What all of the drama has done for me !!!!!!!

I certainly didn't want to become the doom and gloom lady most of what I have experienced is because I didn't ask the right questions and didn't care I just want something to take off the weight. I am certainly not sorry about the surgeon I picked on the contrary he was fantastic when I needed him to be and has been there for me ever since any time I call. He has kept me sane through this. That said I will agree 100% that you can not read too much or ask too many questions or spend too much time looking at all available options. Do what works best for you and what you need and your long term goals. Also decide how hard you are willing to work at weight lose. Let's face it if we were dedicated would any of us have to do this? I know I can and will do this but I will work at it for the rest of my life. This is the last time I want to put myself through this.

Sheri,
I am so appreciative of your courage and strength in posting this.  This is exactly why I joined OH---I needed to hear accurate information in order to make an educated decision about revision.  Newbies need to hear about real experiences and I commend you for saying it the way it is.  There are potential complications with ANY surgery and ANY surgeon can have patients with complications...it doesn't necessarily mean that he/she did anything wrong.

I had posted before about Probiotics...I really think it's worth a try to start to establish some balance in your poor colon.  You can find them at any GNC or other health store (they need to be kept in the fridge because they are live organisms).  They give you good bacteria for your gut with the goal of restoring the balance of flora in your colon.

Keep posting, your honesty and real experience is refreshing and helpful for all of us.

Keep your chin up!!

Hi Sheri,
I have ERNY, but not as a revision.
I am so sorry to hear about your infections. That is always hard, but any surgery can result in an infection.
You need to just concentrate on getting well. I think you will feel much better down the road.

I am 3 years and 8 months out from my surgery. I lost all the weight I wanted to ( 146 lbs) and I am having an easy time keeping it off. I think it's  because of the shorter common channel.
I do have to watch the carbs. I have gained a few pounds and had to lower the carbs to get it back off. But 2-3 days is all it takes. I can't let it go to 10-20-30, because I know it will make me miserable.
I don't have many problems with loose stools. I had IBS for years, but had already figured out ways to deal with it and live with it before the weight loss surgery.
One is to take benefiber, another is to watch the things like sorbitol, manitol...all the " tol" sweetners. I can eat them, but 3-4 popcicles with sorbitol means a couple extra trips to the toilet the next day. Calcium seems to have a good effect on me! At least I don't have the constipation side of it ever! So for the most part, I don't have issues. I can drink milk, and eat cheese etc.

I think you're going to have to try things out and see how it goes. One thing for sure, there is NO WAY to predict how things will go 100% for anybody, or any surgery for weight loss. Dr. Husted posted about that point yesterday. or the day before.  So don't beat yourself up about having a bad time, no way could you foresee the infections.
One thing my surgeon did tell me was I could expect to lose at least 100 pounds with the type surgery I had. I beleived it, and it took me more than a year to get to 146 lost. Iost the last 43-44 in the second year with a couple in the third. So don't dispair, you're early days, and you have plenty of time.

I am very pleased with my surgery, I feel I have improved my health, and I look better too. I would have been happy at 170 pounds, but I was fortunate to make it to 140, give or take a couple.

If someone has ERNY and tells you their problems and their successes, you have to accept it and work with that knowledge. If people who DO NOT HAVE ERNY, tell you ANYTHING about how it goes, or what happens, unless it is your own health care provider, take it with a grain of salt. They have no first hand knowledge, they have no experience of the outcome personally, and they have an agenda besides supporting you while you recover and become healthier and lose your weight.

There are several ERNYers around who will be right there with you while you get better.
Best wishes!
Sally

Thank you Sally its so good to hear a success story. I am always looking for tips. I have been sticking to the proteins and away from the carbs other then a banana once in awhile I don't do fruit since I always had a problem before with it so I am sure I would now also. Raw veggies have not worked for me yet either other then alittle lettuce now and then. But you did clue me into something I didn't think of that I will cut out and that is Arizona Ice tea Diet but I wonder now if the sweetener isn't working against me. I think I will leave it alone and see what happens.I do Steel cut oats and skim milk and Benefiber for breakfast. Benefiber again at night and a shot of pre-digested protein which is 36 usable grams. Eggs string cheese hot dogs greek yogart ham anything with protein and I feel that I am on the right track there. Thanks for letting me know of your success. It makes me very hopeful. I will stay in touch for more pointers if I may.

Sheri,

A lot of your problems may be due to yeast and bacterial overgrowth related to repeated antibiotic use. Probiotics are the best long term treatment for this, and may need to be taken life-long, which about 20% of Americans should do anyway. Different brands of probiotics will have different effects, even if they are the same species, so it pays to experiment with different brands. I recommend soil-based probiotics to my patients with intestinal dysfunction, as these create the proper pH of the intestinal lining for other animal-based probiotics (such as those found in yogurt) to live and work properly. The only commercially available brand of soil-based probiotics I know of is the Primal Defense brand, which you can get for about $35-$50/month. The relative short-gut syndrome of your procedure can account for some diarrhea as well, until the intestine's capacity to absorb more occurs.

