Micropouch needs revision--help?!?!

Hi, folks. :-) I had an open RNY Micropouch in January of 2002. I started at 390 and went to 205 with my tummy tuck and hernia repair. I sat at 225-230 for a long time and felt good there (size 14/16). Then I started to slowly gain back. I wasn't eat junk, but I was definately able to eat more and more. My husband also had an open RNY, but a different surgeon did it and he still can only eat a little bit and be full. It is very dissapointing and upsetting. I am now at 255-260 and have been here for like a year. I tried increasing exercise and REALLY restricting my food, but the only thing that appears to work is to take Phentermine to make me not feel hunger, but then I feel like crap all day, my head throbs, and my mouth gets dry. I want a revision, but I know nothing about that gastric band thing (not the lap band) or a DS. Does anyone have experience with going from RNY to DS? What is done? Does it work? Any suggestions???? I am not looking to be a stick...never will be...but I do want my weight to start with a "1"...heck, I'd be TOTALLY satisfied at 195. PLEASE HELP!!!

Who did your RNY?  I am scheduled for surgery in September.  RNY by Dr. Syn (in Lubbock).  I have not heard one bad thing about him or his work!  He is wonderful!  I had a VBG done by Dr David Hall and I am really disappointed.  My surgery will be a revision to that surgery.  I am really excited to be on the losing side again!

Dr. Micheal Wood in Detroit did my Sapala-Wood Micropouch, a smaller version of the RNY; however, the stoma tends to stretch, allowing more food in, so from what I"ve been reading today, our WLS has a tendancy to fail as the years go on and people regain. I am totally bummed. I had a friend in Lubbock get a VBG there and it didn't work so she ended up getting and RNY from your surgeon and is doing well. Best of luck! :-)

You might want to go to one of Dr. Syn's seminars.  I think the next one is this Saturday.  Here is his website.  www.advancedbariatricsurgery.com  It has the dates of the seminars on the left hand side.  They also have a message board.  You should definitely check it out. 

Paula,

I had an open roux en y in 1985-my stoma was so large that I regained 80lbs back.  My doc was able to place a lap band on the stoma.  It was done laparoscopically.  Since 4/4/06 I have lost 59.5 lbs...you may want to consider this...it is not a debilitating as an open surgery and you have a lot of control with the banding.

good luck

Stacey

With my RNY (it was open), I was off of work for 4 or 5 weeks, and I sort of remember wishing it was a little longer than that. I was pretty miserable for the first 2 months. I don't have any time off really (well I get one day a month into my bank- I am a teacher) and I wanted to do it over Thanksgiving when we have 4 days off and then use my August and September earned days off to add to it. I don't know if I am giving myself enough time to heal from a lap surgery...especially since I was such a weenie with the first surgery. I did call Dr. Blackstone (as I now live in Kingman and will be having surgery in the Phoenix area) and they said she does do revisions, but NOT to the DS which is my first choice. I am interested in banding the pouch, but how often do you have to go in for fills? I live like 4+ hours away and have a new baby so I can't just drop everything to go get filled every week or two. Also, do you know of any other rny people who got banded? Is this common? Thank you so much! :-)

Paula, They didn't do my first fill for 4 weeks, then it was every four weeks after--only if you need one.  You may only need one fill and will feel a huge difference.  This is the first time in about 14 years I have felt full!.  I really could have gone back to work after a week....but they wanted to pay me for four weeks...so I took advantage of it.  Its' too bad you are so far away...I am actually a little over an hour from the docs..I live almost in Maricopa so it takes some time.  The hospital was amazing, I am a nurse and was nervous and am also a weenie and was treated like a queen both in the hospital and at the doctors...what a difference from some of the others that I have seen.  Really check out the DS....there must be a reason so many docs do not do it(I don't think its because they cannot do it)....plus you will have a longer recoup time with the DS.  Dr. Blackstone does a great job with the laparoscopy....we thought since my surgery was so long ago I would need an open procedure, but she was able to accomplish everything with the scope Good luck and keep in touch.  Stacey

The reason relatively few surgeons do the DS is that it's considerably more difficult technically than the RNY so they can't learn it at a weekend seminar and open shop. If you look at the list of surgeons who legitimately do the DS (the OH list is very inaccurate...www.duodenalswitch.com has a very accurate list), they're well-known highly respected surgeons. However, an RNY to DS revision generally wouldn't be done on someone whose BMI no longer qualified them for WLS in general...It's much easier to get either a stoma revision or a lap-band placed if that's the case...and of course the banding is by far the least invasive revision. Nancy

Hello again. I meant to ask you if the band was placed at the top, where it normally goes, or it was placed at the bottom where the stoma is. My stoma is the problem, my pouch is tiny so I was interested in knowing if it was at the top or the bottom. Thanks! :-)

From your profile it doesn't look like your BMI would be high enough for the most extreme revision to a DS. Most revisions in cases like yours would be to fix the actual problem...the enlarged stoma, and these days the most common and least invasive fix is placing a lap-band at that stoma and adjusting it over time to the correct diameter for your pouch to function properly again. Another person I know of who's had this revision is Walter Lindstrom the attorney from www.obesitylaw.com Nancy