RNY to BPD...is DS possible too?
Hello again Everyone. I'm still trying to figure out where I fit in on the boards...DS forum, Revision forum, local? I just don't know.. :-)
I wrote my first message recently explaining that I'm looking into a revision from an RNY to something that I'll have better success since I never lost much weight and gained back what I did lose.
I have only met with the surgeon once and I was nervous and I didn't comprehend as much as I would have liked. I've been trying to read-read-READ as much as possible but I'm still confused. When a doctor does a revision from an RNY to BPD does it also include the duodenal switch? Dumping isn't that much of a concern for me but I DO have bad bouts of hypoglycemia and I hate that. It's an awful feeling and the DS part of the surgery sounds very enticing to me mainly because I have read that wouldn't happen. But if I'm understanding correctly my RNY would have to be completely taken down to do that...is that correct? I know it would be less risky if they didn't have to do anything with my stomach pouch.
Can someone please explain this to me ? I would like to understand it better so that I'm prepared to ask better questions when I next meet with my surgeon.
I'm still getting tests done, I've had a CT Scan, Fluoroscopy (those crystals and the drinks=UGH!) and I'm having an endoscopy on Wednesday.
Thank-you in advance for any help in understanding all of this! :-)
I wrote my first message recently explaining that I'm looking into a revision from an RNY to something that I'll have better success since I never lost much weight and gained back what I did lose.
I have only met with the surgeon once and I was nervous and I didn't comprehend as much as I would have liked. I've been trying to read-read-READ as much as possible but I'm still confused. When a doctor does a revision from an RNY to BPD does it also include the duodenal switch? Dumping isn't that much of a concern for me but I DO have bad bouts of hypoglycemia and I hate that. It's an awful feeling and the DS part of the surgery sounds very enticing to me mainly because I have read that wouldn't happen. But if I'm understanding correctly my RNY would have to be completely taken down to do that...is that correct? I know it would be less risky if they didn't have to do anything with my stomach pouch.
Can someone please explain this to me ? I would like to understand it better so that I'm prepared to ask better questions when I next meet with my surgeon.
I'm still getting tests done, I've had a CT Scan, Fluoroscopy (those crystals and the drinks=UGH!) and I'm having an endoscopy on Wednesday.
Thank-you in advance for any help in understanding all of this! :-)
Tabitha
Have you chosen a Dr yet ?? you really need to finish up your test so he can make an informed decission about what your options are . I never went in and told my surgeon what I wanted ! I asked him what options I had?? You would not be a true D.S.'er since the pyloric valve has been compromised. plus do you want to subject yourself to an extensive surgey with extended risks ??
Plus you need to decide if the consequences are worth it ??? Some people can not live with the issue's that may result ....
You can get lots of opinions here .. But in the end its your Dr you need to communicate and trust to do whats best.
Tabitha,
I'm looking at the same thing except that I had a stomach stapling done back in 1980. I plan to get the opinions of at least two experienced qualified surgeons as to what they reccomend for me before I decide what I want done.
From what I've learned so far, I'm leaning toward the DS, but like I said, I'm going to get two surgeons opinions before I decide.
Kerry
I'm looking at the same thing except that I had a stomach stapling done back in 1980. I plan to get the opinions of at least two experienced qualified surgeons as to what they reccomend for me before I decide what I want done.
From what I've learned so far, I'm leaning toward the DS, but like I said, I'm going to get two surgeons opinions before I decide.
Kerry
Kerry, I'll be watching for your updates!
I do have a surgeon and my final test was supposed to be tomorrow, my endoscopy. But I have an infection and very sore throat so I had to reschedule...rotten timing. My surgeon talked with me about bpd and xrny and of course will need to see the results of my tests first. Based on my experience with the rny I think an extension would not be enough for me to lose and maintain. Thank-you for answering about the pyloric valve, that was the part that was confusing to me. I sure would love to have the hypoglycemia go away...it has put me in scary positions a few times and I hate when it happens.
I do have a surgeon and my final test was supposed to be tomorrow, my endoscopy. But I have an infection and very sore throat so I had to reschedule...rotten timing. My surgeon talked with me about bpd and xrny and of course will need to see the results of my tests first. Based on my experience with the rny I think an extension would not be enough for me to lose and maintain. Thank-you for answering about the pyloric valve, that was the part that was confusing to me. I sure would love to have the hypoglycemia go away...it has put me in scary positions a few times and I hate when it happens.
Tabitha,
I asked Dr. Ungson about about what the chances are that my plyloric valve will work and he said that they wake up immediatly as soon as food is introduced unless the nerves are damaged. In my case we already know it's working because of the leakage between my pouch and lower stomach so that won't be an issue.
