Is it vanity?

I have not been on here in years.  Back when I had my RNY (2001) OH was just starting up.

The reason I am here (unfortunately) is due to weight gain.  I started 353, lost down to 180 and had a stable weight of 200 for 11 years.  In the last year and a half I have gained 55 pounds.  I have been under huge amounts of stress due to a doctor sexually assaulting me.  Lots of legal stuff related to that and I had three dogs die in a four month period in a tragic manner.  I also found out I had kidney cancer and epilepsy.  Yes, it's been a tough year.  I suppose that is why I gained the weight but I've been so stressed out that I don't even know exactly how I gained it.  I'd like to say it was related to the cancer but I doubt it.  I also have clinical depression with suicidal ideation, only since this regain.

Ok, so I am scheduled to have the RNY converted to a long limb bypass on July 1st (common channel = 150).  I have done all of the required things by my insurance company.  Then, two things happen that scare me.  Both involve bathroom incidents with DS patients I've come in contact with in the last couple of months.  This is where the ? comes up to me of whether or not I am vain for worrying about such a thing.  I assume that I don't need to explain the word "foul" on this board HAHA but let's just say I walked into the lobby of the hospital and instantly detected a smell which, to me, smelled like death - something rotting.  I asked my husband if he smelled it too and he did. We went down the hall at least 50 feet and there was a public restroom, single stall.  I had to use said restroom, and never in my life have a got dry heaves from smelling a BM but I was gagging and had to pull my shirt up over my nose to use the restroom like a kid in 5th grade.  So, you get the picture.  Then I have a friend who had the DS and has the same odor.  She is a teacher.  One of the faculty members came to her and asked her to stop using the faculty bathroom.  Her only other choice is to go in with the students to their restroom.  You can imagine the embarrassment related to this and what will happen when they realize the smell is coming from her.  You get the picture here.

So, yesterday I talked to the nutritionist and I asked her about this and she of course said she couldn't make any promises, that it could happen and it could not.  Might be food related.  Told me all of the possibilities to manage it, Poo-Pourri, Devrom, Ozium etc. 

I have to be honest, and please don't yell, I am considering not having the surgery.  The main purpose of this surgery is to stop the Type 2 Diabetes.  I am 5'9" and 250.  Wear an 18.  I'm nowhere near where I started back in 2001.  Is it vanity?  Have any of you walked into a bathroom after a DS BM and experienced the same thing?  Do you think if he made a longer common channel my chances of developing this would decrease?

PS - You may wonder why I am not going to a full DS.  My initial RNY had complications (fistula) one year post op.  The stomach had to be cut and stitched a second time.  The surgeon does not want to cut the stomach a third time so my only option is to go to LL RNY.

Normal BMs for many of us is once or twice before work and we're done for the day. I have to wonder if the folks you know aren't giving themselves enough time in the mornings to clear their systems or if they are eating carbs, gluten or sugar alcohols that are really messing them up. Most don't have the issues at work you're talking about but we can have bad gas at night. There are ways to fix this though; probiotics and lots of them. I work in a professional business environment and have to travel on business as well,and haven't had an issue yet in 6 1/2 years. I stay low carb and low or no gluten. Also, if you take enough calcium and iron, you're more likely to have to deal with constipation than loose stools. 

I follow Vitalady's DS vitamin plan and have tweaked it to go with my labs over the years; no nutritional issues since I switched to her. 

I wouldn't suggest anyone is more concerned with vanity than their health when they come here a bare their soul as you have. Do what you have to do for you. Please keep us posted.

--gina

You already got some great advice, but I have a question - how to you know that the awful smelling bathroom at the hospital was related to someone with a DS? Are you assuming this just because, one time, you smelled a similar smell from someone known to you with a DS? Do you think only people with the DS can have a foul smelling stool, or that just maybe there could be "normal" people, or people with other conditions, who might have the same issue?

