RNY takedown or Reversal

I am just starting my journey about reversals so I have mostly leads and not stats. Here is a link a surgeon gave to me that mentioned this item about the UK and reversals:  http://gastricbypass.netfirms.com/reversal.htm

I just recently had a bunch of labs done last week and I am pretty pleased with them. My D3 shot from 27 to 102 in over 3 months. I had supplemented with 30K IUs a day for that time and I also had changed my diet over to a ketogenic paleo type. I am backing off to 5K IUs daily and we will see if I can maintain. (My regular doc asked me to be only 5k daily previously and it wasn't sufficient.)

How do you know that most surgeons don't cut the vagus when I have surgeons tell me they do? My understanding is they may not perfectly re-attach but they can heal. I remember reading years ago post bypass that the villi in the intestine grow immensely over the year post bypass to compensate for the decreased absorption. The body has a remarkable ability to heal itself. We just have to figure out how to assist it in doing so.

As I have said previously, "Cutting the vagus nerve decreases ghrelin, decreases hunger, causes weight loss," and dumping does come from cutting the vagus nerve. I no longer have dumping syndrome. It went away after a few years. Could it be that my vagus nerve healed it self?

My hs-crp lab  test is very high. A serious marker for cellular inflammation. That was probably the only bad thing on the lab. Unfortunately, that is not a routinely done lab test for obesity but for other things. I do present that inflammation has a major part in the obesity picture. That is what I am working on.

I may not need to have the RNY reversed but I am going to get as optimally healthy as I can. I am not worring about gaining weight. Fixing the hormones, healing my gut, plus other things will help the cravings and the weight gain to go away. I have never addressed those things before. 

When I looked at the DS procedure I was horrified to see that the gallbladder was removed. Recent studies, which I am in the process of reading and absorbing, link gallbladder removal with osteoporosis. We need our gallbladder to remove excess estrogen (E2).

From of my physician coach's writings he talks about the link of estrogen and the gallbladder:  this means that when fat is broken down it liberates E2 into our guts to get rid of the excess. If you no longer have a gallbladder you slowly begin to concentrate E2 in your body. The fatter you are the worse it gets. Fat people are estrogen sinkholes. This is why many neolithic (note: he means modern) diseases are tied to obesity and high estrogen levels. This is the main reason for estrogen sensitive breast cancers in older females. Humans become estrogen dominant (both male and female) when they eat the standard Western diet. You need a gallbladder to rid your body of excess E2. It is a critical point. I could write 2000 diseases right here now that all have estrogen dominance as a cardinal feature. This is how an innocent error can lead to a magnificient mess twenty years latter when you get diagnosed with some new neolithic disease. No one in medicine today sees the links from removing a gallbladder to that mess. If you show them this blog they will downplay it and tell you there is no good studies to prove this might be true.
http://jackkruse.com/cpc-3-do-you-need-a-gallbladder/

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My impression from the link you provided is that you are basing some of your opinions on unreliable sources. There is nothing in that link to truly support the idea that lots of gastric bypass reversals are being done in the UK, just an unsubstantiated statement from one nurse. I have great respect for nurses, but this is not a substitute for reliable information.
      In reality, the article does state that gastric bypass reversals are somewhat risky and not often done, and that many gastric bypass surgeons do tell their patients to think of this operation as permanent, even though technically, it can be done. In other words, someone would have to have a very strong reason for a reversal, it would not be something done routinely or semi-routinely for people who don't want to take vitamins anymore, and even for people with documented nutritional deficiencies, it would be the last resort.
     Regarding removal of the gall bladder, this is NOT mandatory with the DS. Some surgeons do it routinely, many don't. In fact, we have DS patients posting about needing their gall bladder removed months or longer after their DS. Also, I can find nothing about gall bladder removal causing elevated estrogen levels. What I can find is information that higher estrogen levels are one factor in causing gallstones, which is one reason this is a more common problem in women than in men.
     I'm going to stop posting at this point because I can see that you believe what you believe, and your beliefs are, for the most part, not based on actual documentation (except for the part about inflammation contributing to obesity), and I don't think there is anything more I can say. I wish you the best of health and hope that you never need to have your gastric bypass reversed.

