Seeking Insight: Please Help!

Hi Everyone,

It has been years since I have been on these boards and it feels good to be back again and reaching out to a whole new group of people: those with a duodenal switch. My story is somewhat long, heartbreaking, and messy, but it's my story and I own it. I'm hoping these boards are still the judgment-free place they used to be, so here it goes:

When I was 17 years old, I weighed 315 pounds. My parents were concerned for me. I had been a big kid all my life, despite their best efforts to keep me on strict diets, which I complied with. A friend of a friend had a gastric bypass surgery and my parents thought he looked great. The next thing I knew, I was meeting with the surgeon. I turned 18 years old on June 2, 2000. On June 4th, I graduated high school, and on June 25th, I had an OPEN RNY gastric bypass. I was able to eat like a normal person, even after surgery. My lowest weight was 265 pounds and the re-gain started happening. I reached out to my physician who simply labeled me as non-compliant, but due to his high mortality rate and complication rate, he no longer has a license to practice medicine in the state of Massachusetts so I would venture to say his opinion of me is incorrect.

In 2010, the re-gain was too much for me to bare and I looked into a band over bypass. Despite the fact that the failure rate for the band was a statistical nightmare and the band proved an ill-fit for morbid and super-morbidly obese people, I had it in my mind that I could beat the odds. Dumb, dumb, dumb. I had a laparoscopic gastric banding in July of 2010. Did I lose weight? Sure, from dieting and starving myself. I never hit my "sweet spot" and after an episode of a tight band due to a large fill, I was scared. The band became a choke collar and I started eating slider foods. Even with my band completely empty now, I have a hard time with certain foods. I have developed reflux as well.

This brings us to today. At 332 pounds, something needs to change. Losing weight is not hard for me to be honest. I can drop 30 pounds with no issue, but I can't keep those pounds off to save my life. I live in Boston where the DS is illegal. Seriously, that's what the surgeon's office told me. I have researched and there is not ONE DS surgeon in the state for that reason. The surgeon I have consulted wanted to possibly conduct a distal procedure to which I promptly declined thanks to all of the wonderful insight I have been given here.

I have decided to be proactive and in addition to getting myself back on track with what I am eating, I can't stop thinking about the DS. The seriousness of the surgery is not for the faint of heart. I actually attend bi-weekly counseling sessions to prepare myself for the possibility of embarking on this journey and I am working with my dietician every 3 weeks once again. Since we do not offer the DS in Boston, I am going to be traveling to meet with Dr. Mitchell Roslin during the first week of August to talk about an RNY to DS revision. I'm scared. I'm scared of complications. I'm scared that he'll turn me away. I'm just nervous. With that being said, can anyone help with the following questions?

1.) Has anyone had their DS with Dr. Roslin? I don't care if it was a virgin DS or a revision, I would love to hear about your experience with him please.

2.) Anyone else have an open procedure first and still able to revise to the DS without a problem? Was your revision open or lap?

3.) Has anyone had to travel for their DS and if so, how did you do it? I feel the likelihood that my DS will be open so I am considering staying at a hotel in NYC a few days after surgery in order to stay in the area in case of complications. How did you all approach this?

4.) Any success stories as an RNY to BOB to DS? Or an RNY to DS?

Thanks for al of your help in advance and as always, being a supportive group.

~Kelly

I haven't faced your challenges but I want to wish you well and good luck. I've heard wonderful things about Dr Roslin, but as always, educate yourself too.

--gina

Thanks very much, Gina!  

Well, I've been around here for years, and this is the first time I've heard of any doctor referring to the DS - which has been a standard of care bariatric surgery for many years now - being called illegal! You think you've heard it all, but there's always something new.

