Harrowing appointment with surgeon yesterday (VERY LONG and I'm sorry)

I went to see a surgeon a couple of months ago and told him about my issues with my RNY from 11 years ago.  I had the original open RNY and didn't have much success in terms of weight loss.  I did end up with a nice, big hernia as a result as well.  When I went to have the hernia repaired the 2nd time I told my surgeon that I didn't have much restriction and never had.  He did a scope and found that my outlet was too large....probably always had been.  So, when he went in and re-fixed my hernia, he also bypassed more intestine.  I'm not sure how much, I don't remember what he said and am having a horrible time getting my records from the hospital which has changed hands.  My surgeon is retired.

After my revision, I have never had a solid poop (sorry, tmi)  I did lose a little more weight and have managed for the most part to keep the weight off within 20 lbs through illness, pregnancy, divorce and whatever else life through at me.  I have suffered gas, runs and dumping, but I did learn how to deal with it for the most part.  I could somewhat control it with what I did and didn't eat.  Fast forward to now.  For the last year, my stomach issues got worse to the point where I can only eat protein and know that I won't have issues.  Anything else and its a game of Russian roulette.  Starting last year, I quit eating until night time.  It was to the point that eating just wasn't worth it anymore.  I feel great when I'm fasting and after I eat,  I either end up feeling sluggish, gassy, bloated or have hypoglycemia.  I dump on fat, carbs, dairy, sugar and have issues with several veggies as well.  Like I said, low fat meat is about the only guaranteed safe food.  I have lost 50+ pounds over the last year and wasn't even dieting.  Not that I don't still have room to lose more, I just wi**** wasn't because food is a horrible thing for me now.  At the moment I'm at 222, I started at 353 and have sat between 280 and 260 for the last 10 years.

I went to see the doc who did my last hernia repair, he had tests run (upper gi, endoscopy)  Come to find out, he thinks a lap band would help because I have rapid emptying.  My intestine bypass is longer than normal (have no idea how much) so the part of my intestine food is dropping into can't handle it.  This makes sense to me.  After reading online, I found that the DS would probably be a better option and would give me my pyloric valve back, BUT its a HUGE surgery and I have a severely disabled daughter, and I am her main caretaker.  So, I have been thinking about having the lap band put on for the next couple of years and if it helps, ride it out until it stops working, then plan on being out of commission for over a month to go to another state and have the DS.

I have been going to a surgical center here in my state mainly for the nutritionist for the last 3 months.  When I first went and saw their surgeon, he told me that all of my issues were caused by my diet and totally self inflicted.  He figured I was trying to take the easy way out instead of buckling down and changing my diet. ( at this point I had been only eating meat at night, nothing during the day for several months)  I decided to give it my all and see if he was right.  The first month they put me on 4 protein shakes during the day, and a meal of meat and veggies at night.  I did pretty well, I would have a reaction to some of the drinks (mainly the Atkins, probably due to the fat content).  It was also hit and miss on the veggies/salad with dinner.  I had to cut out salad dressings and only use the spray on stuff.  The next month they moved me to 3 meals a day of protein and low starch veggies.  I started feeling bad again during the day with gas, bloating and such.  I wasn't having any dumping, but at times even my calcium chew seemed like too many carbs and made me feel sleepy.

I talked to the surgeon yesterday about the fact that I was going to see Dr Stewart in Texas about a DS and my other Dr about the lap band.  He made it clear from the get go that he didn't want to do anything surgically to me.  He believes that all of my issues are my own fault, that I'm not really following a clean diet (which after following the liquid/1 meal diet the first month, I lost 20 lbs!)  I maintained the loss this last month.  I told him that I thought my bypass was distal or extended or something, I'm not really sure how much is bypassed, just know I have maintained weight loss even when I ate to much, but also had the runs and gas pretty frequently.  So, he said that nothing would help me, that he didn't believe I had a distal or extended bypass, that my issue is bad choices.  That if he ever had proof that I had a distal bypass, the only thing that  would help would be to take down my RNY or shorten the bypassed section.

