Hubby wants a revision, but not to DS because of me.

About 7 years ago my husband had an RNY done. He weighed in at the time around 400 and lost to a low of 250 ish (he's 6' tall). For his frame it was a good weight. Of course as with many RNY's he has gained a significant amount of weight back, something near 80, possibly 100 pounds. He is now looking towards a revision, however, because of my tramatic and lengthy revision post op journey he is NOT looking to revise from RNY to DS. No amount of talking about it will change his mind. He's set for a BOB or a stomaphyx. I've told him that our insurance doesn't pay for the stomaphyx or ROSE procedure, yet he still talks about it. (fine...whatever). I've told him that he should go see my surgeon since he's done lots of revisions, but he is concerned about the distance and the fact that I don't drive and the daughter is in college and isn't available to drive home from the hospital if he did in fact have surgery 2 hours away. As a result of all of this he is now looking into a "revision" closer to home. No one, in my experience, here in the Allentown, Bethlehem, Easton area performs revisions. He's got me looking into Allied Surgical Group in Morristown, NJ where his original surgeon did his RNY. I feel that all of this is foolish, but we have gotten into so many arguements about this that I just feel that at this point he should just do what he thinks is right. No amount of information given to him, leading to  begging or pleading with him is going to get him to have a DS, this I am certain of. Besides his weight gain he currently suffers from reactive hypoglycemia, rapid emptying and insatiable hunger all from his RNY.  Been there...done that.

Does anyone know of this group of doctors (Allied Surgical Group) or heard anything about revisions from them? I'm well aware of the revision pitfalls even with a doctor who has performed many revisions and I know the vetted doctors who perform the RNY to DS revision, but I'm looking (per my husbands request -- if he had the time he would be doing it.) for other alternative revision doctors. Truthfully I feel just ill even having to ask knowing what I know.

My secret hope is that he will find that finding a doctor to revise him to something like a BOB difficult and he will start thinking other avenues. Any help would be appreciated.  Also, I have heard of RNY to RNY. What the heck that is escapes me. Any ideas? 

I've put this on the revision board too not that I expect to get a great deal of education from that board.

Do chime in.

Oh, of course he knows I am not typical, but he is a worrier and afraid that something similar might happen to him and given that he is the breadwinner of the house he worries that if something long term and chronic did happen to him we would be in a world of trouble.  I really think what is going to have to happen for him is that he finds out all the information and then will come to the only revision conclusion one can come to, which is a DS.

No help to offer but just wanted to lend you what I do have which is support.

You and your hubby will be in my thoughts and prayers that he comes around and after research makes a better choice than anything as risky as revising to BOB or a stomaphyx. Of the surgeons I've been researching for myself most won't even do those surgeries.

Happy thoughts for you!

Brenda

I can appreciate his point of view, after he's seen all you went through...but I would like to point out a couple things: (knowing you may have pointed out some or all of this already)

1) if he has reactive hypoglycemia, etc, anything that doesn't alter his stoma permanently won't fix these problems. Even "fixing" the stoma, i.e. making it smaller, won't necessarily fix these problems. What is the point of having any kind of revision, however low the risk, if it doens't fix the problems?

2) stomaphyx, ROSE, etc, don't work. They don't even work short term, let alone long term. People do lose a little weight from being on a liquid diet for a couple weeks after the procedure. That's it.
    With any procedure, you always need to weigh the potential risks vs the potential benefits. If there are no potential benefits, there is no point in taking even a small risk. And that's aside from the financial considerations. Since these endoscopic procedures are considered experimental and have NEVER been shown to provide any benefit, no insurance I know of covers them. Not just your husband's insurance, no one's insurance. And the going rate, last I knew, was 10K. For no benefit, just more disappointment.

3) I haven't seen any statistics regarding results of band over bypass. Frankly, I think it would just add another potential set of problems (all the band issues) to the set of problems he already has.

If he can find a surgeon who can truly "fix" his RNY without getting cute with unproven/experimental/no good results even seen procedures, maybe that would be an alternative to DS. There is no question that the risks of RNY to DS are substantial. But these other, more gimmic-y procedures are, IMHO, nothing but a waste of time, money and energy.

Since he isn't listening to you, you can tell him I said so.

Larra

All I can say is that I hope over time he will change his mind. Maybe if he sees others who have had a revision to DS and been ok he may start to come around. I had rny and stopped losing weight after 6 months. After working with my surgeon without any success to lose the weight he decided to do a revision to a distal rny (made pouch smaller and bypassed more intestine). He told me the fat should just melt off of me, but unfortunately I only lost 36 more pounds but gained reactive hypoglycemia. I then decided to go back and fight for the DS since I was told that would fix the hypoglycemia. When they did my independent medical review they basically said that they shouldn't have done a revision that is similar to the first surgery because it wouldn't work. I've also never seen anything positive about bob or stomaphyx and nothing about it helping the reactive hypoglycemia which is dangerous as you know. I have to be completely honest with you when I say that your story had me very afraid to have a revision to DS, yours and a couple of others. I did know thought that I was very afraid of the hypoglycemic episodes that I had been having too so I went ahead with the revision. Dr Rabkin here in CA did my revision and I couldn't be happier. It is possible to have complications from any surgery that he decides on. I just hope that he will decide to take that risk with the surgery that is more likely to actually fix the problems that he is having.

I know I haven't helped but I guess I just want him to see that there are some of us out here who have made it and without the complications. I have not had one single episode of hypoglycemia and I'm below goal.

 Topic: DS vs RnY

refer him to this bookmark for starters and keep talking to him and dont let up letting him know you cant support his decision based on all the info you know at this point. Hold tough on this and don't let up. It will be for his own good the rest of his life. Treat it like it is that serious and pull out all the stops to get him to listen to reason!

 Maddy
Doesnt Greenbaum do a distal RNY now. He doesnt put the stomach back together anymore when he does  a revision I dont htink. He should go see him.  

i understand his fear, but you were the extreme.  :)

Donna

Hey there Donna. I email Dr. G and apparently he does to an RNY to RNY revision. He makes the stomach pouch smaller, fixes the stoma and makes the intestines more distal. I am going to call him tomorrow and make an appointment for me for a follow up and for hubby for a consult.