Sphyx follow up with Dr. O -disappointed

Aww Pat, I do feel for you.  The money I spent for the SPhyx was the hardest for me to let go.  I have a kid going to college next year, so you can imagine my quilt in being selfish... Anyway, I don't know what procedure is right for you.  If I had the choice of the RNY or the DS when I had it done (I didn't know about the DS at that time,and my doc didn't tell me).. I would have gone for the DS.  Too late for me now.  My orig surgeon doesn't do ANY type of revisions.  Are you considering your original surgeon to do your revision?  If not, do you have one in mind that your insurance will cover and do you mean if you go with a DS that you are sure that insurance will not cover it?  I know you have a tough decision to make and I wish you luck and maybe a higher hand of wisdom will touch us all to help us through this :) T oh btw... I think it does make some sense that if a stomaphxer was NOT producing the expected results, that it would be best to not include her in your follow up.. you know.. the black sheep of the group?  Just ignore her and she won't ruin the precious success rate numbers.... hmm, something to think about..

Thanks, Tina. The best surgeon in VA for a DS is not covered by my insurance, although he says he can work with them and maybe reduce the cost. I don't want to base any decision this big just on finances, but I have to be realistic too. I did not want my original surgeon to do the revision, and the one I saw last week (and who sent me for the upper G.I.) will see me this Thurs. and decide, but I am not sure I want him to operate on me.....and yes, I think Dr. O prefers the "black sheep" (those of us for whom the surgery did not work) to be left out of his otherwise successful statistics....

My take on what to do.  I had proximal RnY 2.5 years ago. I stopped losing at 8 months out, then last fall strarted a regain and have gained 40 pounds .  I am now seeking a revision to a DS. It is not too late. I do have to travel 3 hours by car to get to the surgeon I will be using.  Dr. K is an expert in doing revisions to DS. The only downfall he does charge four grand for a revision. I think in the end it will be worth it for my health, but am having a bit of trouble getting all the money together.  The DS, though, in my opinion sounds like the best way to go in order to get this weight off and keep it off. I wish I had known and pursued it in 2005.  Check out the DS forum here on OH or duodenalswitch.com and read all the ins and outs. Though some mention malnutrition problems, from what I have found it, there is very rarely any problems like that if you take your vitamins regularly. I am not saying NEVER, but then again the RnY can cause problems too, as well as the lapband with erosion and slippage.  It just depends what you are willing to put up with.  This surgeon I am going to see, Dr. Keshishian, said that upwards of 55% of people who have had the RnY will fail or the surgery actually will fail them.  With lapband, more so, there will be failed attempts to keep the weight off.

Pat, I'm so sorry that you too have had the same results with Dr. O.   I trusted him, totally.  I don't know if that trust was due to the fact that I needed something... someone to help me.  I was willing to go or do almost anything and I think that these doctors know that we are that desperate and may be taking advantage of us for quick easy money (come on... 20 min work for $9000 ? - does anyone else make that kind of money???)  I am so upset with the doc, but about the procedure, I'm torn.  I'm having a real hard time only eating 3 meals a day.  I can feel a little more restriction that I had before, but am still eating things I should not be.  I have rejoined the gym (and yes, have been going..lol)  which is helping me I know.   I just don't know how I feel.  Like I said, I trusted Dr. O, but thinking back, he was VERY willing to talk to you on the phone (I had 3 diff conversations with him directly) before I went down there.  I thought, wow.. how unusual is that, and he was willing to do the procedure without an EGD or any tests.  I am so sick of making poor decisions... This stompahyx.. is it the answer we've been searching for? Or a money making scheme created by the partnership of surgeons and the medical companies creating these devices?

I've posted my comments in the past about the different doctors I consulted with regarding StomaphyX. There are definitely MDs who are in it for the money. Dr. O tracked me down by phone, wanted to do the procedure in less than a week, and said the other doctors were just out for the money by wanting an UGI. He said that if I could eat 1 1/2 cups of food then my pouch was stretched out and I needed StomaphyX. I chose another MD who evaluated my UGI and determined that my pouch was too small for StomaphyX (not stretched out at all!) and I would be wasting my money. I'm concerned that this procedure is getting "bad press" when some of the people who had it done may not have been the best candidates for this particular procedure. Maybe it's not the StomaphyX that failed, but the MD.

