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anyone who had DS after vertical sleeve?



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Hi everyone!

I had sleeve surgery in May 2013. Initially I lost about 140lbs, but then about a year and half post op I got pregnant. I gained some weight during and after pregnancy, and then lost some weight as well, and now I'm having a complication of some esophageal issues where I'm not able to swallow correctly. I have an appointment with a really great surgeon at an exceptional hospital in the Chicago area. I will have my first visit with them in April.

I was hospitalized in January for Fluid build up and severe infection of my right lung. This was caused by aspirating food and fluid due to my esophageal problem. They did an esophogram and upper GI while I was in the hospital, and the gastroenterologist who was treating me in the hospital informed me that my sleeve had stretched, my stomach was nearly the size of a normal stomach. Additionally, the lower part of my esophagus where it connects to the stomach is dilated, as if my lower esophagus has been acting as a food pouch for quite some time.

I was really shocked by this, as I had no issues post op from my sleeve and only stopped losing weight when I became pregnant, which I figured was to be expected. But since I had my baby in May 2015, I have struggled to lose anything. I was doing a Keto diet at the end of last year and that was working, until I got sick in January. Now that my esophageal issues have been diagnosed, I have trouble eating anything solid. My weight has maintained since I was admitted in January but I haven't had any significant loss since then.

Long story short, my primary focus is to get my esophagus issues figured out and fixed, but they referred me to two different docs - one that specializes in swallowing disorders, and the other is a GI/bariatric surgeon to address my stretched pouch. Since I'll likely need surgery to fix my esophagus, it would make sense to do any revision to my sleeve at the same time.

I feel like I have 2 options (maybe 3) to discuss with regard to fixing the sleeve. Either re-sleeve, DS, or revise to gastric bypass.

I should note that my highest weight was around 460, so even when I was at my lowest weight before getting pregnant, I was still at 306ish. I'm currently around 340-345 putting my BMI around 48.

When I first started thinking of going the surgical route for WLS, something about the gastric bypass didn't appeal to me. So now I am struggling with if I should re-sleeve or go for the DS. I'm thinking since I still have so much to lose, the DS might be a better choice, but I honestly don't know enough about it to make a decision.

I've read the limited info I could find about DS, I realize it's not a particularly popular surgical choice, but I want to hear from people who've had it, possibly people who had it after having a sleeve. I'd love to hear your stories and thoughts on the DS!

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I have no information for you but I'm really sorry about the situation you are in. Remember your doctors are the experts and want to do what is best for you. Good luck!

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Hi there "makemyownluck". First of all, I am so sorry to hear of your situation. Deciding on the surgery in the 1st place is such a huge choice to make, and it doesn't seem fair to now have this terrible swallowing issue. I agree with your opinion about Gastric Bypass....I felt the same way. I believe there are only a certain number of people who have the strength and will to have that procedure, and I am NOT one of those people. You risk dumping syndrome if you should do the slightest thing wrong and I was NOT going to go through that!!! I knew there would be mistakes along the way so GS was the choice for me. My 57 year old brain is not as sharp as it used to be, so I am not able to figure out what your abbreviation DS means. I know once I hear it, I'll say "duuuuh", lol. Lastly, I would really try to NEVER make a negative comment about someone's doctor, because you may really like and trust him/her. But hearing your belief that your esophagus has been working as your pouch, I would get a 2nd opinion and see if an error was made during surgery. That just doesn't sound right to me. I would get the esophagus issue taken care of 1st thing. I think you are running the risk of something really bad happening. I think you are very brave considering another procedure and you seem to have a good mind set on this whole thing. Please let this "old lady" know what DS is so I c an better understand your situation. Take care of yourself and I hope to hear back from you.

Cassie

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Just now, Cassie111 said:

Hi there "makemyownluck". First of all, I am so sorry to hear of your situation. Deciding on the surgery in the 1st place is such a huge choice to make, and it doesn't seem fair to now have this terrible swallowing issue. I agree with your opinion about Gastric Bypass....I felt the same way. I believe there are only a certain number of people who have the strength and will to have that procedure, and I am NOT one of those people. You risk dumping syndrome if you should do the slightest thing wrong and I was NOT going to go through that!!! I knew there would be mistakes along the way so GS was the choice for me. My 57 year old brain is not as sharp as it used to be, so I am not able to figure out what your abbreviation DS means. I know once I hear it, I'll say "duuuuh", lol. Lastly, I would really try to NEVER make a negative comment about someone's doctor, because you may really like and trust him/her. But hearing your belief that your esophagus has been working as your pouch, I would get a 2nd opinion and see if an error was made during surgery. That just doesn't sound right to me. I would get the esophagus issue taken care of 1st thing. I think you are running the risk of something really bad happening. I think you are very brave considering another procedure and you seem to have a good mind set on this whole thing. Please let this "old lady" know what DS is so I c an better understand your situation. Take care of yourself and I hope to hear back from you.