One point I believe needs to be clarified here: A ERNY or distal revision is not the same as a DS. It is not  a matter of everything "being the same except the stomach". The DS is based on the BPD procedure, which uses a different intestinal anatomy to effect a change in the patient's metabolism, and ot just malabsorption. This is due to the production of certain gut hormones induced by the DS anatomy that is not found in distal or ERNY revisions. This metabolic effect of the BPD is, in my opinion, as important as malabsorption in maintaining weight loss in DS patients. For complicated DS revision surgeries fron RNY, if there is too much scar tissue in the upper abdomen, it is possible to use the patient's existing RNY pouch and hook it up to a BPD limb, which would leave the patient with an older style BPD procedure, as has been done in Europe for decades. This works better if patients are able to eat sufficient amounts of protein prior to revision. Even this RNY to BPD revision is a bigger procedure that a ERNY, but is a safer revision option when hooking the pouch up to reconstruct the stomach for a DS would be tricky.

As important as malabsorption is as a revision tool, metabolic change can be as well.

John D Husted, MD

Thank you for taking the time to respond to my post and I appreciate your advice. I am in the process of looking for the probiotics and I am hoping that they help.I am sure that with some patience on my part and a little trial and error I will get through this. It was just unexpected in some areas but as they say what doesn't kill us makes us stronger and I might add more determined. Again thanks for taking the time to respond it was very kind and considerate of you.

 Dr. Husted, because there has been so much confusion on this board regarding the risks vs. benefits regarding the RNY to DS revision vs. the RNY to ERNY revision, I wonder if you could post some type of essay/explanation of the differences on how the intestines are "hooked up" and why the DS is supposed to be more effective, especially if someone did not lose all their excess weight from their RNY or lost initially, then regained a significant portion back.  

So many on here have this problem, and there are those of us who would like an answer from a doctor who routinely performs this particular revision.  So many doctors do not perform this RNY to DS revision and I no longer TRUST their opinions after having read this board for over 2 years and having seen what they tell people.   There are so many folks, including me who think/thought that the ERNY was "just as good as the DS, with much less risk".   Now, I'm wondering if the risk is really that much more, because being opened up for surgery and getting anesthesia is a risk no matter what procedure one has done.  The benefits appear to far outweigh the initial risk of having the pouch reconnected to the stomach and then made into the sleeve.   There may be the risk of leaks, but continuing to have the pouch has it's risks also, when it is left intact.

Could you please shed some light on this subject?  Thanks in advance.

Hey there SheriAZ!
I'm so sorry you're having a rough road!  It sounds like you're going through much of the same post-op stuff that I experienced.  I've gone through some depression since I didn't have the kind of recovery that other's had had and since I'd always recovered well from other surgeries.  I guess we drew the short straw when the "possibilities" list was past around.

I've found oodles of help from the [email protected] site.  There are DS'ers from all over the world who are many many years out.  There are Disttals, Erny's and all their varieties.

Things that have helped me was a course of flagyl then followed immediately and forever after by a Billion type pro-biotic.  The one I'm using now is only found on the internet pharmacies...FloraQ3 and is about $55.00 for 30 days.  I've tried Culturell **** and a few others.  .....  Big difference!  ....  But, air fresheners, candles and some good chewing gum may be our forever friends:-)  .....  It sounds like you already "eat clean" so perhaps try increasing the natural fiber from your foods and going with the blander proteins.  Before i have major "tight space" outings, I have chicken, fish, and rough low glycemic veggies like steamed cabbage, fresh spinach, lettuce, etc.  I visualize little scrubbers going down my short little cc cleaning out the yuck.  Flax and whole wheat are great....low carb wheat tortillas, etc.  Red meats and spices seem to gunk up the system and then the brown cloud returns.

Flush your system with pure water and stay away from caffeine.

I had issues with a spot on my incision that took a long while to close up too.  It seemed like my recovery couldn't really get on trac****il my protein grams were pushed up near or over 200 grams!  I also found that the collagen protein options didn't absorb well for me so I went back to the pre-digested whey protein powders and have about 4 or 5 "smoothie" type shakes a day.  My ankles swell, my breath starts smelling, i get lethargic and my hubby makes me a protein drink right away!  We just can't absorb the needed protein through food since food zips right through.

Support group tomorrow at 4.  Can you make it?  Some of the revisions are going to supper together afterwards.

Take care!  My size 2 is VERY high maintenance!!!  And on days when I could care less what size I was cuz I feel so lousy; I remind myself that anything I've gone through recently isn't as bad as the heart and diabetes of pre-wls life.

Joyce
Revision to Erny 12/26/07
at goal

Thanks Joyce for the great tips I will be trying the Probiotics on the advice of many on here.The other tips will also be put to use since I am afraid to leave the house for fear of accidents in public.I have hopes that by fall to be in better shape. Not sure when I can get to Phoenix for a meeting but I will try for the next one. Sheri

Hi Sheri,
I hope you are feeling a little better.
I know some of the posts here haven't helped and some have probably made you feel worse.
Just remember you have malabsorption on your side to help with your loss, and you can get where you want to be.

According to all the papers I have read on the metabolic effects that occur with bariatric surgery, like RNY and DS, the full mechanism by which diabetes is put into remission or cured isn't fully understood. I guess there is new information on the role of gut harmones and what happens with rerouting the intestines every day. Maybe the future of WLS will be something like VERGITO, which relies entirely on change in gut harmones to work, without malabsorption. 

 I just hope that the changes that occur with the surgery you have been revised to are beneficial, and take you where you want to go.
 It worked for me, and some others who have posted. Keep us up to date ok?
Sally