approved for revision, now what???

A little history   I had gastric bypass in 1993.  At that time I weighed 370.  This was sold to me as a cure not the tool that we all know now.  I got down to 215 with the bypass alone.  I dieted with the help of phentermine to get down to 190. 

A few years pass and new medications (including a series of oral steriods, birth control shot and antidepressants) and I began regaining weight with a vengence.  My weight got back up over 300 when I was pregnant with my second child (first one was pre bypass). 

I finally decided that I was going to pursue getting a band over my bypass.  Come to find out that I have a gastric fistula.  Now I am going to have a revison done.  The usual procedure for getting WLS done at this practice is to go through the "Novus Center".  They provide all the pre op work ups, education, insurance follow up etc.  Since I am having the revison, I didn't have to go through all the paperwork and there for didn't go through the "NovusCenter" (saving $3100 in the process - not covered by insurance).

So now I am kinda lost at what to do next.  The receptionist that scheduled the surgery (Jan. 6, 2009) told me to go on a "modified atkins" diet.  When I asked how it was modified, she didn't know and told me to refer to my Novus Center paperwork.  Then she realized I am not going through them and was going to find out for me.  After calling the hospital they told her to have me research it on the net.  I had to explain to her that there are hundreds of ways to modify atkins.  Finally I got a paper from her on the diet which is a high protein, low carb, low fat diet.  Good thing I didn't modify it myself, I might have added carbs 

So now I know to diet for 2 weeks before the surgery but I have no info on what to do afterwords.  I won't meet with the dr (Dr  DePerry) again until 12/30 (a week before surgery).  This is part of the reason I failed the first time, no information on what to do once I have surgery (actually I was told to not eat anything with sugar in it's first 3 ingrediants - that was all the instructions I had to go by 

I really don't want to pay $3100 just to have this center tell me what/how to eat when I am done.  I am creating a list of stuff to ask the dr when I go back.  I just don't feel that they are used to do ing ANY education.  Ugh.  Do you have any advice???  Or really was this just a rant 

Go to the message board from your state. I am sure someone on there has gone through something similar and you will be able to get some information. Also look into support groups and a nutrionist that deals with bariatric patients.  Again good information you can get from your state or regional board.  Good luck and I am praying for you.

Thanks, I didn't even know there was a state board.  Sounds like some good advice!  I was ready for someone to tell me to just pay the $3100 and get the info from the center 

Oh Boy! Those medications you mentioned are known to cause significant amounts of weight. Birth control, steroids, antidepressants. Wow! They will really pile on the pounds.

Glad you are having a revision. You will feel so much better about yourself.

I am going to have a revision also. And I am scheduled to go to the doctors office about a week before surgery for all my pre-op tests and procedures.

They will go over the post op diet with me then so I will be able to stock up on the post op food before I go to the hospital. They will advise me then on what to do and expect post operatively.

And then I will be meeting with the doctor 2 weeks after surgery for follow-up. Then every 2-3 weeks for the next few months.

So, except for what I have found out on my own, I don't know much about the post operative part yet either. 

                                                     

I'd be pestering them for more information - what revision exactly are they doing? I'm guessing they are repairing your fistula, but I can't work out if your RNY working 'properly' only got you to within 20 pounds of goal or whether it had gone wrong at that point...

If it won't be enough even when the fistula is sorted, could the extend your bypass a bit, and make you distal or extended - seems a shame not to do it while they've got you on the table.

