E RNY Revision Approved!

  I am approved for revision and scheduled for March 23rd.  I am very excited.  I feel bad most of the time due to ulcers, and my stoma is dialated allowing my food to empty quickly into my intestines. 

I am wondering what kind of diet I can expect to be on right after surgery, and then for lifetime maintenance?  I will be going for some appointments to find this all out, but was curious as to what you all do that has worked and got you to a healthy weight and kept you there.

Shele

 Each doctor has their own diet they want you to follow, so it is difficult to compare them.  Basically, you will be following a similar pre and post op diet that you did when you had your first surgery.   And, the maintenance diet will also be similar.   Depending on the length of your common channel, you will probably have higher requirements for certain vitamins and nutrients, especially protein.    I have also read of many patients having bowel issues and some have needed to be medicated for these problems for many months.   But, again, it depends on your common channel length and whatever else your surgeon is going to change in your digestive system.  Do you know exactly how he is going to revise you?   The ERNY's I have read about don't involve making any adjustments to the pouch at all and just adjust the intestinal part of the bypass.

Good luck!

Hi Shele.....CONGRATULATIONS   on your date! You must be so excited.

I had ERNY and when I was first out of the hospital I had liquides the first week and then progressed to soft foods.  To maintain I just try to eat a healthy balanced diet.  I stay away from white carbs not only for the empty calorie reasons but they can also cause gas. 

I am sure your doctor will  give you his requirements.  Good luck to you.   I hope all  turns out like you need it to be!

Shele,
Congratultions on your ERNY.  You will do well.  Liquids is usually the first stage,  then soft foods, every program is different.
Deanne

What is the E RNY??  Very curious...  Thanks!!  Theresa

"For the vast majority of patient, a revision which significantly increases the malabsorptive component of their by-pass will result in the greatest weight loss. This increase in malabsorption is achieved by moving the Y further "down stream". This shortens the common conduit (bowel carrying both food and digestive juices)while lengthening the bilio-pancreatic limb (the bowel carrying only the digestive juices). Barring complications, very little if any intestine is removed with this type of surgery.
Much has been written about converting a "classic by-pass" into a DS. While there are indications for this procedure, if one wants to be technically correct, it is very rarely done. To actually convert a "classic Rny" into a DS would require disassembling the connection between the pouch and the intestine, reconstituting the stomach, resecting the left side of the stomach, dividing the duodenum, connecting the Roux limb to the first portion of the duodenum and moving the Y "downstream." It should be obvious that this operation is extensive. It is this type of revision which carries the "high risk" frequently cited in the medical literature.
The revision of a "classic Rny" to a highly malabsorptive operation can be more safely accomplished by revising it into a highly malabsorptive Rny (ERny). This procedure moves the Y downstream. It is the LEAST risky of all the revisions to a highly malabsorptive procedure as neither the pouch nor the stoma is touched. You gain the vast majority of the advantages of revision to a DS with only a small fraction of the risks.
Intermediate in risk between revising a "classic Rny" into a DS and revising a "classic Rny" into a highly malabsorptive Rny is revising a "classic Rny into a BPD. In this revision, in addition to moving the Y down stream, the excluded stomach (distal remnant) is removed. The theoretical advantage of this revision is a greater reduction in grehlin. There are no studies that document that the reduction in grehlin is greater when part of the stomach is removed. There is no information as to how long the reduction in grehlin lasts after any WLS.
Varying the length of the common conduit (bowel with both food and digestive juices) between 50 cm (most malabsorptive) and 100 cm (most conservative) will determine just how malabsorptive the procedure is.This is a decision to be made with your revision surgeon. Not every patient needs the most aggressive operation."

Thank you for the information Joyce.  Do you know if they do this procedure in MI anywhere, and if it is covered by insurance?  Just wondering.  Thanks, Theresa

Hey Theresa,
I don't have any lists to pass on but I'll bet you could call any of the reputable DS surgeon's (supplied on the DS forum) and talk to them about which type of Revision they would recommend.  If they can do a DS they can definitely do an Erny which is supposed to be less complicated.

Good luck!  Revisions Rock and we all deserve a 2nd chance at healthy!

Congrats Shele

Your Dr will answer all your question in the next few weeks.  a lot is going to depend on what he/ she plans to do to your  body.

Personally - My  post op  diet was liquids for the first week and then progressed to soft  foods and  a normal diet from there.  

I had to work out a couple bugs in my new plumbing - I had to learn how to  care for it. 

The best advice I can give you ... Keep  open communication with your surgeon - He / she is your second best tool.  Dont be afraid to call and ask questions.  they want you to be their greatest success yet !!   Its a win - win situation.

Thanks to all fo you for your helpfulness and good wishes!   I go for the pre-surgery appointment on the 6th and I will be asking lots of questions!
Thanks again!
shele