ABC's of Revision II Rny weight regain

Thank you so much for this fair, supportive and informative post.  After losing 230 pounds I am currently facing a 60 pounds gain. Part was Paxil which wreaked havoc with my metobolism! However, I still am faced with the fact that I have gained.  My HMO won't approve another visit to my surgeon because I am 4 1/2 years out. So, my question is: would you recommend going back to my surgeon OR starting over.  Again, thank you for your post.  Marcy

Marcy I don't need mean to pry and I don't know what your financial situation is but I needed to see my surgeon and my insurance wasn't active (inbetween jobs I think) and they billed me for the visit. The amount was $99 because I was a patient of his they may have given me a discount for self paying. Contact your surgeon's office let them know you're having problems and ask how much an office visit would be and if you could maybe pay some and they bill you for the rest. Please let me know how you make out! Blessings, Samari

Marcy, Your chances of long term success are best with an excellent follow-up program. Support groups play a key role. Being active in OH forums such as this further increases the likelihood of long term, ongoing success. Let me answer your question with some questions that will hopefully assist you and others confronted with the same or similar dilemmas. Do you like and trust your surgeon? Does he/she answer your questions in a way that you understand? Does your surgeon's office provide good long term follow-up? Do/did they contact you when you became "missing in action" from their program? If the answer to these questions is YES; Go back to your surgeon. If the answer to these questions is NO; I believe that you would receive better from another surgeon, one who provides all of the above. Aside from you and your spouse/significant other/best friend/parent; no one should care more about your success than your surgeon. You and every WLS patient deserves to be cared for by this type of surgeon. Good luck! Eric Schlesinger, MD, FACS AZ Weight Loss Solutions

Thank you Dr. Schlesinger for your honesty! I appreciate you taking the time to speak the truth and not go on a rant like most docs/surgeons saying that we ate our way through out tool. Even though it is possible to abuse the RNY system most people who are emotional stable wouldn't have risked their life and altered their life so drastically by having WLS in the first place only to sabotage the entire thing.  Am I a perfect eater now? No! But for the first 28 months I was I worked out and concentrated on protein and nutrition like it was my full time or newborn child. (NO I don't have children but you get the point!) Even after all that time I was only down 63 pounds but for the most part I was ok with that as long as I didn't gain any back--well now all hell has broken loose with my body and it's like it's rejecting the RNY all together. After all the research I did and all the post ops and docs that I spoke with prior to my surgery no one stated the weight regain could occur due to MALFUNCTION OF THE POUCH OR THE ENTIRE RNY system. I feel lied to.  So thank you Dr. for your honesty and your support-it means far more to me than you know.  God bless you, Samaria

Hi.I have to admit my surgerons follow up is horrible.I seen him just a couple of months ago and he was happy with how much I have lost but I am not.I am 2 years and 4 months out and my weight right now is 276 and my starting weight was 367! Now when I seen him my weight was 256.Now I just had blood work done and my thyroid levels are out of whack so I am trying to get them back where they should be with my family doctor who thinks its the reason for the weight gain. I am really starting to think about a revision as I am not happy with my weight loss from the first surgery at all.I am depressed and feel like a failure .Yes I have cheated at times(like Thanksgiving,Christmas) but I did not go overboard at all. I am at a loss as what to do. To be honest I had dreams of being like 160.My surgeron told me I could lose 100 to maybe 150 and thats about it.I have read about so many people losing so much more and getting down to a healthy weight and that was my dream. I have never been thin.My weight problems started at age 3.The school nurse would tell my parents that every year I gain 30lbs. I have Polycystic ovarian snydrome(PCOS) and low thyroid and before surgery I had Diabetes which is under control now(3 month blood surgery level was 4.8 and this was just 2mos ago) oh and I had a large pituitary tumor that was removed in 2002.So all in all I have things that are working against me in my weight battle.

Michelle,

I applaud your honesty and courage. If you would like to talk in a more private forum; call my office: 480-419-2280

Eric Schlesinger, MD.FACS
AZ Weight Loss Solutions

I just thought I needed to add a post to reply about no failures, bad information.. What woudl you do with a person who came into surgery at 355 pounds, what was referred to as a health obese female(40 years old) plaed 36 holes of golf the two das prior to her procedure. She didn't have enough co-moerbiditis, other than the wieght for insurance to pay, so she was a self pay. Durign her procedure her colon was knicked,- it was not totaly cleaned up and 3 days laer as she struggled to walk the halls of the surgery ward, she had peritonitis- 3 iches of yeat through out her abdomen. A clen- out was done, but the new design of how the rny was to be woudl not hold, leaks were common and ongoing,. SHe bled out twice,respiratory failure twice, since left bedbound, developed bloood clot in the venacava,and still sat with tubes putting food in and oosing brown stuff coming out for 2 years. SHe returned home after visiting a prominent midwestern teaching hospital being told, " she woudl either heal or die" so much for the second opinion. A four-5 inch open gaop in the stomach, barely able to manuever a wheelchair, she came home to either live or die. after returninf to food(nothing by mouth for 2 years) she lost weight- from 355- 127. SHe still had pain, remanant stomach removed,pain, acid, gallbladder removed, pain,ignored,weigh increased up to 200 pounds and acid has returned to pre surgery levels. MOst recent scope showed a growth over stomaat small intestines, 2 centimeters, removed, but acid remains. Food is impossible. I meal a evening with a pain pill so I get some nutrition... Is this a revision case? Or is this a let her go home and die even though it may be 5 years fom now>

Dear Wigglypoo,

That is a VERY sad and disturbing story. If the patient is you; you have been through hell (pardon my language). YOU ARE NOT A FAILURE! Don't give up hope! Your case is complex and far from straight forward. If you would like another opinion; send your records to me. After I have reviewed them; we can talk and explore your options.

Eric Schlesinger, MD, FACS
AZ Weight Loss Solutions

I first would like to apologize for the typos in the above mesage- not my normal style, but yes, I woudl like to send my record fory ou to review, My surgeon seems to "discouraged" stalls, putt-off. anytime I ask for reords, so to date, all of my care has been done through their office, I realize there may not be an answer ,but have been through so many rat mazes and made felt that I am totally at blame for so much, it is easy to get disheartened, and ready to throw in the towel. If you give me your addres, I will attempt to get as complete records that I can I appreciae your concern and interest. Amy H in Michigan

Amy,
Here is my address:

Eric Schlesinger, MD, FACS
AZ Weight Loss Solutions
20950 N. Tatum Blvd.
Suite 380
Phoenix, AZ 85050