RNY to Distal Gastric Bypass (not as happy)

OK I don't mean to sound ungrateful, but I guess I am.  I am having revision surgery in 2 weeks.  I thought I was having RNY to DS with a small modification.  I read all about RNY to DS & I was very physched.  Turns out I am having RNY to Distal Bypass.  I am reading that those results are not as good.  Don't get me wrong, I am happy about losing some, but not estatic.  I am 275 lbs 5'3".  Doc told me reasonable for me to get to 200 lbs.  I was hoping for 150.  Doc says the risks that come with full conversion are not worth the extra lbs I would lose. He didn't give me the option.  I was so shocked my insurance covered me & I was kind of surprised when I went to my appointment today so I hadn't had a chance to look up what I have read about this & I am now even more disappointed.  I don't want to back out, but I would love to hear that a have a realistic chance to weigh a more healthy weight than 200 lbs at my height that is not good.  Has anyone had this done?

Oh Suzanne! Honestly, hon, the results are not good long term for the distal RNY. There is a reason you are questioning this surgery, and you SHOULD!! Dr. Greenbaum is obviously a very skilled surgeon and he CAN do this surgery. If he won't do it, then find someone who will. Dr. Roslin in NYC did mine and he is an excellent surgeon. Please don't settle for a revision surgery that won't get you the results you want. It's hard enough finding a revision surgeon for a 2nd surgery. Make this one count girl. This is your chance to make it right. It's not too late to back out-not until you're not placed under anesthesia on the operating room table!!

Sandy

Why are you opposed to the distal RNY (so are many others)?  Do you know anyone who had it done?  Dr. Greenbaum is one of the best in the east coast & says he has only been doing it this way for 6 months and feel it is the way to go.  He says the results will be A- instead of A+ which is not that much of  a difference but the risks are so much better.  Why are so many people against it while he is so much for it.  I am so confused.  So far I have only found one person on here who had it & she had excellent results but I have found many negative comments about it.  I can't force Dr. Greenbaum to do the DS on me.  He says he doesn't want to because I had open the first time so it would be riskier.  Also realistically I don't want to have to reapply through my insurance again & risk getting denied.

 Suzanne-please just do some more research before you committ.  What is he doing to your pouch?  Why are you revising to begin with?  The distal RNY will give you additional malabsorption, but the reason so many RNYers fail is due to not having a pyloric valve that you would get back with a VSG (a DS would give you this).   I don't know your whole situation, but I can tell you that many people have had significant regain from the RNY due to the anastomosis dilating and not allowing you to have a full feeling for any significant length of time.  With that comes the reactive hypoglycemia.  He may be tightening your pouch up, but the anastomosis WILL dilate again over time.  I, too, had open RNY back in 2000.  Dr. Roslin did my revision to DS laparoscopically on July 11.  It took 5 hours.  Yes, there were adhesions, as there always are with previous abdominal surgeries.  All I want to do is try and make sure you have done your research.  I spent a lot of time here on OH before my revision and thanks to the passion of the vets who have had the DS or RNY/DS revisions, I learned quite a bit.  I knew that a second surgery was my last chance to get it right, so I wanted to make sure I made the right decision.  Whatever you go with, I sincerely do wish you the best of luck.  Please feel free to message me with any specific questions or concerns.  

Sandy 

He is not touching my pouch.  Besides me going back to carbs & having 2 babies,  I failed because the tube that goes from esophogus to pouch is too long.  I don't get a feeling of fullness. (at the same time, I am not hungry often either)  He is not changing this.  He said from him doing the bottom half of the DS, the malabsorbtion & me eating differently and excercising will be what gets me my results.

I don't know if my insurance covers the DS. I was shocked they approved me at all as my insurance says 1 WLS per lifetime. I also know Dr. G who is one of the best in the country is leaning against DS as a revision for anyone but is even more opposed to people who had open RNY the first time because of risk.  He said the difference in results is not that great but the risk is. 

The only people who I see who actually had the ERNY complain about vitamin defiency but that could happen with DS too & slow weight loss but that seems to be about equal for people who lost & people who didn't.  Most of what I am finding is from people who didn't have distal bypass.  I am not putting anyone down for that but I don't understand why they feel so strongly about it but yet my doctor feels the opposite. I believe him to be a very good doctor.   It is really confusing me.   I did just write to him to ask him if he will do the DS.  I don't think he will because I had open surgery.  I also don't want to risk my insurance turning me down if I pull out & reapply with a different surgery.  At the same time, I don't want to fail in finally reaching a healthy weight.

 The one person you said who had the distal and who had good results, how far out was she? Because there is a difference between the honeymoon period and long term results with these surgeries. Also, was this person a revision, or was this a "virgin" surgery? That makes a difference too. 

Honestly, I think the risk of long term nutritional issues for only a 75 pound weight loss just isn't worth it. This is only the rest of your life that you're looking at, after all. And I'm 5' 3" too, it isn't unreasonable to weigh around 125 to 130 lbs at your height. I did during the golden days of my RNY. 

You're worried that you may not get insurance approval again, so you're willing to go through with something that you're not entirely ok with. You DON'T KNOW that you won't get approval again! Don't risk everything based on something you don't even know will happen. 

Besides, insurance can be fought with, so don't worry about future approval. There are people here who can help you with insurance woes. 

Please, please don't jump into something based on unfounded fears of your insurance giving you trouble. 

Good luck, 

Lynda

The person who had excellent results is 10 years out & she had exactly what I had RNY to distal.  She is 5'1" & 115 lbs.  I realize she is not the norm.

Distal & DS both have better long term results then the RNY.  I wish I had known more about DS before I had any WLS.  I am not sure I would have went with it or not because I actually do like the fact that I dump. But 80% weight loss vs. 60% might have swayed me. 

I am very comfortable with my decision after speaking with my doctor again.  He did tell me a good doctor if I chose to switch to the DS.  It happens that I see that doctors name on here recommended by many.  I tried to contact him just to speak, no success.  Unlike my doctor who contacted me less than 12 hours later and did not just to persuade me in anyway just wanted to explain it more to me and make sure I was comfortable.   There have only been 8 people who had it performed the way he is doing it.  I wil make number 10. (yes person in between)   3 of the people who are the furtherset out (6 months) have lost between 50 & 60 lbs so far. It is expected that will be doubled.    That is right on track to where I want to be.  200 lbs  would not make me happy.  150 lbs absolutely would.  125 or 130 not appealing to me regardless of what the books say a 5'3" person should be.  I know people who have had great success with WLS who did get the books goal & I have no desire to be as thin as they are even if I could. That may all change when I get closer.  One step at a time is how I want to look at this.  Not usually how I operate, but honestly it feels good to slow down a bit. I am such a control freak that I have every step of my life planned out.  It feels good to say, "you know what, time will tell & just do your best".

I'm not worried about my insurance right now.  If things don't turn out as I believe they will, I'll fight that battle when it comes.  So far life has been good to me.  I really do believe things happen for a reason.

6 days & counting

Hi I am going in on the 8th of june to talk to my doctor about a revision to a  distal. I wonder if you would let me know how it is going for you now and if you would still recomend it? If they did not fix your pouch or stoma what kept you from eating too much? or having your food slide right thru stoma?

 This is such an old thread, and you will likely have to look at that posters history to see her latest, as she stated a while back she doesn't come here much. At that time, she said she made many trips to the bathroom, and wasn't losing as much as she hoped. 

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