The thing I have to worry about is scar tissue because of the pulled out staples, you can see them in the xrays and they are just splayed out all across my stomach and I have no idea what sort of problems they will cause.
I really like the DS option becuase of the normal eating and malabsorbtion, but will have to wait and see if it's really an option for me.
Kerry
I asked Dr. Ungson about about what the chances are that my plyloric valve will work and he said that they wake up immediatly as soon as food is introduced unless the nerves are damaged. In my case we already know it's working because of the leakage between my pouch and lower stomach so that won't be an issue.
The thing I have to worry about is scar tissue because of the pulled out staples, you can see them in the xrays and they are just splayed out all across my stomach and I have no idea what sort of problems they will cause.
I really like the DS option becuase of the normal eating and malabsorbtion, but will have to wait and see if it's really an option for me.
Kerry
Kerry
From listening to ex-RNYers I think the way they do the DS is firstly to reverse the RNY. Your stomach shape is returned to normal, before being given a sleeve gastrectomy to make it smaller and banana shaped. However they can only do this if your pyloric valve still works - the longer you've had RNY the less use you've made of your PV and the less likely it will 'wake up' after the DS. Its this valve that stops DSers dumping, because it controls how much food passes out of the stomach, unlike the stoma in a RNYer which is just a hole really.
The second part is to replumb your intestines, to give your body less time to absorb food. Usually DSers have only 100cm of intestine where food and enzymes mix, which is much less than RNYers.
So if your PV is shot, you'll end up with a RNY pouch rather than a DS stomach. And because RNY pouches tend to be smaller than DS stomachs, you dont want as much malabsorbtion (because you're already taking smaller amounts of food in) so some surgeons will just make your RNY more distal - like a compromise between the proximal (normal) RnY and the DS.
I've re-read this and realised I'm a total WLS nerd....hope it helps.
From listening to ex-RNYers I think the way they do the DS is firstly to reverse the RNY. Your stomach shape is returned to normal, before being given a sleeve gastrectomy to make it smaller and banana shaped. However they can only do this if your pyloric valve still works - the longer you've had RNY the less use you've made of your PV and the less likely it will 'wake up' after the DS. Its this valve that stops DSers dumping, because it controls how much food passes out of the stomach, unlike the stoma in a RNYer which is just a hole really.
The second part is to replumb your intestines, to give your body less time to absorb food. Usually DSers have only 100cm of intestine where food and enzymes mix, which is much less than RNYers.
So if your PV is shot, you'll end up with a RNY pouch rather than a DS stomach. And because RNY pouches tend to be smaller than DS stomachs, you dont want as much malabsorbtion (because you're already taking smaller amounts of food in) so some surgeons will just make your RNY more distal - like a compromise between the proximal (normal) RnY and the DS.
I've re-read this and realised I'm a total WLS nerd....hope it helps.
DS revision from failed lapband
Hey! Nerds are great! LOL,
I think you have very good knowledge of WLS and I do appreciate your thoughts.
I should have more information in a week or so after I have the Upper GI Endoscopy done and have a chance to discuss my options with a couple of surgeons. My hope is to get my PV back, but what ever it is, it is.
Kerry
I think you have very good knowledge of WLS and I do appreciate your thoughts.
I should have more information in a week or so after I have the Upper GI Endoscopy done and have a chance to discuss my options with a couple of surgeons. My hope is to get my PV back, but what ever it is, it is.
Kerry
Thank-you both for posting this information, it is helping me to understand things more clearly. I'm so disappointed that I had to reschedule my endoscopy! I should have been there now but I have the worst sore throat I've ever had in my life and it's been going on for a week and they thought the timing was bad. I'm on antibiotics but they are not helping so far and they thought between my throat being swollen and the risk of infection being pushed down that I should wait. I hope I can get rescheduled quickly, I waited a month for this appointment.
Kerry, I hope your endoscopy finds everything looking good and optimal for the surgery! I have no idea about my pyloric valve....I guess it hasn't been used in 8 years now since my RNY. I just want to know either way what my options are, I have so much anxiety wondering and worrying what the results will be.
Thank-you again for both of your posts. I love WLS Nerd help! :-)
Kerry, I hope your endoscopy finds everything looking good and optimal for the surgery! I have no idea about my pyloric valve....I guess it hasn't been used in 8 years now since my RNY. I just want to know either way what my options are, I have so much anxiety wondering and worrying what the results will be.
Thank-you again for both of your posts. I love WLS Nerd help! :-)
My surgery is scheduled for Dec. I had a VBG in 1996 and like you lost and gained and gained and gained! Dr. Overcash(Ocala, FL.) told me that he plans to do an RNY, but if he can't he will do the DS. I too post on 3 boards, because I don't know where I fit in either. The good news is that wherever I post, people are always freindly and helpful, so good luck.
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