VSG to DS revisions

[SJB41976]

Hi! I'm Susan and officially researching a VSG to DS revision. Who on here has had one (i'm already familiar with a few just from reading)?

I'm self-pay, and if I do this, I would likely use Dr. Greenbaum. I'm in Tennessee and proximity just wins out with him. My second choice would be Dr. K, but California is just too far (and expensive) to have surgery and stay for a week or so. Also, he has a more affordable self-pay rate. If Dr. K. had his price I *might* would go the extra distance, especially since I have heard so many wonderful things about him.

Anyway...I'm here researching and gathering information. I've posted before my biggest concern is complications right after surgery (or in the future). And the infamous "bathroom issues". LOL. I know I am stuck there, but I just want to know what I am getting into. I don't want to be farting all day long. I'm not too worried about diarrhea after reading most of your posts, unless I eat something sugary and carby, I should know when I choose to eat something like that (more than a bite or two) then I will have issues.

That's not what I'm talking about. My biggest concern is having gas and it be horrible or uncontrollable, etc. I've read all about trigger foods (things that make you gas and bloat), being lactose intolerant, etc. I get all that. I'm just afraid that after I eat, even if it's high protein with a few veggies or fruit that my body is going to react differently and make me self-conscious or feel like I can't do day to day regular activities or I can't share a room with someone because of embarrassing gas.

Am I really worried for nothing? Is it really that trivial? I want to know. How the gas is going to affect my day to day life?

I also see people on here living their life, even though they've had complications or had "issues" they would do it again....tell me why. What would be the reason you regretted this surgery??

And then I see people, most of the people just live. They had no complications. They figured out what they can eat and not eat and they just live.

I'm also worried about my disordered eating. After I had my VSG I went into major food deprivation mode. My head was not screwed on right. I blew my chance at optimum weight loss because I chose to eat junk thinking I could and it not hinder my weight loss. Then my weight loss just stopped. I didn't gain anything for about a year and then it slowly came back on. I have been in therapy. I have worked on my head issues, but I still eat crap. I make bad choices...UGH!!!!! I still struggle with all or nothing BIG TIME.

The best way for me to lose weight now is to either eat 100% clean, make all my food, and eat in moderation. Or eat Paleo and stick with it 90-95% of the time. It has been over a year since I have been able to do that consistently. I invite processed foods and sugars back in and even though I 'm not abusing them, I'm eating them. I can't lose weight when I do that. And paleo, well....it's hard, it's hard work, lots of prep. I've struggled with finding a happy medium so here I am another year at the same weight. Except now I have arthritis and knee and foot issues from all the excess weight I have been carrying.

Even with 2 (restrictive, not malabsorptive) weight loss surgeries I have not been under 200 pounds since I was in high school (I'm 46).

I keep thinking that one day I will get it, and do it, or accept myself at a certain weight (my therapist seems to feels that way. But she is also there to support me in whatever decision I make). Me, I'm just tired of wasting another year being MO.

I'm happily married to the most supportive guy on the planet. Seriously. I have two kids, ages 9 and 6. Very busy, active boys.

I want my life to be different. Can it really be different? Do I really have to go to this extent (a DS revision) to have a different life?

Thanks for listening. I just wanted to share more of my story and get some feedback.

Thanks!
Susan

 

[southernlady]

Am I really worried for nothing? Is it really that trivial? I want to know. How the gas is going to affect my day to day life?

I also see people on here living their life, even though they've had complications or had "issues" they would do it again....tell me why. What would be the reason you regretted this surgery??

And then I see people, most of the people just live. They had no complications. They figured out what they can eat and not eat and they just live.

It can be exactly THAT trivial. I am sure you know some folks who have never had abdominal surgery at all and still can have farts that are paint peeling!

I will admit, mine have gotten stronger but it is almost ALL within my ability to control by how I eat once I found my problem foods. Okay, it isn't 100% controllable as we can get a bacterial overgrowth that has to be handled but day to day, it's a non issue.

I am one of the lucky ones in that my DS post-op has been complication free.

And yes, most just go on with their life...the ones here who are long term are usually here to pay it forward so others can experience the freedom we have.

