Why would Dr. Husted say that revision for restriction would be of limited benefit?
(deactivated member)
on 4/6/09 2:16 am, edited 4/6/09 3:21 am
on 4/6/09 2:16 am, edited 4/6/09 3:21 am
Goodness, it is great that you people (esp. Dr. H) responded to my previous post (http://www.obesityhelp.com/forums/revision/3896543/4cm-stoma/).
I'm trying to figure out why revising the stoma, according to Dr. H. would be of limited benefit. Does anyone know?
On April 3, 2009 at 10:11 AM Pacific Time, eloisie wrote: Yes, I know. It's kindof what I knew in my gut (both senses intended) for a long time. I had a lot of nausea vomiting on the FIRST bite of food when I was advanced to solid foods (if you trace back my posts, you can see some of this).
That passed, but by month 4 I had only lost 30 pounds, 11 of which were lost in the hospital, and 9 more during the first three weeks of liquid and soft food. Over the next year, I lost a further 9 pounds for the total of 39. I have kept off 10-15 pounds at year 5.
By month 4, I also posted here about seizing and frequent BMs and asked for help (as I remember, I this had been going on for awhile before I posted...because I was embarassed).
At the time, the nutritionists kept telling me to eat more protein, and I did. I walked. The original doc was not concerned, and it was only that a new person (resident?) was on the service at the year check that I got an upper GI which showed my GI tract was a raceway.
Nothing is too late.....I've been this way for almost 5 years (5th year anniversary is in June).
Why would re-introducing restriction be of limited benefit?
I'm trying to figure out why revising the stoma, according to Dr. H. would be of limited benefit. Does anyone know?
On April 3, 2009 at 10:11 AM Pacific Time, eloisie wrote: Yes, I know. It's kindof what I knew in my gut (both senses intended) for a long time. I had a lot of nausea vomiting on the FIRST bite of food when I was advanced to solid foods (if you trace back my posts, you can see some of this).
That passed, but by month 4 I had only lost 30 pounds, 11 of which were lost in the hospital, and 9 more during the first three weeks of liquid and soft food. Over the next year, I lost a further 9 pounds for the total of 39. I have kept off 10-15 pounds at year 5.
By month 4, I also posted here about seizing and frequent BMs and asked for help (as I remember, I this had been going on for awhile before I posted...because I was embarassed).
At the time, the nutritionists kept telling me to eat more protein, and I did. I walked. The original doc was not concerned, and it was only that a new person (resident?) was on the service at the year check that I got an upper GI which showed my GI tract was a raceway.
Nothing is too late.....I've been this way for almost 5 years (5th year anniversary is in June).
Why would re-introducing restriction be of limited benefit?
I'm not a Dr. but I do know that restriction plus malabsorbtion would give you a greater chance to lose the weight and keep it off. Seeing that you only lost a small amount of weight and should have lost much more, you might need to add more of the malabsorbtion part of the surgery.
WHEN LIFE KNOCKS YOU DOWN TO YOUR knees, JUST REMEMBER THAT YOU ARE IN THE PERFECT POSITION TO PRAY. HW 395, RNY 4/2/07 345, Lowest Weight 248, Revision to Distal RNY 1/13/09 278,Revision to DS 10/15/10
Pretty sure it's because your body is already metabolic resistant, and that this may only mildly help for a very small time. (I'm guessing this because your weight loss was kinda low, but then again, maybe you didn't have a lot to loose in the first place?)
And he quoted someone else one time and said "If the only tool you have in your toolbox, is a hammer, then every problem looks like a nail"
Meaning...you can't use one tool to fix everything.
If you are metabolic resistant, you need something besides restriction. And fixing the stoma would only give you that again, and in my opinion, why do something again, that has already failed you?
Hopefully he'll chime in!
And he quoted someone else one time and said "If the only tool you have in your toolbox, is a hammer, then every problem looks like a nail"
Meaning...you can't use one tool to fix everything.
If you are metabolic resistant, you need something besides restriction. And fixing the stoma would only give you that again, and in my opinion, why do something again, that has already failed you?
Hopefully he'll chime in!
Diana DS Revision from '99 RNY
UHC Denied Jan'09/APPROVED Feb'09
DS-SW287; CW/190 GW/152
"Metabolic resistant" is a good way to put it, which appears to be an issue with RNY patients with failed procedures. My observation has been that it is of limited benefit, especially because you are so far out from your original surgery (and there is no longer any appreciable metabolic effect from your RNY, and after three years from RNY maladaptive eating behaviors start to recur at a higher incidence than they did before RNY). Increasing restriction by decreasing pouch or stoma size also has the potential of pushing patients even further into the soft-calorie syndrome, if this is something that is already occuring anyway (which it seems to in a large number of RNY patients).
John D Husted, MD
John D Husted, MD
Dr. John Husted
DISCLAIMER: I am not your surgeon, any comments made by me are not meant to be taken as medical advice, just general guidelines. Contact your surgeon about your specific problem!
DISCLAIMER: I am not your surgeon, any comments made by me are not meant to be taken as medical advice, just general guidelines. Contact your surgeon about your specific problem!
The same thing was said to me by my surgeon too. He said 'restriction hasn't worked the first time, it isn't going to work a second time either' and agreed with me that DS was the best option.
It kind of proves what we thought before - we can eat very small amounts of food and still stay fat. We must have really efficient bodies or something. Malabsorbtion sorts some of that out - its an extra tool for those who put weight on just sniffing a cake shop!
It kind of proves what we thought before - we can eat very small amounts of food and still stay fat. We must have really efficient bodies or something. Malabsorbtion sorts some of that out - its an extra tool for those who put weight on just sniffing a cake shop!
DS revision from failed lapband
Yeah well, many of us here like surgery so much we did it twice...or three times...
RNY is the thing for a lot of people - thank goodness there aren't thousands on this board saying it hasn't worked. Sadly you're one of the unlucky ones - welcome to our club! Might be worth speaking to a surgeon and seeing what your other options actually are.
We have people on here who have had most combinations of things - RNY to eRNY, RNY to DS, RNY with band, revised RNY; you name it they've had it. It seems a bit of a lottery though - all you can do is research, find a good doctor and cross your fingers...
RNY is the thing for a lot of people - thank goodness there aren't thousands on this board saying it hasn't worked. Sadly you're one of the unlucky ones - welcome to our club! Might be worth speaking to a surgeon and seeing what your other options actually are.
We have people on here who have had most combinations of things - RNY to eRNY, RNY to DS, RNY with band, revised RNY; you name it they've had it. It seems a bit of a lottery though - all you can do is research, find a good doctor and cross your fingers...
DS revision from failed lapband
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