Contemplating Gastric Sleeve Revision

[KyahRose 2]

I had my gastric sleeve in March of 2012 with a starting weight of roughly 283 lbs at consultation / start of my journey. The lowest weight I was able to get to was about 185-188 lbs which was in early to mid 2015. Later that year, I developed a wrist injury and eventually needed surgery in 2016, and began around late 2015 to early 2016 putting on weight. From October 2016 to now I've essentially regained all of my weight back.

I am contemplating revisional surgery at this time, and looking around for surgeons. I have a consultation with one surgeon set for Nov. 27th with Dr. Alibhai in Irving, Tx. (If anyone has any experience they can share, please do.) My other choice of surgeon would be Dr. Matin who did my mother's Gastric Bypass around 2007. I'm wanting to revise to the DS....but, now I am reading and learning about the SADI DS and I now don't really know which one of these I would like to do. My mom is trying to talk me more into doing the gastric bypass rather than the DS. I understand she's worried, she knew someone who recently passed away who was having complications with her DS....I don't know the specifics, but that is the gist of her reasons for not wanting me to go with the DS.

At the same time, I'm 10-11 years out from my Sleeve surgery, so I've also had some thoughts about if I could possibly get a re-sleeve along with the DS. (At this rate, I think I've decided I want the DS, just not certain if I want the traditional DS or the SADI version.

If anyone has any experience with Dr Mustafa Alibhai and / or experience with Re-Sleeve + DS / SADI revision, could you please share? I would really like to get back to the 180s at the very least. I felt soo much better at that weight, even though I was still a good 50-70 lbs over weight (I'm 5'3). Thank you!

[ChunkCat 728]

Hi KyahRose!

I just had the DS surgery on November 1st. I considered SADI-S, Bypass, and DS when deciding on which surgery to go with. In the end I picked DS even though it is the scariest of the surgeries, because I wanted the benefit of my co-morbidities going into remission which the other two surgeries can do, but the DS does best. Plus I wanted a surgery that has a lot of studies behind it going out years, and while the bypass does have that, the SADI does not. I didn't want to have an experimental surgery, enough of my medical care is experimental. LOL

The DS has a proven track record and is safe for the vast majority of people who have it. That being said, it IS a serious surgery. You can make yourself very ill if you don't follow the Protein and Vitamin recommendations, and even the vitamin recommendations from the docs are often not enough. I highly recommend going over to bariatricfacts.com and joining the forum there to talk to the DS vets. I'm over there as Shrinkingmytiara. These are people who have had the surgery 10+ years. They will tell you the good, bad, and ugly and make sure you understand the ugly and what you are getting yourself into. There is a wealth of info on that site about DS and some about the SADI. On FB there is a Duodenal Switch SUPPORT Group (there are a number of them, but I'm in that one) which also has a lot of vets in it. It has people with DS and with SADI. You'll read a lot of complaint posts from people who are having issues (common for any support group) but it'll give you an idea of what some of the challenges are post surgery. Again, your odds of having complications are quite low (though a little higher than the other surgeries), but it is still worth seeing what others are experiencing. I'm sure you could find the same for Bypass.

I have had no major complications with my surgery so far. I had a lot of nausea and ended up in the hospital an extra night while we stabilized that and my pain levels. Once I came home I've only needed my nausea meds a handful of times and I didn't need pain meds. I wasn't able to ingest whey Protein Drinks for the first two weeks but my surgeon told me the body has stores for 3 weeks, so to focus on Water and the rest would come. He was right! I can drink them now and am getting protein in what I eat now that I'm on soft foods. I've met my fluid goals every day, some days are harder than others. I've had some diarrhea on and off but my system tends that way even pre-surgery. I could drink lactose free milk and Bone Broth the first week so those are what kept me going. I actually feel more energy now most days than I did before surgery which is strange to me! I do tire out a little easy though because I'm still healing. My stomach did these spasms while feeling like it was turning in cartwheels inside me for about 2 weeks. They finally faded like the surgeon said they would.

I'm diabetic. My fasting blood sugar now sits at 87 which is stellar. They told me to stop the diabetes meds. I had high blood pressure but they took me off those in the hospital and my blood pressure is normal! 105/76 when checked at my 2 week follow up!! I've lost 21 lbs in 3 weeks post surgery, for a total of 35 lbs from my highest weight. I can't wrap my head around that, it happened so quickly! I had a moment post surgery when I panicked over permanently altering my body in such a drastic way, but then I reminded myself that the way my body was pre-surgery was killing me, this was the only path forward to health that I could see. I don't regret it at all. I'm happy to talk with you more about it if you want, and you can feel free to message me if you want to keep in touch! There aren't very many DSers around here active anymore!

