gastric sleeve stricture diagnosed over 1 year post op

I am so frustrated. I had VSG about a year ago. I had a great surgeon and followed all the rules of the sleeve, stayed on track with mindset and have worked very diligently to be successful.

Along the way I realized that I felt something wasn't quite right. I went to several different Drs and told them about my struggles to stay hydrated and increasing intolerances to foods etc. but they brushed me off saying I had weight loss surgery and was to be expected.

I kept on track but my symptoms increased. I started having episodes of orthostatic hypotension. I was told the same thing by Drs regarding WLS and they suggested I see a neurologist. (I clearly thought it was bariatric related).

I finally received an appointment at the local bariatric center. They finally started offering the sleeve although they haven't actually done one locally yet. They still really push lap bands (I don't like that at all and it makes me wary fwiw) but I was finally able to get a full bariatric lab panel and an upper GI. The upper GI showed aspirations. This was bad because I take a biologic injection called Humira that really lowers my immune system and I have a higher risk of aspiration complications in my lungs etc. My Dr who prescribes that told me to stop injections immediately so that my immune system can start to rebuild. I had an EGD the next morning and he found that my sleeve healed in a way that the scar tissue formed a stricture. That led to increased pressure in the sleeve and my symptoms, a hiatal hernia and GERD. My throat is sore most of the time and I swallow constantly. It often takes me an hour or more to finish a protein drink and getting enough hydration is a full time necessity. I have nausea, pressure, food intolerances and reflux, GI symptoms etc.

The local surgeon wants to place a stent for 6 weeks or more but my original surgeon thinks the solution is conversion to RNY. I trust my original surgeon very very much but I am so sad to think that I would convert to RNY. I don't want the stent placed. I don't think it will work and I am a single mom and I have concerns that the stent would be very difficult to live with (pain, more nausea, risks when inserting and removing, risk of migration or perforation etc.)

I can find very little online about people who find they have my issue over 1 year post op gastric sleeve. I know that eventually I will have to make a decision. I am posting this because I have been so frustrated with not finding very much online and if anyone finds themselves in my situation to know they are not alone and to trust your body if you feel that something isn't right don't give up.

I am 5 foot 9 and my weight has dropped to 129 pounds. My goal was 160. I am so thin and I don't even really like to leave my house any more because I feel like people are judging me when they see how thin I am. I look very ill like I have cancer or something. I am angry and frustrated that this is happening when I have invested so much into doing everything I can to make it go "right'". I had VSG / WLS to change my life so I could be a healthy mom for my kids and I am angry and frustrated because I wonder if local Drs had listened to me if this could have been more easily managed or dealt with rather than where we find ourselves now.

If anyone has any input on longer term stents for late gastric stricture or conversion from sleeve to rny for my issue rather than for regain please post. I would really value input here. Thanks if you have made it this far

I would convert to RNY in a heartbeat if I had physical issues that warranted it.

Like Erin, I too would switch to the RnY.

Also though you might want to go in and edit your post to include some blank spaces. You don't have to do it in exact paragraphs. Just put some spaces in different places up there. Otherwise people may not be able to get through enough of it to help you.

I don't have any advice, I just wanted to say I'm so sorry you're dealing with this. It's frustrating that doctors wouldn't listen to you despite you knowing something was wrong. I'm glad you kept pushing and advocating for yourself. Good luck.

A stricture is just that the wound healed over with too much scar tissue. A doctor can open that in a few minutes. It concerns me that the doctor has not done that for you. Getting RNY for a stricture is like amputating your for a hangnail.

While RNY might be the best surgery for you, opening the stricture should be the first step. At this point it might take two or three tries to get it open and staying open. RNY can also form a stricture.

I've done my research on strictures. I realize rny can develop strictures. My sleeve is bent at the stricture. Where the stricture is located, length and origin make a difference. I disagree with your opinion after what I've read about the context of my situation but thanks for sharing your opinion. I just thought I'd clarify balloon dilation is not an option and why. My surgery was in Mexico and I live in the United States. My original surgeon will fix this if I go there and what I've read verifies his opinion. He is an experienced surgeon and I trust him. I'd hoped to receive care closer to home but it may not be an option. Hope that clears a few things up

I am confused. Did you move? You mentioned a new surgeon and then you mentioned your original surgeon.

If the local surgeon only does lap bands, how are you going to get the RNY? Are you going to go back to your original surgeon?

I would not do a stent.

If I can't receive care close to home I will return to the original surgeon it is just further away

I'm sorry that you have to deal with this BS. It's so maddening to read so many posts on here where patients keep running into docs that don't listen to their concerns or take them seriously. I think you are right to be wary about a bariatric center that pushes bands. Is there a dearth of bariatric centers in your area? Are you near any major hospitals that would have an upper GI/metabolic surgery department?

So, if I am understanding your situation, you had your sleeve done in Mexico, but didn't have a doctor established here prior to aid in your recovery. So when you experienced complications, you went to various general practioners who couldn't or wouldn't help you. Then you got into a bariatric clinic, but you don't trust them (which is probably one of the reasons that prompted you to have surgery elsewhere). Is that generally correct?

If so, for those that may be reading and considering surgery outside the US or otherwise not local, it is imperative to find a PCP prior to surgery that will oversee your recovery. This type of scenario is not uncommon. Many doctors don't want to take on the responsibility of another doctor's work.

With that said, before you make a decision, you need to make sure you have postoperative care nearby. You didn't say why you don't want an RNY, but many VSG patients have to revise to one to deal with ongoing GERD issues. If you search OH for VSG revisions, you will find many threads about it. If you decide on this option, will or can the local center do this, or at least be available for your postoperative care?