VSG revision to DS questions

[livelifeagain]

Hello. I am new to this board and have been reading your very helpful posts. I am hoping for some advice for my situation. I had VSG surgery 5 years ago and was successful in getting to goal (150 lb weight loss). My high BP and diabetes 2 health issues were, for a time, eliminated. Unfortunately, over the past 2 years I have started to regain and despite best attempts at dieting, nutritional advice, joining and following WW, etc. I have continued to gain. In recent months the weight gain has really increased, 50 pounds now regained and I am borderline diabetic again and BP is high. I cannot seem to halt this and am terrified that I will continue to gain. I am looking at what my options are and wondering about a revision to DS. Although I still have restriction, I am hungry much of the time, fatigued, etc. I seem to be able to eat no more than 800-1000 calories a day just to maintain. In the past year many life events have occurred, creating a great deal of stress, (2 deaths in the family, husband with cancer, very ill mother-in-law, and other events) that have diverted my focus and energy.

The DS would be self pay as was the VSG. I am 67 and in otherwise good health. I would like to tap into other's experience with a VSG revision to DS as this is a big decision for me. Would a conversion to a DS this many years after the VSG help me succeed in losing this weight and maintaining the weight loss? How rapid is the weight loss typically? Is the recovery difficult? What is the diet like following surgery? How is the appetite after the DS? Is there any hunger restriction as there was with the VSG? Any/all advice or comments are welcomed and greatly appreciated. Also, any advice/experience with surgeons in Mexico doing this surgery, Dr Esquerra is one surgeon I see who does this surgery. The flight from where I live to San Diego is about 8 hours. Is this length of return flight doable following DS surgery, considering possible bowel issues, etc. Thank you.

 

[Munchkin]

The sleeve is just a diet with a smaller stomach. Restriction only. The DS introduces malabsorbtion to the mix and makes it easier to maintain while being able to eat more normally(NOT having to live on a starvation diet). Esquerra is a good choice. Very doable. My sister and H had to fly from Spain back to the US. I would just spend a few extra days postop in MX or San Diego before I flew home. As long as you are willing to take the supplements, you will be fine. Recovery from only the switch portion of the surgery is not bad at all because the hard work has already been done(the Stomach).

Postop, your diet will be high protein, high fat, and low carb. It will be a big change because instead of starving, you have to eat around 100gr of protein per day. And high fat everything! No more low fat diet crap. Fry your eggs in butter, eat real cheese, etc. But you will lose things like potatoes, bread, and pasta(carbs). And no drinks with sugar.

50/60 pounds should be no problem. But it will take a while to come off. People with 2 part DS do tend to lose a bit slower.

 

[Marquis Mark]

Hi,

I had a sleeve to DS revision after 6 years with sleeve only. To answer your questions:


Would a conversion to a DS this many years after the VSG help me succeed in losing this weight and maintaining the weight loss?

Yes, definitely.

How rapid is the weight loss typically?

Everyone's different, but you can see my stats below. It's been pretty quick in my case.

Is the recovery difficult?

It was a lot harder for me than the sleeve. You will feel very fatigued. I would describe my post-surgery energy level as being akin to that of a narcoleptic tree sloth with congestive heart failure on hunger strike. Obviously exaggerating a bit, but you will be fatigued for 4-8 weeks after. I'm fine now.

What is the diet like following surgery?

Munchkin nailed it. Eat what you want, but limit carbs and get lots of protein and no worries on the fat. The pivot is going to be that you actually need to make sure you eat enough protein. If you do that, you won't have as much room for crap so it kind of works itself out. And vitamins are NOT optional. Neither is the gas, which is worse than Hitler sometimes. Those are the two biggest complaints.

How is the appetite after the DS?

Same as before for me. Some people claim their tastes/appetite changes. I will say my body demands (and guides me to) more protein, so it leaves me less room for the carbs. I still crave and eat carbs, but it's better.

Is there any hunger restriction as there was with the VSG?

You already got that with the sleeve. The intestinal switch won't affect your hunger level, but it may alter your cravings.

