Help! May not get the DS afterall!

I desperately need some advice from the vets. I just got a call from my surgeon, Dr. Buchwald. He was reviewing my medical file, endoscopy report, etc. in preparation for my revision surgery tomorrow morning. He called me and expressed some concern that he may not be able to perform a DS due to problems with my pouch being so small. He said it's so tiny that he fears he'd possibly have to cut into my esophagus. My stoma, on the other hand, is quite large.

When I met with him for my pre-surgical consult, he presented me with two surgical options for my revision, the DS or a long limb RNY. When he called today, he said he may  have to resort to the long limb RNY for safety reasons because of the issues with my pouch. He did say he will o in with the intent of performing the DS first, but if there's not enough tissue to work with in my pouch, he may end up having to do the long limb RNY.  I'm really not as familiar with that procedure. I've been researching it now and basically it sounds like a distal RNY. He told me my intestinal configuration would be the same as the RNY, I just wouldn't have the sleeve. I'd have the longer limbed pouch instead.

I really don't think he's the type to pull a switcharoo unless he really felt it was medically necessary. I told him I need to think about this and would only want to pursue that option as a last resort. I need advice. I don't think this will be as effective, but he assures me with the way he performs the procedure that I will have just as much weight loss, if not more, than I would with the DS. What do you all think? I'm just afraid I'll end up with something that won't allow me to lose the weight I want and then end up needing a third surgery in time.

He told me to sleep on the decision tonight and that he'll talk to me about it in the morning before surgery. I plan to tell him I want the DS unless it's absolutely impossible to give it to me due to my internal configuration. I'd appreciate any and all advice. I have to leave around midnight tonight for Minneapolis and will try to get as much information as I can ahead of time to make the best decision in the morning.

I meant to say he stated my intestinal configuration would mirror the DS, but I would still have a pouch, with the long limb though instead of the sleeve. Sorry, I'm rather frustrated right now. He didn't say he wouldn't perform the DS, just thought he might not be able to do it. He also mentioned that he might try to create some type of bridge that he can work with to make it happen. Hell, I just want my DS! I sound like a whiny baby, but I really didn't expect to hear this this late in the game.

Unfortunately, I have no advice.  But, I will be sure to pray for your decision, the doctors decision and a healthy outcome for you. 

Alisha

I personally would not agree to keeping the pouch.  We just had a person post with a very similar story who was told by one of the CA docs that there was no reason to think she couldn't get her stomach put back together.

Please think hard about whether you can live the rest of your life with pouch issues.

~Becky

www.obesityhelp.com/forums/ds/4448101/Xpost-PLEASE-help-Has- anyone-had-the-micropouch-with-Dr/

You should read this thread.

~Becky

I so know how you feel.  8 years ago, I thought I was going in for DS.  Told Dr. Elariny, I DEFINITELY did not want a Scopinaro (losing my pyloric valve).  He ran into issues with pancreatic tissue around my duodenum and was only able to perform the sleeve.  Eight years later, I was 50 lbs more than my initial pre-surgery weight and absolutely miserable.  I went back to Dr. Elariny, fully expecting to have to have the Scopinaro, but I was desperate to do something!!  So I went under thinking that was what was going to happen.  Lo and behold, I woke up with the DS!!  It took him 8 hours, most of which was spent peeling away pancreatic tissue from my duodenum.

You have to do what you think is best for you.  I was willing to do just about anything to lose weight and was blessed to get the DS, albeit eight years later (shows what 8 years of experience can do for a surgeon).

Best Wishes to you.

Donna

Oh honey, I'm so sorry. I'm hoping someone will chime in with some more info for you. Just let him know how strongly you want the DS and nothing less!! First and foremost is of course your safety. I will be thinking about you in the coming days! Please keep us updated! HUGS sweets!


Ruby

 If I were you, I would postpone surgery and get another opinion.  You can always decide to move forward with Dr Buchwald again, if you decide to, so you really lose nothing by having the consult for the second opinion.

I believe that Vitalady has something similar to this, perhaps you could message her?

I'm sorry this is late - but it is only MY opinion, and you will need to do what is best for you.

IF IT WERE ME:

1) It would depend to some degree how much I hated the pouch, dumping, etc.

2) I would be thinking about the fact that Keshishian and Rabkin are not known for saying this kind of thing (I'm not SURE, but I've not heard it).

3) I would be thinking (and I just KNOW this is going to come back and bite me in the ass someday in the not-too-distant future, since I'm 58 myself) about the fact that Buchwald is 79 years old, and maybe this is something that a mature but younger surgeon might be better at.  As well as the fact that it might not be his hands doing the surgery.

4) I would also think about the fact that Buchwald is not known for bailing on a DS either.

To be honest, I would probably not want to feel pressured into accepting his opinion without having the opportunity to get a second opinion from the same files and endoscopy report from one of the CA surgeons.  But if you don't have pouch issues, maybe you'd be better off with "gittin' 'er done" tomorrow.