2nd Revision help

So, I had Rny in 2002 lost 75 pds from 375. I never lost more. In 2009 was revised to gastrojejunostomy  and gastrojejunostomy which Im still not sure all it entailed and how it will or would affect a second revision since I had my pouch resized. Had this done in Germany and I do speak fluent German, however it was done in conjunction with hernia repair and scar tissue removal and my dr.  deployed shortly there after. He did tell me that at the time the regain of weight would be likely but with the condition if my hips I had no other option as I was not able to walk. Anyway lost 40 pds and regained.  Im at 280 now, 5'7 and have not gained anymore thank goodness. Had a double hip replacement that same year. I have been looking into DS seriously for the last 4 years as it seems like the most feasable at this point given my situation. However, Im not sure if a second revision is possible? My main concern is my hips. I want to keep them as long as possible.  Anyone have any info on this? Thanx for any info that will help? 

You need not to be casual about the type of surgery you have had.  Go and get/demand your medical records. Why don't you know what a gastrojejunostomy is if you had it!  Shame on YOU! You're a grown woman having SERIOUS surgeries - you should know every single thing about them!  

The duodenal switch is an absolutely wonderful WLS but it is not for kids.  It is for the super intelligent, reliable, responsible, take charge of their own medical issues, self-advocate, curious scientist kind of person.  The DS is not for someone who has their head stuck in the sand.

I am sorry to be harsh, but when will you learn and take the lesson.

Oh, and find a good surgeon.  YOU DO RESEARCH!  DO YOU YOUR OWN SELF CARE!  You have no room for error this time.

I absolutely wish you the absolute best.  Be wise!  Be interested!

I suspect you didn't appreciate Zee's comment, as I see you have deleted something, but as a person with a DS, let me just say that I think she gave a dose of tough love, and please don't disregard the information even if you don't appreciate the delivery.

The revision to DS from RNY is far more complicated than a virgin DS, and so there are very few surgeons that will (and fewer who SHOULD) do it. There are truly only a handful in the world I would allow to do this particular revision if it were me. 

The stuff about needing to be informed and advocate for yourself is also very true if you have the DS. It's not uncommon for me to go to see a Dr that does not know what the DS is, so I may have to tell them, and explain how it influences what is going on. I also need to track my labs myself, after making sure they have actually drawn all that they are supposed to.

I've been around long enough to see that those that think that   1. the Dr will know to draw all the right bloodwork, and    2. they will tell me when something is going wrong - those people end up with deficiencies and sometimes serious problems.

It's so much harder to pull tanked vitamin levels or protein or whatever out of the depths than to just maintain it at the right level to begin with. I have had to argue with my physician to draw adequate labs, and argue that levels were not OK because they were rapidly trending down, despite the fact that they still showed as "in range".

I'm a fairly quiet person, that does not enjoy confrontation, and I don't track my labs because I'm anal or OCD. I've just learned that this is how you have to be to stay healthy with a malabsorptive surgery, especially this one. 

There are some surgeon lists, and I know there are message boards with other revision patients that may have helpful advice if you'd like me to steer you that towards them. Good luck with whatever you choose. 

Here is my reply to her and no it was not helpful at all:

RNY on 09/11/02
First of all u dont know my story and have no business shaming someone who is here for help! I do not have to explain myself to u or anyone else. I asked for specific help if anyone had any info whi*****ase u have not noticed that is what the name of this site implies "OBESITYHELP." It doesnt mean I get a lesson from someone such as yourself who adds a comment that had nothing to do with what I wrote. Take your own advise and learn how to be helpful in your response by asking questions if u dont understand something about what is written on here. U assume I do not know about the ds or other procedures and u are not correct and assumed the worst as u did. I know plenty and I continue to research and learn. If u dont have anything helpful to say then dont reply just so u can hear yourself. I dont need those type of replies as I am my own critic.

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**hipsqishingvinegarball

Having said that, I do have a vetted ds surgeon that I  am looking into but my insurance is in transition right now. I have military insurance and picked up bcbs with my job that will not take effect until Jan. Trust me at age 48 and loaded with issues, I do not take anything lightly or for granted. As aforementioned this is a path I have been on for years and I am going to stick to it until I am healthy. I think that if I would have had the option insurance wise years ago I would be in a better position at this point. My hips have really hindered me but I cant give up. Thanx for the great info in your reply :)

I may be reiterating what you already know, but it takes more than just one of the good vetted DS surgeons to do specifically, the RNY to DS revision. Most folks travel all the way to Rabkin or Kesheshian in CA, as they don't flinch at the tough cases, and so they get most of them. OODLES of experience. Not sure where you are, but there are only a few others I'd trust with this revision.

And I hear you on the hips. Even if you can get surgery to repair some of the damage, we often need NSAIDs for some pain for life, and there was no way I'd survive the rest of my life without any NSAIDs if I'd gotten RNY. My DS was at 42, and I had enough years of obesity to leave my knees, hips and back with degeneration. I may get by with no more surgery, but the sleeved stomach with the DS makes it possible to take NSAIDs as needed. Thank goodness. 

Yes, I totally hear you and I have been to 3 DS surgeons at my own expense since our military insurance doesn't cover DS. My latest trip was yo Washington state from Louisiana to Madigan Army Med Ctr and Im hopeful for the first time in a long time. Will be going back to WA for an endoscope in early Feb. to check out my rny anatomy.  I too have been taking NSAIDS but have cut them down because I worry about the scar tissue potential. Im at the point where I really am at the end of my options and the more I research the clearer it becomes that the ds is the only procedure that could help me.  I know that my commitment will make the difference between sucess and failure.  I worry about the malaborption aspect but I already take a ton of vits and have no choice. I will keep posted after my scope in Wa. Hoping all is well with u too :)

Madigan?? I know Dr Martin does the DS there, and I've heard there is at least one more surgeon that does now too. I know several who had Martin and he is highly thought of.

Yes! Thats what I hear ? So much good info on here. That helped me figure out where I could go  despite my military insurance not covering ds. 

After having a revision already there may not be to many doctors that are going to want to do another revision and that is if they even can.  A person can only have so many WLS surgeries when there is just nothing more that can be done.

The DS is a very complicated surgery and if it is not a virgin one being done there can and may be complications.

You definitely need to get the weight off or your hips will not last long at all.  My husband just had a right total hip done a week ago and even though he is 5'11" and weighs 225 he was told to lose weight to prolong the life of the replacement. 

You have to take a serious look as to why you are regaining.   Most people say they are eating healthy and only eat a certain amount, but in reality they are eating a lot more than they realized.

Are you tracking everything you eat?  How is your water intake?