Some threads to read:
http://bariatricfacts.org/threads/the-ds-and-travel.1635/
http://bariatricfacts.org/threads/complications-or-lack-thereof.2383/

 

[SJB41976]

@southernlady Thanks@ I wil read those.

If it were you (and anyone can answer this but I know @southernlady had surgery with Dr. Boyce) would you simply pay more and travel 2 hours for surgery and recovery just to make it easier? Or is it worth it to travel to New York from Tennessee.

I traveled to Texas for VSG and had to stay there a week for my follow-up appointment. I respond well to surgery, I'm very determined about walking, sipping, etc. By the 5th day my mom was worn out by all the stuff we were doing. Day 6 of recovery we went to a botanical garden and strolled for a few hours. I wore my mom out! LOL.

But DS is different....I will have to be gone at least a week, right? If not longer? What if I have complications and I am in New York away from my family. My poor kids...they won't know what's going on. At least in Knoxville 2.5 hours away I could see them (if I wanted to).

I honestly think and pray very positively, and know that given my history and the fact that i am active (work out with a trainer 2x a week and workout out on my own additions 1-2 days), and that I really have no co-morbidities except arthritic, that statistically I should be fine, and that's what I go in praying and thinking. But even with the VSG I was afraid of the "what if's". We had my baby's 1 year birthday party on saturday and I had surgery the following Tuesday...I kept thinking, what if I don't get to see him grow up??? I can't imagine what I will be thinking with the DS because the risk IS SO MUCH GREATER. Anyhoo...I'm getting off subject.

Deciding to travel for surgery is another biggie decision. I know you all can't answer that for me. But, it's what's on my mind. Maybe I will post a different thread about traveling for such a serious surgery. After I read the post link above about it. Thanks!!!

 

[southernlady]

Okay, yes, I had Dr. Boyce but I was prepared to travel.

When I first started my journey, I ended up as Dr. Williams' patient (Boyce's partner). HE said I was too small for the DS. My starting BMI was 35.2 and at the time, the VSG was not a covered option under my Medicare Advantage policy. (Medicare did not cover the VSG until 27 July 2012 and I was 18 months out by then). My ONLY option according to Dr. Williams was the RNY in spite of my need for NSAIDS. That summer (2010) I did LOTS or research on vetted DS surgeons and contacted most on the Eastern seaboard to find out 1) if they accepted Medicare Advantage and 2) was willing to do the DS on a lightweight. The one I found was Dr. Pomp in NYC.

My husband ALSO transferred from Dr. Williams to Dr. Pomp. We did travel to NYC in Dec 2010 and stayed for almost two weeks when he had his surgery. We could have gone home after 5 days but we had traveled via Amtrak and getting a different day was impossible. So we stayed the extra 2? days and let him heal a bit more. By then I had found out that while my insurance approved the DS, they would not approve an out of state surgeon. We got there on Sunday before the 16th of Dec, saw Dr. Pomp on Mon as well as all the hospital admitting stuff. Had 2 days to hang around, his surgery was Thursday, he was back in our room on Sun and we could have gone home on Tues according to Pomp's office but didn't until Christmas Eve. (Fri)

I was on my third appeal trying to find an IN state DS surgeon (and at that time we had 4, two in Knoxville, 2 in Nashville). I contacted EVERY bariartic surgeon in the state to find out if the 1) did the DS (and most said no) 2) would do the DS on a lightweight 3) WERE IN NETWORK. Only two IN network, Dr. Williams and Dr. Boyce. In order to transfer to Dr. Boyce, Dr. Williams had to release me and allow Dr. Boyce to become my doctor. He did and the rest went quickly. I could have had mine in Dec but with my husband already scheduled, I delayed mine til Jan so we could get thru the first few weeks of his.

Honestly I WISH I had been able to go to Dr. Pomp but mine wasn't gonna happen if I had not had Medicare.

While you will get a good surgery experience with either surgeon, you have to decide if the extra money is worth it. Both options are solid, vetted DS surgeons. Point of note, Dr. Greenbaum WAS on the vetted list when I was in my hunt for a surgeon. Reason I had to bypass him was that he did not accept my Medicare Advantage policy. At the time *I* had my surgery with Dr. Boyce in Jan 2011, he was not on the vetted list (he IS now) but WAS known. Dr. Boyce was mentored by Dr. Dennis Smith and has been doing the DS since about late 2009.

