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I had RNY surgery in February 2004. I lost around 130 pounds with some bounce back. Kept it off for 7 years, staying around 190 lbs. I had so much energy, I decided to go back to school to become a doctor. Medical school is when I started to gain (about 20 pounds per year). Over 4 years, I gained back about 75 pounds. It is tough trying to keep up with my colleagues and shameful to be an overweight Physician. I dieted during those 4 years, and never lost more than 15 pounds. I tracked food and found that if I ate more than 1400-1500 calories daily I was gaining, my metabolism was shot from the starvation of the RNY and I had absolutely no sugar dumping or satiety or restrictive effects left from the surgery. Exercise was impossible and keeping under this calorie count was very difficult as I was severely limited in time, having to eat cafeteria food while walking/running to the next task. Also, being exhausted by the end of the 14-16 hour day, I would just grab convenience foods to quickly eat so I could cram in some studying before bed.

Finally, I looked into revision surgery. I researched quite a bit to make the best long-term decision. I figured that I needed a malabsorption component because restriction does not last. The Duodenal Switch surgery has the best long-term statistics of any of the other procedures and I determined that if I was already taking all these vitamins, what's a few more. The most mentioned post-surgical concern of gas and diarrhea seem to be controllable according to other DS patients on multiple forums - but it is highly individual, requiring a person to determine triggers and adjust to avoid this reaction. 

My insurance was one of those "will not pay for any WLS" types, so I knew I would have to self pay. I did intially consult with Dr. Kemmeter in Grand Rapids, MI for this revision. I would have been happy to have him do the surgery but it came down to the hospital providing cost quotes and the initial quote I was given was about $10,000 less that the final quote. As a resident Dr, I am making much less money than the RNs that I work with and I have huge school loan debt.

This prompted me to rethink. I could also not afford any complications (as I was already extending my residency for 4 weeks of recovery), Dr. Keshishian was the most favored physician that everyone was talking about on the forums. I just made an online inquiry and within 48 hours had spoken to his office, had a quote for $3000 less than the initial in Michigan and was assured that I could keep the same surgery date. The cost savings was enough to pay for travel expenses (and it was subzero temps in Michigan). Dr. K has performed over 800 of these surgeries and has a standard operating procedure and proven successes. His office is very organized and competent with every aspect. Once I started communicating with them, I just knew in my heart that this was the way to go and my stress, fear and concerns were decreased substantially. When I spoke with Dr. K, he was very reassuring and confident and spoke with respect. All the pieces fell into place from that point. 

The pre-op process was continually smooth all the way through to the operating room. Everyone at Verdugo Hills Hospital was very kind, patient and helpful. It really was a pleasant stay. The RNs & techs understood post-bariatric care, were gentle with walking rounds and every aspect of care. I have a place in my heart for them. I spent two nights at the hospital and went back to the hotel room with my husband for 7 more nights. I had a 1-week post-op appt with Dr. K & was OK'd for travel back home. Did get a chance to get to the beaches in LA (during record high temps -yippee) and many more activities before returning back to MI. 

Now I am home, post-op week 3 and learning trial and error eating. I have been walking, drinking 48-64 ounces of water and getting ~60grams protein daily. Do have pain around feeding tube (that I have not been using) and some seeping from incision but is improving daily. I have lost 21 pounds since I left for California.