Okay I am a second timer. I had gastric sleeve 3/9/21 and I gained it back. I am considering the SADI and I am looking for information about it. I have posted on the revision forums and the duodenal switch forum without response. Is this just a really rare procedure or am I posting in the wrong place? I worry that even if this is the right surgery for me I may regret it if I can’t find the support along the way because it is less common.

Edited March 19, 20242 yr by ShoppGirl

like the DS, it's not a common surgery - but in addition, it's also fairly new - which is probably why you haven't seen much about it. It supposedly as fewer complications than the DS (although it's sort of a new-fangled version of it)

19 minutes ago, catwoman7 said:

like the DS, it's not a common surgery - but in addition, it's also fairly new - which is probably why you haven't seen much about it. It supposedly as fewer complications than the DS (although it's sort of a new-fangled version of it)

Yea. He said it’s definitely a more aggressive option than the bypass for revision with a few more risks but better weight loss for most people. I read somewhere that when you eat the wrong foods that it causes gas pain and bathroom issues which if that’s true I think as much as it would not be fun it may be just what I need to remind me to keep making the right choices. Also If I understood correctly it does more to reduce the hunger hormone which was definitely my biggest issue. From day one with the sleeve I was able to eat more than expected at every given stage. I just chose not to and that was easy while the hunger was gone but when it came back it came roaring back so I lost most of my weight and then gained it all back like a yo yo. In the beginning I was still eating all the right foods but I was starving so I ate more than I should have. I am really hoping that this procedure the hunger hormone remains less intense for good.

the malabsorption from it also helps - you won't absorb all the calories you eat (or the nutrients, either, so keeping on top of your supplements will be more important than ever..). I know some people with the DS get really gassy (and sometimes get loose stools) if they eat too many carbs - not sure if that's an issue with the SADI or not.

7 minutes ago, catwoman7 said:

the malabsorption from it also helps - you won't absorb all the calories you eat (or the nutrients, either, so keeping on top of your supplements will be more important than ever..). I know some people with the DS get really gassy (and sometimes get loose stools) if they eat too many carbs - not sure if that's an issue with the SADI or not.

One site says that the gas and more frequent/ loose bowel movements are a little less than the DS but definitely an issue with the SADI and the gas can be quite stinky as well which is probably the biggest fear I have right now aside from the real scary risks.

I THINK the bathroom issues are just when you eat bad and if that’s the case that may actually help keep me on track because I obviously don’t want to have those issues. I have an appointment tomorrow morning with my family PA and that’s definitely a question I will be asking her if she knows.

I think the supplement question is more likely going to be one for the surgeon but I will ask her about that as well. I have until the end of next month when I meet with the surgeon to come up with a list of questions for him (whatever I can’t get answers for before then).

Thanks again and please Let me know if you think of anything else I should ask. Until yesterday morning hadn’t even heard of this procedure. At least I have a list of questions to start with now.

I am having my Sadi revision from sleeve next Tuesday 5/28, I am excited and nervous but looking forward to it

4 hours ago, cjbowers2005 said:

I am having my Sadi revision from sleeve next Tuesday 5/28, I am excited and nervous but looking forward to it

Good luck with it. My dr decided I need to have a scope on Friday to make certain that SADI is most appropriate for me.

Hey @ShoppGirl, not sure if this has been discussed or not, but what are your thoughts about the GLP 1 drugs? I remember someone on Dr Weiner’s podcast saying how it stopped the food noise in her head & reduced her hunger. Dr Weiner has been doing a few podcasts about the medication which may be worth listening to. May be an avenue to consider especially has you have concerns & questions about proceeding with the Sadi & hunger is an issue for you.

1 hour ago, Arabesque said:

Hey @ShoppGirl, not sure if this has been discussed or not, but what are your thoughts about the GLP 1 drugs? I remember someone on Dr Weiner’s podcast saying how it stopped the food noise in her head & reduced her hunger. Dr Weiner has been doing a few podcasts about the medication which may be worth listening to. May be an avenue to consider especially has you have concerns & questions about proceeding with the Sadi & hunger is an issue for you.

