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Obviously you need to decide what's right for you. I was in the same boat as you in that they discovered inflammation during my EGD. I had already been leaning toward RYGB anyway, but that sealed the deal as far as I was concerned. My doctor stressed that even though I wasn't having issues with GERD, there was a strong possibility I'd develop issues if I insisted on SG. As far as risk is concerned, all surgeries carry some risk and since RYGB is a more complex surgery, you are correct that some studies show a marginally higher risk profile. Interestingly, other studies show no difference. Keep in mind that obese people are all going to have a higher surgical risk for ANY procedure than a normal sized person. Other factors that increase risk are things like heart disease, diabetes, smoking, etc. Also, surgical experience and the quality of the facilities play a huge role in overall risk. My point is that cross sectional studies showing risk are not equivalent to YOUR risks of surgery. In terms of "convertability", I think my opinion is somewhat the opposite of yours. Technically, RYGB is completely reversible, since unlike SG, nothing is removed from your body. This to me was a huge plus in my decision making process. When we look at revisions, keep in mind that revision of SG due to GERD is pretty common and those revision surgeries basically revise the patient to gastric bypass to alleviate the GERD. I can't speak to your malabsorption concerns since first of all, malabsorption in and of itself is potentially a good thing for weight loss. i can see a concern for malnutrition, but I was willing to commit to a lifetime of vitamin and calcium supplementation. I also try hard to eat a fairly healthy diet, thus also upping the chances that I have no issues with malnutrition. If you are not willing to commit you those things then yes, this may be an issue for you. Keep in mind that while it's less common, SG patients can also suffer from malnutrition. It's actually recommended that all bariatric surgery patients use supplements and eat a healthy diet and I think as long as you do those things, neither surgery is going to be an issue. Best of luck whatever you decide.
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I am pending a Sadi revision to my sleeve and I know it’s pretty close to DS so I am looking for info from people with knowledge of both surgeries. I have read a couple of people mentioning issues with meds not absorbing properly making it difficult to treat common medical issues. Is this common post SADI or DS?
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Revision, are things going as they should?
joya09.24 replied to Kak7365's topic in Revision Weight Loss Surgery Forums (NEW!)
You sound like me. I was lapband to RNY revision. 5 weeks out. Not a single issue. I can eat and drink anything I try. Scale is moving and I am not hungry. -
Modified Duodenal Switch
ShoppGirl replied to Lara in Arkansas's topic in Duodenal Switch Surgery Forum
For me the recovery was a great deal worse with the SADI than the sleeve but it was just gas. I think the gas thing is hit or miss and some of us are just unlucky. With my sleeve I was up walking in recovery and home the next day off pain meds and having to be reminded that I just had surgery and to take it easy. After SADI I was literally crying, begging the nurse for more pain meds after five days of not passing gas. It was awful until one morning I passed fade like 5 or 6 times and with each one I felt more and more relief. I honestly don’t think that pain medication does anything to touch the gas pain and if you are unlucky and get it stuck somewhere bad you just gotta deal with it unfortunately. My revision was robotic assist and the sleeve was not. That’s the only real difference. Same surgeon. Same incisions. Similar starting weight. But night and day difference in pain. I did get my gallbladder out with the revision but it was the gas pain that was the issue. After that it was about the same. -
Surgeons will have their preferences based upon their experience and background. When I had my VSG around 14 years ago, the sleeve was fairly new, but most surgeons included it in their practice, though most were not that experienced with it yet (and it often showed in the outcomes, with quite a few rapid revisions needed.) I travelled to SF to have my sleeve done as there wasn't anyone in the LA area where we lived that was very experience with them, but there were several good BPD/DS surgeons in the Bay area, and as the DS uses the sleeve as its basis, those are the guys most experienced with it - my surgeon had been doing them for around 20 years at the time. Note another difference is that we do see more revisions of the sleeve, in part because of that "infant mortality" problem of when most surgeons were still working up the learning curve on it, but also because it CAN be readily revised, whereas the RNY is difficult to revise, so it, or reversals, are not done commonly owing to the complexity. So, if one does wind up with, say, a GERD problem, which does happen occasionally with the RNY, too, then one is stuck with medicating it, or reversing it if things are that serious.
