Need Advice

 Hi Everyone,   I had stomaphyx on Feb 1st...no significant restriction so I regained the 17 lbs that I had lost.  Had an Upper GI last week and saw MD this past Tuesday.  My pouch is relatively small, and stoma is probably 16mm maybe less (probably less since Stomaphyx).  Spoke heart to heart with MD (LOVE this man) and he essentially said that everything LOOKS as though it's fine (why then do I weigh 300 lbs +?).  He spoke about the complications and possible outcome of revision surgery and said that it's major surgery with really questionable results.  I guess he would possibly re arrange the plumbing, but said that there really are no guarantees with revision surgery especially since my original surgery appears intact (from 1982!) He also mentioned a lap band, but said that he would talk to his team about it and I will call him tomorrow (Friday) and he will give me the answer.  I feel as though I am prepared for whatever he says although it will be hard to hear if he just recommends dieting.  I spoke to him about DS etc and he again reiterated that revision surgery is tricky and much riskier than original surgery  (scar tissue and adhesions being a biggie) with results that are not always favorable.   I trust and respect the expertise of this man.  He is the President Elect of the American Bariatric  Association, so I have gone to the best.  My question: 1.)  When I speak to him tomorrow what should I ask?  Can anyone think of any other ideas I could propose? 2.)  Has anyone had success with lap band placed over smallish pouch with success?  I will also go over to the Lap band forum and read what's over there. 3.) ANYONE else with the same problem as me?  What did you do? 4.) If the original surgery is still intact, then why have I gained it all back??? Thanks in advance for all your help!! Sue  

Hi Sue I can only offer support but not much advice! You're in a difficult situation from what you've said - if it was me I'd want to know what was 'wrong' now before thinking about the best way to fix it. Are the sizes for your pouch and stoma 'normal' then? Can he think of any reason why you aren't losing? All I can think of is that the restriction isn't enough for you - it wasn't for me with a band. Perhaps he could make your common channel shorter and give you more malabsorption if he doesn't think the DS is appropriate? Does he do RNY to DS revisions at all - I think revisions generally are more specialist, and it might be worth getting a second opinion before you take the plunge for anything. Not sure about the band - I'm biased after all, but if you have a small pouch now a slightly smaller one might not make much difference.  Like I said, not much advice but I hope you get some answers anyway Sal

I went to my doctor and had a ugi and egd done and he said my pouch and stoma where fine, but yet I stopped losing weight after 6 months and only 90 lbs. I still need to lose more than 100. I have an appointment with him June 10th and after reading the success that someone had with bypassing more intestines that is what I'm going to request. If your insides are fine then maybe you didn't have enough malabsorbtion either. That is what I would ask him about.

You may have gained the weight back because your body got more effective at absorbtion of the fat, etc. in your food. You can ask him about more malabsorbtive surgery like distal or extended RNY - unless he's already ruled this out. Or, perhaps he can do a BPD-DS. Someone else on here is having it done and their leaving her pouch alone.

Go down a month or so and look for Dr. Schlesinger's ABC's of Revision and he explains most of the common questions that is asked.  Went to see him last week and he is just great.