Questions question questions..

I am meeting with my surgeon on Wednesday to discuss a revision. I have trouble not only with weight gain, but medications in my pouch. I cannot take any antibiotic without trouble and in addition I am on 3 different anti depressants and mood stabilizers. As well as pain killers and muscle relaxers. I need some help in trying to make the decision to do a revision. I have tried very hard for the last 3 weeks to lose the 80 lbs I put on in the past few years but I still weigh the same. I am doing on average between 1100 and 1300 calories a day most in protein, fiber and carbs., with a smattering of fruit in the mix as well. I do at least one or two protein drinks each day.

I have several questions. Instead of putting them all in one message, I am going to ask them in bits and pieces so it is easier for me to separate them for husband and doc when I see them. At this point, when I met with the surgeon a few months ago he made the whole DS thing sound horrid with severe problems with bowels and gas. As a result my husband is not so keen on this whole deal.

So anyway on with the questions….

What kind of hoops did you have to jump through to get the revision surgery, both with the Doc and Insurance? Has anyone had trouble with Tricare approving revision? What are the normal physical requirements to qualify for revision? Can you be less than 100 lbs overweight? I am about 80 with a BMI of 30 but have a lot of weight problems. The main one being an inability to stay on my feet because of a bone spur and twisted Achilles. Although this will most likely result in a surgery down the line I would rather have the revision than the surgery at this weight. Also, as I said, I am on a lot of medications that seem to have caused a lot of trouble with my pouch.

And

Medications- did anyone who had the revision have to change the dosage of non weight related drugs? Ant depressants, anti inflammatory, muscle relaxer or antibiotics to be specific.

Thanks in advance!

 

Please post on the ds board, lots of smart ones over there to help ya!

 

I had mechanical failure of my rny and did not have to meet bmi requirements.  I have cigna ins.  If you have issues with the pouch, I would do ds, no exceptions!

I actually did post there too.. getting some really great answers from everyone! Thanks!

For the revision, I needed the psych clearance (my own therapist did it, she's the best), nutritional consult (nutritionist made me come at least 2x before writing the letter), upper GI & gall bladder ultrasound, pulmonary clearance, and I did most of the 6 months of supervised diet with my primary care physician. I didn't technically need it due to mechanical failure (I had a ring around my stoma that caused vomiting & esophageal erosion).  I started in the summer (July) and had surgery in December. It was a bit rushed because my company was changing insurance on Jan. 1.

All in all I felt it was easier than obtaining approval for RNY in 2003, probably because the RNY surgeons were overloaded at the time. I wish I'd had the DS then.

Hiya Butterfli,
I want to lasso you up and hold on to you tight until you read every piece of research available!  Kudos to you for asking a lot of questions.  That's a start.  Next...head to the www.dsfacts.com and make some light supper reading WITH your skeptical hubby so he knows the real deal as well.

You asked if someone can have less than 100 lbs to lose and still revise to a DS.  I had about 15 pounds to lose (I gained for the surgery) and just had a revision to a DS!!!!  There are a lot of different reasons to select a procedure.  Your description of your needed meds not meshing with the pouch are one of my main reasons that I was revised.  I needed to take Nsaids, big doses of calcium citrate, iron and allergy meds and I needed some real tummy for that.  The pouch wouldn't cut it!!!

My story is long so I won't bore you with it but just know that the DS answers MANY types of  questions and is not only the best option for the next surgery but as your LAST surgery!

I've been there/done that so I'm a bit anxious that everyone else climbs aboard the DS train!

Good luck with your journey!

Thank you thank you thank you!!!!! Friday I went to my PCP and after nearly 4 weeks of strictly maintaining 1400 calories or less (usually 1000-1200) I had not lost a single pound I was so down (still am) but at that point I decided I was done! I do not want to diet and I dearly want to eat healthy and have it work in keeping me and my body healthy! And as I said before.. Medications I take are a real concern. I is awesome to have someone who has been through this hold me up! I have read the DS site three times already! Evey link and sublink there is! I did show it to my husband and he is more supportive of my  wanting this process so that helps a ton. But after learning my weight had not even changed after a month of trying hard to get back on track it makes it really hard to stay there. It is also really good to know that my weight should not matter that much. I have been afraid I might not qualify unless my weight was over 100 lbs. so have actually been trying to get it up to that.. funny- when I want to gain weight you can't and when I don't want to I do. What the heck??? Anyway- since that should not need to be 100 overweight I think I will just go back to the healthy eating. I felt better. And then just wait and see what he says on Wednesday. I imagine I will have to have all the tests again, so it is going to be a wait,but I wish he could just say ok and schedule me! I want this done!! I feel like I did pre op for the RNY!
THANK YOU AGAIN... your post really lifted me up for the day and gave a whole lot of hope. Knowing someone is gunning for me out there makes such a huge difference!

 If you don't go to one of the handful of surgeons who can actually perform an RNY to DS revision, your surgeon won't even offer the option to you.   All you will be offered is:

1.  Stomaphyx (aka "Stomafail) or the ROSE, neither of which have had great success.

2.   Band over Bypass (aka BOB) - can be successful if the patient can tolerate the band.

3.  ERNY - from what I've read on OH, very few have found the success they wanted with it.

Please do your research and decide which type of revision would be the best for YOU - then go to a surgeon which offers ALL of them.   Otherwise, the doctor will *convince* you to do the procedure which he/she offers (or is the easiest to get approved by insurance) and not necessarily the best one for you.