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Not to confuse you further but consider the SADI surgery as well in your research. It’s fairly new. I started with a sleeve and had to revise because of immediate weight regain and I revised to the Sadi but the SADI can be done as a virgin surgery as well.
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So I follow the food before and after thread and I’m always amazed by all the yummy looking things they come up with but I am more of the five ingredients or less kind of cook so I lurke and admire but rarely post anything. I really struggle with variety and I am always looking for new ideas. Today I bought lean beef, mahi mahi and chicken breasts and now I’m sitting here trying to think of what to make for dinner but nothing sounds good. Does anyone have any tasty, yet somewhat easy, recipes or suggestions. I am trying to start eating close to how I will be eventually eating post revision surgery that is scheduled for early august. What your plan for dinner tonight??
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Need to decide which surgery to go with
SpartanMaker replied to cjpom's topic in General Weight Loss Surgery Discussions
I also take prescription NSAIDS due to significant back issues, so I initially thought I could not go with bypass. However due to the risk of GERD (symptomatic and verified by endoscopy), my doctor did not recommend sleeve. The resolution was to go ahead with the bypass. With my doctor's blessing, I have continued to take the NSAIDS and have been successful because she also prescribed a Proton Pump Inhibitor for me. If you have any history of GERD, it would be best to at the very least have an endoscopy done to make sure you are still a good candidate for the sleeve. I don't know what the overall revision statistics are, but there sure are a lot of folks on here that initially had sleeve and had to get a revision to bypass. Some of those were due to poor results, but a lot seem to have been due to GERD. -
Wegovy not working
ShoppGirl replied to wendywitch7's topic in GLP-1 & Other Weight Loss Medications (NEW!)
That’s awesome. I have been very pleased with my revision to SADI. My surgeon didn’t mention the intestine length thing but he did have me do the barium swallow, an endoscopy and a gastric emptying study before saying that the SADI would be an option as well as the bypass and it was up to me which I wanted to do. There are pros and cons to the SADI revision. statistically (which by definition means there are outliers that are more or less) but the majority of people lose faster and the loss is more durable which got my attention but the possibility of bathroom issues is significant (fortunately I didn’t have this at all until I recently started chemo but I don’t think it has anything to do with the surgery). One con though of SADI is that many doctors have never heard of it. From my family Dr, to the urgent care, ER physicians, gyno, radiologies, breast surgeon, etc. Even the gastro dr who will be doing an endoscopy and colonoscopy on me Monday has never heard of the SADI but my bariatric doctor said he will explain my anatomy to her and it will be fine. I always tell them it’s a modified version of the Duodenal Switch with one anastomosis instead of two and if they still look confused I tell them it’s not exactly but kinda like a bypass and a sleeve combined. But obviously I need the person putting a camera in there to understand better than that. I think you will be very pleased with your results from either one but another thing to consider is if you have a complication or need revision to the SADI how many doctors are able to operate on you. My surgeon told me that if I had a complication he would stabilize me but he would send me to a nearby hospital if I needed any type of revision. I appreciated that he was willing to admit his limits and I was okay with that but I guess it is a risk you may want to ask about. Your surgeon may very well have done lots of these but mine had not. Also, not a lot of doctors will do a revision to the SADI just because of regain. You would be more likely to find someone to revise a bypass. Not that we are hoping to need a third surgery but obesity is complex and a lifelong struggle so it’s something to think about. I wish you the best of luck. And hope to hear about your surgery date soon. -
Co-Codamol & Bypass
ShoppGirl replied to Bypass2Freedom's topic in POST-Operation Weight Loss Surgery Q&A
Well post sleeve alcohol has absolutely no effect on me. I figured it’s a waste of Callie’s and money and stopped drinking. Post revision I figured why try it now that I’m used to not having it -
Hi everyone, I had my Lap-Band placed in 1999 in Monterrey, Mexico by Dr. Roberto Rombaut, and I’ve had it ever since — over 25 years now. I was a longtime patient of Dr. Brinkley in Maryland, who recently retired. She always performed blind fills for me, and that approach worked perfectly — I’ve maintained success with my band for decades. I typically only need a fill about once every 3 years, so I’m not seeking ongoing adjustments — just an occasional, simple fill when things begin to loosen. I’m aware that my pouch may be slightly distended over time, but I have no interest in surgery or revision. I just want to continue with what has been working. If anyone knows of a caring, experienced provider in the Fairfax, VA or Washington, D.C. area who still performs blind fills, I’d be so grateful for any recommendations. Thank you so much! Beth
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Anyone preop for a revision.
