OMG...WHAT TO DO NOW???

GOOD LORD...I THINK I NEED SOME POINTERS... I WENT FOR THE BARIUM SWALLOW TODAY AND ALSO SEEN THE SURGEON...DAMN-DAMN-DAMN. I'M NOT SURE IF I'M GOING TO BE ABLE TO GET MY REVISION DONE AND THIS REALLY ****** ME OFF...THE SURGEON SAID THAT MY POUCH IS INTACK AND THAT IT IS 30.5 CM., HOWEVER SHE IS GOING TO DO AN EGD TO CHECK FOR SURE ON THE POUCH SIZE AND THEN MAKE A DECISION ON SURGERY OR NOT. I TOLD HER THAT I EAT ALOT AT A MEAL AND THEN AM HUNGRY WITHIN HOURS LATER...SO WHY CAN I EAT SO MUCH?????? SHE FEELS FOOD MOVES THRU TO QUICKLY ALSO, MAYBE FROM ENLARGED- STOMA (BUT SAID SHE WON'T DO STOMA REPAIR BECAUSE THEY DON'T LAST). I HAVE BEEN STRUGGLING UP/DOWN WITH MY WEIGHT FOR WAY TO LONG AND AM NEEDING SOME HELP HERE. IF ANYONE HAS SOME POINTERS/SUGGESTIONS/SUPPORT PLEASE FEEL FREE TO SEND ME SOME.

OK first thing is first - don't panic and turn the all-caps off! 

I went through the exact same thing as you are going through and finally got my revision approved.  I know how you feel though.  Here's what happend.

I had RNY 10 years ago - lost all excess weight and started to regain over the last 2 years.  When I went in for tests, the upper gi and endoscopy showed that my pouch was still small (intact, succesfull etc) and there was no good reason for my regain.  However, after a little bit of research I went in for another round of tests and asked a different set of doctors to do the upper gi and endoscopy tests with a focus on the stoma and not on the pouch.  When they did, they found that my stoma was indeed enlarged.  No wonder I was always hungry!

The stoma is the area where the small intestine is attached to the small stomach pouch.  In a patient with a gastric bypass like us, there is no pyloric valve to keep food in the pouch so when the stoma is enlarged it allows any food that we consume to go from our small pouch rapidly out into the small intestines. This is not something you want to happen because not only do we lose the ability to feel full, which is a major component of the gastric bypass as a tool for weight loss, but it can also cause severe dumping and other unpleasant side effects. 

So ask for them look at the rate at which your pouch empties, and also to focus on the stoma size - anything more than say 13mm or so MAY be enough to be problematic, ie a mechanical failure.

Don't give up. 

sorry... The cap thing seems to bother alot of plp...  thanx for the input, My doc said the stoma is enlarged and refuses to do any repair because she said they don't last long.  However she is doing an EGD to recheck size of pouch. i also never feel full and eat way to often.  If I feel I'm getting a brush off I plan on contacting Batriatric team or go to other facility.

Your doctor is most likely correct that the (non-invasive) methods to repair an enlarged stoma - stomaphyx, ROSE and sclerotherapy - don`t work. They come up every few days here but I have yet to see someone for whom it worked longer then a few weeks at best. There are other options that actually DO work, but they are a lot more invasive then the stoma repair. It`s band over bypass (will give you some restriction back, relatively easy to do, but results vary wildly and it is not a good methd if you have more to loose), ERNY (adding malabsorbation so that it doesn?t matter that you can eat more - more risky and probably more effective then the band over bypass), or a revision to a full DS. That is the most complicated of all revisions and the most effective. It solves the stoma and pouch problems because your phyloric valvue is put back in place, so you`ll get restriction back, and it also gives you more and lasting malabsorbations. For someone with more then 70-80 pounds to loose, it might be worth the risks, because the ERNY and the band over bypass are unlikely to bring more then 50-70 pounds of weight loss and the big question how long a band over bypass will last - at least the "original" band surgery is not a permanent solution and I don?t think that there is already enough longterm data to know if the band over bypass works that much better in terms of longterm sucess, complications and reoperation rate.

What jeanyjane said is what tallies with what I have learned and researched myself.  I decided that the best option for me, because I have more than 80 lbs to lose, is to convert to a full DS.  I'm scheduled for surgery at the end of Oct.  I agree with you though, if they blow you off, make an appointment with another doctor who has experience with revisions - not all do.

Thanx to all for the advice/input.  I plan on following thru on wed with the EGD and take it one step at a time.  Also gonna try to not panic so much, I was just really bummed with the blunt approach given from the doc. She sounded like diet & exercise were the only options, and nothing could be done to help me.

Hey there Jeanyjane,
I completely respect all of your postings.  You explain things very well and are very positive in the delivery.  I just wondered if you have any specific source for the ERny and Band over bypass in regards to an average weight loss following a revision?

I wonder because I seem to be just one of 3 or 4 on this site of ERny's and there are only 3 or 4 BOB's on here as well (that post).  I'm wondering about the other zillions out there?  .....  If our experience is the "jest" of what people are going on then your average weight loss # (50-70 lbs) is correct but if the support group I attend is more like it then the average ERny loss is well over 100 lbs.

I'd love info if you remember your sources and don't mind pm'ing me with the link?

thanks so much!