Seven years out and OMG!
Hi All,
I had my RNY almost 8 years ago. I never lost all the weight my surgeon wanted me to, but I was happy. In the last 2 years I have gained back 65 of the pounds that I thought were gone for good. I never stopped following my new eating protocol, so I am frustrated and sad. In the last year or so I have had pouch pain when I eat and , believe it or not, still throw up about once or twice a week. I talked to my endocrinologist and we did all kinds of tests to make sure it wasn't my thyroid disease acting up. She tried to refer me to my bariatric surgeon, bit I was denied twice as not being medically necessary. They consider my surgery a success. I went beck to my endocrinologist and she tried again citing the pain in my pouch. The insurance approved a consultation to a gastroenterologist. This Dr. does not deal with gastric bypass.
I am confused. Do I go to the gastroenterologist with the hope he will refer me to a bariatric surgeon
on a hail mary play for a revision?
Any advise would be great!!
Jana
I had my RNY almost 8 years ago. I never lost all the weight my surgeon wanted me to, but I was happy. In the last 2 years I have gained back 65 of the pounds that I thought were gone for good. I never stopped following my new eating protocol, so I am frustrated and sad. In the last year or so I have had pouch pain when I eat and , believe it or not, still throw up about once or twice a week. I talked to my endocrinologist and we did all kinds of tests to make sure it wasn't my thyroid disease acting up. She tried to refer me to my bariatric surgeon, bit I was denied twice as not being medically necessary. They consider my surgery a success. I went beck to my endocrinologist and she tried again citing the pain in my pouch. The insurance approved a consultation to a gastroenterologist. This Dr. does not deal with gastric bypass.
I am confused. Do I go to the gastroenterologist with the hope he will refer me to a bariatric surgeon
on a hail mary play for a revision?
Any advise would be great!!
Jana
What is your current BMI? Do you still have any co-morbs, like diabetes or high cholesterol? Hypertension? Anything?
If you're maintaining a loss of 50% of your excess weight, then yes, they WILL consider your surgery a success---unless you have a mechanical failure of some sort, or it's causing a medical problem (like the pain you're having).
Definitely see the gastroenterologist. Maybe he'll find a defect that you can use to appeal for a revision.
If you're maintaining a loss of 50% of your excess weight, then yes, they WILL consider your surgery a success---unless you have a mechanical failure of some sort, or it's causing a medical problem (like the pain you're having).
Definitely see the gastroenterologist. Maybe he'll find a defect that you can use to appeal for a revision.
Insurance can be a pain. I had an rny in 2003 and gained quite a bit of it back. Ughhh.. Because I switched jobs my insurance now won't cover anything. I just had a band over bypass in Mexico and although it is slow, it feels good to be going down instead of feeling out of control. There are several here who have posted rebuttal letters to insurance. Also, there are lawyers who offer the service. Good luck!
I am in the middle of having a revision from Lap Band to Sleeve BUT this may be of some help to you in the meantime.
I too have developed pouch pain and have worked for a Gastroenterologist's office before as an assistant. What I would do with your symptoms and insurance company is start on a PPI as it sounds like you definately have a LOT of inflammation in there. This will reduce the amount of acid produced in your pouch. You can take TWO of the Prilosec OTC and that equals 1 old RX dose of it or generic Omeprazole 20mg if you take 2 of those that's equivalent to Nexium. Take that medication daily for about a week or until you get into see the Gastro doctor the insurance wants you to see. A gastro doctor may not do WLS but we saw a lot of patients with previous WLS and we knew how to do Upper Endoscopy (flexible scope w/a camera) on patients with a WLS history. With the scope the Gastro can look around and take samples (biopsies) to see if perhaps you have something else going on like H-Pylori or ulcers causing your pain. IF he is unable to figure out what the problem is, they can tell the insurance company their concerns and why you need to see a WLS.
Best of luck and feel free to PM me.
I too have developed pouch pain and have worked for a Gastroenterologist's office before as an assistant. What I would do with your symptoms and insurance company is start on a PPI as it sounds like you definately have a LOT of inflammation in there. This will reduce the amount of acid produced in your pouch. You can take TWO of the Prilosec OTC and that equals 1 old RX dose of it or generic Omeprazole 20mg if you take 2 of those that's equivalent to Nexium. Take that medication daily for about a week or until you get into see the Gastro doctor the insurance wants you to see. A gastro doctor may not do WLS but we saw a lot of patients with previous WLS and we knew how to do Upper Endoscopy (flexible scope w/a camera) on patients with a WLS history. With the scope the Gastro can look around and take samples (biopsies) to see if perhaps you have something else going on like H-Pylori or ulcers causing your pain. IF he is unable to figure out what the problem is, they can tell the insurance company their concerns and why you need to see a WLS.
Best of luck and feel free to PM me.
Lap Band Aug. 2005, Revision to VSG and Band Removed Aug. 2010
I revised from RNY to DS. I kept off over 100 lbs, but had complications and was still overweight enough to qualify. I am amazed at how much better things are with the DS, and I'm down 60 since December.
I threw up all the time with the RNY, couldn't eat normally, and really had a crappy quality of life. I mean, who the hell wants to go out to eat with friends when you know you're going to have to excuse yourself to go lose it? I used to beg to go to soft food places rather than go where I wanted to go.
