Revision = a WEIGHTY decision!

Wondering about a certain type of surgery as a revision?

Consider:

Any proof it works?  Any peeps that have had success outside of 6 months (if a Rose or Stomaphyx) 18 months for other types?

If there is a trend on this forum (and across the other boards) that one surgery type is more successful than another and that seems to be coming from the majority and those who are a distance out from their surgery dates, then there might be something to it!  You think?!  I serioiusly doubt if a bunch of busy people just ganged up and decided to bombard the Revision forum with the idea of pushing a surgery type.

Be smart!  It seems so many ignore the obvious.

And...."if" your insurance says you can ONLY go to one surgeon or ONLY have one type of surgery option; please know that there are hundreds who have seen beyond those limitations and have:

Appealed and won!
Gone through a medical review to plead their case and won!
Worked with other surgeons to get the surgery and have been successful!
Have traveled outside of their city, their state and even their Country for a surgery and have found the funds and path to success in spite of the odds!  It happens all the time!

See beyond the 1 year post-op results from a procedure and look ahead to years down the road.  Which surgery will serve you the longest (a lifetime) with optimum health possibilities?

Do your research.  That usually means more than asking a few of us for our opinions.    It also means going beyond the advice of one surgeon who may be limited to one or two types of procedures.  Of course they will recommend what they do best! 

Assuming that you are on this forum because you have already had one failed surgery; know that revisions are riskier and require a surgeon with a level of expertise that is sparse in the U.S.  There is a small handful of qualified revision surgeons!  Be protective of your life!

It's YOUR body!  Be pro-active and get the best that your money can buy or your insurance will cover!!!!


Proud to live in a Country where we have some amazing choices!!!

Happy 4th weekend!    Be safe!  Choose wisely! 

Thank you for posting, most people just take whatever their doctor says will work. Going through the process of getting a revision is a slow path but it can be a rewarding one. I have learn that I should study and review all options, seek out the best surgeons and to never give up. You and many other have been there for me when I thought there was no hope of which now I am full of. Thank you Joyce for your assitance and advice and soon one day I will be a revision DS too!!!!!!!!!!!!!!!!!!!

Sophia

Hey there friend!
Kudos to you!!!  Keep hanging onto that hope but don't hesitate to put some "muscle" into YOUR decision too!  You'll be rockin your own DS before you know it!!!

Let us know how we can help over on the DS forum!!!

Hugggzzzz!!!

 Great post, Joyce!!      But, I think that in order to be clear, people need to know what surgery is causing the controversy.    You didn't say it, so I will.   

For those of you out there who are new to these boards, please look and see how many people are looking to revise FROM the DS surgery to something else.   You will find NONE.   That alone speaks volumes!  

You will, however, find people looking to revise from lapband to RNY and then from RNY to ERNY and then from ERNY to DS (which is what they should have had in the first place).    

You will also see people who are choosing the lapband or RNY because those are the only surgeries their insurance companies will easily pay for.    "EASILY" is the key word here.   Many have fought their insurance companies and won the right to get the surgery of their own choosing.  The surgery which is BEST for THEM -- not their doctor -- not their insurance company!

Just try and find anyone who has had a lapband in them for 10 years.   Most need to be revised either to another lapband or the RNY or the sleeve (which they probably should have gotten in the first place -- if only their original surgeon had told them about it!)

For the WLS lightweights, the sleeve surgery (VSG) may be enough to control their issues.   For the SMO people, the DS would be the way to go.   But please remember this ... if you cut your stomach up into the unnatural configuration of the RNY pouch with the stoma and take your pyloric valve out of the equation, you DRASTICALLY limit the type of revision you can easily get if your RNY is not successful for  you.   And, the more times you have to be revised, the more dangerous the surgeries get and the more possibility of leaks and complications.

More and more surgeons are now offering the sleeve surgery, which preliminary stats are showing has excess weight loss amounts similar to the RNY.    The sleeve preserves the natural configuration and function of the stomach.   You get to keep your pyloric valve - you don't get an unnatural man-made stoma and pouch which ALWAYS stretch out!

 And, the BEST thing is, if you do end up needing a revision down the road, the DS is much easier to do because all the surgeon has to do is add the intestinal bypass portion of the DS.   There is no pouch to reconstruct into a working stomach again and this reconstruction is the most dangerous part of the RNY to DS revision and where the most complications arise.

More and more insurance companies are covering the sleeve surgery and even if your insurance company doesn't at present --- maybe they will in 3 or 6 months.   Isn't it better to wait a bit to get a superior, more modern surgery; than to take a mediocre surgery just because it's available sooner?

