Is this the right place for me....long post??

Hi everyone, I've had quite the wls saga and I'm trying to figure out where I belong.  It seems my surgeon or the weight management center's team doesn't have much of a clue either and other then the dietitian they are not at all supportive at this point.

I had band surgery in August 06, I was so excited about the surgery, I did all the testing, lost the weight required etc.  I did well for the first few months losing weight slowly but steadily.  They began filling the band and by November I began to experience fairly intense acid reflux with very little fill in the band.  The WMC staff changed my medication to protonix and filled the band slowly.  By February 2007, the acid reflux was untenable requiring sleeping propped up and doing mostly liquid eating.  I tried the usual, eating earlier in the evening, watching what I ate at dinner, etc.  I believe I had maybe 1.8cc's in a 4cc band at that point.  But I was miserable and planning a vacation trip to Belize.  I had the six month check up appointment with my surgeon, he listened to my concerns and ordered me to have an upper GI he suspected the band had slipped.  About five days before leaving for Belize I had the upper GI which showed a very swollen esophagus.  So ultimately they removed all the fill in the band, ordered another upper GI in a month to see if my esophagus responded to removal of the fill.  Within about 48 hours the acid reflux was gone as an aside I had an awesome trip to Belize.  In early May 2007, they started filling the band again, by the time I had about 1.2cc's in the band severe acid reflux was back with no real restriction.  To the point that I would wake up in the night with vomit coming out of my mouth, not vomiting just coming out.  After another upper GI in July, they felt that I had another hiatal hernia, they had repaired one during the band surgery the previous year and that they might move the band.  So another surgery in September of 2007. 

Following the surgery, two of the WMC surgeons operated on me, they found no hiatal hernia but decided to replace the band and reposition it with the larger 10cc band.  Following this surgery I was miserable, I developed hives from a medication, and I was just exhausted.  My recovery was very very slow.  I began seeing a dermatologist as the hives just wouldn't go away.  After several visits he ordered blood work and it turned out I had a high antinuclear antibody test which would indicate I have some type of auto immune disease.  Meanwhile the WMC began filling the band, I honestly don't remember how much was added with the first fill but I had no acid reflux at that point.  The dermatologist sent me to a rheumotologist who eventually diagnosis ed me with a form of scleroderma called CREST Syndrome but I have few of the symptoms, but a big one for most autoimmune disease is acid reflux but truthfully I never had it before the first band surgery.  The other symptom of severe fatigue probably explains the extreme fatigue I felt for months following the surgery and still feel.  So again I see the surgeon after six months, very little fill has been put in the band with little restriction, truly I can eat anything, I still try to avoid bread, pizza, pasta but I could eat them.  Lobster, steak, shrimp are no problem.  I do chew them well but no issue at all.  But there was a return of the acid reflux, I am not sure if related to the band or the CREST Syndrome.  There are those people/medical staff who suspect that my auto immune disease has been caused by the band itself or the silicone in the band.  When I saw the surgeon and explained my new diagnosis he immediately felt that he wanted to remove the band.  He told me he wanted to consult with the other surgeons in the practice but felt there was too much risk of permanent damage to my esophagus.  Again most auto immune diseases cause issues with the motility or the movement of the esophagus.  The surgeon spoke with me about the removal of the band with the thought of the conversion to a gastric bypass.  I am a diabetic and I am hoping to avoid any damage related to the disease that I can.  I also wanted to avoid insulin. 

So now my surgery has finally been scheduled to remove the band and convert to gastric bypass.  I've had limited contact with the WMC, mostly only with the dietitian.  They did ask that I see the psycologist again, as with two failed band surgeries I understandably could be depressed.  My third wls is scheduled for Oct. 20, I've had several family weddings with the last one in the UK on Oct 1st and I wanted to work around those family events.  My insurance did approve the third surgery.  I did lose all together 50lbs, when the acid reflux was the worst after the first surgery and before they had to unfill the band the first time.  I've never gotten back on track, never really had any restriction again, I am up about 25lbs.  So at this time I am hoping for a successful surgery one that lasts a lifetime for me.  Thanks for any thoughts you have.  Ellen

I think in the long-haul you will feel better with the RNY.  I had the band and after 18 mos had the too tight, and reflux at night. Got to a point like you ..couldn't eat /drink in the night...morning so would calorie pack during the afternoon.
The surgery itself for the conversion was easy...and not having that port in the stomach muscle is great!   Food with the RNY is easy to make better choices for foods aren't getting stuck or one bit syndrome with the band.
I hope your surgery goes well and you get on with the weight loss you want.

