Sleeve to bypass revision

[mistysj 1,940]

It has been a while since I was posting regularly here. I had vsg in May 2013, reached my goal weight and a healthy BMI in about 16 months, and have had no trouble maintaining. I've been very happy with the sleeve overall.

But I have had some trouble the whole time. Basically I dump (severe diarrhea and sometimes severe hypoglycemia too) after almost every meal. We are talking agonizing, clear-the-ladies-room, stuff. I actually experienced it right after surgery in the hospital and they said it was normal and would go away. It never has. I've worked with my surgeon, dietitians, other gastroenterologists, I've had all kinds of tests including numerous endoscopes and colonoscopies. I tried going dairy free, gluten free, low carb, low fat. I had my gall bladder removed after a severe attack and hoped it might help. I took Questran at 4x the normal dose. I tried Calcium. I tried eating g things that tend to block other people up. I ate 120+ grams of low fat Protein a day. Nothing helped.

Now I have another problem too. Despite being on nexium since surgery, I have severe acid reflux and bile reflux that have caused my stomach and upper bowel to develop severe ulcers. The acid reflux is a relatively common long term complication of the sleeve. The bike reflux is often genetic and doesn't cause a lot of trouble with a full size stomach apparently. My current gastroenterologist is going to revise my sleeve to a bypass, which will eliminate both types of reflux because it will be impossible for the acid and bile to reach the pouch from the blind stomach. He also thinks that the bile reflux is causing the dumping because it is impeding the break-down of food, which is passing through me only partially digested.

So I will be having the revision Monday morning and I get to re-experience the joy of the 6 week post-op diet. My surgeon is confident that any weight I lose will only be temporary, since I really don't need to lose more. I may actually gain a bit because I will be absorbing more nutrients.

I don't know how many sleeve to bypass revisions there are, so I wasn't sure where to post this. Hopefully it is helpful to someone.

[swimbikerun 1,048]

Thank you for trying to help others through all that you are going through.

[Katcloudshepherd 630]

I surely hope this will correct the problems. I hope the surgery goes well and you heal quickly. Thank you so much for sharing this since you never know who will be helped with the information.

Blessings,

Kathleen

[feedyoureye 3,087]

Thanks for sharing, and best of luck to you...

[rhw94123 115]

I think there is a dedicated section for sleeve to bypass revisions-- hope you connect with those knowledgeable folks! The most recently-active person with sleeve to bypass that I'm aware of is Band07. Best wishes & kudos for your tenacity in dealing with all that!

[mistysj 1,940]

I saw a section for band to sleeve and one from band to bypass but not one for sleeve to bypass. I will look again. Note that this is also different from sleeve to duodenal switch. Thanks!

[feedyoureye 3,087]

I believe that lil'miss Diva had that done... don't see her around here so much any more... check her out...

http://www.bariatricpal.com/user/151241-lilmissdiva-irene/

[mistysj 1,940]

Thanks for that info! My biggest concern is what my pouch capacity will be compared to the sleeve now. My surgeon thinks I will not have any trouble but it is in the back of my mind as I have never really noticed a loss of restriction. I still don't eat more than 50 grams of dense Protein at a time for instance.

[ausmith 374]

Thanks for that info! My biggest concern is what my pouch capacity will be compared to the sleeve now. My surgeon thinks I will not have any trouble but it is in the back of my mind as I have never really noticed a loss of restriction. I still don't eat more than 50 grams of dense Protein at a time for instance.

Misty it is so good that you are back on the site. Although I feel for you in regards to the issues you are experiencing. I often wondered how you were doing. Please keep us updated on your progress

[mistysj 1,940]

Thanks for the welcome back. I have to say I can't get used to all the ads though.

Surgery went fine yesterday morning. It took two hours including a massive hiatus hernia repair (had it repaired as part of the sleeve surgery too but it came back). This morning I had clear fluids for Breakfast with no trouble (about 6 ounces total I would guess). The expected amount of pain. Everything seems easier this time around even though the sleeve was very easy too.

I'll be out of the hospital tomorrow and on full fluids for two weeks, mushy for two weeks, then gently back to normal. I expect to be back at work (desk job, work from home) next week.

[mistysj 1,940]

I'm home now. Tolerating free fluids fine. My capacity is better than with the sleeve. I'm nursing a Protein Shake now. It's funny not to be so worried about the calories as I was the first time. To maintain I probably have about 1600 and I don't really count anything. So during the liquid phase it will be nearly impossible for me not to have a deficit. It's also weird to realize that this time my goal is to maintain, maybe losing a couple of kg but it's not a priority at all.

[rhw94123 115]

Sounds like you are doing well! The couple of cases of revising from sleeve to bypass that I have been aware of were inspire by lack of weight loss (or troubling re-gain), so your journey will be interesting to watch since you're not trying to lose a great deal.

Truly hope this is the beginning of a great new era for you – you have sure been through a lot!

[mistysj 1,940]

Still doing pretty well. Bring on week 2 of liquids. Back to pre-op weight now. Not really trying to lose anything which is weird in a way!

[MichiganChic 3,262]

@@mistysj glad you are doing well. How is the reflux?

[mistysj 1,940]

It's tricky to say as it was "silent" reflux. I didn't really ever have proper heartburn. So I'll find out at my 4-week appointment. Because of the way the bypass works I was told it would be almost impossible for me to have reflux afterward.

It's hard to tell with the diarrhea as well. It seems like it might be a smidge better but I am still on liquids so it's still not expected to be "normal" yet I suppose. So just waiting a bit longer to see.