Cassie

DS = Duodenal Switch. It is sometimes used as a 2 part after getting a sleeve for patients with a higher starting weight who don't meet or come close to their goal weight from the sleeve alone.

I am very anxious to get my esophagus problem sorted - it's a daily issues as any time I eat I have discomfort and only about a 50/50 shot of food staying down at all. It's not fun!

I don't know if my original surgery was the problem. I honestly think it was because I got pregnant too soon after surgery. Being pregnant shifts all of your organs around to make room for baby. I wouldn't change having my son for the world! But before being pregnant, my post op life was a BREEZE - ever since being pregnant, I have felt 'off'. Had reflux issues that I didn't have before, had some food sensitivities...

As far as my esophagus, they definitely will have to operate. I was hospitalized in January for 2 weeks and needed a thoracotomy to drain and clean my lung. I was in ICU for a week, on a ventilator for 5 days... I developed sepsis in my blood and my kidneys shut down - so the worst DID happen (and scarier still is that I had NO symptoms leading up to the problem!) and I am constantly fearing that it will happen again because of how long the wait time for an appointment has been!

Thank you for your concern and reply, I definitely hope to get some answers when I see these docs in April. This is not the same hospital/doc that did my sleeve, so I'm hoping that they will be able to tell me more about why my sleeve stretched the way that it did.

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OMG! I can not believe what you went through in January! Horrible is an understatement. And the trying to keep food down now? I am so very sorry for you about this. And yes, of course your son was more than worth it, but you have paid a huge price. And I think it's so very strange that the weight isn't just falling off of you now, because you don't keep everything down. I hope your appt. is EARLY April because you must get yourself taken care of!! And thanks for the DS answer. I have heard of it, but know nothing about it. I will educate myself and look it up! I truly hope that you will keep in touch, as I am very worried for you. (But I don't even know your name, lol) which if you'd prefer not to offer it up, that's fine. If you would like to write to me off of the site, you are more than welcomed. tomswifeforever@aol.com

PLEASE take care of yourself and keep in touch!

Sincerely, Cassie

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Are you going to Northwestern, University of Chicago or Loyola?

I would go with DS over Bypass.

At this point DS still makes the most sense and since you didn't react very well to the sleeve the first time, it seems like you need DS or SIPS.

If you are going to have another surgery might as well go all the way with DS, it has better weight loss than RNY and the Sleeve.

Who did your original surgery? Did anyone off you any reason why your sleeve stretched? A properly formed sleeve should not stretch. Have you reached out to that Dr?

And yeah being pregnant probably affected your sleeve. If I have high waist pants on, I can hardly eat with my sleeve. I can't have any pressure on my mid torso to be able to eat. I can only imagine what a baby would do.

There are fewer long term people that post here as of late and I can't think of any regular poster that went from sleeve to DS but I know there has to be some.

Good Luck!

Edited by OutsideMatchInside

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On 3/31/2017 at 6:54 PM, OutsideMatchInside said:

Are you going to Northwestern, University of Chicago or Loyola?

I would go with DS over Bypass.

At this point DS still makes the most sense and since you didn't react very well to the sleeve the first time, it seems like you need DS or SIPS.

If you are going to have another surgery might as well go all the way with DS, it has better weight loss than RNY and the Sleeve.

Who did your original surgery? Did anyone off you any reason why your sleeve stretched? A properly formed sleeve should not stretch. Have you reached out to that Dr?

And yeah being pregnant probably affected your sleeve. If I have high waist pants on, I can hardly eat with my sleeve. I can't have any pressure on my mid torso to be able to eat. I can only imagine what a baby would do.

There are fewer long term people that post here as of late and I can't think of any regular poster that went from sleeve to DS but I know there has to be some.

Good Luck!

I'm going to Loyola. The GI that I saw when I was in my local hospital didn't have much info, he wanted me to see the specialist at Loyola for the swallowing issue and when my records were reviewed, they scheduled me with 2 different docs at the same visit. Unfortunately, they couldn't see me til April 20th, which is three months after my discharge. I'm really hoping I haven't accumulated any Fluid or continued to aspirate as they gave me nothing to treat this issue in the meantime. :\

My original surgery was at Rush University Hospital in Chicago, Dr. Luu. I lost my insurance about a year and a half after having surgery and haven't followed up with him since a little over a year post op. I did continue to see my PCP and get bloodwork, but I bounced around insurances for a bit and never got the referral to go back to Dr. Luu again... not a valid excuse, but that is the reason I didn't continue my post op follow up to a T. Very curious to see what these docs say about my condition now.

The little research I was able to do on the doc at Loyola, it looks like they do offer DS, I don't even know what questions to ask about this. I feel like I was SO PREPARED when I wanted the sleeve, and I know nothing about DS and haven't been able to find much other than the actual surgery and not a lot about post op life with that option.

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How did your appointments go last week? With your esophagus issues I don't think you should consider a revision to another sleeve, which can cause GERD in people that never had it before surgery and it doesn't typically result in as much weight loss as the DS or RNY. My prayers are with you that you'll get your health back soon. All the best.

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