Advice?

HI everyone,   I’m new here and hoping to get advice. I have another account on here, but am afraid of condescending/degrading remarks I have gotten in the past…   I had Lap RNY 2 years ago OOC. I was back in the USA in the hospital with dehydration and malnutrition (never thought I’d hear that!) because of a stricture and ulcers. After about 4 scopes I was put on Remeron to help keep food down. I was a lightweight to begin with.. started at 235- but had PCOS that was getting worse. I dropped down to 165 with my gallbladder surgery, and have gained back to 195.   I have seen the obesity centre in Ottawa for help, and was given an upper GI, it showed that the anatomy was ‘that of a Bilroth I and not RNY’. I’m NOT saying my surgery was done incorrectly.. I’m saying that’s how it is now (trying to stay out of trouble…) My stomach was described as an ‘upside down funnel’ and all the food was emptying into my bowels too fast, as I was hungry every hour (just about). I was given a scope to check things out. The surgeon was on the side of the departmental head.. that nothing was wrong and the surgeon didn’t make any mistakes (which I never said he did.. I just wanted help).   I have since reached out to Dr. Gagner who is to get my GI pictures today and take a look.   I contacted the hospital’s patient advocacy group who got me referred to HRRH for a second opinion (as the head of the department originally denied my request- and offered me THEIR weight loss program (optifast) to lose weight..)   I’m just wondering if I have any other options? I’m 26 and can’t afford to pay for a revision, but not sure if Dr. Gagner can help me fight OHIP or who I would even contact?   ANY help or advice would be greatly appreciated.   Thanks for reading everyone.

I think the first step, if at all possible, would be to get a copy of your operative report, even if it's in a foreign language.  Any potential revision surgeon would want this. It's not a substitute for the tests you have had done, but it might be helpful.

A Bilroth 1 isn't a wls. It's an operation that used to be done for ulcers, back in the days before all the great meds we have now became available. It involves removing the lower half or so of the stoma*****luding the pylorus, and connecting the upper half of the stomach to the duodenum.
    I think what they are saying is that the connection between your pouch and your jejunum is a loop rather than a RNY. Of course, I could be wrong, having never seen your x-rays or scope, but there is a wls called a "mini gastric bypass" which does this. It's never been accepted by the AMSBS or any other major medical organisation, but there is one guy in the USA doing it, and possibly others OOC. 
   
     Bottom line, you need an experienced revision surgeon such as Dr. Gagner to sort this out, and figure out what can be done surgically to help you. My understanding from other Canadians on this forum is that he has helped with appeals with OHIP, and I hope he can help you.

Larra

You need to get in to see Dr. Hong in Hamilton, he is the only Ontario surgeon who does the DS and the only surgeon who might even consider recommending that as a revision. He has referred several OHIP patients to Dr. Gagner. Dr. Gagner can't really help you fight OHIP, you need to get in to see a surgeon, tell them you're interested in a DS revision and that you want to see a DS surgeon to be evaluated - which means a referral to Dr. Hong. If Dr. Hong says no, then you have to go to the appeal board, but the experience of other people is that the appeal board never finds in favour of the DS if you don't meet the OHIP criteria. One woman on the Ontario board had Dr. Gagner and another surgeon testify on her behalf at her appeal (she spent $7500 on her appeal) and she was still denied because she didn't meet the OHIP criteria (virgin surgery, BMI too low). Basically, if you can get to Dr. Hong, you have your best shot as he has approved some revisions in the past, but if he says no, you're looking at self pay with Gagner for $18500.

sorry I dont know enough to help out but.....

 I have another account on here, but am afraid of condescending/degrading remarks I have gotten in the past

so now people have to start another account just to ask a question so they dont get picked on or hate mail..

really people grow up!

Thanks for the enhanced access.

Chill the **** out.

A Billroth I:


Your pylorus is GONE if you've had a Billroth I.  A proper DS is not an option.

Oh Lordy, I hope that's not the case :-(.

Need to look at something else,,, if you had a Billroth l your pylorus is no longer there !!!

You also need a VERY good surgeon to correct it so you do not Have your"upside down funnel" , that and better meds....