Gastric Fistula?
on 2/14/10 5:38 am - Branford, CT
I am 10 years post op, RNY which as done Laparoscopically. Day one, post-surgery, a fistual was discovered. I was placed on antibiotics and was observed for a few days to see if it would resolve on its own, which it did. A few endoscopies later revealed no opening at all in the pouch; it had healed completely. An NG tube was placed along with TPN through the central line, I was sent home to wait for the next surgery. Aproximately 6 to 8 weeks later, an open revision was performed, recreating an opening to the pouch. I went on to heal without any further problems. I was successful in losing 164 pounds, reducing my BMI from 51 to 24. I was able to stay within a healthy weight/BMI for about 5 years without much work.
5 years ago, I started gaining weight. I started to work out, running 5 miles per day; if I did not run, I would gain. I noticed I coiuld eat more than what I was used to eating. I noticed that I started to overeat without having any nausea like I had in the past. Around this time I developed a few occasions of gastritis but what really sticks in my mind, is the fact that when I vomitted during these times, stomach acid was present which had been absent in the past...(sorry, don't mean to be graphic).
I do not know if it is normal for an RNY patient with 150 cm bypassed to experience this but it does make me wonder if somehow my insides have grown back together because of a gastric fistula had occured. It wouild not surprise me with my past experience.
Currently, I have a re-gain of 70 lbs. I am in need of some help, my insurance does not cover weight loss surgury and I am not sure of how it goes with a prior surgery needing to be revised. I have been trying to tough it out on my own but I am have been losing the battle, yet again.
I have moved to Florida and I am at a loss as to how to proceed down here, where to go and if there could be any help for me... any information on where to turn and what anyone knows about the stomach "re-attaching" would be great.
Last October I finally said enough is enough and went to my surgeon to start the ball rolling. The insurance person who once working at this office coded my surgery request as gastric bypass revision. The repair of a fistula is not gastric bypass revision and shouldn't be coded as such. I wasted several months fighting with my insurance company because of this person error. A new person was hired and after one simple phone call to my insurance company they told us gastro/gastric fistula repair didn't need a pre-authorization. Within 2 weeks of finding this out I has my fistula repaired. I checked on-line and my claim has already been paid to the hospital.
I suggest you research available bariatric surgeons in your area and make an appointment with one you feel comfortable with and discuss your concerns. Also discuss with them the proper procedure coding as this might save you time and headaches.
Good luck with your journey.
on 2/17/10 10:49 pm - Branford, CT
I am so happy to hear your story. I am 7 yrs post RNY. I have a diagnosed gastro-gastric fistula and had the band around my stoma removed because it had eroded into the pouch/intestine. I am trying to find a surgeon to fix me up as I have gained about 70 out of the originalk 100 back. It took me 4 years to ask for help again. I am getting the run around from the surgeon I'm working with now. It seems like he is afraid of me for some reason???? Did you have an open procedure to fix the fistula? I'm having a hard time finding a surgeon who seems competent to do my revision.
Tate,
What state do you live in? I had bypass surgery done in 2004, Roux-en-y and I weighed 453lbs. Then between 2004-2007, I got down to 224lbs. In 2011 I started gaining weight, little by little until in 2015 I was 354 again. I then almost died from a perforated bowel. After surgery, I had endoscopy done and Dr. Said my gastric bypass was no longer intact, due to staple line failure. He said I couldn't get it repaired and couldn't have bypass done again. Then, six months ago, I saw online about gastric fistula repairs. Not knowing my exact problem (my Dr was a liar), I had my PSP refer me to Dartmouth Hitch**** clinic in NH. Well, all said, I had gastric fistula repaired endoscopically last week, 8/2/2018. Surgery took 1hr 1/2 and I am repaired and ready to lose pounds again and forever. Same day surgery, no pain, Tate get it done. You deserve the chance. You earned it after first surgery and all the upsetnes wet gained back causes. Let me know if you have a ? or need anything else.
Good luck,
Drew