To revise or not revise?

That is the question!

Here's my story:

RYN 10/2002, Starting weight 340.....now 9 1/2 years later maintaining @ 215-220.  I am 5-8 putting me at a BMI of ~32. 

Over the past 1.5 years I have lost the my ~20lbs that I had regained over the years but seem stuck at this point.  I am doing many of the right things.....managing my liquids, watching the amount of processed cabs, journal my food, overall eating a very healthy diet.  Not perfect, but very aware and doing well.

Long term complications include some micro nutrient deficiencies including slight anemia....the doctors don't seem too concerned.  I am taking iron supplements.  The most concerning complication is late dumping syndrome...."reactive hypoglycemia".  With limiting carbs and not having liquids while/after I eat events have been sporadic.  

I am within 5lbs of my lowest weight ever as an adult....however I would like to get down in the 180's.

I had an upper GI and was told that I have moderate stomal dialation.

I am considering a revision but am not certain it is the right choice, which procedure, and how it will affect the hypoglicemia issue.

I am considering RNY-RNY revision, ROSE or BOB.

Anyone out there have similar issues?  Oppinions?

Hey J.R.,

My story is the same as yours. I am consulting with Dr. Cirangle in San Francisco. He thinks the BOB (Band) is the way to go. Check out his website for more info.
Do think your insurance will cover?

Mtoma....

Pretty sure my insurance will cover it.  

BOB doesn't sound that great to me, but I have also been told the same.  ROSE sounds the best to me regardless of the negative posts here.  Perhaps it's just not the right time for it as not enough has been done and technology isn't advanced enough yet.  I just want to slow the food from passing.

My biggest concern is making it worse.  My BMI is only 32, 15 Lbs and I'm no longer obese...and other than the hypoglycemia no other major complications.  I look pretty good, albeit I still would like to be thinner, but healthier is more important.

Have you had any hypoglycemia?

Good morning,

I am shooting for 50lbs. I have not had an issues with hypoglycemia. ROSE does sound good but you seem to managing really well. So you probably can afford to wait. I believe my stoma has stretched and I need to get it together before it's to late.
Anyhow, Dr. Cirangle seems really nice. Just waitng to see the nutristionist.

 ~40Lbs is my main weight goal getting me in the 170's.

I agree that I am holding it together pretty well, everyone that knows me keep continually say I'm looking good....and I agree.

I am back with the rest of the world as if I never had RNY, I can eat way more than I need and without tremendous willpower and dedication I cannot maintain, and it is very hard to loose.  

I am not going to rush into anything here.  1st things first.  I am going in for a endoscope in a few weeks to better evaluate my anatomy thus giving me a "picture" of how things really are.  The barium test said that I have "moderate stomal dilation" and this is what I would like to correct.

I am hopeful that the ROSE procedure could be successful for me since I am not looking for major weight loss....only a stomal repair.  The slower the food passes....the less reactive hypoglycemia I will have.  

I'll google Cirangle.

Has this doctor discussed stomal repair or the ROSE procedure with you?

Good luck with the nutritionist.  I need a revisit here too.  In the mean time I have been using www.myfitnesspal.com everyday tracking my food on my iPhone.....great service and completely free, check it out.  Friend me there, my user name is JRAlphaDog.

Good luck, let me know what your doc thinks about stomal repair.

Just from what I've read here on several forums the ROSE is a very bad procedure and doesn't work. Can't cite anything for you but if you read back on this forum you may find more about it.  Good luck to you!

 I've read the posts.  Im not really sure what people are dissatisfied about specifically.

Additional weightloss after the ROSE procedure isn't exceptional, perhaps only 20-30lbs, but it's really just a tightening of the STOMA.  I researched several clinical papers that reference this procedure and they have seen some success but the amount of patients involved isn't very large.  Also, no long term studies are available at this time.

The advantages that I see are that it is the least invasive revision, if the sutures don't hold I think it just reverts to where you started, if they do.....them your STOMA is restored.

Perhaps it's not ready for prime time, with so many RNY's needing to be revised technology and technics will evolve and produce a viable solution for those of us in this situation.

 
They are dissatasified with the lack of weight loss.  They lose about 20# on the post op diet and as soon as they start back on regular food they regain the 20#.

I've been here a total of six years.  In the past couple of years people have been getting and posting about the ROSE procedure only one did well and it turns out she was a shill for the surgeon she was pushing.  She never even HAD WLS so in the end, not a single person posting here has done well with ROSE.  It is a complete waste of money and most ins co's don't cover it and can you really blame them?

BOB... the problem with that is that bands don't last forever.  They weren't designed to and the band makers don't claim they will.  It buys you MAYBE 10 years.  Check out this:

www.lapband.com/en/learn_about_lapband/the_procedure_safety/ risk_information/

Note, they claim 88% will have complications and I'm here to tell you, when a band goes bad it IS bad.  Life is a horror.  I had a band (no bypass) for 18 months and I couldn't hack it, I opted for a revision to a sleeve.  In six years of posting here I know of one person that has had her band for 10 years and is happy.  I've met three others and they were actually contacting me for revision info on a sleeve.  So in the end  you have to ask yourself, you get a band and let's say you keep it for 10 years, what then?  There is also a great deal of maintenance with a band.

There is the option of a revision from RNY to DS but that's kinda risky but effective for life.  And you get your pyloric valve back... no more dumping.

Least invasive doesn't always mean safer and that is the bands mantra.

You are right, there are a ton of people with RNY wanting revisions, probably almost as many as banded people.  I think that is why DS is becoming more and more popular.

 JR, I had a BOB, last June.  Hit me up if you have questions. I am 3lbs from my RNY post-op weight loss.  Feeling great.

Heather
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