Hello all Sleeve looking at a revision

[Dani]

Hello everyone, I am new to this site and wanted to say hi and introduce myself.
I had my sleeve done in Mx in 2013 by Dr Kelly. I was a lightweight (190lbs) at the time of surgery as I kicked ass for 2 years before surgery and lost 60lbs. Post sleeve I found that I was an extremely slow loser and only lost approx 35lbs and this was with doing a ton of exercise and running 7+ KM a day. I put on weight so very easy that it is frustrating as hell. Due to increased GERD (I think from an extremely stressful work situation) I could only tolerate slider foods, and developed a protein intolerance where my body decided that protein wasn't my friend. At this point in time I have gained back all my weight, which I am very pissed at but I only have myself to blame. I have now left my very toxic work environment and am continuing to work out (not experiencing GERD and am able to eat meat again). I know that I will struggle to lose this weight as my body just loves to be chunky lol I swear that I am one of those that genetics say up your going to be fat for life lol
I am looking into doing a revision but not sure which one would suit me better. I know that either DS or RNY will require vits and that will be a must. I sent in some requests for info to some Mx surgeons and most want to do a MGB instead of RNY. I haven't heard much about that one so I am looking into what it is and if it's really worth me going under the knife again for something that may not work for me.
Any suggestions or helpful hints/info would be greatly appreciated.

Dani

 

[southernlady]

Welcome @Dani
Personally I would stay fat if the DS had not been an option for me. And I am also a lightweight. Starting BMI was 35.2.

 

[Larra]

Welcome!

the so-called MGB - mini gastric bypass - is NOT a standard of care operation in the USA and never has been. I'm guessing you are looking at Mexico again, and anything goes there, not so much here. The only difference between the MGB and what you call RNY, which is really RNY GB, is the configuration of the small intestine. The standard of care gastric bypass is done with an RNY configuration (hence the shorthand name we use in these forums but which we really shouldn't) and the MGB is done with a loop. That's it.
The reason the MGB has never become standard of care in the USA is that it creates the risk of bile reflux, which, if it occurs, is extremely difficult to treat because bile is a base (the opposite of an acid) so antacids don't work. And from what I've read, the weight loss is no better than with a standard of care RNY gastric bypass. So there is, IMHO, no advantage to the patient, just an advantage to the surgeon because it's quicker to do. I suspect the reason it's being recommended for you has nothing to do with you and everything to do with making the operation quicker and easier and thus allowing the surgeon to do more operations/day.

I hope you will thoroughly research the DS. It has the best statistics of any bariatric surgery for percentage excess weight loss, for maintenance of that weight loss, and for resolution of almost all comorbidities. You already have learned that your body clings to every calorie. a purely restrictive operation got you nowhere, and gastric bypass, after the first 12-18 months, works almost entirely via restriction and behavioral changes, as it has so little caloric malabsorption to start with, and much less metabolic changes than the DS. If you are looking at Mexico, the only DS surgeon people here would recommend is Dr. Esquerra, who has an excellent reputation. There are a bunch of his patients here if you want to reach out to them.

 

[Clematis]

Esquerra patient here. I recommend him highly. Adding DS will be easy peasy recovery. Are you in a PPI for GERD?

 

[Eztli]

I am a failed sleever as well. I was a normal BMI sleever (or a light-weight as they are called here). I don't think they do normal BMI sleeves in the U.S but I'm not sure. Anyways I now weigh much more than I did when I got the sleeve, but still much less than I did at my heaviest weight. However, let me assure you that as someone who can out-eat the sleeve, I can easily out eat an RNY. It is not proving easy to get the D.S, though it seems surgeons wanting to convert me to an RNY are about as common as Starbucks. If you decide the D.S is the surgery for you, be prepared to fight for it.

 

[Dani]

Esquerra patient here. I recommend him highly. Adding DS will be easy peasy recovery. Are you in a PPI for GERD?

Yes I am on a PPI - some days it works other days it doesn't. I am hoping to get the scopes done so that I can see if something is wrong with the shape of my sleeve.

Dani

 

[Clematis]

I asked because different types of PPIs are more effective for some than the usual Prilosec (omeprazole) or Nexium (I've forgotten it's generic name). My doctor had to cycle through all of them to treat her own GERD.

Also I believe there is a direct correlation betweenPPI use and dense protein puking. Protein needs stomach acid to digest. I had to go to the lowest dose PPI to digest any solid protein. I've tried to wean myself off but rebound acid is a killer!

The only WLS with 30 yrs of documented success is the traditional DS. Not only do I think RNY is butchery (keep your pyloris!) but there's no data to support life long success. I for one wouldn't COULDNT be on a diet the rest of my life.

 

[Dani]

I asked because different types of PPIs are more effective for some than the usual Prilosec (omeprazole) or Nexium (I've forgotten it's generic name). My doctor had to cycle through all of them to treat her own GERD.

Also I believe there is a direct correlation betweenPPI use and dense protein puking. Protein needs stomach acid to digest. I had to go to the lowest dose PPI to digest any solid protein. I've tried to wean myself off but rebound acid is a killer!

The only WLS with 30 yrs of documented success is the traditional DS. Not only do I think RNY is butchery (keep your pyloris!) but there's no data to support life long success. I for one wouldn't COULDNT be on a diet the rest of my life.

wow thanks for the info, I did not know that about PPI's.

 

[hilary1617]

Hi and welcome @Dani!

 

[DSRIGGS]

I asked because different types of PPIs are more effective for some than the usual Prilosec (omeprazole) or Nexium (I've forgotten it's generic name). My doctor had to cycle through all of them to treat her own GERD.

Also I believe there is a direct correlation betweenPPI use and dense protein puking. Protein needs stomach acid to digest. I had to go to the lowest dose PPI to digest any solid protein. I've tried to wean myself off but rebound acid is a killer!

The only WLS with 30 yrs of documented success is the traditional DS. Not only do I think RNY is butchery (keep your pyloris!) but there's no data to support life long success. I for one wouldn't COULDNT be on a diet the rest of my life.

I have never heard that about the dense protein puking and PPI usage. Not saying that isn't true, but I haven't seen a study on that relationship. It would be interesting to read if you know where to find it. I am on 80mg of Protonix daily and the only time I ever puked was because I ate too much too fast, or something my stomach didn't agree with (it hated tomatoes early on for some reason and they were guaranteed to come back up if I ate them...lasted probably 9 months). Now heavy dense proteins sat like a brick in my gut early on, but I never puked from it unless I over did it. Now, I couldn't eat burgers, steaks, chicken breasts, pork chops until about 6 months but since then I have been eating them.

BTW, I am very happy to hear you are able to eat dense protein now without puking.

Regarding weening off the PPPI I would like to cut back on mine if I can but haven't been successful yet in doing so.

 

[Clematis]

No @DSRIGGS what I meant was PPI doesn't leave enough acid (at least in me) to properly digest dense protein. And this was happening before DS. I may or may not vomit but it sits like a stone in my stomach for many hours. I know of no study but I can't be the only one.

 

[Butterfly]

Hiya! Welcome to you. I'm a fellow sleeve person and I'm revising to a DS in a bit over a week. After looking at the RNY and the DS, there's no question which one I wanted. I know the RNY wouldn't be enough for me.

Good luck no matter which way you go.