That is something that’s still in the back of my mind. I have heard mixed things about them though. I plan to speak with the surgeon about them before I make my final decision.

On 3/19/2024 at 10:38 AM, ShoppGirl said:

Okay I am a second timer. I had gastric sleeve 3/9/21 and I gained it back. I am considering the SADI and I am looking for information about it. I have posted on the revision forums and the duodenal switch forum without response. Is this just a really rare procedure or am I posting in the wrong place? I worry that even if this is the right surgery for me I may regret it if I can’t find the support along the way because it is less common.

YES! I see you!! I'm super curious as to how you are doing after your revision surgery, because I'm on a similar path. Right now I'm waiting to see if my insurance will approve STARTING with the SADI-s/SLIP rather than either going with the Roux-y or a sleeve and then a revision. I don't really WANT to go through two surgeries (sleeve and later revision) but with a BMI in the high 50s/low 60s I keep getting nervous about which surgery to choose. I've posted elsewhere about my concerns with the Roux-y (higher chance of hernias / dumping syndrome /long term malabsorption/no longer taking NSAIDs) and read probably the EXACT same sites you have cautioning about the SADI-s and its main two possible side effects being 'bathroom issues/gas'. I came to the same conclusion myself; seems like a better, less complicated surgery, especially if I can START with it. After hearing a bunch about the Duodenal Switch I started second guessing yet again. Choosing is SO hard. How is it going for you?? I hope fantastically!

1 hour ago, Hiddenroses said:

YES! I see you!! I'm super curious as to how you are doing after your revision surgery, because I'm on a similar path. Right now I'm waiting to see if my insurance will approve STARTING with the SADI-s/SLIP rather than either going with the Roux-y or a sleeve and then a revision. I don't really WANT to go through two surgeries (sleeve and later revision) but with a BMI in the high 50s/low 60s I keep getting nervous about which surgery to choose. I've posted elsewhere about my concerns with the Roux-y (higher chance of hernias / dumping syndrome /long term malabsorption/no longer taking NSAIDs) and read probably the EXACT same sites you have cautioning about the SADI-s and its main two possible side effects being 'bathroom issues/gas'. I came to the same conclusion myself; seems like a better, less complicated surgery, especially if I can START with it. After hearing a bunch about the Duodenal Switch I started second guessing yet again. Choosing is SO hard. How is it going for you?? I hope fantastically!

I am still pending my revision. My dr ordered a few tests to help him decide between the Sadi and the bypass as a revision and the SADI. I see him on Monday and hopefully I will have some answers.

On 5/22/2024 at 4:02 PM, cjbowers2005 said:

I am having my Sadi revision from sleeve next Tuesday 5/28, I am excited and nervous but looking forward to it

How are you doing?

My advice to everyone is to first trial the GLP1 type drugs and see if it helps with weight loss. Maintaining the weight loss will be a lifetime commitment no doubt. But it's much better than having drastic bariatric surgery. Why change your anatomy if drugs can do the trick. So if your insurance covers weight loss medication, please consider that route first. Weight loss surgery does improve one's quality of life, but it has its fair share of drawbacks too.

For those recommending medication over surgery:

I am having the SADI surgery on July 25th. I considered medications initially, however, most of them aren't covered by insurance; and if they are, the insurance approval process usually requires a diabetes diagnosis. While I have a BMI in the 50s, my A1C is extremely health, which means I would pay out-of-pocket.

The medications are intended as life-long commitments. Stopping them can have serious impacts including weight regain.

Out-of-pocket for the cheapest meds I encountered was $900 a month. Out-of-pocket for my procedure is one-time $19,000 (unfortunately, not covered by insurance)

If we look at the impact in 5 years of both...

