I dont know where to begin anymore.....

So I had my RNY on 10/10/2003.  I went from about 280 to 135 (for about a day).  It took about 1.5 years to lose.  I was up to 175 by 2010- then I went to vet school! - and now up to 250+ in 2013.  I am still currently in school and have AWFUL insurance.  I was looking into the endoscopic procedures to cinch back in my pouch - but I have heard mixed reviews on efficacy.  I know my stoma is stretched - I had an endoscopy done and he was able to look all around and down my guts.  Ugh!!  I need to get the measurement he took of my stoma.  I want to say 4cm!!  But that sounds totally ludacrous and well, I was waking up from the whole gross procedure when the GI doc was taking to me.  Thing is... I think im mad.  I am mad that this was supposed to be the fail-safe, perfect fix (with incredible hard work).  All the support group meetings, no one mentioned COMPLETE regain.   I realize I need to get over being mad and start to do something about it.  I just do not have the insurance or money (or time) to fix me right now.  I am in veterinary medical school for another year and then hopefully residency.  I dont have time for another major surgery or to feel weak for weeks.  Even now, I  am still dealing with sometimes debilitating iron deficiency that requires iron infusions.  SO - Im asking for advice.  Please.  I think at this point I have so much to lose again that I seriously need to consider the DS.  That terrifies me a bit now that I know A LOT more about malabsorption, etc.  DO I have to go thru the WHOLE process again??  I really do not want to speak to a psychiatrist, go to months of support meetings or have a full dietary review, again.  However, I do realize the benefit to these things.   Advice??

The RNY is NOT a perfect fix at all or fail safe. NO WLS is fail safe. We have to do our part.

It is a tool to weight loss. If we work around our tool we WILL gain weight.

Go back to basics. Protein, protein, protein,,,,,veggies, and complex carbs.

Exercise is a must for long success......

Attack your weight loss like you have VET school......you are worth it !!!

Completely agree with you!  My problem is that I have absolutely NO restriction with my pouch.  For me that was the effective part of this surgery.  I need to get that restrictive feeling back.   I still have vitamin deficiencies and dumping (if I am not careful).  I can probably lose some weight by going on high protein diet - aka Atkins.  Im hoping someone that has had the DS revision can offer some feedback on how restricted they felt after the 2nd surgery.   

I never had any dumping or any problems so I guess that is what cause me to fail my new tool, I am determined this time to make it work for me though I have to make the change cause my co morbs are to much for me anymore and are affecting my kids!

Hello Sarah.  I had RNY in May of 2007.  Lost and regained.  Not an unfamiliar story unfortunately.  Regain happens a lot with RNY.  Any*****gained, had lots of food intolerances and severe reactive hypoglycemia.  Had a revision to DS in April 2011.  Best thing I have EVER done!  I'm 2 1/2 yrs out and still have great restriction.  The issue with RNY to DS revision is that there are only a handful of surgeons in the states that can do this complicated surgery.  You CANNOT go to just ANY DS/Revision Surgeon.  You have to get one who has the expertise to do a TRUE RNY to DS revision.  Where are you located?  There are two of the best in CA.  I went to Dr. Henry Buchwald in MN.

YES YES!!  Thank you for sharing!!  I will be doing my clinical year at Oklahoma State.  I have a 3 week break next year - this would be the opportune time to do some investigating.  I will certainly not go to just any doctor.  I am from NC, lived in OH and will be in OK for a while - hopefully 4 years, and I have family in Houston area.  Cali would not be too far to go.  Do you know their names??  

Did you feel like you were essentially starting all over after the 2nd surgery??  Hairloss? Tired?  B-12 problems.... 

Here is the list of RNY to DS revision surgeons in the US that we frequently refer people to:

 

Dr. Keshishian, located in California

Dr. Rabkin, located in California

Dr. Simper, located in Utah

Dr. Elariny, located in Virginia

Dr. Roslin, located in New York

Dr. Buchwald, located in Minnesota

  I felt like I was essentially starting over after the 2nd surgery because I was basically back to my first surgery weight and the diet was much different.  I did a lot of research on the DS prior to having the revision so that I would know what to expect and so that I would know how to keep myself healthy.  The malabsorbtion in the DS is much greater than that of the RNY and it is good to have a healthy dose of respect for that malabsorbtion.  You have to be willing to do the work (labs, tests and vites) for life.  As the malabsorbtion is permanent.     I did not have any more hairloss than i did with the first surgery.  I did not lose too much hair, so it wasn't a big deal.  I know of people who have lost a lot and some who have lost none.  There is a chance to lose hair with any surgery.  It is a reaction to the anesthesia.     Tired?  I do have issues with my iron and ferritin levels.  My ferritin has been low for a long time, but I did not really get it addressed until my revision.  I see a hematologist and get IV iron infusions as needed (usually once a year).  When my ferritin levels drop I feel more tired.     I don't have any issues with B12.  I take one 2500mg subingual B12 per day.  That keeps me where I want to be.  

WOW!  Thank you so much for all of this!  I do remember researching McElariny in VA.  You sound like exactly where I would like to be with all of this!  I really appreciate your response.  I just started getting iron infusions this summer.  They are AMAZING!!  I get twice monthly B-12 shots and I do generic gummy vitamins (not preferred! haha!).  I just feel like everything has gone to crap since I have been studying abroad for vet school so I have not been to my GI docs hardly at all in 3 years.  I only get 3 2-week breaks/year and I have spent the vast majority of those dealing with other doctors and health issues - like thyroid cancer (UGH!)  Since I arrive back in the states this Christmas - I think it is time to get myself back on track!  I will definitely look into the DS and see if I can at least get a consult with a bariatric surgeon to discuss it.   I did see a doc at Duke - he was the first to mention that I had probably gained too much to just revise my pouch and the lap band over RNY was not very successful.  I was totally bummed out by that!  I love this 'community' and my thyroid community.  It has been so helpful and encouraging!  Thank you agian!!

Hi Sarah,

I too am a RNY revised to DS. I actually ended up with a fistula from my RNY early after my surgery in May 2005. I only lost 50lbs then regained about 30 of it. I had some malabsorption issues, lots of food intolerances and just lots of problems period. I always felt like crap!

 I started researching the DS about a year ago. At first they thought they could repair the Fistula but it was too large. I had the revision in March of 2013. They went in, reattached everything then redid the surgery to a DS. My stomach now has a pyloric valve and looks like a little banana! I can only eat about 3oz at a time. My common channel is 125 so its middle of the road for malabsorption. I have lost 75lbs , my food intolerances are pretty much gone and I feel so much better. I am 63, haven't had any problems and have absolutely no regrets. I would recommend it to anyone- just wish I had done it sooner.

Good luck in your decision!

Sharon

Went yesterday and had my EGD,UGI, Blood work and Dopplar on my legs (no clots) but sadly my pouch has stretched to 2/3 the normal size so I am looking at a Complete revision of the Gastric Bypass its self!