That is what I'm trying to do, the MGB actually bypasses between 7-10 feet of intestines, is that small ? I'm not sure what is standard with the regular bypass. The procedure that rectifies the bile reflux has been done since 2004, not a long time but not exactly new either.

I tried to post a link to the study but it won't let me.

 

[Larra]

In almost all cases, at least in the USA, when a gastric bypass is done there is only a very short segment of the small intestine that is bypassed, not 7-10 feet. That's why there is so little caloric malabsorption (not none, but little). It's called a proximal bypass. Sometimes, when this fails, a revision is done in which what is called a distal bypass is done, but this generally doesn't create much more weight loss. So sometimes what is called ERNY (E is for extended) is done where a lot of small intestine is bypassed, but when you combine this with the loss of function of the pyloric valve that is present in ALL gastric bypasses, you can really get into trouble with vitamin, mineral and protein deficiencies. There are people who make this work, but it takes a thorough knowledge of what vitamin and mineral supplementation is needed and great diligence.
And of course there is NO gastric bypass that preserves the function of the pyloric valve, NO gastric bypass where NSAIDs are not contraindicated for the rest of your life, NO gastric bypass where there is no risk of dumping...you get the idea.
I'm not saying that no one in the history of bariatric surgery has not made a success of gastric bypass or loop gastric bypass (which is what MGB is), but I am saying that there is NO bariatric surgery with better documented loss of excess weight than the DS, and no bariatric surgery with better success rates for resolution of major comorbidities than the DS. The results, long term, are very well documented. Again, it's your decision, but aren't you tired of struggling by now? Don't you want to give yourself the BEST possible chance for permanent weight loss and resolution of your comorbidities?

 

[southernlady]

Thank you Larra ! That is what I'm trying to do, the MGB actually bypasses between 7-10 feet of intestines, is that small ? I'm not sure what is standard with the regular bypass. The procedure that rectifies the bile reflux has been done since 2004, not a long time but not exactly new either.

I tried to post a link to the study but it won't let me.

The thing is, the MGB and the RNY are KNOWN for the ability to reabsorb food after a few years. The only permanent malabsorption part is vitamins and minerals NOT calories and esp NOT fat which makes most food taste good. Even noticed that low fat is typically HIGH sugar? That's because low fat in stuff makes it taste bad so they add sugar to it. And check the candy aisle (hard to avoid sometimes)...notice that things like Twizzlers put on their bag "LOW FAT" well, duh, it is but just because it's low fat does not mean it's good for you.

The traditional DS, while SOME absorption of food recreates itself, MOST of it does not due to the placement of the common channel.

You still have your pyloric valve...do you REALLY want to give that up? THAT is the ONE biggest negative of the MGB I see...and I didn't have to read a study to find that out. Do you want to permanently write off a class of pain meds the rest of your life. Cause with the MGB and the RNY, NSAIDS are no longer an option, ever again, even topical ones. BTW, that was MY biggest negative as I require NSAIDS.

At least with the SADI, you keep your pyloric valve BUT we don't have the long track record either. I think the "oldest" ones are still under 5 years out. Not very long at all.

 

[Band07Sleeve13]

This does give me more to think about and consider, I will do more research on the DS. Thank you !

 

[Elizabeth N.]

Aren't you just a very special snowflake. Go get a nice chunk of your small intestine cut out by some dude in Mexico. That will fix you just fine.

 

[Band07Sleeve13]

Aren't you just a very special snowflake. Go get a nice chunk of your small intestine cut out by some dude in Mexico. That will fix you just fine.

You know, I came here for actual support and to get the opinions of others. I don't feel in any way that I have been rude to unappreciative of others responses nor do I feel that it is wrong to ask for more information when someone states those thoughts or opinions which not only do I value but I also take into consideration when trying to figure out what I want to do. Why exactly are you even contributing to a support forum if you can't be anything but rude, offensive and hurtful to others?

 

[Elizabeth N.]

You know, I came here for actual support and to get the opinions of others. I don't feel in any way that I have been rude to unappreciative of others responses nor do I feel that it is wrong to ask for more information when someone states those thoughts or opinions which not only do I value but I also take into consideration when trying to figure out what I want to do. Why exactly are you even contributing to a support forum if you can't be anything but rude, offensive and hurtful to others?

You don't read much, do you? Bye, have a nice life.

 

[southernlady]

Okay, @Band07Sleeve13 and @Elizabeth N. please put each other on ignore.

