Revision from bypass to sleeve? I have chronic anemia

[BookWormMamma]

Hello everybody,
I had a gastric bypass in 2005; went in with 265 pounds, got to 165 aprox, but since then, and after 2 pregnancies, I've gained 50% back, and have developed a chronic anemia.
I went to a doctor who is the leading surgeon in the country (I live in Chile) and I am now going through examinations in order to see what's going on and see what options I have - if I have any.
The doctor mentioned, during the initial app, just thinking out loud si guess...he mentioned converting from bypass to sleeve. Have you heard about such procedure? I understand I would solve the anemia problem,but would I still be able to lose weight?
I have an app with the doctor on Oct 5, and I'd like to go with some ideas or suggestions.. by the way, the doctor does hundreds of surgeries a year and about 5% are revision...so I trust him, but I'd like to have a broader picture of the options...I appreciate any input! Thanks!

 

[bearmom]

I can't help with info about whether a revision may help, but am wondering what you have taken for iron, or if you've had any infusions. Many people with RNY or DS get iron infusions.

 

[DianaCox]

Yes it could be done, and no I wouldn't just do a sleeve - that's the HARD part of the revision surgery, and you may as well get the intestinal repairs/revision and have the benefit of the full DS. There is a surgeon in Brazil, though I haven't heard of him doing the DS in a long time - Marchesini.

 

[southernlady]

Welcome @BookWormMamma

 

[BookWormMamma]

Thank you all for the welcome and the answers!

Just a question though, @DianaCox, I will ask my doctor about the DS, but since the bypass led me to chronic anemia, wouldn't DS do the same? I had Rx with contrast (Esophagus-stomach-duodene) and the doctor told me my pouch was very very small, which would explain the anemia; If I do get revision surgery, they would use the stomach that is 'standing-by' for the sleeve, right? I am speaking based on what I've read in forums, I really don't have any medical knowledge whatsoever...and I am worried that if I lose the malabsorptive part of the surgery, it might end up in failure, again...I feel such a failure now...when I initially had the surgery, I wasn't psychologically ready; I was 29, but I was so shy, I didn't go out, I didn't have many friends...once I saw myself 'slim' (I was never skinny, I never got to my 'ideal' weight) I kinda lost it and started doing all the things I hadn't done before...I became a party animal, and I know that most of my regain comes from alcohol; back then, I would party every single day, drinking beer and wine...I went crazy. Now, I am 40, I have 2 kids (5 and 2 years old), I am in a different place and stage in my life, and I want to be healthy for my children, I want to be able to do things with them...anyway...do you have any ideas on how I could talk the doctor into the full DS? Or, if they do the whole thing 'from scratch' using the 'unused' stomach I still have in there it might work better now? I also have a very low level of Vitamin D and Calcium...any ideas, I would really appreciate them!
Thanks a have a nice day!

 

[BookWormMamma]

I can't help with info about whether a revision may help, but am wondering what you have taken for iron, or if you've had any infusions. Many people with RNY or DS get iron infusions.

Hi Bearmom, thanks for answering!

Well, I have to take iron (pills) from time to time, and with my pregnancies I received iron infusions; with the first labor I lost a lot of blood, and my level went down to 20 something...doctor didn't infuse blood because he knew the reason was the bypass...and my body has become 'used to function' with anemia, meaning, I've had low levels that (according to doctor's words) normally have people fainting or falling asleep anywhere, but I go on like normal...which is, actually, not normal.
Right now I am only taking calcium+vit D, since those levels are really low too. B12 levels are normal.

 

[Clematis]

You have anemia and only take iron pills "from time to time"? Well unless that is defined as 2-3x a day every day, I think you've found your problem. I don't understand why your doc isn;t recommending infusing or at least supplementing.

I'm not that knowledgeable about RNY supplementation but, geez, it seems like you take WAY to little of everything. Look at the recommendations on VitaLady's site (and shown here) for what you should be taking. Then take vites according to the results of your labs.

We DSers take a handful of vitamins 2-3x a day. C and D are only part of it. The fat soluble vites (ADEK) must be taken in DRY form, not the oil capsules usually sold in stores as DSers malabsorb oil.

50k of vitamin D a day until your stores are up. Protein load in preparation for whatever surgery you have.

 

[BookWormMamma]

You have anemia and only take iron pills "from time to time"? Well unless that is defined as 2-3x a day every day, I think you've found your problem. I don't understand why your doc isn;t recommending infusing or at least supplementing.

I'm not that knowledgeable about RNY supplementation but, geez, it seems like you take WAY to little of everything. Look at the recommendations on VitaLady's site (and shown here) for what you should be taking. Then take vites according to the results of your labs.

We DSers take a handful of vitamins 2-3x a day. C and D are only part of it. The fat soluble vites (ADEK) must be taken in DRY form, not the oil capsules usually sold in stores as DSers malabsorb oil.

