After years of waiting......Revision #2 in 11 days!!!

Hi. My name is Heather. I am a 41 year old Family Nurse Practitioner, wife, and mother of an 11yo son. I haven't posted here in years (since 2010) because I just never believed I would get approved for the revision I've been fighting for.

My background- at 25 years old and 421 lbs., I had a VBG in 1999. My surgeon retired 3 months after my surgery and I never saw him again. I lost 100 pounds without any real follow up or support. By 2001, my weight loss had slowed and the RNY was quickly becoming the WLS gold standard. I had RNY in 2001 at 320 lbs. with Dr. Voravit Wongsa in Cy Fair/Houston and I lost weight steadily postop. Approximately 18 months after surgery (at 203 lbs), I got pregnant and miscarried. I stayed around 200 lbs until 2004 when I got pregnant again and slowly started to regain throughout and after my pregnancy. By 2010, I was up to 275 and seeking help to lose the weight I'd gained. After an EGD, I was told my roux limb was very short (approx 60-70 cm) compared to the norm (most are ~100cm). I already had that working against me. By this time my pouch had stretched and developed a sort of "side pouch" that doubled the amount of volume I could eat. I visited several surgeons who said I needed a revision, but that it was too complex for them to handle. Dr. John Husted in Kentucky said he would take my case, but the surgery was denied by insurance 3 times! Devastating. By 2015 I weighed 361 pounds and needed a knee replacement at 41. I started seeing a dietician and a therapist on my own and have lost 30 pounds in 2 months. I also went to see Dr. Matthew St. Laurent in Cy Fair/Houston in early Sept 2015. He is skilled in RNY revisions and conversions to sleeve/DS AND has revised many of Dr. Wongsa's "short" gastric bypasses. He submitted my info to the insurance on September 23rd and I was approved September 29th!!!! I cried when I received the call. My surgery date is in 11 days. It will be performed in 2 stages for safety reasons - 1) Conversion of RNY to gastric sleeve up top 2) Conversion to full DS approx 9-12 months post sleeve. It's really happening! I start my pre-op diet tomorrow morning. I'm scared and excited and grateful for this last chance to get it right. Sorry for the lost post, but I know I'll need support and input from people who understand.

I can certainly understand your frustration. I had my WLS RNY surgery in 2003. Lost my weight within the first year taking me from 238 down to 123. I maintained my weight for more than 7 years and when WHAM! back it came -- This was during a time when I needed some antidepressants. The weight came on so quickly before I knew it I was up to 200+. Was referred to doc and had monthly visits with the WLS doctor and nutritionist. Tried all - weight loss protein shakes . So Wednesday I am scheduled for a revision and feeling a little disappointed in myself as anxious to get this surgery.

Wow. Wednesday! How exciting! :) I just feel so lucky that I'm getting another shot at this....and I definitely understand the anxiety. Here's to a fantastic outcome for both of us!! Please post an update when you're feeling up to it! :)

Congratulations on being approved, Heather! Great choice in choosing the DS!

Hi Heather!

So right now you have a distal RNY - right? If that is right, how will a ds help you in terms of weight loss? I suppose your sleeve will be tiny so maybe restriction?

Good luck with everything.

Best,

Layla

Hi Layla,

No. This means that, compared to the average RNY, my roux limb is more proximal. I have less intestine bypassed, therefore less malabsorption. The DS will increase my malabsorption and give me better results long term....that's the plan! :)

Wow, DS perfect then!!! Wish all your health and weight loss goals come to fruition.

All Best,

Layla

Lots of good luck wishes to you, Heather. I had a revision two weeks ago and my 44 year old daughter had it in July. She is doing great!

Hi there! I am a 40 yr old RN Clinical Director of Home Health and Hospice in Upper Michigan. I had RNY in 2011 and originally lost #140. I developed marked iron absorption issues, needing IV feraheme on a quarterly basis to survive! The worst difficulty I faced though was reactive hypoglycemia that was refractory to diet and medication. I had 3-4 low blood sugars daily, and I lost my ability to leave the house alone at all because it seemed like I had less and less ability to know when this was happening. I would get confused and even lose consciousness! I just underwent a reversal of my RNY and conversion to a VSG in March. I also had a repair of a rather large hiatal hernia at the same time. Tis was not an easy recovery though :( I did develop a leak on postop day one. I knew something was wrong because I was weak, had lots of pain, and couldn't breathe well. I became tachycardic and I was taken for a gastrograffin small bowel follow through. It was noted that the dye was leaking from the upper portion of my sleeve and pooling in my pelvis! I went back to the OR right away. Once the peritonitis cleared up I went home. I have also battled anastamotic strictures due to scar tissue since the revision and I have had an EGD with balloon dilation every month since June. I am slowly healing. I was #238 the day of surgery and I am around #185 today. I wasn't expected to lose much weight, but lose I have. I would be thrilled to lose #5 more and have skin removal surgery. I wear a size medium and juniors 11 jeans. Good enough for me! Good Luck! Reversing this blasted surgery will save your life. Make sure you have the right surgeon! Mine was adept and I still had a leak.

Oh, wow. Thank you for this reply! My surgeon and I have had many discussions about the possibility of leaks after my revision. He actually described a certain top portion of the sleeve as a "watershed area for leaks" after conversion from RNY. Multiple suture lines are created in an area with an already reduced blood supply. Risk of leak in this area is around 3-5% with a skilled revision surgeon. I actually had a small leak with my RNY, so I'm pretty nervous about it. Fantastic to hear how well you've done with your post-revision weight loss!! Congratulations! I can't tell you how encouraged I am to hear that you've done so well!! Thank you! :)