researching revision.

Hello everyone!    I'm new to this board and starting researching a revision.  I have an appointment with a specialist in revisions here in MN in December. 

Here's my story ~
I started prior to my original counsult with RYN Dr at a wt of 252.  On the day of surgery I was 235.  I lost a total of 75 pounds from surgery date to my 6 month appt.  Since then I have not lost.  I maintained at 160 for about 6 months, then over the past year, I've been gradually regaining.  I don't dump on ANYTHING.  I feel like I didn't really have the surgery.  I know that I can eat more than most RNY post ops.  I'm almost 2 years out.  And now today I weighed in at 189.  Which means I'm just down 46 pounds since surgery.  I haven't gone to my original surgeon because I'm sure they will just throw me into nutritional counseling, which I'm pretty sure I don't need.  Just because I don't dump, I do still try to make right choices.

HELP!!  Can anyone provide some insight if you were in the same boat that is willing to share their story with me?  Anyone have any advice?  Is this even worth pursuing?  What options are there from RNY? 

Thanks Paula

 Hi Paula,

I had RNY in 2001.  I started out around 242 and lost down to 125 at my lowest.  Over the past couple of years I have regained up to 184.   I will admit that some of this was my own doing.  Because I consumed to many carbs when I couldn't handle meats that well.  I totally screwed up my behavior modification part of it.  Other then that I also have a stretched pouch and have since learned that my original surgeon did not bypass that much on the intestinal portion.

I just went through a revision on 10/3 to an ERNY (Extended RNY).  With this revision the Dr. gave me a common channel of only 75 cm for greater malabsorption.  Day of my revision I weighed 174, today I weigh 163 and I went from a size 18 (and increasing) back down to a size 12.  I originally narrowed it down to 2 choices the DS or the ERNY.  The reason I chose ERNY was because I did not want my pouch revised do to the higher risk factor on revisions.  At least with the ERNY I have the same lower half as the DSer.  I also did not dump.  Some do and some don't.  I am not sure if a surgeon would have even considered me for a DS as my bmi was not over 40.  But this may vary with surgeon.  I know I had difficulty finding a surgeon in my area who would even consider me for a revision because of my bmi.  I ended up traveling to get mine done and am so happy I did.  I couldn't have chosen a better surgeon for myself.

There are many choices out there for revision.  DS, ERNY, Band over RNY, Rose, Stomophyx (these last 2 procedures don't appear to be yielding very good results) etc.  You have started doing the right thing by researching.  Look at the pros and cons of each procedure then choose the one that will best suit your life style and wants.  

One thing you may want to start proceeding with is getting an upper GI and an EDG.  These 2 tests will tell you the condition of your pouch and your stoma.  It will also help with getting insurance approval if there is a mechanical failure noted.  Perhaps your specialist will order these for you when you go for your appointment.

Good luck to you.  Please keep us posted on how you make out.

Thank you!  I too do eat too many carbs, but I'm back on Weigh****chers to keep me eating healthy.  I am hoping that the December meeting the Dr will order those tests.

I will keep you all posted and hang out here more. 

I'm doing the cottage cheese test on Saturday to get a "gauge" of how many oz the pouch is.

Can I ask you what the cottage cheese test is? I had the suregery March of 07. I started out at 250 lost weight before the surgery. I weighted in at 236 day of suregery. Today I weigh 124. I still have a hard time eating, but I would love to know what that test is and how to do it.

As I understand...in the morning when you'd normally eat breakfast, you eat cottage cheese until full or for only 5 minutes whichever comes first.  Then you measure what you have eaten.  I guess you take a new container of cottage cheese and when you are done you replace with water to measure what you've just eaten.

 You're welcome.  You can also try the 5 day pouch test.  It can be found at http://www.livingafterwls.com/index.html or by putting it in google and it will bring it up.  It is suppose to help you get back on track and kick the  carb habit.  

Also the link below will bring you to the cottage cheese test and some other very good information.  You actually eat as much cottage cheese as you can in 5 to 15 min.  Weigh out your cottage cheese in ounces before starting.  What you have consumed is the size of your pouch.

www.angelfire.com/super2/kbc0219/PouchRulesForDummies.htm

Hi Paula, we have *very* similar stories.  really we do.  I did a year of medical weight management while I waited to change insurance companies to get my revision covered, all the time regularly going into see the surgeon doing my revision.  My weight loss after my revision hasn't been fabulous, but I have stopped gaining - that is a blessing.  The tests starting out for me and most people were an upper GI and an endoscope.  i did have some anatomical problems which were a problem from the first surgery and that gave me relief to know it wasn't all my doing.  Regardless, see the new Doctor, check your insurance and go for it.  There is no shame and it is most certainly worth it.

Depending on your surgeon, he might offer a DS or a Distal RNY.

Good Luck

Hello Happy Girl. will you give us an example of your slow weight loss in pounds?  I am so worried that a revision will not yield significant weight loss.  After my first surgery I lost 35-40 pounds and the weight stayed off unitl last year when I had a cyst on my spine ...I was bedbound 2 months & onn steriods. 

I lost weight the first 3 months and it stopped, I exercised ate properly (although I was able to eat any and everything and a higher quanity that I thought should be possible)  My concern is if the surgeon does not legthen the common channel and fix my stoma I willbe in the same boat I was the first time....WLS loose a little weight--keep it off but remin obese!  Don't think I can handle that emotionallu.  The surgeon talked about lining my a part of my pouch and stoma with mesh so that they cannot expand allowing more restrictive eating (didn't have much of that the 1st time around)  He is very conservative about considering going beyond proxial he does not want me to loose 2 much weight (ha ha ha) I am starting out at 5' 1/2 inchs tall and 2220 lbs...they tell me I'm a light weight but my back & knees don't agree.  The surgeon won't commit specifically what he will do until he goes in to see exactly what the previous surgeon did.

Im just so concerned that the surgeon will not be aggressive enough with my revision so that I can have the significant weightloss I see others experience.  Sorry for the long post just needed to sound off.....again :)