Larra

Larra,
Sounds good. As I said, I am just following leads trying to find info. I just started looking a couple of days ago so I can't help but not have all the answers  today. Making a decision to have or not have surgery based on one article is unwise, yes?

It is unfair to say my beliefs are not based on actual documentation. I just started this past Friday to look into something that I may not do for a couple of years. I can't have any beliefs until my fact finding is more comprehensive. Remember, I just started looking a few days ago and I came here to find more info about it. To expect me to come to a final decision or be in agreement with you in less than 3 days is a bit premature.

I didn't say a removed gall bladder causes elevated estrogen levels. If the estrogen is trapped in the fat depots then it won't show up necessarily in a blood level. Meaning, until the fat releases the estrogen we won't see it in blood tests. Estrogen blood levels spike during fat loss, especially rapid fat loss. Excess circulating estrogen is what causes gallstone formation among other things.

This is why people who loose weight quickly get gallstones and pain.The gall bladder helps excess estrogen be eliminated. If it is not there to eliminate then the blood circulating level of estrogen will climb because it won't be eliminated. Then we see an increase in breast cancer, high blood pressures, migraines, fatigue, PMS, stroke, aging, clots, etc.

Taking bile salts is one way to assist the gallbladder so one does not go to get it removed.

Thanks for your input. All the best.

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I also doubt the revision will really make a difference for you except you most likely will gain a lot of weight.
Supplementation is the key.

I am a woman, only 4 years post op - but during that time i had to increase proteins intake from 80 gr a day to 120-150 gr a day to make sure that my blood proteins level are 7+

I used to take B12 - subligually - but that was not enough - somehow I was not retaining - so now I get B12 injections. weekly - 1000 mcg per week. (most people do fine with monthly B12 injections) 
 
Last year I got iron infusions - and my ferritin got from 9 to 93.  I do not absorb much - if any irons from food or supplements.
I take extra B-s (B-100 capsule per day) in addition to 2 x day full spectrum multi. (Centrum equivalent)
 I also take additional B1, Dry A, Dry D3 (my D was low - but 3 month on daily dry D# 50,000 iU got it up to 150... A few months low - and now I maintain at 80-100 with 2-3 times a week 50,000 IU - inexpensive and easy to take dry D3)
Add calcium citrate - I take 1500-2000 mg per day - divided dosage - no more than 500 per dosage 
I take magnesium and other minerals with calcium, also - vit K1 and K2.

I also take app 800 mg of mag oxide every night. (helps with BM)

And some other minerals and vitamins.

I also stay away from carbs and most grains. 

Eliminated (or limit) artificial sweeteners and flavors.

Check your cholesterol - on a very low carb diet - it may be really low - and you may need to try to increase that.,  High cholesterol may not be too good - but low - may be bad as well.
Check your hormones: our body uses cholesterol to make hormones and low cholesterol may mean - low hormones.  (when my cholesterol dropped to 100 - I went into instant menopause... , all my hormones got too low. Now I supplement - age thing. )

After I read what I wrote - and realized how many pilsl I have to take...... crap...no wonder you rather have reversal...

I wont gain a lot of weight. In fact, my weight loss should accelerate. As I balance my hormones and many other components of my physiology that which cause me to gain weight disappears.

As I stated, I am of the opinion that Obesity is a disease of cellular inflammation as I responded to Larra above. One of those things that reverses the inflammation is following a ketogenic paleo diet with some very specific parameters. That is why I hired a gifted physician to coach me and to bio hack my labs to return myself to optimal health. He and I have talked about how that may mean one day getting my RNY reversed. My treatment and progress is guided by my labs. I have more labs done than are required for gastric bypass. I am even having a DNA panel done to look for mutations. It is pretty specific the path I am following I the results give me hope.

My opinion is one has to increase protein requirement because we malabsorb. I don't want to do that. I would be drinking protein shakes all day long. That gets tiring as the years go by.