Meds = $54,000

Procedure + Vitamins = $19,000 + $3,800 = $22,800

How about 10 years?

Meds = $108,000

Procedure = $19,000 + $7,600 = $26,600

The financial impact was a huge consideration for me.

Please understand that the decision to move to surgery is not quick or easy. The financial impacts and health impacts are serious and really should be discussed with a trained medical provider.

The purpose of this forum is to help guide others. We should be focused on the questions they're asking instead of offering an off-topic alternative. The OP made it clear in her posts that conversations with a trained medical professional led to the decision for another surgery. Shaking her confidence in medical guidance from her surgeon is not our place. We should accept that surgery is her path and give our own anecdotal experiences as references to help her understand what she might experience.

Edited July 13, 20242 yr by Rosslyn
Typos

1 hour ago, Rosslyn said:

For those pushing drugs over the procedure:

I am having the SADI sugery on July 25th. I considered those drugs, however, most of those drugs aren't covered by insurance; and if they are, the insurance approval process usually requires a diabetes diagnosis. While I have a BMI in the 50s, my A1C is extremely health, which means I would pay out of pocket for those drugs.

They're intended as life-long drugs. Stopping them can have serious impacts including weight regain.

Out-of-pocket for the cheapest meds I encountered was $900 a month. Out-of-pocket for my procedure is one-time $19,000 (unfortunately, not covered by insurance)

If we look at the impact in 5 years of both...

Meds = $54,000

Procedure = $19,000

How about 10 years?

Meds = $108,000 (not including inflation)

Procedure = $19,000

Please understand that the decision to move to surgery is not quick or easy. The financial impacts and health impacts are serious and really should be discussed with a trained medical provider.

Please help guide others on the questions they're asking instead of offering an off-topic alternative. The OP made it clear in her posts that conversations with a trained medical professional led to the decision for another surgery. Shaking her confidence in medical guidance from her surgeon is not our place.

Yea. I checked and I don’t have any coverage for them either so to get the real deal I would be looking at a considerable amount out of pocket like you. I didn’t mind the suggestion though, some insurance companies are actually covering them for weight loss now and when they do they are much more affordable. I have a friend who just got on Wegovy for weight loss and her copay is only $25 a month!!! If I had that coverage I would for sure be asking more questions.

A lot of companies are also making compounded ones that are like $2-300 but it’s not really clear if they are as effective and/or safe quite yet. . My primary provider said they were working on getting the compounded ones in their office so I assume those would be safe but still I question the effectiveness and they are only beginning to work on it now so who knows when it will actually happen. My primary said if it was her she wouldn’t wait for that option to become affordable since my numbers are creeping up.

Anyways, your surgery is getting really close. Are you excited? Nervous? I am already a little of both. Mine is Aug 7. I keep on questioning if I am crazy to go with the newest option just because there isn’t as much help out there for me post op. At least I haven’t found it yet. I already spoke with two nutritionists and both of them claimed to know beforehand about the procedure then both of them pushed the same information on me as they would for a bypass. Total waste of money. I have an appt soon with the NP at my office, though. I’m hoping to get some answers about the regular diet and the supplements that are specific to the SADI. Have you started your pre op diet yet??

Edited July 13, 20242 yr by ShoppGirl

3 minutes ago, ShoppGirl said:

Yea. I checked and I don’t have any coverage for them either so to get the real deal I would be looking at a considerable amount out of pocket like you. I didn’t mind the suggestion though, some insurance companies are actually covering them for weight loss now and when they do they are much more affordable. I have a friend who just got on Wegovy for weight loss and her copay is only $25 a month!!! If I had the coverage I would for sure be asking more questions.

A lot of companies are also making compounded ones that are like $2-300 but it’s not really clear if they are as effective and/or safe quite yet. . My primary provider said they were working on getting the compounded ones in their office so I assume those would be safe but still I question the effectiveness and they are only beginning to work on it now so who knows when it will actually happen. My primary said if it was her she wouldn’t wait for that option to become affordable since my numbers are creeping up.

