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The DS as a virgin procedure is more challenging to perform than a VSG or RNY, which is why relatively few bariatric surgeons offer it, despite its' demonstrably better performance (the RNY is "good enough" for most patients...) That's your first challenge - finding a reliable DS surgeon. Converting a VSG to a DS is straightforward for any DS surgeon, as the DS uses the VSG as its basis, so it's mainly a matter of adding the "switch" part - the malabsorptive part - to the VSG. Revising an RNY to a DS is another, much more complicated matter, and surgeons who can do that are few and far between. It used to be, a few years ago, that there was maybe a half dozen surgeons in the US that reliably did them, and I have seen references to a few more have joined the ranks in recent years. Rabkin and Keshishian in CA have both done them for many years, as has Roslin in NYC. I've heard that someone in Salt Lake has done some, along with some docs at Duke University in NC, possibly Kemmeter in MI. Some surgeons who don't do the DS will offer to revise to a distal RNY instead - that is a "long limb" RNY that has malabsorption more akin to the DS. However, it does not have a great reputation, and is usually not approved by US insurance as a primary procedure (but often will as a revision under the right circumstances.) My take on why it seems to be more problematic than the DS is that it is rarely done, and the surgeons and their practices aren't all that in tune with its' long term requirements. A DS, and by association the distal RNY, has a quite different nutritional and supplement requirement to the standard proximal RNY, which is well known to those in the DS world, but not all that well appreciated by those in the RNY world. Like with the RNY, and much more important with the DS, is to commit to having annual labs and follow ups for life - with the altered absorption and nutrition/supplement requirements, things can go askew in sometimes if you don't stay on top of them. Those who do stay on top of things typically have minimal long term problems. I would not go to MX for a procedure like this, as you really don't know what you will end up with. Historically, there has only been one reliable DS surgeon in MX - Gilberto Ungston - who, if not retired, is heading that way. He has trained a couple of others to do the DS, but I haven't heard of him doing the RNY to DS revision. There are, of course, the various horror stories of MX surgeries gone wrong, and in particular of those seeking a DS and getting "something else" (who knows what.) There are great, reputable surgeons down there for the VSG and RNY, but I wouldn't go there for something more complicated like a DS, unless it was someone well vetted in that procedure (such as Ungston,) - the differing legal systems leave one with no recourse is something doesn't go right (and the chances of that happening with something as complex and an RNY/DS revision are high there.) Good luck - it is a long search for what you need, and be prepared to travel. Being in CA myself, and my wife is a Rabkin DS, we have seen several successful revisions like this from both Rabkin and Keshishian, so it is viable when done by someone experienced with it. It, also, is not a simple outpatient procedure, and Rabkin's standard practice for travelling patients is to remain in town until at least the 10 day post op follow up. Most everything else can be done remotely (and they are set up for doing so.) Keshishian is similar in this regard.

For reference, I have a complicated medical history including several co-morbidities, an autoimmune disease that has affected my gut, eyes, and spine, with a history of small bowel ulcerations, and a history of iron deficiency and vitamin D deficiency that only respond to high dose pills (Vitamin D) and regular iron infusions. A while back I saw my first bariatric surgeon and had an awful experience. The guy was dismissive of my concerns, brushed off my questions, and was in the room less than 5 minutes and told me the DS was my only option and anything else would fail. His nurse was rude and took my blood pressure with the wrong cuff and when it came out at 175/112 told me I was just too nervous. (I know what "white coat hypertension looks like and mine does not look like that!). They rushed me through, didn't answer my questions, and I felt like a number. I saw my second surgeon today and the difference in visit was like night and day! He was much more engaged, has the same concerns about my surgery that I do, and said that it may be possible to only do a sleeve but if that ends up being the case we will make the best of it! He even volunteered to call my Gastroenterologist and chat with her to get her opinion and risk assessment if we go for a more invasive surgery. She has treated me for almost a decade so I really trust her opinion but I couldn't get an appointment to see her. He thanked me for giving him an interesting challenge to work on! And I got to meet my case manager who was super sweet. So all in all I am feeling much better at this place, super thankful for the long chat the doctor took the time to have, and incredibly relieved that the concerns are not all in my head like the last surgeon made me feel! To anyone with lots of questions and a doctor who won't answer them, it was definitely worth the effort to get a second opinion. As one of my doctors said "You need to be REALLY confident and comfortable with the surgeon that's going to cut into your gut and rearrange your insides!" LOL Oh, and my blood pressure was 104/67. 🤣

Most insurance will require you to have 2 comorbidities as listed above. https://www.barixclinics.com/comorbidities-of-bariatric-surgery Joint/back/knee issues related to your weight may also help you qualify.

