2nd Opinion on Revision!~ Desperate in Seattle
Amy Farrah Fowler
on 2/1/10 1:25 am
on 2/1/10 1:25 am
That is because they cannot do DS revisions. You need to see a real DS revision surgeon, and the closest are in CA.
Rose and Stomafix seem to be a total waste of time and money, as the only weight lost is during the liquid phase. Then that's it.
If you do find a surgeon nearby that is willing to try a revision on you, they will only say you need whatever it is that they are capable of doing, which will only be a band over bypass, or ERNY. You really need to consult with a DS revision surgeon, and there are several on the list at DSfacts.com
Rose and Stomafix seem to be a total waste of time and money, as the only weight lost is during the liquid phase. Then that's it.
If you do find a surgeon nearby that is willing to try a revision on you, they will only say you need whatever it is that they are capable of doing, which will only be a band over bypass, or ERNY. You really need to consult with a DS revision surgeon, and there are several on the list at DSfacts.com
Thanks for your reply. It was a Dr. @ NW Hosp. and I mean he was ADAMENT that I did not need a revision. He kept saying things like " I wish the majority of my patients had your pouch" and " I feel so strongly that you dont need surgery that I would not feel comfortable doing it,etc" BUT I HAVE GAINED ALL MT WEIGHT BACK???
I am so confused!! I am goinf forward no metter what and am getting revision cause I have to win this battle! What is the best procedure? What did youi have exactly and how much have you lost?
Also can you share with me the insurance part of a revision? Is it anything like the inital fight for coverage for the 1st procedure? I got my RNY thru a appeal! It was a long battle!
I am so confused!! I am goinf forward no metter what and am getting revision cause I have to win this battle! What is the best procedure? What did youi have exactly and how much have you lost?
Also can you share with me the insurance part of a revision? Is it anything like the inital fight for coverage for the 1st procedure? I got my RNY thru a appeal! It was a long battle!
Can you whisper in my ear your original surgeon? Might tell me a bit about your surgery.
The first two fixes you mentioned are temporary. You have a good working pouch, so they would not be suitable.
An ERNY or distal rny leaves your pouch as is, but just reroutes your intestines to be more like a DS. It's what I have.
The DS requires someone to put your stomach back together AND rearrange the intestines.
It's totally up to you how much surgery you want, and where you want it done.
I suspect I know where you want and even why you got the answer you got.
But let's go from there
The first two fixes you mentioned are temporary. You have a good working pouch, so they would not be suitable.
An ERNY or distal rny leaves your pouch as is, but just reroutes your intestines to be more like a DS. It's what I have.
The DS requires someone to put your stomach back together AND rearrange the intestines.
It's totally up to you how much surgery you want, and where you want it done.
I suspect I know where you want and even why you got the answer you got.
But let's go from there
Michelle
RNY, distal, 10/5/94
P.S. My year + long absence has NOTHING to do with my WLS, or my type of WLS. See my profile.
Thanks for your reply. It was Dr. Chebli @ NW Hosp. and I mean he was ADAMENT that I did not need a revision. He kept saying things like " I wish the majority of my patients had your pouch" and " I feel so strongly that you dont need surgery that I would not feel comfortable doing it,etc" BUT I HAVE GAINED ALL MT WEIGHT BACK???
I am so confused!! I am goinf forward no metter what and am getting revision cause I have to win this battle! What is the best procedure? What did youi have exactly and how much have you lost?
Also can you share with me the insurance part of a revision? Is it anything like the inital fight for coverage for the 1st procedure? I got my RNY thru a appeal! It was a long battle!
I am so confused!! I am goinf forward no metter what and am getting revision cause I have to win this battle! What is the best procedure? What did youi have exactly and how much have you lost?
Also can you share with me the insurance part of a revision? Is it anything like the inital fight for coverage for the 1st procedure? I got my RNY thru a appeal! It was a long battle!
OK, if your pouch is working, then band over OR any of the 6-wk fixes won't help. It'd be your common channel that needs fixing, unless it is your eating plan.
before it sounds like I'm pointing a finger, note that some programs launch ppl on a plan designed to fail. I call it a "bad launch", having you avoid what you should eat freely, eat freely what you should avoid, setting up bad habits..
before it sounds like I'm pointing a finger, note that some programs launch ppl on a plan designed to fail. I call it a "bad launch", having you avoid what you should eat freely, eat freely what you should avoid, setting up bad habits..
