Preparing for Revision

April J.
on 5/22/09 1:20 pm - Bowie, MD
I meet with my doctor on 6/26 to discuss revising the RNY he performed in 2004. Is there anything I can be doing now to prepare? I dont want any delays in having the surgery, so should I be having some type of scope done so he'll know if my pouch has stretched?
Keisha R.
on 5/22/09 2:28 pm - Fairburn, GA
Depending on your insurance you may be required to participate in a 6 month supervised diet, nutritional consult, psych evaluation,  and an upper GI to see if the pouch has strecthed.  Also be ready to list any co-morbs etc. as proof of medical necessity just in case. 
katydid
on 5/23/09 1:18 pm - Mishawaka, In
I just saw my surgeon for the same thing and he scheduled the scope when I had this apt. Its almost like the first time. So many tests   and the same waiting period of 6 weeks.  I was dissapointed that they want so much time before doing the revision. Next week I have to have a physical, a pap and pelvis, abdominal ultra sound,chest x ray and I have to schedule a psy aptpointment also. I will also have to follow an extreme diet before revision surgery( 2 weeks ahead). I hope I cn get through all this. I am just so dissapointed.  Lets keep in touch and maybe boost each other up through all this testing. I am going through Dr Rosen from the original Wish center in Downers Grove, Il.   Good luck to you..I'll keep you in pray. Kalyn
April J.
on 5/24/09 12:10 pm - Bowie, MD
Definitely. It is discouraging enough that I have regained the weight, I just want the revision ASAP. We must keep each lifted.
candysims
on 5/25/09 3:48 am

Hi, Kalyn:
I am going through the same test sfor my revision surgery.  But, I am happy that my doctor is requiring all the pre-op stuff.  Gives me peace of mind.  My insurance company approved me a week ago and I am soooooo excited.  My doctor is Dr. Raul Rosenthal at Cleveland Clinic in Weston, Florida.  Think back to how you felt before your first WL surgery...excited, scared, excited, scared, want it over with already!  Right!   I just thank God that I'm getting a second chance.  I would love to keep in touch and let's go through this together.  My personal email is [email protected].  With my first WL surgery, I think I made a BIG mistake not to make friends or connect with others in the same "boat."  Well look at me now!!  Back at the dock  trying to get back on the boat while others are living their lives outside the fat suit.

Good luck with all the tests.
Candy

jeanyjane
on 5/24/09 6:04 am, edited 5/24/09 6:05 am - Germany
Inform yourself about tthe different revision possibilties - there are serveral options, and they are VERY different from each other.

- band over bypass: low risk, but also slow weight loss; weight loss may not be sufficient

- procedures to fix an enlarged stoma like ROSE, stomaphyx, scleropherapy: lowest risk, non-invasive, but not covered by insurence; no longterm studies exist to prove they work, and the results reported here on OH are extremely dissapointing

- RNY to ERNY (bypassing more of the small intestines to increase malabsorbation): medium risk, results mixed. Some report good weight loss, but if you have a lot to loose and if you`re not having any restriction due to an enlarged stoma and/or pouch, it is unlikely to give you good results. With a ERNY, you`ll have even MORE malabsorbation then a DSer, while you`ll have all the problems associated with the RNY pouch, so that gives you the worst of both surgeries.

- RNY to DS: highest risk, but also best results. It requires to take down the RNY pouch and reconnect the phyloric value, then doing the sleeve, and then rearranging the intestines. Many surgeons will tell you a revision to a DS is not possible. That is a lie - look at the DS board, there are many whose RNY was revised to a full DS sucessfully. Just recently a woman got a full RNY to DS revision in a 3 hour surgery without complications (so far). It`s a complicated surgery and only few surgeons do it, but those few do it regularly with great sucess.I guess your surgeon is not one of them and he will tell you that it`s either not possible or too risky. If you`re interested, go to the DS board and learn more about it. You can also get a list of surgeons there.

Only you can decide what`s best for you, how much you have to loose will certainly be a factor. Please do yourself the favour and LEARN as much as possible about each of these options and make an informed choice, since you`ve already failed once. Each of these revision has their downside - the safest are not very effective, and the best one in terms of weight loss (DS) is the riskiest and only done by few surgeons. I`d try to find a surgeon who does all of these revisions and consult with him what might be best for YOU. If you go to a surgeon who is not doing the DS (and most don`t do it), you won`t get an unbiased answer because he won`t want to loose you as a customer.
cinhope
on 5/24/09 5:33 pm
I had my surgery 7 years ago and due to breast cancer and lots of steroids, I gained back aprox 60lbs. I have just learned about revision and have made an appointment with my Dr for June 10th. They told me he has done many but I did not realize that there are more then one type of revision. Im hoping that because of all the test that i had done because of cancer, that this will cover any test that he may need. It's sad that we all have to have this done again but if your even thinking about this then you know that this i what you have to do. You know everything about what will happen. My question is that 7 years ago I had open and know that I need a revision can it be done lap.

                                                                                           CIN FROM CT
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