Hi I had my lap band (originally inserted 2009) removed and replaced by a gastric bypass yesterday at 11am and sent to ICU here in local hospital. No one told me and I’m losing my ever loving mind here because I haven’t had anything to drink since the tiny bottle of pre-operative body armor drink I was given to drink before my surgery! I was told to do liquid diet 24 hrs before and then nothing after midnight so 12:01 am Tuesday morning I stopped drinking anything, headed to hospital I was told to drink the little bottle of body armor which was about 7 oz. Arrived early taken back and done early and into ICU room by around 2-3 pm Tuesday. Upon waking I immediately asked for some water and was told that I am not allowed to have it! I was shocked and asked when it would be possible and nurse said that I have to wait until the next day and that I have to have a bariatric fluid drink and test before I can have a drink! I’m dying of thirst here and still can’t believe that this is happening! nothing I read anywhere says this!!!! Has anyone else been through this? I have asked when the test will be and they said they will check on the schedule and let me know. I’m also a little frustrated bc they have a catheter in me and I’m pretty much stuck in the bed here, I’d have preferred to have been able to go to the bathroom but they don’t have a real bath in the room either just a toilet and there is literally a door that has a window across the room about 8 feet away… I’m not kidding. I’m really feeling like a prisoner in here and the little prison toilet just ads to it! im thinking of calling the bariatric testing center to see if I can get some answers. Is this normal? Has anyone else had this problem?

I had my revision June 21st, original R N Y in 2005. Just remind yourself it is to make sure your liver is smaller to make the surgery less complicated for you! If you haven't tried them yet, bariatric pal has awesome protein shots available. I love the orange. It's like conentrated Tang! 100 calories, 15 grams of protein. Other really good protein shakes that got me through it, Redcon1 Protein shakes are 0 grams of sugar 250 calories and 40 grams of protein. Also KaChava is a good powder shake with alot of protein and super foods in it. I still incorporate these in my diet post surgery and it definately helps. Hope your surgery goes well with no issues!

Absolutely! Amazon has a few with good reviews. I made sure to search for surgical compression garments. They are a lil pricey but it seems worth it. Several bariatric patients told me in person that I need to wear a girdle of some sort to help with the excess skin amount and weight loss . Told me it will help out a lot for contouring without having to get a lot of surgery.

Absolutely! Amazon has a few with good reviews. I made sure to search for surgical compression garments. They are a lil pricey but it seems worth it. Several bariatric patients told me in person that I need to wear a girdle of some sort to help with the excess skin amount and weight loss . Told me it will help out a lot for contouring without having to get a lot of surgery.

Ok lovelies! I have created a Facebook group after doing some Google research lol it is a private group and you will have to request to join. It is called "August 2023 Bariatric Surgery Support Group" There is also a group chat there so we can all talk a little easier 🙂

Bariatric buddies, I need help with encouragement. I've done SO MUCH for 9 months worth of bariatric pre-op requirements and surgery is on Thursday coming up. Now that I'm getting closer it seems like I want to back out but at the same time I don't. I'm having a battle with myself right now and it sucks. I've been overweight almost my whole life (since 6, 30 now) and I'm sick of it but I know I will miss being able to eat to feel good again if I have the surgery or so I think right now. I am able to control myself but it's the reality of not having that choice that bothers me. Also I can like chug a nice cool whole water bottle down nonstop in like 5 seconds (and I'm proud of it lol) and I won't be able to do that anymore. I do want a healthier life but that gut feeling is getting more intense and real the more time ticks. Feels like I'm almost at the high peak of roller coaster except you can get out before it drops.

