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Discussion in 'Duodenal Switch' started by shelly culver, Jul 10, 2018.
Sorry to hear about your issues... I would also check out Dr. Rabkin in San Francisco. He does revisions and he is very good. He is one of the Drs people here like.
Hello Shelly! How successful was your RnY? Did you reach your goal weight? As a Rny to DS revision recipient I would look at all your options before any surgery. For me I gained ALL my weight back, my stoma had stretched to the point where I had what one surgeon told me was a big "tube" so I no longer had that small pouch restriction. I had dumping syndrome, and reactive hypoglycemia. I did lose 130 lbs but never reached goal. If I had it to do all over again I would have done the DS from the start however that option was not even presented to me. (in 2003)
How compliant are you with your diet? Could getting back to basics help? I'm not saying don't do a revision just see if there are things you can change to help your situation right now. 19 pounds is not a little thing and I remember when I was at that point I did seek help, but was basically told by one surgeon to hire a personal trainer and get back to the basics. I gave up and ate whatever I wanted hence the weight gain. lol
I am a very healthy person, no diabetes, no high blood pressure, great blood work just overweight. The recovery from the revision was really difficult so for about 6-7 weeks post op I was miserable. But I have lost about 65 pounds so far and still have a lot more to go. With that being said not having to worry about eating bacon or sausage without getting sick is worth it. I love full fat salad dressings and have found low carb/sugar free sauces to make up for the alternatives out there (I am a sauce/dip person) I love being able to eat hot wings without any guilt or fear of gaining weight. It's a good thing I am a carnivore! But the RnY taught me not to eat carbs which I love, so now I miss them but they now make me feel uncomfortable and sometimes sick. Bread which I could eat with the RnY (but shouldn't have) makes me feel so full and bloated I have to really really want it before I eat it and then it's just a few bites. I know I am still in my "honeymoon" phase and still learning about life with the DS but all in all I think I would do it again. Do your homework, explore all your options and then make the best decision for you.
My experience is mine, and everyone will have a different experience so dont be afraid to ask questions. There are great people here with so much knowledge and desire to help this is a good place to be.
I have a gastro gastric fistula and hiatal hernia and am symptomatic. I lost 104 pounds and was fine. I don’t need to have the switch. I have concurred with Johns Hopkins bariatric center and UMC Baltimore... they have the best bariatric departments in this area.
They refuse to do DS. There’s good reason for this. Same that most insurance companies don’t like to cover it.
I’m glad you all made the choice and are happy with it...
I was very good at maintaining my loss even after I got pregnant within the first year and had another baby within 18 months after that. My babies were healthy great birth weight...etc.
I became a work out junky and love it. I haven’t been doing as much lately ... the hernia makes it uncomfortable. I can eat a lot more and I noticed it within the last year. I knew something was wrong.
I want healthy and I was.
I have done a plethora of research over the last few weeks.
I as well have dear friends who are surgeons ..doctors ...nurses and I discuss all my options with them.
I ate within healthy guidelines. I learned the art of moderation and if I had a craving ...yes I gave in.
I maintained my weight for 14 years with no gaining !!!! If I happened to gain I lost it quickly without issue. Now that’s not at all the case.
I know my limitations and with great grace came to respect those limitations.
Thank you for the concern
Thank you for the advice
Thank you all for sharing and understanding the weight loss surgery experiences.
The greatest gift we have is the absolute fact we are all very different and thus we encompass copious amounts of wisdom to share and learn from.[/QUOTE]
Can you share why?
I know one surgeon in SC who, although knows about the DS, does not offer it cause he’s a solo practice and doesn’t want the upkeep of DS patients. My husband and I both saw him when our PCP got squirrelly about doing our labs. He said that our labs were the best he had ever seen, even with his RNY patients. He also told our PCP to continue pulling our labs.
Johns Hopkins bariatric center and UMC Baltimore... they have the best bariatric departments in this area.
If you are limiting your "area" to the Baltimore metro area, you will not find a DS surgeon. I wouldn't call a bariatric practice that cannot perform one of the standard of care procedures the best of anything - except with all the caveats of being the best of the only partially competent practices unfortunately available locally.
Dr. Elariny in Vienna VA and Drs. Glembot and Wiedower in Winchester are DS surgeons.
They refuse to do DS. There’s good reason for this.
Yes, there is.
They are not competent to perform it, and it requires a LOT more effort to learn how to do it, including proctoring with an experienced DS surgeon.
They don't make money (or as much money) while proctoring.
They don't get paid more (or "enough" more) for doing the DS - RNYs are fast and easy to perform; a surgeon can only do 2 DSs max in one day.
They don't give a shit whether you are successful long term.
They don't have to live on a diet for the rest of their lives because they've given you an easy to perform surgery which they can blame YOU for failing.
They aren't willing to support their patients long-term, and DS patients require more rigorous follow-up.