Any/all advice or comments are welcomed and greatly appreciated. Also, any advice/experience with surgeons in Mexico doing this surgery, Dr Esquerra is one surgeon I see who does this surgery. The flight from where I live to San Diego is about 8 hours. Is this length of return flight doable following DS surgery, considering possible bowel issues, etc.

Yes, everybody says Mexicali is mind-bogglingly good. They won't send you home unless you're ready. Their business depends on good reviews and they know it. As far as bowel issues, you're not going to have food in your system, so I doubt you'll "produce" much. You can always wear one of those sexy Depends for peace-of-mind. If I had to self-pay that's where I'd go. Que te vayas bien y no te preocupes (Have a good trip and don't worry)!

MM

 

[Charris]

If your in California you have 2 super docs in your state. Why not consider them? Rabkin And Keshishian

 

[Marquis Mark]

If your in California you have 2 super docs in your state. Why not consider them? Rabkin And Keshishian

She mentioned she was self-pay. I know Rapkin is something like $32,000. I'm sure Kesheshian is up there, too. Great doctors, but I think she'll likely get the same results with Esquerra.

 

[Charris]

I did see that she was self pay. I didn't realize there was a huge difference in price. I was thinking about her having to pay for travel and room and board. I thought it might be cheaper or equal to from what she would have to pay for 2 people going out of state and having to return for follow up and things of that nature. If it wee me I would definitely check Keshishian price and see how it compares to Esquerra including travel and follow ups along with room and board.

 

[Marquis Mark]

I did see that she was self pay. I didn't realize there was a huge difference in price. I was thinking about her having to pay for travel and room and board. I thought it might be cheaper or equal to from what she would have to pay for 2 people going out of state and having to return for follow up and things of that nature. If it wee me I would definitely check Keshishian price and see how it compares to Esquerra including travel and follow ups along with room and board.

It won't EVEN be close. Esquerra is $9,000 all inclusive except flight to San Diego. Your travelling companion can stay in your room, I believe. For follow up, you would just go to a US doctor. Although she said it's 8 hours flying so I'm wondering if she's outside the US. Even so she'd have to fly to LA for Keshshian or San Diego for Esquerra so no big difference there. Also, Kesheshian insists on a $3,000 program fee on top of the other stuff. Any way you slice it, it's triple the price.

 

[Charris]

Oh ok wow I didn't realize that. That must be why he only accepts Ppo insurance. The program fee is 4000 For a revision. I wonder since she is getting the 2nd half of DS is it still considered a revision if he doesn't resleeve. It's less work. Humm yea I would go with Esquerra too in that case.

 

[DSRIGGS]

Dr k was $26k the last I checked for my brother. That is lapriscopic. Open was $19k.

 

[Marquis Mark]

Dr k was $26k the last I checked for my brother. That is lapriscopic. Open was $19k.

Plus program fee so, yeah, triple basically.

 

[DSRIGGS]

Oh ok wow I didn't realize that. That must be why he only accepts Ppo insurance. The program fee is 4000 For a revision. I wonder since she is getting the 2nd half of DS is it still considered a revision if he doesn't resleeve. It's less work. Humm yea I would go with Esquerra too in that case.

I didn't have a program fee with my revision and he fixed two hernias, ventral and intestinal. We didn't know I had them until he felt te ventral on my Monday consult before Tuesday surgery and of course found the mesenteric defect when measuring my small bowel to get channel length to proper size.

 

[DSRIGGS]

Plus program fee so, yeah, triple basically.

That was everything included.

 

[Marquis Mark]

I had a consult with him last year re revision from sleeve to DS and there was definitely a $3,000 program fee. I went over it in detail. Guess he loves you...

 

[DSRIGGS]

I had a consult with him last year re revision from sleeve to DS and there was definitely a $3,000 program fee. I went over it in detail. Guess he loves you...

Ha, well I am a lovable dude.

I think there was no fee because it was a medically necessary procedure to stop malnutrition...so not technically a weight loss surgery...it was a,weight gain surgery.....but yes he loves me!

 

[southernlady]

I would describe my post-surgery energy level as being akin to that of a narcoleptic tree sloth with congestive heart failure on hunger strike.