My doc wants me to start the day eating 50-75 gms of protein just for breakfast. That is so hard with the pouch. I am able to put away about 30gm. This is without the addition of shakes. My diet is 75-80% saturated fat and about 20% protein and less than 25gms carbs a day. I eat lotsa fat in animal, butter, ghee, palm and coconut oil. No processed food. Occasionally I use Stevia. I do eat lots of dark chocolate in the 99% range but that is for the antioxidant and anti-inflammatory aspect as well as I love dark chocolate.

I take pretty much everything that you do but more of the absorbable varieties. For example, I take 2.4 grams of magnesium malate every night. It helps with the sleep and the muscle cramps plus helps my hair grow back. It doesn't give me loose stools because it is better absorbed than the oxide version.

I am waiting for my salivary endocrine hormone panel to come back to assess sex hormones, DHEA, progenolone, cortisol etc.

Cortisol and hs-crp are some of the most important labs to have drawn to show the state of you body. Lots of docs don't know that.

I eat what most medical professionals consider a high cholesterol diet, yes?

Taking supplements sux, yes? LOL...I am so over it after 11 years.




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Glad to see you are really doing your homework.  Some people come here and what reversal or revision without really trying to see if they can do anything to make this work.   It is not easy.

I am pretty sure you know that revision or - RNY take-down - (I will not call it reversal) - is drastic surgery, and the results will never give you back what you had. I also believe that some of the physiological changes that our body does because of the RNY are permanent and the revision may not correct them. (i.e. malasborbtion of minerals and grain, leaky gut, and extra pancreas- insulin output - sugar sensitivity).
Good luck on your journey. 

It is so good to finally find someone *****ally talks about having reversal! I am over 5 years post op with 150cm rny. My bmi at it's highest was 37. My insurance ok'd surgery because of many medical complications. I had become heavy about 4 years pre op due to drug seraquel. I am 5'7 and now weigh 132 on a good day. In the past in the past 3 months I have lost 20 lbs. it took Mayo EEG, EKG, sleep study, before finally my albumin and pre albumin were tested. And this was only because of seeing a surgeon for a hernia I got at Christmas time. He immediately called my internal med Doc telling him he was concerned and would not do surgery on hernia until I got complete work up ruling out a more serious issue. My doc left his hospital rounds at 4:30 to ck. me over. Final determination was I needed to wait 3 months for surgery because of borderline malnutrition. Yesterday I had another blood draw for my Rheumatology appt. this Friday. All labs are worse except my calcium is coming out of the re. Problem because of the number of tums I take to settle my stomach. I have increased protein, added 2 ensures and increased and split my vitamins to take them 3x a day. I take usually 4 Imodium daily and average 10 bowel movements a day which over 1/2 are diarrhea. Last year I had rotator cuff repair, ligament replacement on both thumbs and a tummy tuck. Well 3 skin cancers also removed. I went off of hydrocodone 5/325 in November, usually 1-2 a day for rheumatoid pain. I do think those helped my bowel movements keep on track. I feel terrible weak, headache, sore, unable to concentrate and finding it so hard to do simple sewing or craft projects. I get mixed up . So I have been journaling symptoms, food intake, sat level,temp., BP and bowel movements. I do not know why she did 150 cm instead of 75. Nothing in notes. I can't have any surgery because I am too weak, where does this end?

I can sympathize with your suffering. I am so there with you.

I am working with a physician who specializes in helping people with broken health. He tells me that post gastric bypass patients are particularly broken. He is a no bull**** kinda guy and very compassionate.

I have hired him as a health coach. He helps other people with other types of severe disease like auto immune problems.

Here is his web site.

http://www.jackkruse.com/

I will pray for you.

 

 

Oh Thank You sooo much! I will check his website.
In reality I never even considered or gave any thought to the fact I may be malnourished. I eat very well, always take my supplements. Can and freeze many of the foods we eat. Really documenting daily intake and symtoms has helped me become much more aware. I have my first Grand Baby ( Girl ) coming in April, I am lucky to be only a couple of hours away. I so need to be strong again..
Thank You,
Cheryl

I know I'm responding to an older post but I do hope you are doing well.  I stumbled upon your post while researching reversal for RNY.  I'm curious where you are in your journey now and how it is working for you.

