RNY takedown or Reversal

Can you post links to sites that detail how the number of reversals is on the rise? I'm NOT being snarky, simply curious. And I agree that anyone seeking WLs should know both the good and the bad.

Have you tried enzymes, like Creon?  Just curious??

Hi Pam,

I have not had much success with finding reversal options. If you have resources I would be interested in them.

I think reversal may be the optimal choice for me some time down the road. I still struggle. This will be my 12th year post lap RNY. I hate to eat. I think about food and preparing it all the time because my pouch STILL works. I think about food more than before surgery. I never used to crave sugar and starches but I do post op.  I can barely get down more than a cup of food if it has any roughage at all. So I have to eat a lot of soft, small meals. I don't get enough nutrition because of my pouch. I hate having to take supplements. I worry about when I get old and won't remember to take my supplements. I hardly remember to take them now.

My body is highly inflammed according to my HS-CRP lab value. It is greater than 6.3. It should be less than one. My body is just an accident waiting to go off. I would challenge anyone who has had WLS to get an HC-CRP done. This will give a good indication of a body's general health. High inflammation in the body leads to cancer, stroke, and heart disease. It is why I have such horrible brain fog now.

I agree with what you wrote above. Thanks for taking the time to write me and offer support.

And no, I won't gain all of my weight back either. I am not a procedure. Many people gain all of their weight back and more with their WLS intact. People out eat their WLS all the time. They are just not going to post about it on a board like this. Or they go and have further restrictive surgery.

I am getting to the mindset that having a WLS is like cutting off your arm because your fingers are not working right. I wish I knew what I know now about nutrition, mitochondria, hormones, etc. before I decided to have the surgery. I probably wouldn't have had it because I know I wouldn't have gotten that big.

 

I can tell you this, INOVA Fair Oaks in Fairfax, VA does them and often.  I just had a bunch of conversations with a lot of the staff members there and know this to be true. The surgeons who perform there list this as a surgical option on their websites and have for years...at least eight that I know of.  If you go to their website or call them, they can give you a list of the surgeons doing this.  It's a top 5 hospital - Bariatric Center of Excellence.

 

My surgery is Tuesday.

 

The day I wrote my original reply, I had begun to compile a list of resources to share... but before I saved it or posted it, I ended up back in the emergency room and being transferred to the city to my surgeon.  I will have surgery on Tuesday morning.  There are bands of adhesions wrapped around the right portion of my small intestine, which has been this way for over a year and rapidly worsening over the last 6 months.  It is very difficult to see on diagnostic images - it required both IV contrast and a GI with contrast and follow through, monitored for an entire day to follow it's path.  Because these loops of small bowel are so tightly clamped together, nothing gets through.... no air... no food.  Because the bowels above the blockage want to do their job, they are backing up inside the bowel above - an intussusception.  Only with tons of colace and enema's will gas or liquid come out.  The doctor's kept sending me home telling me that as long as something COULD get through, I would live - "you know what to do, keep doing it."  WHY? good question.  I was told that I should wait until it absolutely HAD to be taken care of in order to avoid another abdominal surgery, which would promote more adhesions.  Really?  So it's ok if I lose 3 feet or so of intestines or die?  Suffer?  Not live a life but remained chained to the bathroom moaning and crying? The radiologist made it a point to thoroughly describe and show me on the images what was wrong with me.  Later, the surgeon walked in and said my results were normal.  I told him what I knew and saw and live.  I pleaded with him.  He said things like "My work looks good. You look good.  You make me look good.  You are doing something right."  I assured him that his work was beautiful and perfect and it had nothing to do with him - it was ME.  My body was ruining it and killing me.  He told me if he had to put me down as an emergency, they would make him do the surgery at 8 o'clock at night and he was tired and already had a full schedule, but he could do my surgery next week on Tuesday as an elective surgery.  (Sweep wls complications under the rug and put this one on the books as a personal choice, right?)  I'll play.  I want to live.  So, I'm home on liquids and Ensure and in a great deal of pain.... praying Tuesday remains a go and isn't a lie made up by a man who doesn't want to deal with wls patients after the initial surgery.  My opinion of him, as well as the opinion of many other people of him are resting on how he takes care of me now.

 

There are many issues with finding the information: 

1. Are surgeons sweeping the complications under the rug and coding them under other terms?

2. There are many names pinned to reversals and many different types of reversals.  I was offered a modification of my existing RNY - like a half-RNY and a modification to another wls.  NO!

3.  You need to search medical journals.  Try pubmed and begin writing down all the variations of what it is being called and look them up.  (reversal, anastomosis reversal, take-down, revision).  Here's a start, and be sure to check out the related publications on the right side of the page.... http://www.ncbi.nlm.nih.gov/pubmed/22810420

4.  Even the research and medical journals are super specific to a particular group or scenario - not representative of wls as a whole. 

5.  There are many who want to provide research (journals) that support and promote wls in order for insurance companies to continue paying.  If you were a surgeon that performed over 5000 of these surgeries.... would you really need any other business?  Ever hear "build it and they will come"? Put some before and after's on display and the patients flock to you.  Easy.

6.  Even in the journals you will see that wls reversals are pinned to other sources or complications.  (hyperinsulemia, short gut syndrome, malnutrition, adhesions, blockage, ulcers, etc).

 

There's more but my pain medicine is kicking in.... I'll post more when I can.

Hugs,

Pam

and this is a good read too:

http://www.nbcnews.com/id/26076054/ns/health-diet_and_nutrition/t/miracle-weight-loss-isnt/

Pay attention to the section of unadvertised complications....

"Few randomized, controlled studies (the gold standard of research) have been performed comparing gastric bypass with nonsurgical weight loss therapy."

Search these sources:

The New England Journal of Medicine

American Society for Metabolic & Bariatric Surgery (ASMBS)

U.S. Agency for Healthcare Research and Quality (AHRQ)

 

look up bariatric beriberi

I think that's all I can work tonight.... more when I can....

Hugs,

Pam

 

 

 

Thank you. I am looking forward to hearing more. You are in my prayers.

Also make sure you know more about the sources.... what their mission is...goals...vision... etc.

for example:

"The ASMBS is the largest organization for bariatric surgeons in the world. It is a non-profit organization that works to advance the art and science of bariatric surgery and is committed to educating medical professionals and the lay public about bariatric surgery as an option for the treatment of morbid obesity, as well as the associated risks and benefits. It encourages its members to investigate and discover new advances in bariatric surgery, while maintaining a steady exchange of experiences and ideas that may lead to improved surgical outcomes for morbidly obese patients. For more information, visit www.asmbs.org."

I have found a local bariatric surgeon who does lap rny reversals.

Tonight I am having really bad abdominal pain. I think there is some obstruction happening past my pouch. I HATE THIS! 12+ effing years and this is still a focus of my life.

I am going to see if I can see him tomorrow. I may have to have a reversal sooner rather than later.

 

Glad to see you found a local surgeon.  I know this may be to late, just wanted to mention that there is another none revision site here called Failed WLS.  I so nobody headed you that way when you first came here.  Good Luck to you and hope all turns out well.

Hi I was wondering if you ever had the reverse. I was just submitted to insurance and my bariatric has decided to do mine.I had my RNY on 2006 and been having tons of issues was just wondering how it went cant find much out there.