Just curious, you said that some patients pouches may have been to small for the stomaphyx to begin with...  how is this bad press for the procedure?  If the pouch was small to begin with, then making it smaller would be an even better chance for success.  I don't believe whether the initial size of the pouch is too big or small, that it would be the stomaphyx that is producing the results. IF you are shrinking the pouch in any wayl... the results would be from the procedure, not whether you were a candidate or not.   These pro / con posts about stomaphyx is EXACTLY why the insurance companies are not covering it..   It is NOT PROVEN to be successful...  which is exactly what we are seeing with the few posts where people are being honest. I am not giving up and will continue to work it the best I can.  Good luck to you too. T

By bad press I mean that some people are saying it doesn't work and they are very unhappy. That may be true- maybe it didn't work. But I just want everyone to know that not all patients are being screened in the same way. I'm sure I would have been one of these disappointed people if I had been convinced to have this procedure. I was devasted that I couldn't have it done. I don't know how unique my situation is but my pouch was over dilated by a physician when dilating a stricture. This was at 3 months out from RNY. I have a huge stoma but my pouch is very tiny. The StomaphyX reduces the size of the pouch and indirectly rediuces the size of the stoma by pleating the pouch just inside the stoma. My pouch is not big enough to pleat and try to reduce the size of my stoma. I'm trying not to take offense to your comment about not believing initial pouch size matters. My pouch is the same size that it was on the day it was made- about the size of a thumb- but because my stoma is huge nothing stays in my pouch to cause any restriction in my eating. I think that if patients were properly selected for this procedure, the success stories would be the ones we would hear more of. It hurts me to see people disapppointed like they have been.

This is a bit off topic....but I'm mystified by the advice to eat only 3 meals a day of 2/3 a cup.  I certainly couldn't do that.  (I had my stomaphyx with Dr Schlesinger over a month ago.)    I haven't really discussed what he thought I should eat.  (I had a follow up at 2 weeks while I was still on liquid and I don't have another one for 2 weeks.)   And, well, it never occured to me to ask if there was an official diet.  I've been very happy on 1100 to 1200 calories a day split up in a lot (6 or 7) mini meals of 100 - 150 calories (which is the point at which I just start to feel satisfied).  I just trusted that this was a tool to help me be satisified with a reasonable number of calories and ANY sound diet would work.   Me, I'm a calorie counter.  I make sure that my 1100-1200 calories includes a minimum of 100 g of protein, 25 g of fiber and not more than about 20 g of fat.   Other than that, I've been eating ANY I want.  I have had a mini powdered donut (60 calories) one day, grilled chicken EVERY day and a lot of fat free pudding and some air popped popcorn.   All of which keep me full for 2 or 3 hours.  (At which point, I just eat again!)   I didn't think that 3 meals a day was even sound dieting advice anymore.  I thought almost every program recommends 3 meals and 2 or 3 snacks a day?!?   Well, if that WAS the advice, I'm certainly glad I didn't know about it!   I'm happy with what works for me.    I will have to ask Dr. Schlesinger his opinion on my next followup (which, it a lot of ways seems silly because, other than weighing me, there really isn't anything to do.)   And I weigh myself PLENTY at home. As for followup with Dr Schlesinger, he is always enthusiastic at my brief followup appointments and his staff (especially Kathy and Joyce) have been exceedingly quick to respond when I had a question so I never actually TRIED to talk to Dr Schlesinger other than scheduled appointment times.   Just my two cents worth, Lorri

Hi Lorri, I'm glad that you are doing well with it. Nice to hear for a change :-)   I always thought 5-6 mini meals were best too.  Hey.. you do what works for YOU.  Good for you and I wish you continued success! Tina

Hi Janelle, Please don't take offense.. :(   I didn't mean to imply that it doesn't matter as to the size of your pouch being too small.  I just meant that if someone's was too small, and the doctor did it anyway, then it still should further restrict.  I'm glad that your doctor found that the stomaphyx wouldnt' be the best course of action for you.  I'm not sure, in fact I know, that not all doctors would deny themselves a quick buck and NOT do the procedure.  I think that speaks bigger volumes than all these dr's who are doing it, but will not follow up with their patients.  It just really makes ya wonder what their true intentions were.,, My pouch was over 60cc, and the stoma was double the size it should be.  Which, by the way, I knew at 7 months out when I was always hungry, and never full. I wish I had known this 3 years ago, and maybe I wouldn't have been so depressed and angry at MYSELF for failing. I hope that you and your doc can find a solution for you.  I'm sure there is one out there, and again, I am sorry. T