Question:
Is it possible to have DS after an RNY

I am scheduled to have RNY on June 24th (denied DS) I have been feeling ok with my decision and have gotten alot of feedback from RNY people which has helped me in making my final decision not to fight my ins. co., I do occasionaly get people who say I should fight and not settle for a lesser quality of life...this scares me! I am trying to be positive and know this operation is only a tool, but I worry about the long term outcome 2-3 years down the road regaining etc., can I realy live with this? So I am wondering if anyone who has had an unsuccesful RNY if DS is an option afterward, in the event that ins. co.'s in the future deem it not experimental, is this an option?    — jane O. (posted on June 1, 2003)

June 1, 2003
Hi Jane, I wondered the same thing. I went to www.duolenalswitch.com and entered "revision" under the search option....there were a few examples of people who had had revisions from RNY to DS. My sister is going to have a DS this summer. I intend to ask her surgeon about this too. I am very happy with my RNY, but I am such a slow loser and have always had hunger probs...I am more curious than anything else at this point....I am a natural worrier I guess...fear of failure down the road:) Good luck. PS...the rny was the best thing I have ever done...a daily miracle....
   — Maureen R.

June 1, 2003
It is sometimes possible to have an RNY revised to a DS -- there are a number of people on the Duodenal Switch Yahoo group who have had it done or who are getting ready to have it done. Of course, there are no guarantees, and revision surgeries are somewhat riskier than original procedures. Hopefully, it will never come to that for you. The RNY is a very effective surgery too, and the odds are good that you'll get the long-term results you're hoping for. Good luck on the 24th!!
   — Tally

June 1, 2003
Both me and my wife are very happy with our quality of life and were both RNYers. Why would someone be unhappy? We can eat anything in limited quanties.
   — bob-haller

June 1, 2003
Other than you would be able to eat larger quantities you would never have a TRUE DS. In my research the pyloric valve stops functioning the longer you have a RNY. Basically it's not used so it stops working. Consequently when they "put you back together" in the DS surgery the old stomach will not be able to work the same as someone who had a DS from the start. If the valve isn't working I don;t know if you can get dumping etc. I don't think there have been too many of these done to really know how well they will work and what the complications will be. <p>My personal opinion is plan on getting only one surgery and make the committment to make it work. I lived on sweets and other carbs and diet coke before surgery. I haven't had one soda since and I've been fine. My post-op plan is quite sparse in carbs and I eat a small quantity, yet I have done very well with this plan. Not perfect, but very acceptable. I rarely find myself starving or for that matter very hungry. Only if I am really late getting a meal will I start to feel significant hunger. Otherwise I do fine between meals. I eat 4 ounces at a meal. I am 4 months out, so the honeymoom period is starting to wane and the reality of what life will be like is setting in and I'm okay with it. I will always need to keep occassionally reminding myself not to push the quantity because that will just lead to greater amounts of food and less weight loss. However, if I eat the amount I am supposed to I am plenty satisfied. I never leave a meals hungry. I hope you have the same satisfying experiences.
   — zoedogcbr

June 1, 2003
Hi, I don't know what you mean about the diminished quality of life after RNY. I am 18 months post op and my life is great. I have lost 181 pounds, I can eat almost anything I want and life is good. I personally don't eat a lot of breads and pastas and I don't eat sweets but otherwise I eat normally. I do eat some sugar free candy and ice cream when I want a treat. I have reached my doctor's goal and had my tummy tuck almost 4 months ago. I now control my life - food no longer does.
   — Patty_Butler

June 1, 2003
Patti - You are so right about you controlling the food and not the food controlling you. I am seeing those changes a lot of the time also and I'm just 4 months out. I haven't missed the pasta and bread and have even had a 1 or 2 bites but it wasn't like I was craving it. The 1 or 2 bites I had weren't even that great tasting. I've also had 1 bite of a cherry kuchen at Easter and it was no big deal. I know from losing a lot of weight in 1994/95 that your tastes definitely change and if you honor those changes (which I wasn't able to do back then - pre WLS) you won't even think about eating those foods.
   — zoedogcbr

June 1, 2003
In my surgeons practice, I've met a few who have been revised from their RNY to a DS because of weight loss stopping about six months out with regain. So it is definitely possible. Chris, I think you have been misinformed about the pyloric valve. It is at the base of the stomach and is part of what is cut away in the RNY. Since the unused portion of the stomach stays inside an RNY patient, a revision would also add it back and it would be fully functional. With the DS, some digestion goes on in the stomach because the pyloric valve regulates the food leaving. Without this, food goes straight through and more vitamin/mineral supplementation is needed. With the DS you are also bypassed for fat. This is the biggest reason for the minor regain totals, lonterm, for a DS patient. But, I totally agree there is no one perfect surgery. We have to research, research and research some more and make the decision that is best for us. But, if I was certain the DS was what I wanted, I would not let the insurance company win. Most will initially not approve haping you will not appeal. Ultimately, WE make whatever surgery we choose a success in most cases. Carol
   — grammie5

June 1, 2003
I agree that you should do as much research as possible before you have either surgery. Revisions are MUCH more risky and take much longer and require a VERY skilled surgeon. It is not something to be taken lightly at all! I don't understand the quality of life thing. I feel great and can eat whatever I want to in smaller quantities. I would be less happy hitting the potty 20 times a day. But that is just me. As with all things there are plusses and minuses with EVERYTHING! Good Luck!
   — Carol S.

June 3, 2003
Carol Beam, I was told that over time the pyloric valve does stop working in an RNY patient because it doesn't serve any function any more and that is why if you covert to a DS down the road the pyloric valve won't suddenly start working. It may have to do with how long after the RNY you have the DS. Maybe it takes years for the pyloric valve to stop working in an RNY patient.
   — zoedogcbr

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