So Glad to Know I'm Not Alone

I had my RNY surgery on 3/5/04. I never made it to my goal weight. I started at 305 and my lowest weight was 185 in 2005. As of today I'm back up to 220. I was feeling like such a failure because I could not get it back under control. I just happened back upon Obesity Help for moral support when I saw people talking about revision surgery. I was under the misconception that the surgery was somehow reversed until I continued reading. I called Dr. Lin's office in DC and was told my insurance would cover the surgery...can you say jumping for joy. They asked me which revision I wanted. I think I want RNY to DS or the Sleeve. Any suggestions?

I had RNY surgery on 4/1/03 and I was 280 lbs.  I lost down to 178 after 2 years.  I have now gained back up to 224.  I am like you so depressed and feeling like there is nowhere to turn.  The groups I have been to have been people that were just a few weeks out and had no idea what it feels like to have gained weight back.  I think I am going to talk with my surgeon to see what he suggests.  I saw him back in 06 and he just said to get back on the diet.  It seems everything I eat turns to fat.  I am in Tx.  What type of insurance did you have?  Any suggestions for me?

I am telling you, I have tried to start over again. I didnt last five hours. I even joined weigh****chers, that lasted all of one week. I just can no longer get my mind to cooperate with what I know I need to do. I am hoping that the revision surgery will get me back on the right track. It is almost like going through detox. You dont have a choice but to do right. I have Federal Blue Cross/Blue Shield.

 Congratulations April.

So good you get a choice with your insurance as well!  There are many revision types so do your research and pick the one that is best for you and your life style.

The DS shows very good long term statistics.  It is also the most complicated revision to do, especially a RNY to DS because of the take down of the pouch.  So make sure you have a surgeon who has many, many, many  revision surgeries behind him so you can put better odds in your favor against complications.

Good luck to you.  Keep us posted on what you decide.  

I agree. First thing to realise is that weight loss surgery has moved on quite a bit since 2005. Don't just pick the first surgery you hear about and pin your heart on that - your surgeon should be discussing all the options with you, not just asking you 'which revision you wanted'.

This isn't like picking shoes - you already have a complex surgery that has failed you. Revisions carry a statistically higher chance of complications, and are more difficult to perform. Make sure you know what you are doing, what you can live with, what chances of success it will have, what your surgeon is qualified to do, and how it will be different next time.

Until you know the answers to those questions step away from the insurance policy and think for a while!

Wow, it is alot to think about. I have not met with the doctor yet, it was the Coordinator that asked me what type of revision I wanted. All I know is I need something that will be long term. And from what I've read, that will be the DS, but it also seems as though that is the most complicated of the revisions. I guess the doctor will first check the condition of my current pouch. It may just be that it is stretched or an opening is too large. Wouldnt that just be a revision of the RNY?

 You're right, there is a lot to think about and consider.  That is why it is so important to do some research and understand what is available.   Just as important  is educating yourself prior to your appointment with your doctor so that when he starts suggesting your options you are informed and therefore can make a wise choice for yourself.  All WLS/revision procedures have their set of side effects to deal with and only you can decide what you are willing to tolerate.  So many go into these consults not realizing there are options and just take it for granted that their doctor will choose what is best for them.  It should be a choice made by the both of you and should be dependent on your personal situation, what you can live with and what your commitment level for compliance is. 

Some of your options are;

Band over RNY - adds more restriction.

RNY to DS - gives restriction and greater malabsorption by use of a shorter common channel, also one of the most complex and risky revisions.  Would strongly recommend that you seek out a DS revision specialist  who has performed literally hundreds of revisions.

RNY to ERNY (Extended RNY) - provides greater malabsorption by creating a shorter common channel.  Typically the pouch is not touched.  Less risk then the DS but may not have as much weight loss as the DS.  Not sure on how much you have to loose to get to your goal.

Revision of your RNY by redoing your pouch and/or making your malabsorption component more distal

RnY to Vertigo - relatively new.  Not really sure as far as complications or success rates.

Then there are the less evasive procedures meant to shrink your pouch and close the stoma back up, they are  Stomphyx,  Rose and Schelatherapy (sp).  But beware of these procedures, they have not provided many positive long term results past the post diet phase.  However, the Schelatherapy seems a bit more promising then the previous two and may take several applications.

Hopefully I covered them all and if I didn't or incorrectly stated something, there are many on this site who are versed in these procedures, I am sure they will come a long and elaborate. 

I know what you are going through, I was 250 went i started got down to 132 now I'm back to 180, I fell like a total failure, worst off all i did it to my self, My 1st addiction was food then it turned to drinking, 1 yrs worth of drinking packed on 50 pounds!! I don't have any medical insurance right now, I would love to get the revision, But I truly think its my Brian that needs a revision!! Good luck w/your surgery.

Dear Dreamie:

When you say you think it's your brain that needs a revision....You couldn't be more right on!

Most of us who are obese have some issues with food. If we could get into the right mind set we may not have a lot of these problems at all...So it is very important to try and find out what makes us eat by getting some help from a professional....I believe that would be good for anyone who has food addictions...It's no different than alcoholism, or drug addiction....These are all issues created in the brain. Fix the brain, hence we fix our problem...Well hopefully!

Good Luck

Janie

If you go with the Sleeve, will they be reversing the intestinal portion of your RNY??? When done as a 'first' WLS, the Sleeve, is a restriction-only formof WLS.

If the RNY never got you to goal, I'd think you'd want the full DS---a fully-functional stomach, with the targeted malabsorption of fats.The DS gives the very best long-term results of any form of WLS.