One more time replied to ShoppGirl's topic in Revision Weight Loss Surgery Forums (NEW!)
@yesenia1016 would love to hear an update on how your surgery went. I’m about to have revision this coming Monday and and really hoping this will work for me. -
also, your surgeon may not want to do a re-sleeve. Some still do but many consider it to be too risky and it yields too little reward (the weight loss for a second sleeve is statistically less than a virgin sleeve which is already less than the other surgeries). The typical surgery for revision is usually the bypass although a newer alternative to that is to revise to a surgery called the SADI which is what I just did and it is a little more aggressive so it yields faster loss and so far the research shows more durable loss as well. I have lost quite a bit rather quickly with it. You don’t need to know any of this yet. Your doctor of course will know if any of the options apply to you and explain them at that point but just know that it may be a little different surgery if you do go with a revision. One that alters your intestines this time which is a bit riskier.
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I chose the RNY because of the high rate of getting GERD from the VSG, so I don't know why your physician said that it was weight related. While some of it might be, usually it isn't, and with a smaller stomach, the acid can easily go up into the esophagus. If you are able, I would change that VSG and revise to an RNY if you are able, RNY you can't take NSAIDs but the possibility of GERD decreases about 80% of patients. Hope things go well for you, or went well with your EGD, please update us. Wishing you well.
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Why did you prefer Gastric Sleeve over Gastric Bypass?
GreenTealael replied to HopeBar's topic in Gastric Sleeve Surgery Forums
I chose sleeve over bypass because at the time it was considered a safer profile surgery with the same effectiveness. I had other medical conditions I needed to focus on and could not risk dealing with complications. It still makes sense to that past nervous version of me. However this version of me (which needed to be revised from sleeve to bypass from complications from sleeve 🤣) would choose differently. All things considered, All things being equal and if I had to choose again I would pick bypass over sleeve (especially if I was a self pay patient or my insurance excluded revisions). -
Why did you prefer Gastric Sleeve over Gastric Bypass?
FifiLux replied to HopeBar's topic in Gastric Sleeve Surgery Forums
Sleeve was recommended to me by the surgeon as I have pernicious anaemia and after reading up on both I felt the sleeve was more for me, so I could be in more control, especially given that I could then get a revision to bypass if needed. -
For me it has been a life changer. I had the sleeve and lost weight but not as much as I had hoped and then I gained it right back plus some. Never did have the metabolic changes or the changes that made it a little easier to eat healthy so when I got done with my SADI revision I know right away that it was going to be different this time. I mean I still want pizza and burgers but I don’t hate chicken and fish now either so it makes it a little easier to make the healthy choice most of the time. I also exercise a lot and I think that has made all the difference in my commitment to my new lifestyle as well as My mood and overall health. Obviously I can’t say I know if it would have been better or worse with the Bypass but statistically as a revision the SADi does provide more loss and a more durable loss. Of course it is never so not as much long term research has been done and bypass is the tried and true gold standard but as a revision the loss is statistically less than as a virgin surgery. I think for me it was a perfect fit but you will want to keep in mind that you need to understand your surgery well enough to explain it or call your surgeon and ask them to when it is appropriate. Most of my doctors have never heard of it and when I was about to get an endoscopy/ colonoscopy done and the dr hadn’t heard of it I called my surgeon to see if that was okay and he called to explain my anatomy to them. Another thing to consider is whether you surgeon is resleeving your stomach. Mine did not. He said the difference in weight loss was not significant amount to take the risks that come with reducing the pouch. Something to do a bit of research on to decide if it’s worth it to you. If you have any specific questions about my experience let me know.
