RNY Revision to Lap Band or something else?

Brief History:

RNY procedure about 6 years ago. Psychologically I wasn't ready to give up food addictions and I didn't follow the "plan" and I started at 267, went down to about 175 or so - and now I'm back up to 200 pounds, 6 years later. I am (and always have been able) to eat ANYTHING, including full course meals (prime rib, etc.). I don't feel my stomach is at all reduced. I understand it's a muscle and it's stretched, but I feel it's back to being capable of holding a full meal. Yes, I drink while I eat too. Every "rule", I broke it.

Three or four years ago, I had an emergency surgery for a small intestinal blockage / twisting that apparently was pretty serious. They won't claim it was a result of the RNY for sure, but they say the RNY certain probably contributed to it.  It was quite a scary time, but I'm fixed from that now.

Anyways, here I am, 5'3", weighing 200 pounds, so not "morbidly obese", but obese all the same. I don't have any other health ailments (diabetes, arthritis, etc.) - but I do have a lot of digestive issues (cramping, things you don't want to hear about - etc.) - Again, I'm sure it's due to my own poor choices in foods.

So, I have been thinking, now that there is an actual local support group and not one that is a 75 minute drive, I could think about getting my RNY revised and having a lap band put on and "start fresh" and actually follow the rules/plan, etc. and go to the support group and get the psychological support I need for my food addictions.

I have to have an OB/GYN surgery as well, so my GYN doctor already said he'd work with a local surgeon and do the surgeries concurrently/same day, so I'd have to be "opened" just once.

A few questions:

1. Can you have a "revision" and then a band put on at the same time or does the "revision" have to heal first?

2. Would the insurance cover a second procedure if I'm only 200 pounds or am I not heavy enough to do the banding?

3. Would insurance cover the revision without the banding due to the digestive issues I have?

My insurance was *fantastic* with the first surgery 6 years ago. They approved it right away. (So sorry to you guys that have to fight to get yours approved, I know you're probably thinking I'm horrible for having "failed" the first time around.)

I want to finish this. I want to lose the rest of my weight (70-75 pounds) and get healthy! I'm 36 and hopefully starting a nursing school program and I don't want to be a heavy nurse having to stand on my feet all day and be exhausted from carrying around the weight.

Ideas? Thoughts? Opinions?  Please don't bash for me not using my "Tool" properly in the first place. I have already bashed myself enough.

Hi Lynne:

You might be an excellent candidate for the ERNY....which involves shortning the common conduit to give you more malabsorption...There is much information on the boards explaining this procedure and it wouldn't require go into the doctor all the time to get fills and refilled...

I will search on OH the ABC's of Revision and you will find a description for all RNY Revision types that are done...

Good Luck

Janie

When you ask if you can have a "revision" and have the band put on at the same time, I'm not sure what you mean.  Having the band put on is a revision.  Or do you mean you want the RNY reversed and then a band put on?  You can put a band on your pouch, you don't have to have the RNY reversed to do that.  So I'm a little confused.  But if you have the RNY reversed, my guess is they would have to wait for that to heal before putting  band on.

I don't know if your insurance will pay for a revision or not.  I think some won't pay for a second WLS.  And since your BMI is probably below 40 now, you might not qualify even if they would pay for a second WLS.  I guess the only way to know is to call and ask.

I'm not gonna bash you for not "using your tool properly."  But have you tried going back to the basics and following the rules now?  Your tool may still work for you if you work it right.

Kelly

Make sure you don't have any other co-morbidities.  I had sleep apena and did not know it.  I was at 35 BMI.  That is great the OB/GYN is willing to work with another surgeon. 

I have a few thoughts running through my head.

You still aren't doing the basics here, not drinking while eating, etc.  Even if you get a band after bypass you still have to follow the basics or it isn't going to work.

If you aren't trying now, why would you try when you get a 2nd surgery?  I'm honestly not trying to be nasty but I'd just hate to see you set yourself up for something you may not be ready for again.

A band after bypass IS a revision, I don't understand what you are referring to here.  What revision are you wanting in addition to a band?

Banding is a big cause of constipation so depending on your digestive issues...

They would not be able to do a GYN surgery & extended bypass at the same time due to risk of infection but I would imagine they could likely do a band after bypass at the same time of GYN surgery depending on what the GYN is going to do.

Since your BMI is 35 and you have no comorbidities you may not qualify for a revision.

I will tell you this...I have the band now...it is a lot of hard work. You really have to have your mind right. It is a slower process for some. Everyone has different experiences with the band. I lost 60 lbs in two years. BUT there are others with better results than I. From what a have read so far the band if very different than the RNY. BUT from what I have read the band may not be a good choice for you. Really do your research before you consider the band. I am a bit disappointed that I paid $16500  to do the band for the results I have received.