 

I had RNY in 2005 and maintain a weight of between 125-135 whether I like it or not.  I try every day to increase it.  When people see me, they tell me how pretty I am and rave about how thin I am - some chiding with me to eat a cheeseburger - some wishing they could be thin like me and thinking I'm one hell of a lucky woman.  Many, many people see me as a success.  My before and after photo's would sell that surgery to just about every person out there considering wls as a solution. 

 

The reality of what my life consists of is a nightmare and no matter how thoroughly I try to explain that reality to a person who has made up their mind that wls is THE solution, they will not hear me.  That door is shut.  Most of the time, I'm met with a heated debate on all the how's and why's the RNY or other wls IS the answer.  And if it isn't making my health and life perfect it's because I am non-compliant and responsible for the failure.  Mind you, these are not doctors or surgeons - they are wls patients and people who long to be wls patients.  Yet, I find myself defending the mere stating of what my life is - what they don't see, feel, or live each day. 

 

My life, the consequences of which, these people do not have to face or live with each day.  To these people I say, intelligence is the ability to open your mind up, receive more information, process it, learn, realize there is not only one solution, accept the fact that additional information can bring into light that you are or were wrong about something, the world is not a small place, anatomy is complex and varying, consequences vary, solutions vary, nothing in life or the human anatomy is cookie cutter.  There are MANY, MANY, MANY reversals being done each day.  It is not rare.  It is quite common and the number of reversals are on the rise and will continue to rise along with the increases in wls.  It's a fact.  Being on the internet or having dedicated websites to it isn't going to make it a reality or fact.  Not having the publicity, popularity or websites isn't going to make it less real or common.  Maybe there are reasons for not making information on reversal as common as wls.  Consider this: there are so many desperate people out there with their minds made up that wls is the only solution for them and it is hard enough to get them to consider more thoroughly all the options available to them and what the consequences are - making it too public about reversals would only add to the numbers of people determined to go through with wls without giving the other options a chance at all.  OK.  I get that.  It doesn't make it easy on those of us who have to face that reality, does it?

 

My heart goes out to you.  I know you are struggling and going through some pretty tough stuff.  I know it is something at the forefront of your mind in everything you do each day.  I know you aren't taking reversal or any other option lightly and doing your homework to come up with the best solution for your health.  Please don't stop sharing your experience.  There may not be another person with the exact same physical anatomy or complications or solution or maybe there is - who knows? But putting the information out there just may help someone... even it it is only to educate them on something new today. 

 

I have spent the past three years (my rny was 8 years ago) exploring my options.  In doing so, my priority has been making my rny configuration work for me in the best possible way to promote a healthy life.  Taking my vitamins.  Watching what and how much I eat.  Focusing on nutrition.  Living and getting exercise.  For many people, this approach has paid off well.  I know I have done well.  I know I have done exactly what I should.  I know there are physical obstacles in my particular anatomy that I am unable to overcome with will power or dedication.  The intelligent choice for me is to have the physical structure repaired in such a way as to provide the best outcome for me.  If you ask people what would be the best outcome they are hoping for in a situation, you will likely get different answers.  The most common thing I hear from people is "you will gain all of your weight back."  Why do you think this?  I get offended when people say that to me. It is as if they are telling me that I have learned nothing from the past 8 years and do not have a mind or will power of my own  -  like I'm just some beast that consumes food with no brain or ability to stop myself.  Not human.  Really?  Is that what you were going into wls?  I know better.  That said, whether or not I gain weight isn't the issue.  It may be a battle but it isn't an issue.  I want to live.  That's my issue.  Staying in my current configuration, I will not have that option.  How other people feel or what "box" they want to file me away in doesn't change that fact or even matter. 

 

I know I ranted a little but it's more for the folks that are having a hard time accepting the concept of a reversal from wls or feel that wls is THE solution to the degree of being stuck in promoter mode so much so that they even believe the solution to complications is to fix it with another wls.  There are more important things in life than being thin. 

 

I hope you are doing well and I hope to hear more from you on your journey. 

 

Pam