 

[star0210]

Hi! I'm Susan and officially researching a VSG to DS revision. Who on here has had one (i'm already familiar with a few just from reading)?

I'm self-pay, and if I do this, I would likely use Dr. Greenbaum. I'm in Tennessee and proximity just wins out with him. My second choice would be Dr. K, but California is just too far (and expensive) to have surgery and stay for a week or so. Also, he has a more affordable self-pay rate. If Dr. K. had his price I *might* would go the extra distance, especially since I have heard so many wonderful things about him.

Anyway...I'm here researching and gathering information. I've posted before my biggest concern is complications right after surgery (or in the future). And the infamous "bathroom issues". LOL. I know I am stuck there, but I just want to know what I am getting into. I don't want to be farting all day long. I'm not too worried about diarrhea after reading most of your posts, unless I eat something sugary and carby, I should know when I choose to eat something like that (more than a bite or two) then I will have issues.

That's not what I'm talking about. My biggest concern is having gas and it be horrible or uncontrollable, etc. I've read all about trigger foods (things that make you gas and bloat), being lactose intolerant, etc. I get all that. I'm just afraid that after I eat, even if it's high protein with a few veggies or fruit that my body is going to react differently and make me self-conscious or feel like I can't do day to day regular activities or I can't share a room with someone because of embarrassing gas.

Am I really worried for nothing? Is it really that trivial? I want to know. How the gas is going to affect my day to day life?

I also see people on here living their life, even though they've had complications or had "issues" they would do it again....tell me why. What would be the reason you regretted this surgery??

And then I see people, most of the people just live. They had no complications. They figured out what they can eat and not eat and they just live.

I'm also worried about my disordered eating. After I had my VSG I went into major food deprivation mode. My head was not screwed on right. I blew my chance at optimum weight loss because I chose to eat junk thinking I could and it not hinder my weight loss. Then my weight loss just stopped. I didn't gain anything for about a year and then it slowly came back on. I have been in therapy. I have worked on my head issues, but I still eat crap. I make bad choices...UGH!!!!! I still struggle with all or nothing BIG TIME.

The best way for me to lose weight now is to either eat 100% clean, make all my food, and eat in moderation. Or eat Paleo and stick with it 90-95% of the time. It has been over a year since I have been able to do that consistently. I invite processed foods and sugars back in and even though I 'm not abusing them, I'm eating them. I can't lose weight when I do that. And paleo, well....it's hard, it's hard work, lots of prep. I've struggled with finding a happy medium so here I am another year at the same weight. Except now I have arthritis and knee and foot issues from all the excess weight I have been carrying.

Even with 2 (restrictive, not malabsorptive) weight loss surgeries I have not been under 200 pounds since I was in high school (I'm 46).

I keep thinking that one day I will get it, and do it, or accept myself at a certain weight (my therapist seems to feels that way. But she is also there to support me in whatever decision I make). Me, I'm just tired of wasting another year being MO.

I'm happily married to the most supportive guy on the planet. Seriously. I have two kids, ages 9 and 6. Very busy, active boys.

I want my life to be different. Can it really be different? Do I really have to go to this extent (a DS revision) to have a different life?

Thanks for listening. I just wanted to share more of my story and get some feedback.

Thanks!
Susan

I have no gas or bathroom issues at all...except constipation.

Honestly...if you can't get rid of the junk carbs for good then I wouldn't bother having the surgery. No surgery on the planet lets you eat junk and still lose weight.
The malabsorption of the DS does absolutely nothing for simple carbs...we absorb 100% of them.

The carbs I eat (under 30g total per day - some people don't need to go quite that low, but I do) come from veggies, a few in my pure protein drink I have for breakfast every day and occasionally Greek yogurt.
I eat NO bread, rice, pasta, potatoes, grains, etc. just don't eat them. I don't eat cookies, cake, chips, ice cream, etc.
When I get to maintenance mode, I may be able to have some of that every once in a blue moon, but for me those things will NEVER be a regular part of my diet.

 

[Will2014]

Hi! I'm Susan and officially researching a VSG to DS revision. Who on here has had one (i'm already familiar with a few just from reading)?

