ERny

 Hi travis,

Teena had it pretty much on target...

I had ERNY done last October.  My original RNY was proximal and performed in 2001.  I had a revision to an ERNY in October 08 and am very pleased with my choice to date.  An Erny is where the malabsorptive component (the Common Channel.  The part of the intestine where the food and enzymes meet right before the large bowel) is shortened any where from 50 cm to 150 cm in length.  Seems the most common length is the 100 cm.  In my opinion going much lower can be dangerous.  My CC is 75cm.  Typically when an ERNY is performed as an RNY revision the pouch is left untouched and only the intestine is revised.  This can vary according to your doctors practices.  Many previous RNY patients elect the ERNY because of the higher risk associated with the take down and reconstruct of the pouch/stomach like what would be done with a RNY to DS revision.  It is not impossible and you would need a VERY qualified surgeon to do it.  There are a hand full listed on this sight who are considered qualified.

Not sure if this helps.  I wish you well on your search.

would that be the same as a distal RNY?  i have a high BMI, and a surgeon i talked to adviced me he would go 150 cc, i believe.

thank you

ERNY is exactly what some doctors call distal depending on what your common channel ends up being.

 It would be somewhat the same from my understanding.  The procedure itself is exactly the same.  Some doctors term it extended vs distal if they are willing to take your CC shorter then what the average  distal would be.  I believe a 150 CC would be on the borderline of an extended RNY and distal.  I would recommend asking your doctor about a Common Channel of 100 cm, especially if you have a high BMI.

Have you considered a revision to a DS?  I know there is more risk involved and because of this I wouldn't recommend it unless you see a surgeon who has performed literally hundreds and hundreds of RNY to DS revisions.  There aren't many out there who have but there are a few reported excellent ones talked about often on this board.  The DS shows some pretty good long term statistics.

http://www.dsfacts.com/index.html

http://duodenalswitch.com/procedure/procedure.html

http://health.groups.yahoo.com/group/DallasDSers/

http://health.groups.yahoo.com/group/DS_PostOp_Problems/

http://health.groups.yahoo.com/group/duodenalswitch/?yguid=413972281

thank you......i actually have.....but the extra malabsorbion scares me.....and i am not the most pill compliant......

 You're very welcome!  Can totally understand your concerns.  I am glad to see you are doing your research and know yourself well enough to know what will fit in your life style.  If taking your pills are an issue for you then the DS or ERNY is probably not for you.  Trust your instincts and don't let any persuade you differently.  

I was never a very good Pill taker either.  Still am not today if it was by choice.  It is a definite chore EVERYDAY to make sure I get all my vitamins, I don't take iron with calcium, I remember to take dry form instead of gel form etc.  It does get daunting.

The other issue is the requirement for protein.  I am always on the low side and fight this daily as well.  This is actually harder for me then the vitamin taking.  I don't have a problem eating protein rich foods its the additional protein shakes to keep the protein level high is what gets me.  Like everything else....there are ups and downs to anything worth having.  ;-)

Good luck on your search.  Keep us informed of your progress.  If you have any other questions feel free to ask or PM me.
MEW

Marie

Kinda scary to do any weightloss surgery if one is not complient ??

 VERY VERY Scary indeed!  Reading and seeing what the possible outcomes can be if you are not is the one single thing that keeps me on track and to not be complacent about the necessity of it.... The alternative is just to scary.....

Hi Travis:

Depending on the Dr. some call it Distal some ERNY but usually Distal is considered about 150 cc...

If you do have a high BMI I have my doubts as to whether or not you could lose all the weight you desire with that modest of a shortened common channel....

Again, your surgeon should be able to give you that answer maybe better than us...

Janie