Severe hypoglycemia Surgeon wants to reverse Surgery

Hi,

My surgeon does not want to revise my RNY to a duodenal switch.  He only wants to reverse my RNY because I have severe hypoglycemia.  I have blacked out and my blood sugar has been in the low 30's several times.  I am also anemic on a regular basis.

I have tried to avoid all carbs and eat only protein.  But the protein causes a lot of abdominal pain and discomfort for hours.   I get dehydrated because then I can't drink anything without causing more discomfort.

 I am posting @ 3 a.m. because, right now, the pain is keeping me awake.  I also now suffer from esophageal spasms since the surgery.  I have lost 8 lbs. in the last week just from not eating.

They have done numerous CT scans, upper GI series. endoscopis and can't find anything wrong.  Scheduled for another endoscopy Nov. 1st.  But yet I am in pain the majority of time.  I am 5 yrs. post op and still struggle trying to eat.  Spent the first 3 yrs. being in the hospital a lot.  Because I've been to the ER so many times, they  treats me as if the pain is all in my head and I am seeking drugs.  I know it's not in my head, but how do you convince the dr.
  Last  Fri., I was once again in the ER and they just gave me pain meds, did another CT and sent me home.  Of course the CT was normal.  I also have a small umbilical hernia that the surgeon doesn't want to repair even though it causes me pain.

I don't know if DS will be the answer, but right now I am ready to do anything.  Aren't there complications with reversing the RNY.

By the way, my surgeon is Dr. Sayeed Ikramuddin, Univ. of MN.  He has only done 4 DS's.  Says it's too dangerous.

Frustrated and tired of being in pain.

Okay the first paragraph is me to a "T".  I could have wrote the same thing.  Infact I think I did just down the page in another post.  I am sorry you are going through this.  It sucks.

I am revising my RNY to a DS and am couting down the days.  The problem with the RNY is that they make us a "pouch".  We do not have a pyloric valve.  With having a DS you will get a fully functioning STOMACHE again.  You won't have a pouch!!!  Yes your STOMACHE will be smaller but it will work just like it use to.  It might even help your anemia. 

I think you need a new DR.  Find a good Revision Specialist.  Dr Rabkin, Dr Keshishian, Dr Greenbaum, Dr Gagner.  These are the four main ones and they will be able to help you.

Check out www.dsfacts.com all the info on surgeons is right there.  I hope you can find some answers and some peace soon.

Oh my dear friend!

Please go to a different surgeon! Of course it would be dangerous to be revised to a DS with a surgeon who doesn't do them several times a month for several years!  Revisions are high risk and only 3 or 4 surgeons are qualified to do them safely.  I had all kinds of complications from my Extended Rny and the revision to the DS was the "fix".  I rarely "if ever" have any hypoglycemic incidents anymore!

check out www.dsfacts.com  Consider shooting an email to Dr. Keshishian, Dr. Rabkin or Dr. Gagner.  Dr. Greenbaum is off the list for a while til he catches up with his backed up list.  It's worth a few minutes to email and may make the difference in yoru decision to get info from other surgeons (Revision surgeons).

Good luck!  i"m soooo sorry for your pain and your suffering!

Thanks for the responses.  I was feeling pretty depressed and you ladies helped.  I think I am going to start looking for another surgeon.  My mom has been trying to convince me to do just that.

Called the surgeon's nurse to tell her about the pain.  She treated me as if I was a new post-op, talking about getting in enough water and not drinking diet pop, not drinking fluids 1/2 hr. before and after a meal.    Good grief that's not the problem.  The problem is that eating causes pain and after I eat I have to wait an hour(s) before drinking any fluids.

Do you mean Dr. I has only done 4 RNY-to-DS revisions?  I know at least 4 people in real life who've had the DS with him and they've done great.  He's done many more than 4 DSes.  He does discourage it for younger patients or those who want children in the future, though. 

Have you discussed the option of reversing your RNY and getting sleeved at the same time?  Maybe you are not cut out for malabsorptive surgery, but total reversal sounds sucky as an option.  For the record, most DSers don't get bad hypoglycemia (it cured mine) but I've heard of a couple who did, anecdotally.  None of them from the U of M.

Have you consulted with Dr. Buchwald?  He is a good revision surgeon and a little less cautious than Dr. Ikramuddin (I mean that in a good way, though.)  

He was pretty adamant about reversing my RNY.  I don't know why though.  I do have an endoscopy scheduled with Dr. Ik Nov. 1st.  Maybe he wants to see what is going on with my esophagus and stomach first before he considers anything else.  The only thing is, Dr. Ik has so many patients and is always running at least an hr. behind.  Last time I saw him, he forgot why I was seeing him again.  Did he read my chart?

Did you have a DS to begin with or a revision?  I am considering seeing Dr. Buchwald.  Does he have less patients?

Go ahead with the endoscopy, that sounds like a necessity no matter what you end up doing.  Dr. Buchwald also has a big patient load and often runs behind (that's just how it is at the U, unfortunately!) but IMO it's worth the wait for whichever of those two suits you best.  They really are two of the best surgeons in the metro area and I would see either of them if I needed revision.  I'm surprised Dr. I didn't even give your chart a skim before seeing you last time, but maybe it was an extra rough day or something.  Still, that would bug me.  Dr. B actually has his nurse stick your info right to his arm so he never forgets names or surgery dates or anything - he's something else!  

Anyway, definitely make Dr. I explain why he thinks a total reversal is your best option over revision. 

My advice is for you to always bring snacks, a decent book or video game or whatever will keep you from going nuts waiting.  It IS irritating. 

I was a virgin DS with Dr. B a couple years ago.  Remember that he does surgery open, so if that's a deal-breaker for you, maybe stick with Dr. I or even think about going out of state for revision.

I wish all the best for you!  It sounds like you are in a really rough spot and I hope that your revision or reversal solves the problems you've been going through.

I have severe low blood sugar due to rny 8 years ago. Please inform me on the info you have found.

as far as the abdominal pains, unfortunately those of us with the RNY get many post op complications that cant be diagnosed on any testing.  First off, he knows you have a hernia and it is causing you pain, I am not sure why he wont' repair it.  We very often get severe adhesions, twisted bowels, bowel obstructions and other things that can only be detected by going in and looking via exploratory surgery - laproscopically.  It is very easy surgery but can give alot of information. I suffered for months and when my surgeon went in, I had 4 sets of adhesions that were causing my intestines to be all twisted and the connections between the stomach and intestines was adhered to my abdominal wall. I also had a 1 inch hole in my intestines.  I was told if I had waited much longer things could have been much more serious.

I dont' think reversing the RNY is the answer - it is a very complicated procedure.    I would consider revising to DS before considering reversing.

Have you seen an Endocrinologist about the Hypoglycemia?

 
According to this your surgeon is very inexperienced so it makes sense that he can't/won't do it.  In his case it would be dangerous.

There are several surgeons that can safely revise you to a sleeve or DS.  Rabkin, Husted, several of them.