DS Revision to RNY Questions

I had a DS in 8/2010 as a lightweight and lost about 100 lbs, gained back 39.  I have no bowel movements unless I am taking Amitiza.  Went back to doctor to talk about revision as my CC is long (200) and knowing I started out with longer-than-normal intestines.  I am having horrible acid reflux (to the point that every month to a month and a half I lose my voice for up to 3 days) and I have erosion in my esophagus.  My doc wants to revise me to a pouch as he said in the last year they have found out it is better for acid issues.  I researched the DS for years before getting it.  I did not want a RNY but it looks like that is where I am headed.  Anyone have any info or words of advise on going this route?

I am a RNY to DS revision. I had more acid reflux with my RNY. It would wake me up in the middle of the night gagging and burning my throat. I don't have this issue any longer since revising my pouch to a sleeve.

Also, living with a pouch is MUCH different then living with a sleeve. With my pouch, I couldn't tolerate a lot of meats, most veggies, fruits, juice and the list goes on. I ended up with hyperactive glycemia due to my stoma stretching (this is very common in pouches) and food emptying to quickly into my intestines. With the sleeve, I eat so much more normal and can actually enjoy my food again.

I have lived with both and I can honestly say the pouch IS NOT normal... I wouldn't go back to it for any reason or cost.

Good luck with your decision. Hope all works out well for you.

SH

I think I would consider getting my CC shortened, and then address the acid reflux problem. Could you tell us what medicines you have tried to get it under control? Some people have to take more of it then normal people, and might even have to take it a few times a day,,,,,

I am no expert but I have heard relfux can be bad with the pouch too - one reason I didn't consider the RNY. All I would suggest is getting. A 2nd opinion. I have heard success stories with people shortening the CC - seems like maybe talking to another DS doctor might be worth the visit. 

I do hope you're able to get it resolved. I know living with that stuff is miserable 

 

 

Have you had an upper GI lately? The reason I ask, is that you may have a hiatal hernia that is causing the acid reflux.

I went to Dr. K to address lack of weight loss and some regain. He had me get an upper GI and it showed that I had a large sleeve, hiatal hernia and a long common channel. I had symptoms that you describe with losing my voice. I didn't realize that I even had reflux until I saw the films myself. I blamed my sore throats and constant clearing of my throat on allergies.

My repair was 2 weeks ago and he found even more than we suspected. I had a very large sleeve (original surgeon said I had a 46, but that apparently didn't mean much) lots of fundus left, enough to fix the large hiatal hernia. Dr. K also switched me to the Hess method and measured my total bowel length. I had over 800 cm's!! Before surgery, he guessed that for a 5'3" woman, I would maybe have 500 or so. So, my 100 cm cc was way too long for me.

My advice is to seek another opinion! My reflux has almost completely resolved with the hernia fix and my sleeve was even skinnied up quite a bit. With my fix to my common channel, I finally feel that I have a properly working DS. I have nothing but high praise for Dr. Keshishian and his belief in the Hess method DS. He is doing more and more DS to DS revisions for patients than we hear about. Sad, but true.

I forgot to add that I have been on the side of constipation since my first DS 5 years ago. I was lucky if I went daily and that was with stool softeners w/each calcium batch, mag oxide at bedtime and upping fat intake. Dr. K told me that constipation was certainly uncommon for a DSer, even with our supplements that firm things up.

I'm thinking of you. Your post hit close to home for me.

What T Lady said!!!   Definitely get a second opionion from a GI specialist as well as a wls specialist.  Re-losing 39 lbs isn't impossible, but it will take some work.  If you still had a long way to go and are nowhere near goal, only then would I even consider a revision.  If you're only 39lbs overweight, congratulations!  You're the average woman.

Another thing to investigate is a Nissen Wrap procedure (I hope I have that name right), which is used in extreme cases of acid reflux unrelated to wls at all.  I wouldn't dream of damaging a fully functioning stomach, and I'd be concerned if you could gain it back if there are problems with the pouch that many RNY's have had.