Anyways, your surgery is getting really close. Are you excited? Nervous? I am already a little of both. Mine is Aug 7. I keep on questioning if I am crazy to go with the newest option just because there isn’t as much help out there for me post op. At least I haven’t found it yet. I already spoke with two nutritionists and both of them claimed to know beforehand about the procedure then both of them pushed the same information on me as they would for a bypass. Total waste of money. I have an appt soon with the NP at my office, though. I’m hoping to get some answers about the regular diet and the supplements that are specific to the SADI.

August 7th isn't too far away! You're close to the preop diet. I started mine a few days ago and it's testing me, but I knew it would. If I were a smaller person, I don't think it would be such an issue. If I weren't having appetite issues even before the diet, things would be easier, too. What's helped has been sipping on broth or slurping on sugar free Jell-O all day. I go slow with those so it feels like I'm eating/taking in more than I am.

I'm only nervous about one thing: the gas pains immediately after surgery. I've never had surgery before, so I am not sure what to expect. I want to have a realistic expectation of pain before experiencing it. I know I will handle it better that way. Luckily, I have a few family members who have had laparoscopic procedures before and we willing to be honest about the experience. I've been avoiding stories online of others' experiences of that moment, because we all have different pain thresholds and it's too easy to go down the rabbit hole of scary stories. Especially with AI/algorithms thinking we want to see the worst of the worst.

I want to share why I made my decision to have the SADI-S vs a sleeve or bypass. While I cannot speak to what things will be like after surgery, I am confident I'm making the correct decision for myself. I'm in my 30s with no kids, but would like some. I have been struggling with my weight ballooning up and down for the last 20 years. At my heaviest, I was over 320 pounds. I hit that as I made the decision for surgery.

I didn't know what surgery I wanted, so I started doing research into the best bariatric surgeons in my state. I read through their websites and looked at reviews for the surgeons through my insurance provider, google, yelp, and other such websites. Then I asked a few friends in the medical field which doctors they would want doing surgery on them. All of that narrowed my list down significantly. I ultimately went on gut instinct and don't regret it at all. My surgeon is amazing. Her teams is extremely supportive.

Here's some information she gave me on my options:

-- Gastric Bypass: She does not recommend the procedure to any patient. It has more points for potential surgery complications and, in her medical opinion, the highest chance for weight regain.

-- Sleeve: potential to lose 70% of excess weight. Less than 1% chance for complications.

-- SIPS/SADI-S: potential to lose 80% of excess weight. Less than 1% chance of surgical complications.

I want to have children, and she advised that the SIPS/SADI-S (there really needs to be a better name for this) is the best choice to allow me to get pregnant a year or so post-op (depending on how I'm doing) and reenter weight loss when appropriate post-birth. I will have to work very closely with my weight loss team throughout the entire pregnancy, but it really feels like a bonus to have more support.

My surgeon's office also recommends patients to very talented specialists for all surgery clearances. They all treated me like they were part of a huge team dedicated to helping me get through surgery clearance. It was amazing.

I was given a packet with all the possible issues I might encounter post-op, what can be done if they happen, and how to avoid them in the first place. When I read through it spelled out in black and white, it's easy to see what my life would need to be to avoid a horrible experience. The most embarrassing ones are noted as being most common with gastric bypass than sleeve or DS. Most of these complications can be avoided by chewing well, not drinking during meals, and not overeating. One of my doctors said I am going back to being a baby again, digestively. I will need to reteach my body how to process what I eat and not be afraid to push back milestones if I'm not ready to start the next leg of the journey.

I'm definitely anxious. The unknown is always scary. I'm confident at the same time because of the team I'm working with. And because of the support I have at home. I know I'm extremely lucky to have the surgeon and support I do. It's definitely a burden to afford this surgery right now, but I don't believe I will feel that way in 5 or 10 years.