 

[Will2014]

Band07sleeve13 I understand your frustration and desire to beat your obesity once and for all, but didn't I read that Dr. Ungson agreed and X-rays confirmed that your sleeve was incorrectly performed and needed to be reduced? In all honesty, I don't see why at your weight you'd need to do more than that. All procedures have their benefits...and their detractions. I honestly would get your sleeve adjusted by Dr. Ungson in Mexico. I went there to Dr. Aceves who was trained by Dr. Ungson and can vouch that this guy is top notch. I think a DS would actually be a poor decision on your part in all honesty. The malabsorptive component is a knife that cuts both ways my friend, and the need for fistfuls of vitamins daily to stay alive needs to be considered as well. Most Dr.'s won't consider a DS with a BMI under 35, and while I know you are in the ball park, you are in said ball park because your stomach has been too large all this time. My advice?: Get the sleeve fixed and see how ya do. If you struggle again, consider a proven surgery like DS. But no sense running off in a panic until you see how it all works out. Ok man?

 

[Charris]

Having had a ERNY in 2000 I wish i.would have known about the DS then. I lost all my weight but worked like a dog to accomplish it 2 hours a day 7 days a week in the gym. Along with the ERNY can a bunch of problems extreme dumping, osteoapenia (sp?), sever b12 deficiency. I was a 25 then I'm too old now to be trying to be in the gym like that now. NOT really Too old but too many medical problems 13 surgeries on my back, both of my knees scraped out several times of arthritis. Having said that I needed the best possible surgery that would give me the best results with the amount of effort I can put in. So I guess my question to you is I see your reasoning for the mgb and the sadi, and resleeve what is your reasoning for not wanting a DS? Is it because the doctor's never recommended it? If it is, let me help you and tell you the majority of doctors won't recommended it. Why? The don't have the skills to do a DS revision. Also if they can give you a surgery that takes less time in the OR and collect around the same money why not? Instead of taking up to 4 to 6 hours on a revision to DS I can get maybe 2 or 3 more surgeries in the same day. My DS was almost 5 hours. The doctor said it took him 3 hours just to clean out my adhesions so that he could even start the surgery. What scares you about getting a ds? I need to still loose 30 pounds so I understand whether it's 129 pounds or 29 pounds it's still very stressful. Restrictive surgery alone has not worked for you. If you still choose one of the other surgeries at least get it done in the US as to have some recourse if you don't get what you thought you were. Good luck

 

[Spiky Bugger]

Sorry, yes Dr. Rodriguez was who recommended the MGB, I have also consulted with Dr. Wilhmey who works along side Dr. Ungson as well as Dr. Ariel Ortiz and Dr. Corvola. I have done obsessive research and have narrowed it down to those few very well reviewed, well credentialed surgeons. It was actually Mexicali Bariatrics with Dr. Ungson and Wilhmey who agreed to do the resleeve procedure but recommended the SADI should i want to go with a malobsorbtion procedure.

On information provided by his peers as well as my own observations, and belief, The Boy King Ortiz (have you met his mother?) used to stand up at conferences promoting providing band patients with "The Psychological Fill." They just need to be berated into compliance, you know... Didn't go over well with the bariatric surgeons who themselves had bands, lol! (And his wedding? You ought to hear his fellow surgeons describe the event! ROFLMAO!!!)

Yes, he can be charming. Lots of really bad people can be.


The ONLY medical thing I'd allow Ortiz to do to me is clean up my ass after a reinfection with c diff. And even then, I'd want it all on tape.

Sue

 

[Larra]

Thank you, @Spiky Bugger ! This thread was badly in need of a dose of humor (along with the reality check).

 

[hilary1617]

In my view, based on risk-reward analysis, there are three viable solutions since you are on your third bariatric surgery. (1) Re-sleeve, (2) DS, or (3) highly restricted diet and exercise.

The other surgeries (a) are known to produce long term weight loss maintenance results which are inferior to DS (or are unknown for SADI); (b) are riskier than the re-sleeve alone; (c) other than the SADI, all involve the significant sacrifice of the pyloric valve, and (d) a few of the options, pose a risk of bile reflux.

(1) Re-sleeve: Taking into account your actual experience with band and sleeve, restrictive surgeries have not proven effective at provide the results you seek. Thus, if you re-sleeve, your history indicates you would initially lose some, maybe all the weight you desire to lose, but then once the sleeve stretches out and/or you eat anything other than a totally limited diet, you are highly likely to regain. On the plus side, the re-sleeve would not require vitamin supplementation and you'd wake up from surgery faster (not that you will remember how long you are under anesthesia). See option 3 below for the lifestyle necessary to maintain weight loss down the road.

(2) DS: Best long term weight loss / maintenance results. Probably overkill just thinking about the 30lbs you want to lose now, but a far more reasonable option if you consider it as prevention of a likely continued increase which will ultimately bring you back up to your highest weight. DS will provide the least restrictive dietary lifestyle, with access to normal portion sizes and normal-content meals (specifically a high protein, high fat diet). However, there has to be a commitment to getting enough protein and lots of specialty vitamins and routine blood testing to keep healthy.

(3) Dietary restriction / exercise alone: Unlikely to work. (or almost none of us would be here!)

The most important decision you can make is which doctor in which you will entrust your life. Of those you mentioned in your post, Dr. Ungson is the only doctor that I would allow to cut me.