Wow. I mean, WOW! I guess it is because it was a long time ago, but believe me no one told me about how much vitamins I needed after the bypass. Doctor told me 'take a multivitamin once a day and B12 shots once a month for a year', and that was it! I am checking the vitalady website...mindblowing. Thanks a lot for suggesting it!

50k of vitamin D a day until your stores are up. Protein load in preparation for whatever surgery you have.

 

[bearmom]

If it's just the iron deficiency you want to deal with, then I'd just supplement or get infusions. I will admit I'm concerned that you are not getting adequate supplements, and that you are not getting thorough enough lab work to know this.

If you actually need a more effective weight loss surgery, then revising to sleeve may not be enough when you've already had a malabsorptive surgery. The DS is the most effective, but the thing with the DS is, that supplementation is even more important than with RNY. Inadequate supplementation can kill you if you are inattentive or lax.

 

[Clematis]

We see this all the time @BookWormMamma Doctors -- even "famous" docs at big medical centers -- send patients off with "chew a Flintstones" and a pat on the head and patients end up very very sick -- not immediately but in time. (And then they blame the surgery saying DS is dangerous, when in fact it's only their nutritional advice that is wrong.) Surgeons cut; nutrition ain't their thing and they are not trained in it. Unfortunately nutritionists don;t seem to have any better clue of how to advise WLS patients, especially DS patients. Get your nutrition recommendations HERE!

Even with identical surgeries, we are all different and need different supplements. The VitaLady protocol is just to start, then as @bearmom says, get COMPLETE labs and tweak your vitamins. (See the vitamins and labs section on this site for more info.)

A lesson to learn here is that we all are responsible for managing our own health. When you've given someone the authority and trust to take a scalpel to your innards it's natural to assume they know what they're doing with the aftercare as well. In the majority of cases, that's simply not true.

The good news is that NOW YOU KNOW!! You can supplement and get lab tests and turn your health around. All you need is a doc to order the labs that YOU SPECIFY. (If you were in USA there is even a company who can get that arranged for you without your own physician.) Then post your results on this site and many will help you interpret the results and make recommendations for increasing/decreasing vitamin supplements.

I think you have another thread on here, but I want to reiterate that RNY revision to DS is ultra-specialized surgery. (There are only 4 US surgeons that our experts here would recommend. No clue about South American surgeons.) If I were you I would be very diligent in your research of any prospective surgeons for their specific experience with this risky surgery.

 

[DSRIGGS]

FYI - You can be non iron deficient anemic (Raises hand high).

You need to fully understand why you are anemic so full iron panel is needed and then go from there. If it is "typical" iron deficient anemia that is easy enough to treat. If not you will need further testing to diagnose why you are anemic.

As far as a revision to sleeve, as Diana mentioned I don't think that is wise. If you are going to be revised get the surgery that works and that is a DS.

 

[hilary1617]

Hi and welcome @BookWormMamma ! I agree with others that your supplementation seems it would likely be inadequate and that if anemic (due to iron deficiency), iron should be taken daily. An iron infusion would probably make you feel much better, much faster. Revision from RnY to sleeve is a difficult procedure which is likely not going to sufficiently provide for long term maintenance of weight loss. If going through the risk and pain of revising, I would recommend revising to a traditional/full Duodenal Switch. Best wishes!

 

[BookWormMamma]

THank you all!
I am doing a lot of reasearch online...I realized there are vitamins specially made for bariatric patients, however, they are NOT sold in my country...do you use them? Which ones would you recommend? Just so I can try and contact then to see if I can get them shipped internationally or ask someone who goes to the US to bring them back for me, at work people travel there all the time, so it shouldn't be too complicated...anyway...any help, I'd really appreciate it!
I will have an app with my doctor next Wednesday; I will let you know how it goes.

Oh, BTW, I am pretty sure my anemia is due to iron deficiency, but I will ask my doctor for extra blood tests, in case they are necessary

Have a great day, thanks a lot for the support!

 

[southernlady]

THank you all!
I am doing a lot of reasearch online...I realized there are vitamins specially made for bariatric patients, however, they are NOT sold in my country...do you use them? Which ones would you recommend? Just so I can try and contact then to see if I can get them shipped internationally or ask someone who goes to the US to bring them back for me, at work people travel there all the time, so it shouldn't be too complicated...anyway...any help, I'd really appreciate it!
I will have an app with my doctor next Wednesday; I will let you know how it goes.

Oh, BTW, I am pretty sure my anemia is due to iron deficiency, but I will ask my doctor for extra blood tests, in case they are necessary

Have a great day, thanks a lot for the support!

No, I wouldn't use any bariatric vitamin...it's just code for overpriced horse poop. Also, you can't adjust a bariatric to your personal needs.

Example, I don't need A or E, but need extra D and double the K listed on the Vitalady list. If I took an all in one, I would not be able to adjust to my needs.