new here - need advice

Hi all, I'm new to OH and I have a lot of questions and need advice. I'll try to make it short! I had RNY 6 years ago in May of 2005. I was 20. MY highest bmi was 61. My highest weight was 402 and I was about 375 or so when I had surgery. I got down to 197 in 17 months and that was very small for my frame (I'm 5'6"). Between having my 3 year old, my mom dying when she was 10 months, and my 9 week old - I now weigh 292 with a bmi of 47. I feel like a gigantic wls failure. I'm embarrassed to say that I had it done. I was young and didn't prepare myself or educate myself enough on the procedure. My sister and mom had both had it done and I just thought it would work itself out. I think I have stretched my pouch out because I am able to eat a lot now without vomiting. I still dump if I eat too much sugar. I get full quickly but it doesn't last more than 10 minutes or so and then I can eat more. So I do. I can and do drink while I eat. I sometimes have pain/burning right at the top of my rib cage in the center. I have been trying to do weigh****chers but of course I'm having trouble sticking to it.  I'm just so afraid of gaining the rest of my weight back and then some if I don't have some type of serious intervention soon- like a fresh tiny pouch again. I have been so sad lately about what I look like right now.

So here are my questions:

How do you know if you need a revision surgery? 
Does it sound like I need one?
Does insurance cover it at all?? I have BCBS of texas.
Is it safe to even have a revision surgery? 
Can your pouch shrink back down on its own after its been stretched out?

Thanks in advance for any help you can give me. :)

Have you made an appointment for a follow up with your surgeon that did your RNY? I have no good advice as I haven't had my revision surgery yet but I wish you good luck and hope you can find some answers.   Are you eating protein first, and not drinking for 60-90 minutes afterwards? 

I had my surgery in Michigan and I live in TX now so I wouldn't be able to see my original surgeon. Should I make an appt. with a local bariatric surgeon and see what they say? I used to only eat protein first and not drin****il after, but after 6 years and the ability to eat however I want, I don't. I feel like I'm like so weak to food if I can physically eat a lot I'm going to. Ugh.

Unfortunately, I had to delete this post due to privacy concerns.

Hey.  We are in similar boats but I didn’t have a kid :-) I had the RNY in 8/2002 went from 305 to 175 and started gaining back in late 2007 - 2008. I went all the way back up to 246.6.  So, after many unsuccessful attempts, I went to see several surgeons last fall bc, like you, I could eat anything (sometimes a lot) and would stay full for awhile, but, when I ate smaller meals, I was hungry again almost immediately. I believed my stomach had stretched.  In February I had a CT scan with and w/out contrast as well as an endoscopy.  Both tests revealed my pouch was very stretched out my anatomically, everything else was fine (I did have a fistula though) as my staple line is a V instead of 2 straight lines.  But, this is apparently my "normal" as I've never had any issues.  My insurance company has a bariatric rider and I and allows for the following: Roux-en-Y Gastric Bypass (RYGB), Laparoscopic Adjustable Silicone Gastric Banding (LASGB), Sleeve Gastrectomy, Biliopancreatic Diversion (BPD) and Duodenal Switch (DS) Procedures.

I have a $20K lifetime maximum. I wanted the BOB (Band over Bypass) but also considered a full RNY revision. However, I did want to risk it. The complication rate is high with any type of revisional surgery and even though I was planning on using the best surgeon out there (Dr Mitchell Roslin), I didn’t want the risk plus, I feel like it might fail me again. I had heard good things about the band over bypass plus it was a quick, less invasive surgery.    So, that’s my story. I’m scheduled for June 23^rd. If you have any questions please ask. Most people on this site are a wonderful bunch.  Just do your research, educate yourself. 

As for your questions…..

How do you know if you need a revision surgery?  You should either see your past surgeon or ask your PCP to write you a script for an endoscopy. It will show all.
Does it sound like I need one? You are describing what I have been going through the last few years. Many will tell you to do a 5 day pouch test. Maybe try that first and then get the medical tests.
Does insurance cover it at all?? Every insurance is different. You need to see if you have a WLS rider or any restrictions. Some won’t cover the same surgery twice but will if it’s a revision. Pull your policy.  
Is it safe to even have a revision surgery?  Complications rates are 3X that bc it’s a revision. The best way to make sure you are ok is to be as healthy as you can be pre-op and chose a good surgeon. You are young so that is good.
Can your pouch shrink back down on its own after it’s been stretched out? NO. And anyone who tells you it can is full of crap! LOL.

You mint want to consult with Dr. Daryl Stewart in Denton, TX.

If your insurance will cover it, check into the DS.  I am a failed bandster.  Trying to get insurance to cover a DS.....or self pay or whatever........... I obviously had too much or no restriction with my band and based on my eating habits and metabolism I know I need what ONLY the DS will offer me.  Go see how many RNYers are getting revised to DS.  I know some RNYers that "stick to the program" and do just fine.........but it is my opinion....and my opinion only that many of us....especially me.....need help "from ourselves" and the malabsorption part....is our "HELP".......it takes care of the "crap" that we just can't seem to quit eating!!

First of all.... WELCOME!!!!!!!

I am a failed RNY working toward a revision to a DS.  You should check out my profile, and read "My Story".  There is also a list in my blog for RNY to DS revision surgeons. 

My best advice is to seek out a surgeon who does all 4 (YES 4) weigh loss surgeries, so you can make an educated decision.

I second Dr. Stewart.  I got this list off of another website, as this OH website does not have correct/current info on docs.

Texas

Erik Wilson, MD *
Email: [email protected]

UT Houston
6700 West Loop South, Ste 500
Bellaire, TX 77401
Phone: 713-892-5500
Fax: 713-871-0071

 

Daryl A. Stewart, MD *
 

Weight Loss Specialists of North Texas
Denton Surgical Group
3321 Colorado Blvd.
Denton, TX 76210
Phone: 940-382-9429




Take Care!!!!!
-Jamie in Alaska