EROS Appointment Update
Hi All:
I had my firsd appointment with Dr. Bessler's office today at Columbia-Presby. and here's what happened. I met first with the nutritionist, Nancy, who seemed very knowledgeable. We went over my diet, exercise, and supplements and she pointed out that I am not getting enough exercise and that I eat way too much saturated fat. This is an ongoing struggle in my head with the carbs. vs. calories debate. I'm more prone to eating protein but lately I've been straying from lean protein and on to full on fats protein e.g. sausage and I have the elevated cholesterol levels to show it.
We went over the 4 criteria to qualify for the study. I clearly meet the first three (though my BMI at 38.5 was a little lower than needed for the study). As for the 4th, it involves having a stoma size of at least 20mm. I went for a barium swallow in Radiology which they had to repeat to get additional pix. The doctor said that my pouch and stoma had completely failed. Staples had come undone, there was leakage, and, as I interpret it in layman's terms, a large section of the remnant stomach that wasn't supposed to be visible was clearly visible. I suspect I will meet that 4th qualification based on this.
The hospital will let me know this week if I qualify. If I do, they will bill my insurer. If the insurer rejects the claim then the program sponsor will contribute $9K toward program fees. If, for some reason, my stoma opening isn't large enough to accommodate the endoscope used in the EROS procedure, then I can head over to Lenox Hill Hospital where Dr. Roslin has begun a similar program for people with smaller stomas who've had significant regain.
Based on today's appointment, I am not considering DS anymore. I really think I have a shot at managing my weight with the EROS "tune-up" and by implementing the above lifestyle changes. I feel more encouraged about my situation than I have in months.
Finally, Nancy told me that the instruments used for the EROS procedure have been FDA approved. This study is being conducted so that insurance companies will pay for the procedure as a revision.
EROS is an acronym for Endolumenal Revision of Stoma (or of Obesity Surgery). This is the description of the procedure found on Columbia's website:
"The procedure uses FDA-cleared endoscopic instruments to decrease pouch and stoma size and recreate a restriction to encourage weight loss. It does not require surgical incisions. In the procedure, an endoscopic suturing device is introduced through the mouth. Sutures are placed in the stomach pouch and stoma to reduce their size which slows the exit of food from the stomach pouch, enabling patients to better restrict food intake and reverse their weight re-gain."
My layman's understanding of the difference between Eros and stomaphyX is that Stomaphyx uses a polypropylene fastener to reduce pouch/stoma size whereas EROS uses sutures. Perhaps someone else with additional knowledge about these procedures can comment.
I just got a call from Columbia-Pres. They told me that because I've had a significant staple line disruption I need a full revision of the original RNY and not the Eros procedure. I'm supposed to call Dr. Bessler in the morning for an appointment. Maybe it means this time I'll be transected instead of just stapled which is likely the cause of the failure. I'm wondering what happened to those loose staples and where they went?
Kelley,
I'm so sorry to hear about the staple-line failure. It's a good thing you started checking out haing a revision, otherwise you may never have found the real problem. Where will you have the revision, at Columbia Presbyterian? Will Dr. Bessler do it?
I still may have a chance of having the EROS procedure. I have an appointment with Nancy and the barium swallow on 8/15 and I'm to see Dr. Bessler on 8/16. He'll review the results of the swallow, and go over the GERD problem. He'll decide whether I get EROS or another procedure.
Wish me luck
Nan C
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