I'm self-pay, and if I do this, I would likely use Dr. Greenbaum. I'm in Tennessee and proximity just wins out with him. My second choice would be Dr. K, but California is just too far (and expensive) to have surgery and stay for a week or so. Also, he has a more affordable self-pay rate. If Dr. K. had his price I *might* would go the extra distance, especially since I have heard so many wonderful things about him.

Anyway...I'm here researching and gathering information. I've posted before my biggest concern is complications right after surgery (or in the future). And the infamous "bathroom issues". LOL. I know I am stuck there, but I just want to know what I am getting into. I don't want to be farting all day long. I'm not too worried about diarrhea after reading most of your posts, unless I eat something sugary and carby, I should know when I choose to eat something like that (more than a bite or two) then I will have issues.

That's not what I'm talking about. My biggest concern is having gas and it be horrible or uncontrollable, etc. I've read all about trigger foods (things that make you gas and bloat), being lactose intolerant, etc. I get all that. I'm just afraid that after I eat, even if it's high protein with a few veggies or fruit that my body is going to react differently and make me self-conscious or feel like I can't do day to day regular activities or I can't share a room with someone because of embarrassing gas.

Am I really worried for nothing? Is it really that trivial? I want to know. How the gas is going to affect my day to day life?

I also see people on here living their life, even though they've had complications or had "issues" they would do it again....tell me why. What would be the reason you regretted this surgery??

And then I see people, most of the people just live. They had no complications. They figured out what they can eat and not eat and they just live.

I'm also worried about my disordered eating. After I had my VSG I went into major food deprivation mode. My head was not screwed on right. I blew my chance at optimum weight loss because I chose to eat junk thinking I could and it not hinder my weight loss. Then my weight loss just stopped. I didn't gain anything for about a year and then it slowly came back on. I have been in therapy. I have worked on my head issues, but I still eat crap. I make bad choices...UGH!!!!! I still struggle with all or nothing BIG TIME.

The best way for me to lose weight now is to either eat 100% clean, make all my food, and eat in moderation. Or eat Paleo and stick with it 90-95% of the time. It has been over a year since I have been able to do that consistently. I invite processed foods and sugars back in and even though I 'm not abusing them, I'm eating them. I can't lose weight when I do that. And paleo, well....it's hard, it's hard work, lots of prep. I've struggled with finding a happy medium so here I am another year at the same weight. Except now I have arthritis and knee and foot issues from all the excess weight I have been carrying.

Even with 2 (restrictive, not malabsorptive) weight loss surgeries I have not been under 200 pounds since I was in high school (I'm 46).

I keep thinking that one day I will get it, and do it, or accept myself at a certain weight (my therapist seems to feels that way. But she is also there to support me in whatever decision I make). Me, I'm just tired of wasting another year being MO.

I'm happily married to the most supportive guy on the planet. Seriously. I have two kids, ages 9 and 6. Very busy, active boys.

I want my life to be different. Can it really be different? Do I really have to go to this extent (a DS revision) to have a different life?

Thanks for listening. I just wanted to share more of my story and get some feedback.

Thanks!
Susan

Ok, I'd need much more info to offer any advice here. What is your present height and weight? What was your highest weight and when? When was your sleeve done...and have you looked into seeing if it needs to be redone? You have no comorbidities...ok. How old are you? You are 100% correct to consider long and carefully this decision. I am NOT generally in favor of sleeve pt.'s jumping to the DS without comorbidities OR without a significant weight loss need. People trying to lose that final stubborn 30 lbs should NOT be having DS surgery IMO. The malabsorptive issues associated with the DS become increasingly problematic as we enter old age, so one would literally have to be severely lacking in intelligence to undergo the procedure without a definite need to do so. As for the issue with farting, it is an issue to consider but can be managed. Big soda drinker are you? Not if you plan to be around coworkers afterwards or in social situations where releasing room clearing gas would be mortifying. The food we eat is acted upon by digestive enzymes only in the last 9 feet or so of our intestines, resulting in less breakdown and a stronger (and different) aroma to our gas. You'll need to avoid foods known to cause excessive gas, and soda by definition is at the top of that list. Planning to be home alone all day? Drink all ya want!! But it's a scientific fact that gas going in MUST and will come out. One final thought. You may hear some say they can eat all the fat they want and have no issues. Such is definitely NOT the case with me and my 110 CM common channel. I will be running to the bathroom, and at great risk to NOT make it there, if I consume too much fat in one sitting. The days of eating 4-5 pieces of Kentucky fried chicken and fries are gone for me, or else. I really have very little desire or interest in sweets since my surgery. It's not that I never eat them or that I can't, I just don't care much about them. I'm worried about some of the statements you've made suggesting you may have some discipline problems in the area of nutrition. Please know, I make no judgements about you, I was one of the super morbidly obese with a BMI of 54.5 when I started to seek help. But I worry about your ability to maintain compliance with vitamins/minerals day after day, year after year, up to and including your geriatric years. Consider this also as you make your decision. You lack discipline in your dieting and you get fat, you lack discipline in nutritional supplements and you get DEAD. It's no joke and you need to consider my words very carefully.