I regained with the RNY even though I followed the eating protocol and I couldn't overeat with that damned extra ring I had. The malabsorption goes away, and the body overcompensates, piling on the weight. That's why the long-range stats for RNY are showing a lot of people are regaining.
I threw up all the time with the RNY, couldn't eat normally, and really had a crappy quality of life. I mean, who the hell wants to go out to eat with friends when you know you're going to have to excuse yourself to go lose it? I used to beg to go to soft food places rather than go where I wanted to go.
I regained with the RNY even though I followed the eating protocol and I couldn't overeat with that damned extra ring I had. The malabsorption goes away, and the body overcompensates, piling on the weight. That's why the long-range stats for RNY are showing a lot of people are regaining.
Wish I had some advice to offer. I had my RNY in 2005 and have regained almost 40 lbs now. The regain started appx. 2 years ago. First it was just a pesky 10 lbs., but it just kept increasing. I know part of it was because my portion sizes increased.
I met and married a wonderful man who loves to cook and dish out the portions. It was very difficult to get him to understand that I just cannot eat the amounts of food he was giving me. Being raised to "clean my plate" didn't help either. I kept trying to eat the whole serving, and it was more than I could handle. By the time I found a method that worked (saying "whoa" when the serving size was right, and refusing to eat another bite beyond that), I had put 20 lbs back on.
In 2009, I had a mini-stroke (not weight-related) and through an unusual chain of events, the doctors also discovered a aneurysm in the carotid artery near my left ear, along with plaque build-up in the carotid arteries on both sides of my neck. This is not related to my RNY, but now there's concern that the medications I was given for those conditions may have damaged my pouch somehow. I just plain did not understand that there are certain types of medications I can't take.
I'm looking into revision surgery, but it's an uphill battle. The doctor who did my RNY moved to another state just after my 1-year post-op anniversary. The new doctor doesn't do revisions because she says they're dangerous. Therefore, she won't issue a referral either. She also doesn't do RNY -- she specializes in Lap Bands. I actually haven't seen her personally -- I see the Nurse Practitioner. The NP also referred me to a nutritionist who, fortunately, is only a few miles from my home (the wls clinic is 60 miles away).
I just had an appt with the Nutritionist today, and she gave me contact info for a doctor who does revision surgeries. Problem is, this doctor is appx. 150 miles away. There is a clinic appx. 20 miles closer to me, but it's still oveer 100 miles. I called there last month and left a message, and they have yet to reply.
Having said all that, I want to thank everyone here for posting. It helps to know I'm not alone. I've been told so many conflicting things: exercise, don't exercise (because of the aneurysm), I eat too much, I don't eat enough, liquid breakfast is good (I'm not a morning person or a breakfast eater), liquid breakfast is not good (even with the protein powder added), etc., etc.......
It gets confusing. But I know I'm not a "wls failure". I even took a dry erase marker and wrote some encouraging words on my mirror, so that whenever I'm tempted to endulge in negative self-talk, I can remind myself that I'm still a great person. It helps :)
I met and married a wonderful man who loves to cook and dish out the portions. It was very difficult to get him to understand that I just cannot eat the amounts of food he was giving me. Being raised to "clean my plate" didn't help either. I kept trying to eat the whole serving, and it was more than I could handle. By the time I found a method that worked (saying "whoa" when the serving size was right, and refusing to eat another bite beyond that), I had put 20 lbs back on.
In 2009, I had a mini-stroke (not weight-related) and through an unusual chain of events, the doctors also discovered a aneurysm in the carotid artery near my left ear, along with plaque build-up in the carotid arteries on both sides of my neck. This is not related to my RNY, but now there's concern that the medications I was given for those conditions may have damaged my pouch somehow. I just plain did not understand that there are certain types of medications I can't take.
I'm looking into revision surgery, but it's an uphill battle. The doctor who did my RNY moved to another state just after my 1-year post-op anniversary. The new doctor doesn't do revisions because she says they're dangerous. Therefore, she won't issue a referral either. She also doesn't do RNY -- she specializes in Lap Bands. I actually haven't seen her personally -- I see the Nurse Practitioner. The NP also referred me to a nutritionist who, fortunately, is only a few miles from my home (the wls clinic is 60 miles away).
I just had an appt with the Nutritionist today, and she gave me contact info for a doctor who does revision surgeries. Problem is, this doctor is appx. 150 miles away. There is a clinic appx. 20 miles closer to me, but it's still oveer 100 miles. I called there last month and left a message, and they have yet to reply.
Having said all that, I want to thank everyone here for posting. It helps to know I'm not alone. I've been told so many conflicting things: exercise, don't exercise (because of the aneurysm), I eat too much, I don't eat enough, liquid breakfast is good (I'm not a morning person or a breakfast eater), liquid breakfast is not good (even with the protein powder added), etc., etc.......
It gets confusing. But I know I'm not a "wls failure". I even took a dry erase marker and wrote some encouraging words on my mirror, so that whenever I'm tempted to endulge in negative self-talk, I can remind myself that I'm still a great person. It helps :)
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