Anyone Dread their yearly RNY check up?

 T! Here you are the one I look to for advice and support and you haven't been for 2 years! I am crushed to know that!  hehehe

Nobody is perfect.
I have been put on notice by you and Paula.
Will make appt soon.

T.

Hi Paula, it's been quite a while since I've been around and your post compelled me to respond. Thank you for starting this thread. As a post-op nearly 5 years out, I view this surgery now very much the way I view motherhood of my teenaged son:  his first two years were lovely, miraculous, so many "moments" of discovery and joy...and now, I find myself slapping myself upside the head, saying "What the hell???" almost daily - if someone would have told me right after surgery, during those miraculous months of absolutely no hunger that I would one day experience extreme hunger again - the kind that is at times unsatiable and even painful - and that I would have to spend every day fighting for the life of my "newly normal" sized body, I would have said, "Naw....see, I've got this little tiny pouch..." THIS NEEDS TO BE TALKED ABOUT. In support group meetings. In the informational sessions as people are just beginning their research and deciding on whether or not to pursue WLS. And certainly, it MUST be discussed WITH our surgeons as post-ops who are struggling mightily to hold on to our weight loss success.  When I saw Dr. Aranow for my 4 year check up, I expressed my concerns and asked about the possibility of an enlarged pouch or stoma, to which he responded, "Your tool is fine." End of discussion.  It was a closed door. I have since had my "tool" scoped by another surgeon to discover that my stoma is extremely dialated to 32cm.  It's supposed to be at around 8-10cm. We don't need to be made to feel guilty about our hunger and the ways in which we are managing it - or not. We need to OWN the problems we are encountering; and IDENTIFY solutions to solving them. I am maintaining my weight loss, having gained only about 7 lbs. of my 216 lbs. total lost, but I've found what works for me at least for today - the miracle and joy of movement. I can't get enough of moving this body, that used to lumber through space like an overweight walrus - can you imagine an overweight walrus? But I am hungry. A lot. All the time. If you feel uncomfortable with talking to Dr. Aranow about what you're going through, than the doctor/patient relationship is flawed.  Go in there and tell him what you need. He gets paid plenty for it, my friend - and yes, he DOES care. But he MUST address post-operative issues as being real if he wants to maintain his reputation as being one of the most successful surgeons in the industry. Ok, this messenger is going back into hybernation - all the best, Paula. Maureen

Hi Maureen,

Thanks for filling me in on your issue with your stoma being enlarged...at least I'll know that if Dr A dismisses me like he did you, then I'll ask him to please let me be checked, and if he says "no", then I'll continue on to someone else.  I know that's what it is, and if so, I want it fixed.  I didn't go thru all of this to have it be failed...

I'm going to make an appt tomorrow...

THanks,
paula

Maureen,
Our stoma is where our stomach connects to our intestines right? 8-10 is too small. At 8 cm (I thought it was mm) it is considered a stricture. I was sick at 10. I just got stretched out to 15. I will say 32 is too big. Are you getting it fixed somehow? Let us know what is going on.

Hi Kathy, and congratulations on your weight loss, you must be feeling very good! Yes, the stoma opening is how the food passes from our pouch into the intestine, it needs to be small enough to allow the food to sit in the pouch long enough for us to feel satiated and for us to absorb the nutrients of the food. If the stoma opening is too large or dialated, the food passes immediately into the intestine and we get the double whammy of absorbing the calories from the food but not the nutrients. The AMA definition of a stricture is, ""Narrowing, usually by scarring, of an anastomotic suture line."  Basically, this means scar tissue develops that closes the stoma opening. But your information is not correct from what I've been told by two different surgeons. Typically, the stoma opening is approximately 4mm (sorry, I always get that mixed up) right after wls and some stretching can be expected with about 8mm where it should settle to ensure a feeling a satiety and good absorption of nutrients. I had an endoscopic procedure (restorE) which was supposed to have reduced the size of the opening, but I never felt any restriction of any kind - I am a firm believer that these endoscopic "revisions" do not work at all.  The bottom line is: eat healthily and in moderation; work out hard and regularly; live passionately. This is the only way to keep the weight off. There is simply no other way. Maureen

Hi Maureen,

Wow - your stoma opening is 32 cm!  My stoma opening was around 30 cm - and 2 surgeons told me that was HUGE (their words)!  Where did you have the RestorE procedure done?  I had looked into it at Brigham & Womens but they also found a fistula, so I was no longer eligible.  On the 18th of this month I had revision surgery with Dr. Lautz at Brighams - and hopefully, this wonderful feeling of satiation will continue.  I know that I will be able to eat more as time progresses, but no one should be able to eat as much as I could after having had RNY.  I was eating more than I ever did pre-op for the RNY.

Anyways - I always suggest that we stay proactive in our health - including in this segment.  If we think there is something wrong, then we should investigate, even if our surgeon doesn't think so at first.  Only then can we really know what the "problem" is, is it us, or is it our body - and then we can get back on the  right track!

Best wishes to everyone on this board in their weight loss journey.

God Bless,
Kathy Bilodeau
RNY 12/3/03
Revision 7/18/08

Hi Kathy, I truly hope the procedure works better for you. I lost in the initial 2 week post-procedure period, but who wouldn't lose weight on an all liquid phase diet? I lost 10 lbs. but have since gained that back - I have never had a feeling of restriction or fullness after the restorE procedure, even though Dr. Thompson told me he reduced the size of my stoma to 4mm.  If he did, it must have immediately broken open. I don't have any faith in the validity of these procedures, only to the extent that - as I said - anyone will lose weight on a liquid diet but will then regain that weight once they commence to eating regular food again.  I truly hope you prove me wrong! Please keep me posted, feel free to email me directly at [email protected] - would love to stay in touch with you. Otherwise, I've recently done the 5-day pouch test and have lost 6 lbs. and am feeling more satiated, much more so like I felt the first 6 months after gastric bypass.  If anyone is interested in trying this, google "5 day pouch test" and follow the plan - it's quite simple. Be well, Kathy, hope to hear from you! Maureen

Maureen,

I didn't have the RestorE procedure like you (I wanted to, but didn't qualify), I had a laproscopic revision - so, hopefully, I should have better results.

However, I'm wondering, since this 5-day pouch test is working for you - with weight lost, perhaps your stoma has been reduced, and now you are eating properly and feeling full?  It certainly sounds promising to me!  Its quite similar to the post-op diet I am following now, except I'm on each stage much longer.

I wish you the very best, and yes, lets keep in touch - we seem to have had a similar experience.

God Bless,
Kathy

No, the two are unrelated; I am doing this with a group of other post-opers, none of whom had any revision (endoscopic or otherwise) but all of whom are having similar success with the 5-day pouch test. After 5 days, the typical weight loss is between 8-10 lbs. Best, M.