 

[SJB41976]

Okay...

I am 5'5''. I weigh 283 pounds, my BMI is 45 (I believe). My highest weight was 306. I lost 70 pounds with the sleeve. I had surgery April 2010. I lost that 70 pounds within the first year. Within 6 months I was abusing food. I have been in therapy 2 years now with a therapist specializing in eating disorders. Hindsight, when I had the sleeve, I was not in the best place emotionally, I was depressed and hated myself and my body. This is all hindsight now. I understand why I turned to junk food 6 months after surgery, because I hadn't worked on my head stuff. Within the first year after the sleeve, I had a therapist (not ED trained), went through a 12 week class, did Celebrate Recovery for a while (Christian AA). Two years ago I started seeing my ED therapist. It's been pretty amazing.

@star0210 this is my concern, too. That's why I'm carefully considering this. I am not in any hurry. I'm not signing up for surgery tomorrow. I still worry about my eating issues. The biggest thing I have worked on is not abusing food. I don't feel like I abuse food anymore but I'm in recovery, so, one day at a time. My therapist agrees that I have made great strides in that department. It's something I will always struggle with. I have accepted I will never be done dealing with issue but it doesn't mean I can't move forward.

@Will2014 I have ADHD. Discipline is a dirty word. I have been told all my life that my problem is I don't have discipline, especially as a child/adolescent. The thing is, I have great discipline. What I lack is focus. I like to move on before I am finished. So yeah, this is definitely an issue to consider. I start things I don't finish, also a symptom of ADHD. Taking the supplements for life is something I am also considering. The fact that I could die from not taking them is a great motivator. I need motivation to keep going. My guess is I will have to go through a time of acceptance with supplements but I don't think I would ever NOT take them....because I could DIE. I get that.

Food is the issue. I like eating clean but life gets in the way with work, 2 kids, etc. I can sometimes revert back into junk eating. I was in a Paleo food group for about a year and that was awesome. That helped a lot. Now I'm researching freezer meals, meal prep, etc. too, to help with keeping on track. I still have a hard time with all or nothing. What i have been working on is just being normal with food without restricting anything, even though I try to eat whole food most of the time, I definitely want to cleanse off of sugar and white carbs and I don't crave the junk. I feel with being able to eat high protein, healthy whole food carbs, and eat good fats (which is Paleo) and that I enjoy eating that way, and love how it makes me feel, that the DS would be a better option than RNY. Have I been able to eat perfectly that way, no. I do feel that a requirement I have for myself would be to be cleansed from bad carbs and eating Paleo when I have surgery. I don't eat pasta. I went without soda for about 2 years and can easily do it again. I have gotten into the habit of drinking soda occasionally, but again, once I am off sugar, soda doesn't appeal to me. And when I do crave it, I have a sip of my husbands and enjoy that sip and I'm good. So, yeah, soda is not an issue. Cookies, cake and sweets are my downfall. Period. The good thing is that when that stuff is out of my system I don't crave it. I make clean, whole desserts when I have a craving, usually made with whole grains (or no grains. I have lots of Paleo dessert recipes) and honey, agave or sweetened with fruit.

My mistake with the sleeve was reintroducing sugar into my diet. Being in the state that I was it opened the door to the abuse. I thought at the time that I could eat that stuff and lose the weight. I screwed it up. I admit that. I own it. That's why I got into therapy.