I'm sick of seeing people herded like cattle into RNY and lapband factories, with their *free* information seminars where they only tell you about the surgeries that their office performs and convince you that those surgeries are the ONLY way.    They trot out a few successful patients who are usually only a few years out and have just had their body lifts.   Everyone "ooohs" and "aaahs" at comparing the "before" pictures and then seeing the svelte and attractive "examples" in front of them.  I'd like to see someone who is 15 years out and still maintains their weight loss w/o a lot of work!  It makes me particularly sick the way these factories try to silence the few people who have educated themselves on the other surgical types and try to ask questions during the seminars.

The only successful RNY patients I personally know are those who used the surgery as a "jumping off point" to start a whole new lifestyle.   These people run marathons, hike mountains, work out 5X a week, don't touch carbs, etc.   A few even changed careers and became personal trainers or nutritionists!   Everyone else I know who did not change their eating/llifestyle habits is looking for "revision".   Or they are blamed for "not working their tool" by the same surgeons who gave them the WRONG tool in the first place!   These people would have been better served by the DS surgery which has WAY better long term stats, but they were never informed of its existence.

Stepping off my soapbox now ...

Joyce ... you go girl!!  Happy Independence Day!        



  

Good to see you posting, Joyce!!!!

Keep on inspiring!!!
-Jamie

Joyce, met you at a post surg. open forum 2008.  did a "fashion show for you" and the group.  need to know where your support group is now, need assistance ASAP

Jo Ann

Joyce - what does PM me mean?

I want to talk to you - I live in Bakersfield and want to go see Dr. kashisian....You look great!  I had RNY in 2004 and lost 100lbs but I was still at 200lbs!!  Now I am at 220 and I am so scared of getting bigger....can you tell me about your experience w the doctor and insurance?

Julia

Hiya Julia!!

PM= private message  ....If you click on a persons name from their post then it gives you the option of sending them a message (unless they've blocked that function)  Then you can have a conversation without the eyes of the millions.

You'll LOVE Dr. Keshishian!!!!  You may have to drive to his Glendale office though or does he still do Thursdays at the Delano office (near Bakersfield).

My short version. Had Prox Rny in 2003 and lost down to 135 the gained back up to 170 ++ ...had a revision from H#%& to an ERny with oodles of miserable complications...was fighting for my life and watching other ERny peeps losing that same battle......Had enough of that awful life and researched options...ended up being totally GIFTED with the DS revision with Dr. Keshishian.  Other surgeons wouldn't touch me.  He got excited to take on the challenge!  (kind of bazaar like that...in a way that patient's benefit y'know?!)  His office helped me fight the insurance battle that we lost, won, then partially won then finally completely won just minutes before the surgery started!  Dr. K rocks!   The DS totally rocks!!!!

My worst problem was resolved immediately from the surgery and other issues continue to improve and i'm just 8 weeks post-op!!!`

As a revision, you are automatically in the high risk category and can only trust about 3 surgeon's.  Dr. Keshishian and Dr. Rabkin are 2 of the 3 and are closest to you.  Both are excellent.

My experience with the surgery, the out of state logistics, the hospital etc was so smooth.  The hospital room is lovely and is private with an extra bed for your support person to stay right with you the entire time without cost.

Let me know if you want actual surgery and post-op details.

Good luck with your journey!  Be sure and read through www.dsfacts.com

I don't think there is any question but that DS is the best weight loss surgery. But some insurance companies just flat out won't cover it. For those people, if they really really work at it, and realize it's a tool that requires total lifestyle change, RNY can work too. It's not as good, that's true. I would say to anyone that has a great deal of weight to lose, if they can get it covered, go for it.

However, if your insurance literally and absolutely doesn't cover it, and you're willing to really work the tool, you can be a success at RNY. If I can give up carbs, sweets, and sugar at 52 years old, after years of always giving in, there is hope.

But stats don't lie and I agree with you. DS is the best weight loss surgery long-term. I do love my RNY, but it may be (for me anyway) that the pure hell of my lapband caused me to really really look deep inside myself and want health for whatever time I have left (and I admit it - I wanted to be thin too). I realized at my age, and with the problems caused by my lapband, coupled with my insurance, that DS wasn't an option for me.

I do hope as the stats show even more long-term success that insurance companies will jump on the bandwagon and start caring about people's health long-term so people don't struggle so much. I'm the first one to admit, this is really hard work. Worth it, but hard just the same.