Edited November 22, 2023 by ChunkCat

[ChunkCat 728]

Oh, and as for your mother's concerns. They are valid. The unfortunate fact is that the same mechanisms that help us lose the weight and reverse co-morbidities also restrict nutrients and our ability to get fluids in when we are sick. Sometimes that means we end up in the hospital for fluids or electrolytes. But with a more severe illness sometimes it can lead to low Protein levels or low Vitamin levels and the body struggles with that, this can happen with ANY of the surgeries, but is of course a little more common with the malabsorption surgeries. This can complicate an illness with an already complicated clinical presentation. I can see how if it got out of hand and wasn't properly treated, it could contribute to someone's death, but it would be secondary normally to their originating condition. However, what I would invite your mother to consider is how pre-existing co-morbidities like diabetes, high blood pressure, and such contribute to severe illnesses as well. If you don't have these now, you probably will in the next 10 years. Those things can kill you too and can make your health much more fragile when dealing with an extra illness, like cancer or severe pneumonia. The only thing I can think of that would be originating from the DS that could kill you is severe protein deficiencies that go untreated, severe vitamin deficiencies that go untreated, and the possibility of bowel obstructions. All three of these things can also happen with Gastric Bypass. They are by no means common with either surgery, but they are a risk to be aware of and watchful for...

My uncle was in his 40s when he had his first heart attack. It was also his last heart attack as it killed him. He had all the co-morbidities that I have. I thought long and hard about this before deciding on the surgery. I finally decided I'd rather trade a life of medications for a life of Vitamins 4-5 times a day. And a life of being able to move and run and hike, and travel, for a life spent on the couch. And if at the end of my life I get sick and things get unbalanced and that malabsorption does me in, it will still have been a life MUCH better lived than if I had passed up the surgery. And it would (hopefully) be spared the heart attacks, diabetic and high blood pressure complications, possible amputations, etc.. Not everyone would think this way, but I like to go into things with my eyes wide open and I always have to think about the worst before I can let myself dream about the best... I wish you luck in your decision! ❤️

[KyahRose 2]

Thanks for the response. I've pretty much determined that RNY is off the table. I'm currently at a toss up between traditional DS and Sadi....each one has it's own pros and cons that push me to the other, so I'm really not sure which one I will choose in the end. I plan on talking with the surgeon as best as I can during my consultation and try to get a better sense of what would be the best option for me. I'm currently a sucker for chocolate; and I love carbs like rice (sushi / japanese cuisine is my favorite)....So, looking at this fact is pushing me more towards the traditional DS. I'm a bit nervous of the malnutrition potential; but I'm also more nervous that I won't lose as much with the SADI as I may lose with traditional DS.

I am lucky enough to not have any major co-morbidities....so I'm hoping my BMI alone will be enough to allow for the conversion surgery. My mom had Gastric Bypass herself, and has pretty much also regained her weight; I can see her point, but I'm wanting a more drastic reduction, so I am really leaning on the DS surgery and the more youtube videos I watch, the more I'm learning and looking to start the journey again. I have already begun working towards making changes to prepare. I'm working on drinking more Water and limiting or eliminating other drinks. I'm also working on changing eating habits, and foods. I'm referring to this as going back to Bariatric 101....and working to re-learn the rules of the tool, etc and implementing those changes. So far, I'm really not seeing much difference in weight.

I'm with you on wanting to be able to be active and live a more active lifestyle. I have no energy most days, even though I want to exercise, etc I'm constantly just tired. At this point, if weight is what kills me, I'd rather die too skinny rather than be killed because I'm fat. My lowest weight was somewhere between 185 - 188 lbs at 5'3.....There are things that I noticed at that weight that I miss. The energy to go being one.

You mention Bone Broth.....I absolutely love Dr. Kelly Ann's Bone Broth! As for Protein drinks / shakes....Premier Protein is pretty much my go to. I've tried others in the past.....and they either have a bad after taste, or they just straight up taste like you're drinking chalk (I'm looking at you, Isopure!). As for vitamins.....I have never been consistent with taking vitamins; but, if it means I can drop 80-90% of my excess weight, I will put in the effort to take them.