What I have learned going into this is that this is definitely something I need to think long and hard about, about nutrition, about the junk and definitely the supplements. I am much wiser in knowing that if I do this, there will be no experimenting with sugar, white carbs/junk. I made that mistake once. I will be in therapy all through this process (if choose to go through with surgery). This is it.

Anyway....that is me. I am sure there is more so ask away if I need to clarify anything. But believe me, I have the same concerns as you.

 

[Will2014]

Ok...I do have a better picture now, and it seems like you have a lot of good insights into why you failed with your last procedure (I use failed as a clinical term here, it's not to be judgmental. It means a failure to lose at least 50% of your excess body weight for most bariatric surgeries, and for the DS that number should be 60+ %). It does seem that you might well be an ideal candidate for the DS procedure, as long as you can commit to taking your supplements in spite of work, 2 kids , etc. Your body doesn't care about your schedule or life's many difficulties. It needs what it needs, and it will die or be severely unhealthy if those needs are not met. But I'll not harp on that anymore, as I realize you are a fully grown adult and I think I've more than made my point regarding the importance of consistency in taking your supplements. I would encourage you to be sure NOT to just go for the "2nd 1/2 of the DS procedure" which is the intestinal resections, but to be sure your doctor is willing to recheck your stomach and possibly redo your sleeve as well. In my group in Mexico, the estimable Dr. Aceves insisted on checking a woman's sleeve through x-rays and barium swallow tests. He came back into the room the next morning literally laughing his ass off, as he explained to the poor woman that she had the SINGLE WORST sleeve he had ever seen. It was too large by far, and also poorly shaped which doomed her to failure. Yours may also have been done incorrectly, it may not have been entirely your fault that you had trouble losing and ultimately regained weight. Most surgeons will try to just do the 2nd half, but I strongly encourage you to have them check the stomach also. Aceves removed 30% more of her stomach and changed it's shape, along with doing the DS resections. Last I heard she was doing fantastic with her weight loss. I really applaud you for not giving up!! You have already separated yourself from the sheep by taking action to have your 1st surgery to effect the change you need with your weight. Most just whine about their condition, while we here on this site are folks who take action. I'm proud of you, and will pray for you as you continue your research and make your decision. Please don't ever feel that you are alone in this. There are some great people on this site who are extremely knowledgeable and caring. We all want you to succeed and be happy, because we know it's what we all want for ourselves too. Good luck to you and keep us all informed of your progress!

 

[star0210]

I went to Mexico as well and had my surgery with Dr. Ungson who took over for Dr. Aceves after he passed away.
My barium swallow showed that the doc who did my original sleeve didn't touch the bottom part of my stomach and it resembled a backwards L with the horizontal part being very large compared to the vertical part. They were able to trim it up and make it more like the classic banana shape.

 

[SJB41976]

I saw my sleeve after surgery (does everyone see theirs)..I had no idea what I was looking at, but I would like to see it now and I know for pre-op that it's a requirement to get an endoscopy, right? or X-ray of the tummy. If I do this my dr. will most likely be DR. Greenbaum. I would definitely be open to fixing any stretched out portions of the tummy.

Thanks, everyone!

 

[southernlady]

I saw my sleeve after surgery (does everyone see theirs)

Nope, never saw mine.

 

[SJB41976]

They took me down for the leak test and showed the image to me. The radiologist said it looked good. I honestly couldn't tell what it was except it was tubular looking.

Thanks for the challenging questions. It has really had me thinking and examining where I am in recovery. I still have a long way to go. I have made great strides, but food still has a hold on me. It sucks. But, I'm in a better place than I was two years ago.

 

[southernlady]

They took me down for the leak test and showed the image to me. The radiologist said it looked good. I honestly couldn't tell what it was except it was tubular looking.

Thanks for the challenging questions. It has really had me thinking and examining where I am in recovery. I still have a long way to go. I have made great strides, but food still has a hold on me. It sucks. But, I'm in a better place than I was two years ago.

My leak test was done while still in the OR and I was passed out! All I know is I passed cause as soon as I woke up, they had me sipping fluid.

 

[SJB41976]

and when I said I didn't have co-morbidities, I meant nothing like diabetes or high blood pressure. I do have ortho-arthritis in both feet, degenerative disc in my back, etc. It is now taking a toll on my health and well being and being able to get around, which it has never been an issue before.