Ten years post-op, regain, revision?

Hi! I had roux-en y surgery ten years ago. I originally weighed 302 lbs, got to 149, and now sit at 237. Isaw a surgeon earlier this year about the regain issue, he told me I woukld have to always struggle with my weight, and sent me for xrays of my pouch. When I went back to see him he basically told me to go on a diet for 3 mths an then go back to see him.
I am a nurse in a hospital that actually does bariatric surgery, so yesterday I decided to see on of the surgeons there.She was extremely nice, told me to have a barium swallow done and EGD. She said if there is a fistula that insurance will approve a revision.
My question is what signs symptoms did you have with a fistula? I have reflux that began earlier this year, I know my pouch is stretched as I can eat ALOT at one time (and those xrays I had said my pouch was larger than expected but they had nothing to compare it to as I had no other xrays of my original pouch size so they couldn't judge exactly how much I stretched it). So other minor symptoms is I have nausea every once in awhile, out of nowhere, not related to anything, just a slimy gaggy feeling that happens for no apparent reason. I occasionally will get a hot feeling across my  diaphragm that lasts a few seconds, and I do seem to have increased diarrhea, sorry, foul smelling, mucousy, and stringy.
One more question, is it possible to have a fistula if your pouch and stomach were completely divided? If there was a fistula wouldn't pouch contents be emptying into your abdomen making you extremely ill?
Thanks!

Hi there!!!!  What are you looking to revise to?  A Duodenal Switch?
I go in for my RNY to DS revision on 12/29.  There are 2 RNY to DS revision surgeons near you..... sort of.  Dr. Buchwald in Minnesota, I believe, and Dr. Roslin in New York.

I read this publication, and this is what "sealed" my decision!!!!!!!
http://www.dssurgery.com/about/publications/duodenal-switch- safe-operation.pdf

Have you used the search box?  It is on the upper right.  I went there and typed in "fistula" and there were MANY to choose from, but here is one:
http://www.obesityhelp.com/forums/revision/4482097/Ten-years -post-op-regain-revision/




Just my opinion.... but why would you have a surgery "redone" when it failed you the first time?
-Jamie

 I have a fistula in my pouch and according to my surgeon "its my normal".  She said had I been newly pre-op it would alarm her, but, since Im over 9.5 yrs out from an RNY (8-2002), its no big deal and doesn't affect my or my life.  

As for your reflux, you maybe have a hiatial (sp?) hernia, which is what I had and was corrected when I did my BOB.  I had an RNY in 2002, went fron 305 to 175 then back to 246.6. I was banded (band over bypass) on Ju8ne 23rd and I am down 43 lbs. I feel great.  I think you should get a ct scan of your abdomen with and without contrast so they can see the fistual as well as an endoscopy. 

Good Luck.

I had the GI barium study done this morning, the whole way there I was burping up last nights dinner, wouldn't ya know when I got on the table they asked if  I had eaten anything. NOPE! My food was STILL in the pouch at almost 12 hours later! So, I got to wait and hear back from my surgeon, I only asked the radiologist and he said yes there was food in there. I didn't ask about a fistula, he said he needed to study the films closer, so we'll see.
Now I am curious as to why food is sitting in there? I read it can be a partial obstruction due to marginal ulcer. I have noticed the last couple months, waking up in the morning and still tasting what I ate the night before. And this year I have developed reflux.
As for why would I want to repeat RNY? Because I don't feel the surgery failed me, I lost 150 lbs, I just feel it needs a tune-up! And my surgeon said that she does not do duodenal switch because you are never out of the woods with that surgery, lots of malnutrition, just her opinon, and being that we work together I trust her opinion. She doesn't do BOB either, didn't ask why because I never considered that anyway, just want what I got tightened back up!

I was also diagnosed with a margianl ulcer back in March.  I have not taken any NSAIDS, since I cannot with the RNY.  Just my opinion, but, I will be glad to get rid of this pouch and get my pyloic valve back.  Then, I can not only drink with my meals, if there is room, but, since I have aged, the need for NSAIDS is growing day by day.  Just this past fall, I ended up having to take 2 weeks off of work due to my hip...... when I could have gotten away with aleve & ibuprofen.  But, I had to be on pain meds, since I could not take the over the counter stuff, and my job is physical & I drive as well.  That sucked.


And I am glad that you trust your surgeon, but I am sure you already know that surgeons will only sell you what they can do.  That is why I made an informed decision and researched my surgery choice first, and then picked my surgeon.  Also, I want to comment on: "And my surgeon said that she does not do duodenal switch because you are never out of the woods with that surgery, lots of malnutrition"  There is also lots of malnutrion with the RNY and the "distal bypass also known as ERNY".  My best friend got malnutrition, and so did her sister.... we all used the same surgeon, and we all had the RNY done.  Everyone is different.



Everyone's journey is different.  Good luck & keep us updated on how everything goes!!!!!!
-Jamie