Joan

 Hi Ellen,

Yes, I think you are in the right place!  Welcome aboard.

I am so sorry to hear of all your troubles.  I think you will do well with the RNY just be sure to be religious about following the Pouch rules.  The other thing I would suggest is to ask your surgeon about  how much intestine he bypasses.  There is Proximal (shortest amt bypassed), Distal and ERNY (greatest amount bypassed).  My suggestion would be to at least try for the distal as the shorter the common channel the greater chance for long term success.  Good Luck.  Keep us posted on how you are doing.

I have almost the same story. 2 Bands, reflux so bad I could not sleep or eat. Please read my profile.

I did not want to get RNY. I gained 60 lbs of the 110lbs I lost. My endo (I have PCO and insulin resistance) suggested the VSG-Vertical Sleeve Gastrectomy. Please visit the forum. There are lots of us former Bandsters there. I am almost 3 weeks out and feeling great.
You have to be careful about malabsorption with all your endo issues. The VSG is a great surgery. Please post your story in that forum, very knowledgeable ex-band pp there! Best of luck!
lisa

Thanks for your thoughts.  The reason I got the band was due to the malabsorption issues with the RNY but my surgeon doesn't do the VSG.  But I am very careful about taking all the vitamins and calcium.  I switched to the stuff sold by Market America as it's liquid and is easy to absorb in the stomach.  At least I hope.  A friend recommended it and my dietitian agreed with the assessment.  I know I will likely need the B12 shots.  I will repost my story.  Thanks again. 

Hi Ellen

Before you pick the bypass I would strongly suggest you look into the DS. I too had bad reflux from the band, and needed a revision, but also had diabetes with complications that I wanted to be sure to deal with.

RNY has about a 75-80% chance of putting your diabetes into remission, while for DS the chances are considerably higher at 98%. I stopped taking metformin on the day of the DS, and at my 3 month check my HbA1C had dropped from 9 to 4.3. This effect comes from the mechanics of the surgery and not any weight loss.

Secondly, RNY involves having another 'pouch' with pouch rules. After the band I didn't want this, and instead have just a smaller stomach. Also, the blind part of the stomach after RNY cannot be scoped, so you will be advised not to take NSAID drugs (anti-inflamatories). If your auto-immune disease requires you to take any of these drugs you put yourself at risk of undiagnosed stomach ulcers. The DS again leaves the shape of the stomach intact, so we can take whatever medication we need.

If you have questions either PM me or post on the DS board - there may be someone there with the same problems as you that can help.

Best wishes

Sal

Hi Ellen-

My good ness you have had an awful time.  I am going to tell you what I know.

If you have reflux, you should not get banded. It will only make the reflux worse. especially if it is severe.  I have severe reflux and surgeon refuses the band.  another thing, if you had some sort of autoimmune disease, you should not get the band because the autoimmune disease gets all worked up do to the foreign objuect such as the band.  You must of had an auto immune disease that you were not aware of and bang the band found it for you.  I also have poor espophageal motility, hopwever they said after so many test that it is not the scleraderma type???   I have a postitinve ANA titer and Sjogrens these are things that are in the auto immune family. 
 So what I did know sounds like it took so much agravation for you to find out. after the band. 
All of your symptoms sound just like me.  Good luck with everything. let me know how you make out.
I am going to look up that CREST thing because my scleraderma test are all negative. 
I have not had any surgery yet.  I am still very undecided.  I am looking towards the rny, but with the autoimmune history I just dont know.

I hope thing get better for you.  I think you neeed to get that band out.  It is just causing trouble.

Hi Donna, yes I certainly have had a time of it.  The Docs are thinking that the CREST was caused by either taking Pen-Phen, it's on the list of possible triggers or the silicone in the band. I had absolutely no acid reflux prior to the band, I am thinking it's the band.  So yes get it out of there, do the RNY and hopefully I will feel much much better.  My rheumatologist is pretty sure about the CREST because of the rather weird symptoms.  I do not have the typical scleroderma symptoms but do have skin issues, more allergic than anything.  First all over my body but with first the Xyzal then Singular I've reduced them to a eruption or two occasionally, incredibly itchy though.  Just imagine after band surgery, starting to itch everywhere, I had the hives on top of it too.  Thought I would go nuts.  These decisions are tough, I wish you good luck with them.  E