@PennyinAL I highly suggest you hire a nutritionist that specializes in bariatric care. You can find someone who will do telehealth appointments and you can see if you can find someone who takes your insurance! At least a few sessions to get a much better diet plan structured. 500 calories seems too low once you are out of the liquid phase. The surgery (in my understanding) resets your metabolism so you don't want to crash it with going too low on your calories. What used to apply for you for weight loss pre surgery may not apply post surgery because of the change in hormones. You really want professional guidance on this, everyone here varies in their macros because there is no standardization in the field at the moment.

Dollar Tree finds are so fun! I wish I liked salmon, mini packets would be handy for snacks! It may not be the best place for electrolyte waters though as stated above, check and see if they have sugar in them. I have some that don't but they were pretty pricey and not from the dollar store. Who knows though, you never know what brand you are going to find at Dollar Tree, sometimes you luck out! As for protein, it is the same thing, check the sugar, cheaper formulas often use sugar to sweeten and that will ruin your low carb efforts. Also check the protein source. If I recall correctly bariatric patients tend to do best on whey protein isolate or whey hydrolysate because they are gentler on the stomach and absorb better. Plus they should be lactose free, lactose intolerance is common after surgery as your stomach heals...

I agree with Bariatric Master, go to your nutritionist and ask her the question. There are too many opinions on here and your nutritionist is different than mine. For instance, at 3 mos out of sleeve surgery, my dietician said i should be eating about 600-700 calories a day. I know that answer is probably different for many people on this forum. Don't sweat it, you are doing great!

I've been very specifically told that all carbonated beverages after surgery are completely off the table for a number of reasons including the high risk of stretching of the stomach pouch, suppression of nutrient absorption, bloating, irritation of the stomach lining, and especially in the case of regular sugared versions, they're 100% empty calories. There is also a study that was done by the University of Wisconsin that found soda and other carbonated drinks decrease weight loss after bariatric surgery and that they heavily impacted how much weight patients lost. Over 80% of patients who quit drinking soda after surgery achieved their weight loss goals while almost 50% of those who continued their drinking habits had unsatisfactory results. University of Wisconsin predictors of weight loss after gastric bypass study The section that addresses soda consumption is 3.3.1 with the breakdown in Table 3 Edited to insert this section quoted from the study; "Patients who did not drink soda preoperatively or quit by the surgery date were more likely to experience successful weight loss compared with those who drank soda preoperatively and were not able to quit. Given that all soda drinkers were counseled by our dieticians to quit soda consumption preoperatively, this variable may be a proxy for postoperative dietary compliance. Those who were unable to quit soda consumption preoperatively may have been less likely to comply with our dietary recommendations postoperatively. Furthermore, given that consuming liquid carbohydrates such as soda leads to poorer satiety compared with eating solid foods, caloric intake may have been significantly higher in patients who continued to drink soda postoperatively [34,35]. Given these findings, cessation of soda consumption preoperatively continues to be an important part of our preoperative bariatric patient evaluation process."

I feel like im going to destroy my journey because I keep reaching for the sugary drinks too especially soda and I know im not even supposed to be drinking them. Once I saw that I can tolerate them, I allow myself to drink them. I really don't want to drink them because this is why I wanted the surgery so I can't drink them and if I did I'd get sick. But I don't get sick and my mind thinks it's okay to drink it. Ahh! I can only drink about 6 to 8 ounces of it depending on what kind it is. If it gets flat, I don't want it. I honestly believe it's the carbonation that I crave, but im not sure. I just really want to avoid it, it's soo hard. I drink water as much as I can, no where near the recommended amount tho. The drink packets are too sweet for me and I just want something tasted to drink. Maybe I'll start combining fruits in my water for something refreshing with lots of ice. I did save a few videos on tik tok that are meant for bariatric patients that I want to try. I'll have to order some of those sugar free syrups to make tastes drinks without all the sugar and maybe I'll find something 100x better than soda that I'll crave. Or at least that's what I'm hoping. I could totally marinate chicken and turkey or even steak and portion them out and freeze them. It just sucks when you live with family and if you're having something weird they all complain lol.

How often did you all take vitamins? I found Bariatric complete with iron on Amazon. I thought we take them once a day but my nutritionist just said 3.

How often did you all take vitamins? I found Bariatric complete with iron on Amazon. I thought we take them once a day but my nutritionist just said 3.

How often did you all take vitamins? I found Bariatric complete with iron on Amazon. I thought we take them once a day but my nutritionist just said 3.