I can assure you that the type of smell you are describing is not the norm for me, can't speak for anyone else. I can also assure you that I have smelled really awful smells from people that I knew had not had a DS, including a dear friend who has RNY. I'm glad you haven't had that happen to you with your RNY, but she has. As the nutritionist told you, there are no guarantees.

I sounds like your primary reason for wanting further surgery is for your health. That's the best possible reason. Ask yourself how your health is going to progress with surgery and without surgery and make your decision. You don't get any guarantees if you decide against surgery either.

Larra

I made a tough phone call to my friend with the DS and asked her to be frank with me.  She confirmed that the smell came after her revision from RNY to DS.  She has had the principal contact her and want to talk to her about "hygiene issues."  She has all kinds of teachers talking about her and making fun.  They assume it has something to do with something she is NOT doing like showering, using deodorant, etc.  She also confirmed one of the other things I've heard about and that's the body odor.  It is a sour milk smell, reminds you of when a baby spits up milk.  She said no matter how much she brushes she cannot get the smell to leave and uses mints.  The smell also comes from her armpits.  

I am a severely depressed person.  Maybe if I were in a better place I would be able to say "who cares what they think" but I'm just not there right now.  This brings back memories of childhood which I'm sure most of you are familiar with, being made fun of.  I feel like people are looking at me now just for being "fat."  If my boss were to have to come to me and ask hygiene questions because other co-workers complained I don't know how I could continue to work there.

As far as her routine in the morning, she does go, but she has to go several more times during work.  She has very thin diarrhea and has since her surgery in 2009.

Yeah, there are so many variables.  I don't have the issue with the odor myself.  I realize it is exact science but I want to know what exactly *could* happen so that I know ahead of time if this is something I could cope with.  I asked my friend if she ever tried the Poo-Pourri which we have here at the house and she said even it does not make the smell acceptable.  

I am sorry both you and your friend are having a tough time of it, each in your own way.

I can only tell you that this is not my personal experience, and that I have attended support group meetings with a whole large room full of DS post-ops and not noticed the body odors or bad breath you are describing. I don't know why your friend is having these problems and wish I had some help to offer.

would these things happen to you? I can't say. On the other hand, what will happen without surgery? More weight regain? Complications from your diabetes? Worse depression? I can't say on those issues either. You have a difficult decision to make.

One other thought. I have no idea what surgeon you have spoken to, but would recommend that you consult with one of the few surgeons experienced with RNY to DS revisions. It's a very challenging operation that most surgeons don't do. Of course I have no way of knowing whether or not it would be possible, given your prior complications, but then again, neither does the surgeon who already decided against it, and who may be someone who has never attempted a RNY to DS revision at all, which could influence the advice he's giving you.

Depending on where you are, I would suggest either Dr. Keshishian in Glendale CA (near Los Angeles) or Dr. Rabkin in San Francisco, or dr. Roslin in NYC. They all do lots of RNY to DS revisions.

Hi Larra.   I am in PA.  Been seeing Dr. Bonanni in Philly.   Have you heard of him?

I have heard of him and my surgeon actually trained him in Northern VA, Dr Elariny. Dr B isn't known for RNY to DS revisions but he does the DS. Dr Elariny also does RNY to DS revisions. It might not hurt to see Dr Roslyn or Dr Elariny for a second opinion. 

I've heard of a couple of folks having the same issues as your friend. One cleared up the issues by going on antibiotics for a period of time. Another actually had to have the intestinal limb lengths adjusted because the original surgeon didn't do the DS correctly on her.

--gina

Dr. Bonanni is a fantastic surgeon. He did my DS (and another non bariatric surgery) on me 5 yrs ago.  Tell Tim, Noreen said "Hi"

Hi Noreen.  I will tell him you said hi!  At my first meeting with him I told him it was good to finally meet him after hearing such good things about him.  He's like... where did you hear these things????  I told him OH and he laughed.  Do you have any issues with BM as described above?  Do you know the length of your common channel?  Thanks!