Would you revise with heart probs?

Had my RNY in 2006 ,lost weight for the first 6 mnths,then it all stopped ,start weight was 130kg am now 99kg.Tests found that both the pouch and outlet enlarged and food goes straight through.
18 mths ago I found out I had Atrial Fibrillation( heart rythmn disorder ) and a narrowed valve.
By still being obese this means there is still a extra strain on the heart ,plus I need both knees replaced due to arthritis ...........should I have a revision ? or leave it ,as it is a riskier op 2nd time around .. and I will eventually need knee replacements surgery as well
My mind is just going around in circles ..what should I do? or should I do nothing at all ? and stay fat  for the rest of my life  :(
Confused  x

I'd have a talk with a good heart doc that is familiar with bariatric surgery if I were you. I'll tell you a bit about my choices, when I had a virgin DS.

I also have AF, degenerated joints and an inherited disorder that causes extremely high cholesterol (like 500!) and wanted a surgery that would address the cholesterol, allow me to take NSAIDS, and a surgeon skilled enough I knew he'd dealt with others who had similar problems.

I'm not sure what type of revision you are looking at, but know if it's a DS, the top revision guys have crazy skill, and would be able to discuss things like the AF and narrowed valve. It sure seems like some or all of your problems should be helped with a successful WLS, and I've even heard of previously narrowed arteries opening back up post DS.

I DO feel the need to insert some biased opinion here as well. NONE of the other surgeries have shown the same success as the DS as far as weight loss, and resolution of co-morbs (according to studies, not just my opinion) and I don't think I'd put my body through the stress of the surgery if if was for any surgery other than the DS, because I'd want a shot at the great blood fats helping that valve, the ability to take NSAIDs for the damaged joints, and the best shot at getting the excess weight off.

Good luck with your decision, and I hope you find a solution you are comfortable with.

Only a trained surgeon and/or cardiac specialist can assist you with this decision.  Good luck to you.

maryjo

Thank you both for your replies x
The revision I had in mind was to make my pouch and outlet restricted,beleive it or not I have an extended Rny ,the bypass is 2 mts long,so I would be a little scared of having the DS as I already have to be careful with fat consumption... it gives me the runs and foul wind ...

As I live in the UK ,you need to go from one surgeon to another and dont have any choice ! One never "knows" what the other would do ... you seem to go around in circles and end up frustrated that nobody can give a straight answer to your problem!
EXAMPLE..... I went for a face lift last year as I wanted something done to cheer myself up ... asked the cardiologist if it was safe to have a face lift and he just said yes sure go ahead ...which I did ,,,,and nearly died afterwards ...hence my fear of having other surgeries done ,when I saw another plastic surgeon after the facelift ,he said I should have never had it done ...so  you see my predicament ?

Well, the reason I mentioned the fats with the DS, is because you would NOT have to be as careful with fat consumption with the DS. It isn't absorbed, and therefor isn't deposited in the arteries. My cholesterol is now great, despite having genetic issues and eating plenty of fat.

I also prevent constipation by making sure I eat some fat. I was thinking of my hearts health when I selected a surgery, and feel the great cholesterol levels are worth keeping in mind.

Revise to DS if you have a great surgeon you can get to and if your medical conditions will allow for it and if you can keep up with the supplementation needed to stay healthy as a post-op!

I was in your shoes.  Heart problems were just ONE of my medical issues and yet I technically just had about 50 lbs to lose.  I actually lost about 70 with my Revision (I had an ERny since, with my medical conditions, it was less risky than a DS).

But...losing the excess 50 has my heart healthy, my Diabetes gone,....etc.  Now my biggest struggle is to get my vitamins & iron all squared away with my labs.  .....  a good tradeoff from facing open heart surgery!

Life is about trade-offs....no perfect forumula for any of us.  If we stay heavy then many of us face issues far worse than side effects of WLS.

Good luck!!!  Keep studying all your options. 

I've had 3 wls surgeries (that's kinda embarassing)......but each time I went to a cardiolgistt and had complete workup and got a release from him for my bariatric surgeons.  Even tho this last surgery (RNY) was pretty extensive and I had just had a heart stent (my 5th) a few months ago, the conclusion of a conference between my cardiolgist, PCPand surgeon was that the weight I had lost (160) pounds had saved my life.....they concluded that the last surgery was worth the risk (and the risk was minimal) to ensure that I kept the weight off.  I did very well with the surgery.  

Do they think they can fix the original surgery so that it works right? Or will you be switching to another type of wls?

BTW......I've had AF most of my life and I've also had many surgeries (some by choice, most not, so there was no pre-op exams, etc)  in my long life with no problems from them at all.  That is not the say that's the right decision for you......only your cardiolgist can make that call.

I will you well........

Gayle
I would only want to tighten my restriction ,as I already have an Extended RNY ...or so i was told !you wouldnt think it with my weight loss !
So I would like my pouch made smaller and the outlet made smaller ...but what I want and what I would get on the NHS is a different story !
Am glad to hear that all your operations went well though ,this gives me some hope
Sue x

I feel your pain. i have cardiomyopathy,  osteoarthritis ,need  total knee replacemnets and  have lymphedema. My cardiologist and lymph Dr.s are so excited that I am having RNY tomorrow. Both Dr.s  tell me I will feel so much better and may be able to hold off on the knee replacement a little longer. Hard decision but I want to live and be able to have more quality to my life so the chance is worth it to me.

I am wishing that all goes very smoothly for you today missnana !
Please get back when you are fit enough ?
Sue x