Seriously considering VSG to RNY revision 10yrs later

[mi75 1,235]

I'm an old VSG Vet, had my surgery in 2014. Initially lost a successful amount of weight. had some serious 'life' events- change of job, change to night shift, loss of parent, went to grad school and graduated, went to a second grad program, changed career path, etc. I was told in 2017 I had a serious metabolic issue with my liver and that helped me really get focused, went to Keto and lost all the regain I had plus much more, resulting in 100lb total loss. Since then, though, I've regained probably 50-60 lbs. I still feel some restriction which is great.

Long time issue has been GERD, it was severe PRE surgery but my quite renowned surgeon assured me that with the weight loss, the GERD would subside. It did. But with the weight gain over last 2 yrs, it's back and BAD.

I have EGD and colonoscopy coming up in a few weeks to assess the damage. I'm very scared due to the ongoing severe nature of the symptoms I'm having. I'm a healthcare provider so I know all of the 'things' that could present.

Because of all this, I'm heavily considering a revision. I have been on PPI for over 20 years. While my magnesium is fine, my bones are already having a lot of issues AND I'm scared to death of the brain effects.

What should I consider with revision, same doctor, different doctor, etc? Also I know that weight loss can be slower, but what type of rate of weight loss can be expected? Lastly, what kind of time off from my career can I hope for? I took 6 solid weeks with my VSG and it helped get my brain, behaviors etc really corrected before going back into the workplace.