Advice

OK, this is only my second time posting anything on here. I have been an avid reader for over two years but have never had the experience to give any advice. Here goes.

I had a RNY 22 years ago. November 1992. I went from 271lbs down to 150lbs and maintained it for years. 2008 all of the sudden I started putting the weight back on. 5 lbs here, one or two there. I have had sclerotherapy done five times but it never made a difference. The weight just kept coming. Menopause, more weight, stress, more weight. Here I am today at 247lbs again. For years I felt guilty and put myself down for being a failure at the weight loss. That is where this forum has helped me so much at coping with the weight gain, etc. I spoke to my doctor (not the surgeon who did my original surgery) and he made me feel like it was all my fault as well and simply said there was nothing more that they could do.

Yesterday, I had an appointment with another surgeon with experience doing RNY to DS revisions (Dr Lutrzykowski). He said no problem at all. He wants to get it done before Christmas! Sounds great huh?! So why am I totally freaking out right now and second guessing my every thought? Here is my question: Of those of you who have gone through the RNY to DS revision, do any of you regret it or wish you had given it more thought? What advice would you give?

I'm sorry the sclerotherapy didn't help you.  I haven't heard of anyone it did help.

As long as your surgeon is skilled at RNY to DS revisions you should be fine.  I would ask how many he has done.  I would also make sure he is going to do a true revision to a DS whi*****ludes taking down the pouch completely, putting it back together as a normal stomach and then sleeving it.

From what I understand this is a very complex surgery and should only be done by a very experienced surgeon.  You do not what to be one of his first revisions.

If what he proposes is just doing the intestinal portion than really all he is doing is a ERNY, which is the RNY with more malabsorption.  I haven't heard of too many that are happy with that.

You get the worse of both worlds, the upkeep for the malabsorption and the possible side effects of having a pouch.  I also haven't heard of a lot of weight loss that way.

If he is doing a true DS with sleeve you might want to also ask how long he plans on making your common channel.  Some people with shorter common channels, like under 100cc, report more issues.

If you aren't comfortable with this surgeon's skill level there are other surgeons who do have the experience and I would seek one of them out, particularly Dr. Keshishian in California who has the best track record in this revision from what I understand.

Whatever you do, do not let them leave your pouch the way it is.  It sounds like your stoma from the pouch to the intestines has stretched leaving you without restriction.  If he doesn't touch the pouch then I don't see how that would change.