PLEASE do your research when revising from a RNY

This post is to those of you researching a revision from your RNY to an ERNY or a distal RNY….  If I can get even one person to listen or at least do a bit more research it will be worth it.  Only to avoid the road I went down.

I just underwent my 2nd revision and my 3rd WLS.  I could have avoided this 2nd revision if I would have been a little bit more diligent and patient in my research and not absolutely believing what my then surgeon led me to believe. 

I had RNY proximal in 2001.  Long story short…gained back almost all my weight after 7 years decided to start researching a revision due to the return of some of my co morbidity's.  I looked at the ERNY and DS.  After much reading and listening and being tugged on by my doctor of what was best and what was not, I made an error and chose to go with the ERNY.  The reason being; according to my surgeon;

1) you will get the same benefits from the ERNY/distal RNy as the DS and it is a simpler operation.  
2) taking down the pouch is far to risky and I stand an escalated chance of serious complications.
3) you will loose as much weight as a person with the DS because of the shortened common channel.  And you will be able to keep it off long term.

What the said surgeon did not tell me was;  (so did he lie because he omitted certain facts???)

1) You will mess up you metabolic system with the combination of a pouch and a short Common Channel and the ways the intestinal configuration is set up for the ERNY vs the DS.
2) You will struggle to absorb all the nutrients and vitamins necessary to survive, especially the farther out you get.
3)  You will be doomed to in-taking so many none value added calories (carbs etc) just to try and keep your weight above the malnourished level.

Oh yes, I lost the weight.  Got down to the size 2 I am today.  Problem is, I could not stop loosing it.   I literally consumed so many carbs a day to try and maintain 130 lbs, then 130 became 125, then 125 became 121, then when I hit 119 I figured I was loosing this battle and I gave up and the sad part about it is I was eating so much JUNK to try and get and keep my weight up but all the time it was not helping my nutrition values any.

I ended up taking around 30 vitamins a day to try to maintain my labs.  Yep just like the DSers but without the same absorption benefits due to the pouch vs the sleeve and the intestinal routing.  And guess what, this was failing me too.  What a lot of people don't realize is that sometimes you may not bottom out for a year or two down the road so there is a period of time where you may not even know you are becoming malnourished because you think "hey, I'm being compliant and taking all my vites and protein".  Don't let this thought sabotage you.  My labs most always came back "ok" low on some, within range on others.  But this did not coincide with how I was feeling, fatigued, dry hair, nails and skin etc.  There are signs the body gives you when things are not right.


Now that I have been through both the ERNY and the DS surgery, I can honestly say that the ERNY surgery was easier as mentioned by my previous surgeon.  Yep, but so what, if the price of an easier surgery was that I would loose my health.

So I just underwent my 2nd revision (3rd wls).  I revised from my archaic distal/ERNY to a DS.  I did not do this because of lack of weight loss (although I hear and read of quite a few who do not loose more then 20 - 40 lbs by the distal/ERNY procedure.  hmmm think about this, is 40 lbs really worth another surgery?) I did not undergo it  because I gained to much weight.  I am 114 as of this morning.   I did it because I had 2 of my doctors telling me I am malnourished, I did it because I could not handle the fatigue due to the lack of absorption you get with the distal RNY, I did it because if I didn't, I feared my life would be cut drastically short because there was no possible way I could keep up with the demands of nutrient intake it required to survive.  I never even found that balance.  I was eating from the time I awoke to the time I literally went to bed and could not maintain.  I was and am literally sick to death of eating!

IMO I cannot believe there are surgeons still willing to perform this outdated procedure.  It is not an advancement in medical technology, it takes you back to the old BPD procedure that they had to stop doing because of malnutrition, patients becoming seriously sick and some even dying.  Remember…just because a man wears that white lab coat does not mean he is always right or even truthful or is even aware.  Oh he might not be lying to you but always question what else there is to know about any of the procedures.  What is he not revealing?????

PLEASE do yourself a favor…RESEARCH, RESEARCH, RESEARCH.   Don't settle because a doctor says "it's easier and you will get the same."  YOU WILL NOT!  If a distal or ERNY is your choice that is ok, just MAKE sure it is an INFORMED choice and you are very aware of what said doctor will be doing to your gut.  I know of 6 other people who were revised from an Distal/ERNY do to some of the same issues I have experienced or even worse.   THINK HARD and LONG!  

 The ERNY is where they leave you with a pouch and give you a shorter common channel.  The common channel portion is similar to the the DS intestinal portion.  The problem is that the pouch and the short common channel together play havoc with your metabolic system and can cause major issues as it has in so many others.  Is the doctor revising your intestinal portion at all?

Sounds like the not getting the Lap Band will be a blessing in disguise for you.  ;-)

I hear Dr. Roslin is a good surgeon.  Not sure about revisions though.  Have you considered getting a 2nd or 3rd opinion just to be sure?  Sounds like you are going to end up with your RNY again but with the removal of the remanent stomach.  Once they remove the remanent there is virtually no chance of ever going to a VSG or DS.  You will loose your pyloric valve and everything.  Might be worth checking out just to be on the safe side and to be sure.  There are a handful of surgeons who take on some pretty difficult cases and turn them into successes.  You would have to be willing to travel.  I can give you the names of a few surgeons if you wish to consult them.  

I wish you all the best.  Please let me know if you have any other questions.  Good luck to you on your revision and please keep us posted.