Michelle
RNY, distal, 10/5/94
P.S. My year + long absence has NOTHING to do with my WLS, or my type of WLS. See my profile.
StacysMom
on 1/31/10 1:44 pm
on 1/31/10 1:44 pm
The issue may be with your stoma, not your pouch. The stoma may be releasing food too quickly into your intestinal tract. Also, you may not have been bypassed enough in the first place, so the effect of whatever malabsorption you did get has worn off (unfortunately, they really don't know the true amount of bypass unless they actually go in surgically). I've read where some people were opened up to find they were barely bypassed AT ALL!
Don't waste your time with the Stomaphyx or ROSE or any of those endoscopic procedures. Many have come on here all excited at first, but only lose around 20 lbs due to the pre and post op liquid diets. Then, they gain it all back and their only loss is their $$ for the self-pay procedure.
The ERNY has been effective for some, but many ERNY patients are now revising to the DS surgery which is the cutting edge procedure for those with metabolic issues (which I suspect you have since you have gained back all of the weight you lost). The problems I have been reading about regarding the ERNY is that, for it to be effective, the common channel where you absorb nutrients from food must be made dangerously short, sometimes resulting in stool issues, smells permeating one's skin and vitamin/mineral deficiencies. Some have continued to have severe vitamin/mineral issues despite careful monitoring of their nutrient intake. Those with 50-100 cm common channels have had varying results. Some have lost the weight they needed to and others have lost too much or not enough. It depends on the individual and also how much they were bypassed in the first place. Those left with longer common channels (150-200) have complained that they have barely lost anything at all!
The ERNY was heavily promoted by RNY surgeons as an alternative to the DS surgery because they only shortened the patient's intestinal channel and left the RNY pouch alone. These surgeons (who do not even perform the DS and certainly not as a revision) felt it was "safer" for the patient - when the truth may lie more in profits then in what may be best for the patient in the long run!! Many wanted to keep the revision business in their offices and not refer patients to other doctors for surgeries which they do not do in-house.
The DS surgery does not shorten the common channel in the same way and the stomach, although cut into a small "sleeve", it still utilized by the body to absorb certain nutrients, so the DS surgery does not subject the person to the same types of vitamin/mineral deficiencies as the ERNY and the weight loss is greater and longer lasting. It has the best long-term statistics of any weight loss surgery.
Be prepared to lose slower than the first time around because the villi in your intestines have adapted to whatever malabsorption they currently have and have therefore "learned" how to absorb more nutrients (and calories) from the food you have been eating.
Band-over-bypass (BOB) has been successful for some - you may want to look into that.
Don't waste your time with the Stomaphyx or ROSE or any of those endoscopic procedures. Many have come on here all excited at first, but only lose around 20 lbs due to the pre and post op liquid diets. Then, they gain it all back and their only loss is their $$ for the self-pay procedure.
The ERNY has been effective for some, but many ERNY patients are now revising to the DS surgery which is the cutting edge procedure for those with metabolic issues (which I suspect you have since you have gained back all of the weight you lost). The problems I have been reading about regarding the ERNY is that, for it to be effective, the common channel where you absorb nutrients from food must be made dangerously short, sometimes resulting in stool issues, smells permeating one's skin and vitamin/mineral deficiencies. Some have continued to have severe vitamin/mineral issues despite careful monitoring of their nutrient intake. Those with 50-100 cm common channels have had varying results. Some have lost the weight they needed to and others have lost too much or not enough. It depends on the individual and also how much they were bypassed in the first place. Those left with longer common channels (150-200) have complained that they have barely lost anything at all!
The ERNY was heavily promoted by RNY surgeons as an alternative to the DS surgery because they only shortened the patient's intestinal channel and left the RNY pouch alone. These surgeons (who do not even perform the DS and certainly not as a revision) felt it was "safer" for the patient - when the truth may lie more in profits then in what may be best for the patient in the long run!! Many wanted to keep the revision business in their offices and not refer patients to other doctors for surgeries which they do not do in-house.
The DS surgery does not shorten the common channel in the same way and the stomach, although cut into a small "sleeve", it still utilized by the body to absorb certain nutrients, so the DS surgery does not subject the person to the same types of vitamin/mineral deficiencies as the ERNY and the weight loss is greater and longer lasting. It has the best long-term statistics of any weight loss surgery.
