Anyone have to have a 2nd revision? (also on RNY board)

Hi All - this is going to be long... sorry... but I know someone on here has to have been where I am.

 

In March 2003, I got a lap band, which I had for 4.5 years.  I had some initial success but I threw up ALL of the time and gained part of the weight back.  After deciding I could not live with the constant hunger and inability to eat without it coming back up, I had a revision to a sleeve in 12/09.  I loved (and still love) my sleeve.  I cannot even begin to explain how liberating it feels to not feel like food controls my life.  I never got to my goal weight, but I got to a size I was comfortable with.  In > 3.5 years, I only remember 2 times that I ate too much and thew up.  With the band, 40-50 times/week was not uncommon..

 

Around a year ago, my acid reflux came back with a vengence and last winter, I started waking up throwing up.... not very sexy - I would wake up with it coming out my nose or coughing it up where it aspirated into my lungs.  I want to my PCP and she put me on PPI's 2x a day.  I still take them 2x a day.  The episodes started coming more frequently so about 6 weeks ago, after waking up with salad coming out of my nose, I went to the tummy dr.  We did an EGD and Bravo testing and bottom line, my tummy is very disfigured with a tight narrowing where the band used to be and a pouch above it (on top of the hiatal hernia).  As far as the 48 hour bravo results... it indicated extreme GERD even on PPIs.  He referred me to a bariatric surgeon here who did an upper GI, said OMG  take a pic of this (I really have one screwed up looking tummy) and said he did feel he had the experience to perform a 2nd revision but that I needed one to a RNY.

 

Yesterday I drove 150 miles to see my orignal surgeon, who I still love, who gave me 2 options:  live with the symptoms including the bronchitis, sinus infections, lack of sleep, and possible worse complications of vomitting in my sleep or go with a gastric bypass.  He said all of the things I hoped would fix it:  lose the 25 lbs I regained, re-sleeve, more medicine, hiatal hernia repair - just won't fix it.

 

So here I am... facing the surgery that I was afraid to have in the first place.  I know so many of you have had success, but I love my sleeved life. Occasionally I eat a piece of cake and it doesn't make me sick, but I can't eat more than a small one.  Or i have White Russian.... I follow all of the rules most of the time (and have for almost 10 years now).  I'm worried about the side effects, especially the unpleasant ones.  I worried about the increased risk of leaks - its high the first time around but this is my 3rd surgery.  I'm worried about what if something goes wrong down the road - I'm only 44 and 1/2 of the little tummy I have left will be removed... And I can't believe that soon I will have had all 3 of the most common types of WLS.  Did I already say sigh?  Let me say it agin... SIGH.

 

Has ANYONE else been there? (and yes - I know there is a revision board, but not many people go there...)

Hi Deanna - I have the lapband (my 2nd) and suffer from severe acid reflux. Surgeon recommended RNY so doing revision on Tuesday. Not exactly like your situation but my surgeon did tell me that I would likely still have reflux if I revised to the sleeve. Since I'm still pre op I don't know how my body will react to bypass, but there are a lot of vets here and on RNY that post great advice and their own experiences. Sorry to hear of your difficulty. Take Care.

Look back on this page for a list of actual revision surgeons. With all the trouble you are having I wouldn't trust anyone but a surgeon from that list. It sound like a stricture, plus hernia and if you have a sleeve the DS would be the natural progression in revisions. Make sure you at least contact one of these real revision surgeons for a consult, I would only trust them.

It sounds like you are having a revision only to stop the terrible GERD and repair the deformed stomach, not to lose more weight.  Is that correct?  If they are only trying to piece together your remaining stomach to get rid of the bad parts, maybe they can leave a larger pouch than a true RNY.   Also, if you had a sleeve, you still have your pyloric sphincter; I don't see why they would take that out.  If you keep it, you are not likely to have the dumping that RNYs are likelt to have.  If you want more weight loss, they can bypass part of your intestine for malabsorption.  

I am really not seeing WHY he would have to make you a RNY.  It sounds like what you would need is to have the strictured part of your stomach repaired, and maybe have a plication of the upper part to prevent the GERD.  If so, you'd still have a sleeve, just it would be smaller, more like the size of an RNY pouch.  I would really, really get a revision expert to do a second opinion.  You will miss that pyloric valve when it is gone.

The 2nd surgeon is a revision specialist and the surgeon that performed my 1st two surgeries so I have an almost 10 year history with him.  I am not at goal but I am happy with the sleeve and could lose the 30 lb regain if I worked on it.  I am not getting a revision for weight related reasons; I wouldn't qualify based on weight.  The problem with keeping the bottom part of my stomach is I have the damaged area of my stomach (where my lapband was) in between the top stretched pouch and the bottom healthy part of the sleeve.  Revision is needed for GERD and throwing up in my sleep (not necessarily GERD related).  I have uploaded a pic of my tummy in my photos.  It might make it more clear.

I had my band removed due to extreme, chronic, reflux and resulting damage.  According to my surgeon it's possible that if I couldn't get approved for RNY for WL that the gastro guy could submit to correct the reflux with an RNY surgery. (It's commonly used as a cure for reflux)  Both doctors would do the surgery together.  He would NOT allow me to have the Sleeve because the number one long-term side effect is reflux and therefore is not a good choice for people with a history of GERD/reflux.  

I shouldn't have a problem qualifying based on weight so we didn't have to go the other route but this may be a possibility for you if your BMI is too low.

Best wishes for a good outcome!

Lisa O.

There's currently a 7-page long thread on a different WLS board, started by someone with a very similar problem. I can't post a link here, but if you'll do a Google search for "No DS for me :-(" I think you'll find it. Lots of good info there.

Uploaded a pic of my tummy in my photos; may make the issue more clear.

I'm there..but looking at a DS. I've seen way too many RNY revisions in my 13+ years on OH. Very few DS revisions. Also I yhink quality of life is better. Before you go under the knfe, talk to a revision surgeon who does both. If you ask n the DS board, people can help direct you. RNY might be perfect for you, but I'd want to double check that it makes the most sense...esp. as you already have a sleeve.

I have one question, if they are trying to correct your reflux wouldn't the first step be to repair the hernia and see if that helps. Many are fixed once the hernia is repaired.