I can't help you with the diet - RNYers will pitch in about this, cos DS is different really (high fat, high protein, complex carbs are ok). I'd definitely want some answers from them. My surgeon is a bit useless too on what patients should actually eat - I've got more info from OH than him (but then he's an expert surgeon, not a nut)

Sal

I am working on my list of things to ask the surgeon but top of that list is what exactly are you doing.  It is my understanding that he will fix the fistula and make the pouch smaller.  When I had the endo done it showed that my pouch (which is supposed to be 30 ml - well I think ml, but you get the picture) is actually "greater then 100ml"  So my pouch is 3 to 4 times the size it is supposed to be.  I think that is what the problem is, my pouch is too large, surgeon is CERTAIN the weight gain is due to the fistula (a fistual, btw, that can't be seen when they did the endo, only can see it during the upper GI).  I don't want just the fisutla repaired, if we are opening me back up then I want the small pouch back!!!  I am just as certain the weight gain is NOT due to the fistula!  I know how much I can eat and that I am hungry ALL the time.  I think I stretched my pouch because I didn't understand that the surgery was a tool and that I would actually have to watch what I was eating not count on my stomach to stop me.  I understand now.  I want the second chance to make this work again!!!  I just really don't want to spend $3000 to find out what I am supposed to eat..

Hi Lisa,
       Wow you are Blessed, I went to 3 different Surgeons and all 3 of them told me I Had to go though their class's and do the whole program in order to have a revision! As if I never had Stomach stapling. 

     They said it is because we old timers were not given any, or very little information to help us a long on our journey. And they want the best for us now. I can't blame them for that. It does make sense.
      I am one one of the few lucky ones. I did not gain back all my weight! And yes I did have staple line failure too. But I  fought my butt off to keep my weight down as much as I could. I went from 388 down to about  210-220 for many years.

     I  now weigh 241-244 back and forth. I am so glad I did keep up with most of what little I knew I was allowed to eat and drink.  I wish you all the best. I sure hope to have a revision soon. I am a real short gal. So weight on me looks more then I weigh I think. Take care Alizka

To be honest, I was SHOCKED that they didn't make me jump through all the hoops!  I guess I am going to go to the Novus Center tomorrow and talk with them about getting some services a la carte.  They said that was possible.  If not, I guess I will see a nutritionist.  I found one close to me (on the "find a nutrionist" link on the right) and she had 2 comments that were glowing reviews.  I just really want to know what THIS dr wants, KWIM???

Hi...been reading the responses to your post.  I just ahd DS revision on Monday 12/16 and what I was instructed to have ONLY was the following:  water, crystal light, pro clear drinks
skim milk, sugar free jello & popsicles, any flavor broths, plain skinless white chicken, lean turkey breast, tuna and egg whites.  Seasonings are ok but no sauces.  This was for 2 weeks prior to surgery.
Ask the Drs office if they don't have a nutritionist they work with or can recommend.  It should be a bariatric nutritionist is possible.  A consult with one should not be very expensive ($45.+) and well worth the investment.
Also, I would certainly tell the doctor what you are looking for and not the other way around.  This may be your last opporturnity to do it right.

Why are you going to pay $3100 for surgery. Is this one of there extra tack on rip off fee. My Surgeon in AZ did my revision in Arizona an he does not bait and switch any surgery like a some person that posted it and they are totally wrong. My surgeon is very honest and caring and believes in second chances and no one is a failure when it comes to a very conservative RNY. Maybe you need s ERNY that I had done. I really wanted the DS But my surge does virgin ones from lapbanders. He EVEN DOES VIRGIN DS surgery's. I have read and told by all kinds of revisions to a DS can be very dangerous because your stomach must be totally taken down for a DS patient;s and people do get quite of feel leaks that I have been told buy other surgeon's and just buy reading.The stomach tissue is very friable or week after some one monkeys with it. AS you can see Dr Schlesinger is doing alot of surgeries. He is not a bait and switch guy like some think. I have no documented proof but I know one gentle men that had a RNY revised to DS had a ton of leaks and the DS people talked him into it, But you should get the revision of what you want and not not be pressured by DS people. This is just my thought on this issues and i won't be rude and tell you off like other people do on the DS site. We OUR TO HELP OTHER PEOPLE IN A HELPFUL AND CARING POSITIVE WAY. Lisa I wish you the best of luck and don't ;let people presure you on what you want to but certain people will be all over you. Please make the best choice for your self. Please PM if you want to talk. Most people are very supportive and friendly, WE are here for you. Keep us posted and I hope everything goes your way. Good luck