Be prepared to lose slower than the first time around because the villi in your intestines have adapted to whatever malabsorption they currently have and have therefore "learned" how to absorb more nutrients (and calories) from the food you have been eating.
Band-over-bypass (BOB) has been successful for some - you may want to look into that.
OMG Thank you so much for all the info! This has helped me tremendously. This Dr. who is extremely popular and well known in the WLS world just completely threw me off with his info. But I am determined to get a revision. I start a new job this month and my new insurance kicks in day 1! It will be with Cigna. Can you maybe give me some info on the insurance approval side of a revision? What are the best steps to take? The most common reasons for approval, etc.
Wait a sec.
Some popular DS surgeons do switch ppl over to ERNY (but don't call it that). Depends on each person's status. I've referred many to DS surgeons I like and they do whichever they feel fits the situation. If someone is on their 4th surgery (started in the 80's), the surgeon might leave an intact pouch alone because the tissue is so weakened by continued tampering. Not a skill issue at all, but you can only use fabric over and over just so many times.
As a distal RNY, my intestines are exactly arranged as if Dr. Rabkin did 'em. But I have a pouch. 100cm common channel.
The ERNY's and distals like me who do not do well are like DSers who did not have correct instruction or did not follow it.
To look at labs from either, I can't tell the difference, basically. Depends on which part of the country, but often the DSers have more issues with iron and B12 because they may be told they are not issues. (B12 is an issue of aging, regardless of which WLS).
All that said, proximal labs look the same at 5 yrs, too. Under supplemented is under supplemented, no matter what.
The ppl with 50cm common channel (DS or ERNY), well, they have to work diligently to bring their levels back or keep them up. True. But I've seen it done by both.
For someone who does not want to do protein drinks or take pills, any WLS is nearly a death sentence, just some are faster, some are slower.
I agree that the stoma fixes are largely a waste of money. Those who've done the BOB have lost some wt, but still not all.
Having brought so many revisions here or sent them elsewhere, it IS amazing what a person's original op report says vs what the revision doc finds when he peeks inside. Amazing. One woman had her gallbladder out with her original ( proximal rny) surgery. So, did she grow a new one? Musta grabbed the wrong op report, huh?
Some popular DS surgeons do switch ppl over to ERNY (but don't call it that). Depends on each person's status. I've referred many to DS surgeons I like and they do whichever they feel fits the situation. If someone is on their 4th surgery (started in the 80's), the surgeon might leave an intact pouch alone because the tissue is so weakened by continued tampering. Not a skill issue at all, but you can only use fabric over and over just so many times.
As a distal RNY, my intestines are exactly arranged as if Dr. Rabkin did 'em. But I have a pouch. 100cm common channel.
The ERNY's and distals like me who do not do well are like DSers who did not have correct instruction or did not follow it.
To look at labs from either, I can't tell the difference, basically. Depends on which part of the country, but often the DSers have more issues with iron and B12 because they may be told they are not issues. (B12 is an issue of aging, regardless of which WLS).
All that said, proximal labs look the same at 5 yrs, too. Under supplemented is under supplemented, no matter what.
The ppl with 50cm common channel (DS or ERNY), well, they have to work diligently to bring their levels back or keep them up. True. But I've seen it done by both.
For someone who does not want to do protein drinks or take pills, any WLS is nearly a death sentence, just some are faster, some are slower.
I agree that the stoma fixes are largely a waste of money. Those who've done the BOB have lost some wt, but still not all.
Having brought so many revisions here or sent them elsewhere, it IS amazing what a person's original op report says vs what the revision doc finds when he peeks inside. Amazing. One woman had her gallbladder out with her original ( proximal rny) surgery. So, did she grow a new one? Musta grabbed the wrong op report, huh?
Michelle
RNY, distal, 10/5/94
P.S. My year + long absence has NOTHING to do with my WLS, or my type of WLS. See my profile.
I am so glad to see your post! I am having the same problems! BUT I had the ROSE done july 2009 and don't recommend it. I was a canidate for it bc my pouch and stoma were stretched. I have lost almost 30 pounds since having it. I have the restriction and i am exercising but just CAN'T drop the weight. I don't know what to do anymore! I get depressed just like you bc I'm doing the diet and even counting calories (If I wanted to do that I would have done weigh****chers again!) and nothing is happening. I hope you find your answer. I would love for you to keep me posted! Good Luck!
Thanks
Anissa
Thanks
Anissa
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