Did not get answers that sufficiently addressed my concerns with OCC. Decided to go with Renew Bariatrics and Dr. Rene Armenta. MGB surgery is scheduled for September 2nd. I will report back on experience post surgery.

Yay for no more leg cramps!! (and for less constipation!!) I have like 5 different sugar free electrolyte powders around because I'm crazy prone to having low potassium and waking up screaming in pain isn't my favorite way to wake up. 😂 I wondered if bariatric patients could take Miralax, I find it much kinder than some other meds/methods. If you ever have to have a colonoscopy definitely ask them for the Miralax prep! It just tastes like whatever you mix it into...

This past Monday, my PA told me I should probably be consuming 1,000 calories a day. Ta loco! (He's crazy). I reminded him I'm only 35 days out of surgery. I said I was consuming about 600 cals a day now, 60g protein, and 41 carbs (because 21 of my carbs and 60 calories come from my chewable vitamins and fiber supplements). He said I should up my cals. I told him, I'd up them to 700, but that was it. I'm not saying the kid doesn't know his stuff, but this isn't my first bariatric surgery. We know our bodies better than our docs, PAs, and nutritionists. Unfortunately, we know our bodies because we learn through trial and error. That's how we figure out when too much it TOO MUCH, or what foods our particular stomachs will reject or be fine with. "Since grams can be used to measure both solid and liquid ingredients, both types of ingredients can also be measured in a cup. However, while liquid ingredients are always the same weight in grams, solid and dry ingredients are not. Remember that grams are a measurement of weight or mass." Solid food is more dense than liquid. You'll need less solid to fill you up. Liquids will go though faster and easier. Listen to your tummy. Grams only measure the weight of something, not how bulky or dense it is. Also, everyone's tolerance, hunger, and nutritional needs will vary from person to person. The medical teams can give us guidelines, but even if they've personally had bariatric surgery themselves, ever body is different. I don't think that 1 cup of food is too much at 5 years out. However, only your stomach can decide that.

When they said eating and drinking would be your full time job, they weren’t kidding! I am 43 days PO and starting my soft/solid stage. Last week the bariatric nutritionist wanted me to start eating 800 calories a day and it really interferes with getting my fluids in every day since we have to wait 30 minutes prior to eating and 30 minutes after to be able to drink again. I have to wake up at 6:30 am to start my day of eating and drinking and don’t finish until 10 or 10:30 at night - and I rarely get to 750 or 800 calories. I know as time goes on my stomach size will improve in order to take more in at one time but for now I try to listen to my body and be patient! Has anyone else felt like this and how did you deal with it? Hugs to all!!

My nutritionist said pretty much the same thing, that there's not enough research showing we absorb enough through the skin, but that things are always changing so maybe in the future. She expressed her frustration with liquid vitamin manufacturers not making them bariatric appropriate. I tried them for a couple weeks but soon forgot to put them on. I did feel like I had a little bit more energy/alertness, though.

Hello @LibrarianErin, you’re not a failure, you are trying your best. This is a major surgery and it is going to take time for both mind and body to adjust! You got this!! :)) I also struggle to get my liquids for the day and I recommend Nectar daily hydration water packets as adding it to a water bottle multiplies the intake (1 oz is 2; 2oz is 4 etc) which has helped me reach my water goal without having to drink that much to where my stomach feels uncomfortable! It also helps with that dry mouth feeling as it works fast in terms of hydration. (I added it to my gatorade on days I couldn’t stomach water) There are other brands but this brand is 0 calories and sugar free which I find to be very bariatric friendly! And they have a variety pack so you can try different flavors. May you have brighter days ahead! ☀️

Hi all! Newbie here... I've been lurking for months though. LOL I got notice today that my policy covers the surgery but that I cannot gain any weight the entire time I'm in a bariatric program. I'm curious, how many other people have had this as a clause in their policy? And if so, how did you deal with it? Did you gain weight and get kicked out? I find this to be such an absurd requirement. If I could control what the scale does I wouldn't be pursuing weight loss surgery in the first place! I just gained 10 lbs in the last 3 weeks on a new medication (Lyrica) that I have to stop now because its not worth the gain. Doctors are always playing with my meds, what if something else causes me to gain before surgery?? This is such an annoying detail to have to worry about.