Newbie to revision forum... where do I begin???

Greetings everyone!!!
I have been posting and active on the BOTTER"S board on Obestiy Help. I had RNY Surgery back in August of 2007. I was 315 going into surgery and at best got down to 233 on my 5'9" frame. Well the weight loss happened only for the first six months and then no more weight came off no matter how hard I food journaled , exercised or met with my nutritionalist. I could eat much more than my fellow support group members right after my surgery and always felt like a failure from day one. 

I am trying to go to another bariatric surgeon to get a "2nd opinion" on my RNY procedure. Is it truly me and a noncompliance issue that beckons my hungar pains and no feeling of satiety or fullness ever after eating?   Or is there something gone wrong with the surgery?

I'm new to this whole idea of seeking a revision. Just what are my options. Is there a protocol for evaluating a previous RNY procedure? What testing is commonly preformed. What do the surgeons look for?

Any suggested reading or support is very much appreciated. Looking forward to conversing with all of you on this board.
Thanks,
Kathy

 Hi Kathy,

You may have a mechanical failure.  Your PCP or surgeon can order a upper GI and endoscopy to check the condition of your pouch and stoma.  Perhaps your stoma or pouch has stretched.  Or it may be a metabolic issue.  This is also a good starting point to get insurance approval if a mechanical failure is found.

I would also suggest you request a copy of your surgery report from the hospital you had your RNY performed at.  This will tell you exactly what the surgeon did and if you can get it before your consultation with the new surgeon it can provide him with some answers up front.

RNY does not work for everyone and you are not alone.  You ARE NOT a failure!  So many of us fall in to this line of thinking, I think because we went to drastic measures to loose the weight and when we find ourselves gaining again we naturally assume we are the guilty ones for the failure.  This is simply not true in a lot of cases.  If you have been truly compliant  (or at least mostly) then I would check on the mechanical failure avenue for answers.  A good surgeon who understands RNY and complications that can arise after the fact will lead you down the road of correcting the issue without making you feel shameful.

Did you have proximal RNY in 2007?  More then likely, as this is the procedure most RNY surgeons perform.  There are many options for revisions.  Check the all out during your research.  Be sure to 1) choose a very qualified surgeon as revisions can be more risky and 2) make sure you can live with the side effects of the wls you choose.  They all have them.

By the way love your avatar!

Good Luck to you.  Please keep us posted on your new journey!

In August of 2007 I did have Laparoscopic Proximal RNY surgery. I did not meet my weight loss expectations at all. I tried my best to make this work. I can eat anything and had to watch portions and carb counts... as there isn't anything that won't go down or anything that gives me any sensation of satisfaction/fullness or restriction.

I sent my surgery notes with my application to the new clinic. I even had the DVD of the actual surgery and sent a copy of that along ...hoping maybe the new surgeon can see if there were any problems during my surgery.

Not sure why my weight loss did not happen as planned. I'm so frustrated gaining weight even with added exercise and calorie counting. Something just isn't right and I need answers. I like your idea of the endoscope and or upper GI testing. If something mechanical is wrong.. I wonder can it be fixed?? Or do I need to start the whole process all over again.

I'm trying to get in to the Cleveland CLinic Bariatric Center (if my insurance approves it and the center accepts me as a patient). I have heard a lot of great things about this center and hope they can shed some light on things for me. I've learned the hard way... that once you're no longer a bariatric virgin... no local doctors here in my area will even see you for an appointment.

Thanks for sharing and all the support. I'll let you know if I'm given a second chance at the Cleveland clinic . Thanks,
Kathy

You're very welcome!  Don't give up and don't take no for an answer!  When I started researching my revision not all doctors wanted to take me on as a patient either...probably for different reasons then your situation...but....you will get where you need to be if you stay determined and find the right doctor for you!

I heard good things about the Clevend Clinic Bariatric Center as well.  Keep in mind revisions are a bit more tricky so you may have to specifically search someone out who specializes in revisions.  I am sure the clinic will be able to direct you accordingly if they have the capabilities or not.

Good luck.  I will send a prayer your way that you find what you are looking for. 

Thanks Mew,
I'll keep you posted on how my application progresses. I am trying to see Dr. Philip Schauer who is the director at the Cleveland Bariatric Center. I have a friend that had his surgery done by Dr. Schauer when he was at the Pittsburgh Bariatric Center. I've read that Cleveland offers revision surgery but I have not met anyone yet that has had it done there. I am hopeful with more posts on line that I may meet up with someone that has utilized this clinic. Thanks for the prayers I appreciate them very much.
Kathy

I too am seeking a revision. I had RNY almost 20 years ago and have regained 100 of it in the past five years. One way of jump starting your RNY again is to go back to jello and broth and protien shakes for a week or two. Are you chewing your food slowly? taking at least 30 minutes to eat? eating small portions? Not drinking when eating?
I would talk to your surgeon and nutrionist and see what they say if you are following the guidelines.

I have tried the five day pouch test. Getting back to the basics with liquids was a tough go. For some reason I was having bouts of near faintness... and severe vertigo.  My NUT told me to eat three 300 calorie meals a day with 2 carbs per meal (as she thought the faintness/vertigo were low blood sugar attacks).  I was also told to eat two 100 calorie snacks per day, plus drink a minimum of 64 oz of water per day. I can get all that food and water down with no problem at all. Again no feeling of restriction what so ever.   I do not drink a half hour or one hour after meals. I chew my food well and yes slowly. My portions are larger more a regular size to get my 300 calorie meals in. My NUT said something is not right because of the quanities I can consume with no feeling of fullness. I can also drink an eight ounce glass of water down in a very very short time with no problem. My surgeon says ... he "doesn't make mistakes". So I figure if I want answers ...time to find another surgeon for an unbiased second opinion. I just hope I can get an appointment and be seen soon. I'll keep posting . Thanks, Kathy

It does sound like your surgeon made a mistake so I would see someone else. Just Take it easy make sure your taking vitamins. Even after all these years I can only eat maybe a total of a cup of food. So something is not right if you can eat more.

From day one after my initial heal from surgery I could eat way more than a cup of food. I can eat a full dinner with no problems... other than the mental aspect of "why do I feel no restriction ?".  My bariatric support group members were amazed that even right after surgey I could polish off my popsicle and be wanting another one... as they were satisfying and rather soothing.   What can I say I was different from day one after the surgery ...which should have sent up red flags... but I kept hoping "tomorrow it will be better"... well tomorrow never came and the weight didnt' drop off like I had hoped. I await an appoinment with another surgeon and hopefully some answers will follow. Until then... I'm trying to stick to my bariatric diet and continue my workouts at the local YMCA even if the numbers on the scale keep creeping up. I need to stay determined and keep in my exercise regime and hopefully the revision surgeon can figure out why the pounds keep creeping back on.   Feeling no restriction and being able to eat the quanities I can eat just is not "Normal" (if there is such a thing in bariatrics :-)) Thanks for your reply ...

Kathy