I left his office bawling my head off.  Hurt because I had been accused of being a liar and also very hopeless that I would just have to live this way and deal with it.  After I had my cry, I decided I would go to my appointments next week, get the other two opinions and go from there.  If the others agree, maybe I'll just live on chicken breast and protein shakes.  Not the option I want, but I would rather do that, than have my bypass taken down and end up 350+ pounds again.  I'm sorry this is so long, God bless you if you made it this far.  Has ANYONE else ever had these issues with their RNY or is it just ME???

Ok. Let me address a few things. 

1. Don't ask the hospital for all your records. You want to request the surgical report. That's all you really need. You can likely get it from the surgeons office.

2. If you have a distal or extended RNY you will have looser stools and more fragrant flatulence. Not much you can do about this although you could try some probiotics. 

3. If eating is sketchy start to write down the items. I also find that it's easier for me to eat what I call "slider foods." Anything with gravy, mayo, and the like. I tend to eat almost all protein with either greek yogurt (It tastes like sour cream to me), sour cream, bbq, or anything else that acts like a buffer. I also tend to eat a LOT of eggs. Mostly scrambled, but eggs for me are a great protein and ever so easy on my stomach. 

4. I had an RNY to DS revision and had a lot of post op complications. In the end I did end up having most of my stomach amputated along with my pylours. I spent 18 months trying to recover. It took a third operation to fix all that was wrong. If you want the whole thing I will tell you, but I warn you that I am the anonmally when it comes to having a rough revision recovery. For me although it was tough to get well, I would do it again, just not tomorrow. 

5. My personal opinion is that I would never do Band over bypass. I don't want a foreign object in my body for the rest of my life. Not to mention the high failure rate and the terrible reguritations issues. 

6. If you left the surgeons office feeling so bad and being accused of not being truthful FIND YOURSELF ANOTHER SURGEON. You should not feel that way. 

 

 

My original surgeon is retired.  His office is closed so I'm stuck with the hospital on getting my records.  BOO!  I do well with eggs most of the time, but on occasion, I think the high fat in the yolks give me issues.  Only seems to happen when the yolk is runny???  I will try adding some stuff to my meat to see if that helps, but I think the veggies are what makes my condition worse.  Low fat protein seems to keep my intestine from freaking as much.  Thanks for the kind words regarding the surgeon, you are right.  I shouldn't subject myself to abuse like that anymore.

Hi,

I had revision for RNY to DS in December. I met with 3 surgeons prior to deciding what was best for me. The first Dr. , very well respected wanted to go in and "tighten up" my very small pouch and cut out so more intestines. After a bit of research it has not been very successful.  The second Dr. (Rabkin) does not take insurance so I went with Dr. Keshishian. He saved my life. I thank him everyday. I did travel for surgery and had complications that kept me in the Hospital for 3 weeks. Even with that I would do it again in a hot second.

Good luck to you. 

Whitney

sorry for the type-o's

 

Thanks Whit, I know your story has ended well, but you have been through so much!  I am willing to go through what I have to in order to feel good in the long run, its just not really a good time due to my daughter with Angelman Syndrome.  She needs constant care and I don't think I could have her taken care of longer than 2 weeks.  The would require my ex husband (her dad), and my husband using all of their vacation time.  So my reality at the moment is "what if".  I know one of our fellow RNY to DS revision sisters has been in the hospital for over 6 weeks now.  Scary stuff!  I'm gong to give Dr Stewart all of the facts and listen to what he has to say.  I am scared!  lol

I am so sorry you have had such a hard time! I have to agree that you need to find a surgeon that wants to help you. I hope your two appointments go wonderful! I read your whole post and felt so bad for you. Alice

Thanks Alice!  Keeping my fingers crossed!  :)

I am sorry you are going through so much. Hopefully it will all work out in the end. I do not think you should let your Doctor talk to you like that. Find a new one.

Grr. This is not your fault. All the things you mention because of your RNY, and more common with ERNY. Your surgeon was like a carpenter with only a hammer - everything got treated like a nail. Your surgeon did RNY, then ERNY, because he was a RNY surgeon. Hopefully Dr Stewart can help you. I also hope you fire any Dr that was telling your this is all your fault. Shame on that lazy, uninformed Dr.