Same that most insurance companies don’t like to cover it.
What the insurance companies "like" is not what you're limited to - Larra and I help patients win almost all cases (except contractual exclusions) where an appeal is necessary to overcome an improper denial, including where there are limitations to having a certain BMI.
If you don't want to have a DS, that's fine. But your reasons are false or misleading. The majority of RNYers eventually fail - more if you consider that "failure" is ending up with less than 50% of excess weight loss (i.e., if you needed to lose 150 lbs, ending up losing and maintaining a weight loss of only 75 or fewer lbs).
Personally, I could never have made an RNY work for me at all. Kudos to living on a diet for 15 years - I wouldn't have made it 6 months, and I knew that. I far far far prefer to take two handfuls of vitamins/day and eat protein and fat to my heart's content, without fear of regain. I haven't missed the guilt, attempted exercise of "willpower" and deprivation one bit.
A recent day where I tracked everything I ate, at the end of the day, so I didn't even remotely attempt to tailor what I ate for the purpose of writing it down (I will be 15 years out on August 5th):
Upon awakening: My Protonix – the DS did not cure my reflux, but it’s mostly under control, with an orange-mango Sparkling Ice
Before Breakfast: a HUGE mug of really strong coffee with a ton of full fat creamers (plain and vanilla, because the vanilla is too sweet and the plain is too plain).
Breakfast: A big pile of sliced roasted chicken breast on one slice of toasted dark rye bread, slathered in mayo and with a bunch of lettuce, and a lot of salt (my starting-to-get-high blood pressure prior to my DS has been exchanged for low BP, for which my prescription is eat the hell out of salt at every opportunity, which I happily do). (About 20 g protein) Note: about half of the time, my breakfast is a toasted slice of dark rye bread, topped with a fried jumbo egg, and half the contents of a package of Stouffer’s Welsh rarebit (About 23 g of protein)
After breakfast: my first dose of vitamins and minerals of the day, and medication, with more Sparkling Ice
Snack: A leftover grilled marinated lambchop, warmed up and salted, with a glass of Tang (At least 20 g protein)
Lunch: Leftover fish sticks and seafood sauce (About 8 g protein)
Snack: Cheesy scalloped potatoes (also leftovers – I make a bunch of big servings and snack on them for days (About 10 g protein)
Before dinner: my second Protonix
Dinner: Half of a footlong Subway tuna sub with lettuce, red onions, olives and provolone cheese, with a Fresca (About 21 g protein)
Snack/first dessert: A frozen orange juice bar (I’ve got a thing for orange drinks/juices)
Real dessert: Cherry pie and milk (8 g protein)
Before bed: A matzo with butter and salt. It doesn’t suck to be able to eat before bed, without guilt.
Right before bed: the rest of my vitamins, minerals and meds
Middle of the night: my thyroid med
About 80 g of protein. Too many carbs to lose the last 15-20 lbs, but I don't care - I'm good with being at my weight (size 10-12, and I'm big boned), and not having to limit my carbs as much, plus at age almost 65, I prefer to have a little cushion if I get sick.
Hello shelly culver. I am an RNY to DSer. I had a gastro-gastric fistula also, but I gained all my weight back and then some. It seems that the RNY is working for you and you are searching for a fix for your current situation. The RNY to DS is a big surgery and I had major complications that required a month-long hospital stay. It is not an easy surgery and I would also think that fixing the gastro-gastric fistula may also be complicated. Please post what you decide to do as I am very interested to know more about how your situation will be treated. Good luck.
On the east coast, you could talk with Dr. Bonnani and Dr. Antanavicius (Dr. G.) in PA. They have a great program and say they have done 200+ revisions from rny to DS.
I was going to use Dr. G, but discovered Dr. K in CA takes my insurance, so I’m using him now.
Best of luck!
DawnNYC do you have a surgery date?
I had to start my 6-month supervised diet in May, so I won’t have surgery until December. How are you doing?
I'm doing great! Still learning to live with the DS but all in all I am doing really good! I feel so much better with some of my weight gone!
Is the supervised diet a requirement from your insurance?
I’m glad to hear you’re doing well! Yes, BCBS is requiring it for approval.
I’m so curious, what are you needing to learn about the DS?
Its more like learning to listen to your body more intently, especially the digestive system, being careful of what you eat, when you eat it and where you are. There are still foods I have not reintroduced into my diet so have to pay attention to those when I do eat them again. Then its learning what foods are tolerated well and what ones are not. For instance I cannot eat anything over cooked, dried out or too crispy it hurts my stomach and does not go away same for really dense food. Bread which I love makes me feel like there is an army tank in my stomach so needless to say no bread for me. So things like that. We are all different so I suspect others will have learned other lessons! HTH!
I plan on having the DS with Dr. Keshishian soon. I'm not scheduled yet. He is in Pasadena. Does anyone know what the charges are with Dr. K?