Dr g is going to revise me to an erny not the ds
Dr g is going to revise my rny to an erny. My stomach pouch was not seperated just stapled. Dr g feels this is much more complicated to take down and revise to ds so he iis going to do the bottom half of the ds i think Is that what they call the erny???Leaks r a huge issue. I am very dissapointed. I do not have a good feeling about this. Not because of the dr. He is great. He spent weeks going over my records cuz i was so adamant about the ds. But in the end he actually said he is more concerned for my health if i get the ds. By the way he is definitly revising to ds again. He has done quite a few of them since he stopped a few months ago. Sooooo sad!!!
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I don't even understand this (well, I don't have to, since I'm not a surgeon) - but if your stomach is still in one piece, it would seem to me to be even BETTER for a revision to a DS - the surgeon only needs to remove the staples and then do the sleeve, I would think.
I hate to say this, because I used to think Dr. G was one of the best, but his preference for doing some ERNYs really troubles me. I would get a second opinion from Rabkin or Keshishian.
I hate to say this, because I used to think Dr. G was one of the best, but his preference for doing some ERNYs really troubles me. I would get a second opinion from Rabkin or Keshishian.
I'm glad to see that Dr. G is willing to admit that he doesn't feel comfortable, for whatever reason, doing the full DS for you. (I suspect, with no factual basis, that it has something to do with the hospital program, perhaps because he has had more leaks and other complications than they are comfortable with, thus are limiting him in his RNY to DS revision practice. It sounds an awful lot like what happened to Husted, before the law suits started.)
Schlep to CA. What is done to you will be what you have to live with FOR THE REST OF YOUR LIFE. Send your records to Dr. K first - see if he agrees with Dr. G, or thinks HE can give you a full and proper DS.
10-12 days in sunny SoCal vs. 3-4 days away from home, compared to the rest of your life. It's not like you'd be going out of the country either - and there are direct flights from LAX to NYC, Newark, Philly (not sure where you live). In fact, JetBlue out of Burbank would be easier and closer.
Schlep to CA. What is done to you will be what you have to live with FOR THE REST OF YOUR LIFE. Send your records to Dr. K first - see if he agrees with Dr. G, or thinks HE can give you a full and proper DS.
10-12 days in sunny SoCal vs. 3-4 days away from home, compared to the rest of your life. It's not like you'd be going out of the country either - and there are direct flights from LAX to NYC, Newark, Philly (not sure where you live). In fact, JetBlue out of Burbank would be easier and closer.
Diana,
When I went to see Dr. Greenbaum last month we spent quite a bit of time chatting. We talked extensively about the problems I had regarding leak, fistulas and so on. He said that he has been keeping records on RNY to DS revisions and his data as well as his own experience is showing that those who have a staple line across their stomach and the lower stomach is not transected have a significantly higher leak rate. He feels that it has a lot to do with taking down the staple line, reattaching and then having to cut the stomach into a tube that leaks tend to be more prevalent due to blood flow issues and additional trauma, cutting and sewing when the stomach is just stapled across. He said that there are more places for leaks to occur. Conversely in Dr. G's experience he sees a lower rate of gastric leak when the RNY stomach is made into a pouch and the lower part of the stomach is transected. He says all he has to do is take down only the lower part of the pouch and reattach it to the stomach and then cut the tube for the DS. He says that blood flow to the pouch is not really an issue at this point because the stomach has already adjusted to the pouch configuration. I don't have the paper and don't know much about it, but he did mention that he and Keshishian just wrote a paper on RNY to DS revisions and that the data regarding the leak rate of the two types of RNY was included.
He told me that he is still doing RNY to DS revisions, but because of the recent death of a revision (NJ Doodles and no he didn't specifically say her name so no HIPPA laws were broken),that the hospital had to do due dilegence and investigate the death and put a temporary stop to RNY to DS revisions. Lourdes is a small community hospital by comparison and I am sure is trying to protect itself.
It's just my opinion, but I feel that Dr. Greenbaum is offering an option of ENRY and that given his data regarding leaks and such that he is also trying to protect not only himself, but the patient as well. Since I had to have another partial gastrectomy my intestines are still a DS configuration, but I do have a pouch, which was neccesitated due to strictures, poor blood flow and fistulas.
For what it's worth, I was the type of RNY where my stomach was not transected and was just stapled across. I ended up with a long term leak and fistulas.
Maddie
When I went to see Dr. Greenbaum last month we spent quite a bit of time chatting. We talked extensively about the problems I had regarding leak, fistulas and so on. He said that he has been keeping records on RNY to DS revisions and his data as well as his own experience is showing that those who have a staple line across their stomach and the lower stomach is not transected have a significantly higher leak rate. He feels that it has a lot to do with taking down the staple line, reattaching and then having to cut the stomach into a tube that leaks tend to be more prevalent due to blood flow issues and additional trauma, cutting and sewing when the stomach is just stapled across. He said that there are more places for leaks to occur. Conversely in Dr. G's experience he sees a lower rate of gastric leak when the RNY stomach is made into a pouch and the lower part of the stomach is transected. He says all he has to do is take down only the lower part of the pouch and reattach it to the stomach and then cut the tube for the DS. He says that blood flow to the pouch is not really an issue at this point because the stomach has already adjusted to the pouch configuration. I don't have the paper and don't know much about it, but he did mention that he and Keshishian just wrote a paper on RNY to DS revisions and that the data regarding the leak rate of the two types of RNY was included.
He told me that he is still doing RNY to DS revisions, but because of the recent death of a revision (NJ Doodles and no he didn't specifically say her name so no HIPPA laws were broken),that the hospital had to do due dilegence and investigate the death and put a temporary stop to RNY to DS revisions. Lourdes is a small community hospital by comparison and I am sure is trying to protect itself.
It's just my opinion, but I feel that Dr. Greenbaum is offering an option of ENRY and that given his data regarding leaks and such that he is also trying to protect not only himself, but the patient as well. Since I had to have another partial gastrectomy my intestines are still a DS configuration, but I do have a pouch, which was neccesitated due to strictures, poor blood flow and fistulas.
For what it's worth, I was the type of RNY where my stomach was not transected and was just stapled across. I ended up with a long term leak and fistulas.
Maddie
HW (pre RNY) 430 / HW (pre DS) 302 / SW 288 /
Lowest weight 157 / CW 161 / GW 150
"I'm just one stomach flu away from my goal weight"
Hi Randy,
I am feeling well and doing so much better now since the last operation in December to fix my insides. I was ever so sad to see my pylours go, but it really wasn't working right anyway with all the strictures and stuff. I have a pouch and trust that the surgeon who did my surgery did what he had to do, not what I wanted him to do. I can eat now and have only hurled 3 times since my surgery, unlike everyday before.
As for your question regarding the ENRY, I think certainly I would not have had a leak or fistulas though because the pouch is not touched. From that you could say that some of my complications would not have occured, but who's to say that I would not have had other problems afterwards?
I am feeling well and doing so much better now since the last operation in December to fix my insides. I was ever so sad to see my pylours go, but it really wasn't working right anyway with all the strictures and stuff. I have a pouch and trust that the surgeon who did my surgery did what he had to do, not what I wanted him to do. I can eat now and have only hurled 3 times since my surgery, unlike everyday before.
As for your question regarding the ENRY, I think certainly I would not have had a leak or fistulas though because the pouch is not touched. From that you could say that some of my complications would not have occured, but who's to say that I would not have had other problems afterwards?
HW (pre RNY) 430 / HW (pre DS) 302 / SW 288 /
Lowest weight 157 / CW 161 / GW 150
"I'm just one stomach flu away from my goal weight"
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