While it's true there is no one in your state doing the DS, that doesn't mean it's illegal there, or anywhere else in the USA. Many people have to travel for the DS and esp for revisions of RNY to DS, which is a complex procedure that very few surgeons do. Dr. Roslin has an excellent reputation and does do these revisions. It is my understanding that he leans towards the SADI or SIPS or whatever name he's calling it these days, so you will want to thoroughly discuss your options with him pre-op and make very sure you communicate what you want and what you don't want. There is another poster here who will probably come along and tell you that the SADI is an "upgrade" from the DS, but most of us would very much disagree. The long term results of the DS are very well established, SADI, not so much (again, she is going to disagree, which is her choice). So you need to do your own research and make your own decision.

You will also need to plan for a longer stay in NYC, IMHO, than just a few days. It's a very big operation and the complication rate is substantial, even in the hands of an excellent surgeon. The operation involves complete reversal of your present gastric bypass, and THEN doing the DS, and in your case of course also removing the lap band. That's a lot of surgery, and possibly a lot of scar tissue for the surgeon to deal with, so ask how long you should expect to stay in the hospital and then after that stay in NYC.

I will also send you a pm with more info.

Larra

Larra,

Thank you so much for your helpful response, it i so appreciated! I will respond to you via PM. Thanks a million!

~Kelly

I have a band over DS and the band is what took me to the finish line and keeps me there 8 1/2 years later.  I started at 401 with my DS back in 5/2002.  I lost 150 pounds and had intestinal blockage 1/06  that required emergency surgery and at that time had the band placed (My Weight loss doctor did my intestine surgery since no one at the emergency room would touch me because I had the DS) I then took off the last 100 pounds with the band.  Surgery is a tool to assist, if you can not get the food issues straightened out in your head no surgery will help.

Hi Kim,

Thanks for your input. I'm very much aware of that which is why I continue to be in counseling to do so. I appreciate your response.

~Kelly

I am happy to hear that Kelly!  I have seen this step overlooked, some just keep chasing surgery after surgery.  Did you have good support with your band?  If you are looking for a good support group join us on Facebook at Lapband Divas.  I am not sure if you have given up on your band yet but when you get it where it works the best it is an awesome tool.

I had lap DS 05/13/15 with Dr. Ayoola in Frisco TX.  I originally had open RNY in 1996.  In addition he removed my gallbladder and did a liver biopsy.  I think the surgery took just a little bit longer than usual do to the scar tissue from the open procedure, but no real complications. 

I don't know how successful the BOB will be.  I had an upper GI and it showed that my pouch had not stretched, but that food was emptying out of my stomach quickly.  The Dr. tried  to talk me out of DS and into BOB.  I asked him how could this be effective if there was no problem with the pouch- he had no answers.

I had the same fears as you.  I was actually going through my insurance/medical procedures when I got a call from my original DS Dr.'s office called to say they would not do the surgery for me(which wld have been nice, since it was about 20 miles away.)  I was devastated!  Every time I got a call from Dr. Ayoola's office I thought "Oh no, he is not going to do the surgery."

I did have to travel but it all worked out( I have relatives that live in the area.)

Hi Kelleigh,

I'm the other poster on this site Larra was referring to. We're all friends here supporting each other so I can only tell from my experience.

I'm a guy, 6'1 and weighed 287 when I went to Dr. Roslin last year. Another doctor was supposed to perform a standard DS on me in July, and then bailed out a week before the surgery telling me no one at Stamford hospital was qualified to perform a DS. 

Dr. Rosin suggested I go with a single loop DS (also called SADi or Sips). It basically involves keeping a longer common channel with less risk and fewer stitches during surgery. He is a flat out pro and has 20+ years of reviews online for every type of procedure. His reviews are great and you'll know right away he's the right guy for the job.

I had the DS single loop as he recommended in Nov. the were no complications and I was home engaging in normal but low key activity with my kids a couple of days later. In 8 months I'm down to 165 lbs and now run and bike regularly, something unthinkable less than a year ago.

Im sure Dr. Roslin will make the same recommendation to you and I would suggest you seriously consider it. The is one person on this site who declined his suggestion, went with original DS, and now has a number of complications.

Everyone's differs so I would suggest you talk to a couple of surgeons and make the best choice for you. Good luck and feel free to contact me for any more info on Dr. Roslin or the SADi.