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Having second thoughts
SpartanMaker replied to monikapaintsstuff's topic in PRE-Operation Weight Loss Surgery Q&A
I wanted to address the GERD fears as well. Overall, I think the number of people that develop GERD after gastric sleeve is pretty low. That said, I personally am a bit concerned when you say your surgeon "pushes the sleeve". Any doctor that pushes one surgery over another is a bit of a red flag to me? I personally would want them to advise on what they think is best for ME, not what's best for them. My surgeon felt like I was pretty likely to develop GERD if I did go with sleeve, so they advised against it due to what they saw on the endo. FWIW, I didn't even have a history of GERD. It might have helped that I went into the process with an open mind and not fixated on a specific surgery? Lots of people are successful with sleeve surgery even if they have a history of GERD, but this was one I wasn't willing to risk personally. Knowing that bypass is often the revision surgery of choice for sleevers that do develop severe GERD, it made sense to me to avoid all that and go straight to bypass. -
3yrs post of with 80lbs still to lose; need help.
WendyJane replied to Tobemeghan's topic in Gastric Bypass Surgery Forums
You should ask your team what they recommend in terms of protein, but I shoot for 80 grams of protein or more. Protein is the key to "dieting" after surgery. It gives you satisfaction for longer periods of time during the day, and that means protein shakes, lean meats, and after you being to feel the difference, you can then add in about 1-2 ounces of veggies. Carbs are not on you plan if you want to lose weight. I would also recommend getting in more exercise, it it wears you out, it will until you keep pushing yourself and get used to it. The elliptical is a cardio workout, walking is just as good. Not fast, but at a good speed for a half hour every single day, it builds strength and it builds endurance and it is the simplest of exercises you can engage in. Because you get discouraged, I would encourage you to find the time to join in with people that are like you, BariNation has YouTube videos and they have a membership community. For forty dollars a month you have access to licensed social workers, therapists and dieticians, there are member meet ups all of whom have had surgery, revision to another surgery, or they have worked with bariatric patients for 2 decades. If you can afford it on a monthly basis, then I would strongly urge you to get involved. Take a look and see if you are interested. Wishing you the best!! -
I'm in my 50s so also close. I had a sleeve 3 years ago. I'm not exactly sure what you mean when you talk about having it again - do you mean a revision of some kind? Second procedures are necessary for many of us, for many reasons. If we can look at *why* we regained, sometimes we can avert regain a second time around. Sometimes not. If you do go with further surgery (and many of us would if and when we regained I think) it might help before that to go back to the immediate post op rules and stick to those. I went for a sleeve partly because it left the door open to a revision if I *did* regain. I'm only 3 years out and glad to have that escape hatch (but - more surgery is not enticing!!!!) I am totally open to GLP-1 /GIP drugs if I do regain a lot. Just different tools. Also open to a revision if necessary - as I said I kind of chose the sleeve on those grounds.
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How did you get your water in???
ShoppGirl replied to Spoole0902's topic in Post-op Diets and Questions
I agree with the previous poster also keep in mind that it may be an option to just get IV fluids outpatient. I didn’t need them after my safety because they didn’t operate on my stomach. I was a revision but after my sleeve I did and it was just like an office co-pay basically for me to get my fluids. It was that in the hospital, but in the different part of the hospital and you just sit in a recliner and get your bag of fluid and then leave. -
Also 59 and agree it never hurts to ask. And if a revision isn’t an option (for whatever reason) ask about GLP-1 meds or other options available to you. You never know the answer if you don’t ask the question. All the best.
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revision from VSG to bypass and tricare
ShoppGirl replied to meginsf's topic in Revision Weight Loss Surgery Forums (NEW!)
I was on tricare for a short time years ago but didn’t have it for my bariatric surgeries. But after dealing with the revision process with any insurance I I learned that them covering it for GERD would be far more likely than just for weight regain. GERD it would be repairing a complication or side effect of surgery instead of just doing another bariatric surgery. They consider that more of a medical necessity If that makes any sense. -
Mini Bypass reversal
LittleSteve replied to lessismore1001's topic in Mini Gastric Bypass Surgery Forum
Oh thanks for picking that up, revision is what i ment -
Anyone preop for a revision.
One more time replied to ShoppGirl's topic in Revision Weight Loss Surgery Forums (NEW!)
Thanks for sharing your story, im truly happy for you! I was reading a forum on reddit and someone was saying revision procedures hardly produce any weight loss. That doesn't seem to be the case on these forums though. Keeping my fingers crossed was second chance is the winner!