My RNY revision

Hello everyone.  I decided that I needed to do a post on my revision journey because I think that although there is a lot of people that are interested in the topic for whatever reason our shame keeps us from posting our revision stories.  When I began researching revision my immediate go to place was Obesity Help looking for answers but I quickly learned,  as many of you may already know, that this particular board is not very active.  So I was frustrated and researched online to find out as much information as I possibly could find.  Unfortunately, the information out there is very minimal as far as recovery, weight loss, etc.  So I will share my experience with you all and maybe it will clear up some things for those that have the same questions as I did. 

I initially began my weight loss journey in 2009.  I had a laparoscopic RNY.  At the beginning of the process I weighed 358.  I was required to complete a 6 month diet as well as track my exercise during that 6 months.  I was approved through private insurance on the first try due to extreme BMI and comorbidities.  I was successfully able to lose 130 pounds.  My lowest weight was between 220-218. By bariatric standards I had achieved sufficient weight loss.  Shortly after the procedure I lost my insurance coverage due to a job change therefore I was not able to follow-up with my doctor.  I became pregnant a year and a half after the procedure.  Which was too early by bariatric standards as you need at least 2 years to lose all the weight that you are going to lose.  I gained maybe 10-15 pounds with the first baby and after she was born I remained somewhat active and attentive to my diet.  When she was a year I became pregnant with my son. I gained about 20 pounds with him.  I was able to bounce back to a point with him but due to relationship problems and postpartum depression I kind of lost it and the weight began to stick slowly but surely.  I was not as active as I once was.  I became a single while working a FT 8-5 job.  Life was quite hectic.  My diet was not extreme as far as portion size as I still had restriction but I wasn't making the healthiest choices.  I was aiming for convenience.  Microwave ravioli vs home made chicken salad kind of thing.  I was still sticking to the protein first concept and no drinking while eating but slowly things just became more and more lax. On the downside I became a avid social drinker.  If I would go have drinks with friends I chose to have a beer.  Beer was not my friend.  Carbonation is not your friend after weight loss surgery.  I would say that is where most of my pouch stretching came from honestly.  I am not a coke drinker.  I would have one every once in a while but I have always been a water drinker, tea w/ sweet n low, or maybe coffee.  I don't even buy cokes when I grocery shop.  It's too the point that my kids are the same.  Their granny spoils them with cokes because she knows how I am.  lol.  Anyhow like I said my eating habits weren't the best but not really the worst. My activity level was almost zero because I felt like I could not fit any gym time or active time into my life with my two little ones.  They are 2 and 4.  I went to see my primary care doctor for a physical early 2015 and she put me back on blood pressure meds again and I began to have heartburn issues again as well.  She referred me to a heart doctor because I was having these weird pains and heart disease runs in my family so I was freaked out that something may be wrong.  He ran all these tests and said my heart was healthy.  Basically it came down to the fact that I was still too heavy.  My BMI was still too high.  I had gained back 50 pounds and my body did not approve so I was definitely feeling it.  So it was the combination of all of the above that finally led me to seek out a new bariatric doctor not so much a revision.  I just wanted to check in with a bariatric doctor so I could have testing done to ensure that everything was functioning properly.  Revision was definitely in the back of my mind but not my main concern as I didn't even know if I would be a candidate.  I was mostly worried about being healthy for my kids.

In November I reached out to a new bariatric doctor.  Although I loved my first doctor he was 800 miles away from me (bad decision) and I was in need of someone closer.  After I few tries I found one as some doctors will not touch another surgeons work.  I met with him and we discussed my initial concerns.  His plan was to first do some tests and see how things are functioning in regards to the bariatric procedure that was done and then address any concerns after the results are received.  While that was being done he requested I meet with the dietician to rule out any self induced weight gain and to track my eating habits.  Once all the preliminary testing was completed as well as dietician visits, then he would discuss my options which may be revision if necessary or diet coaching depending on the results.     I had to complete the test where you swallow this nasty liquid and they watch it flow into the pouch.  They also check and see how long it actually stays in the stomach.  I was told the test could take hours.  Depends on the person.  I was gone within the hour.  My stomach immediately dumped the liquids.  That indicated to the doctor that either the original surgeon had left the opening to large to begin with or over time that connection had stretched to allow for more to go through it.  So theoretically, although I still had restriction I was able to eat more because the food was not staying in my stomach for long.  So I would feel hungry sooner than I should have been.  The next test that I had to complete was the test where they put you to sleep and go down your throat with a camera.  The doctor uses this to check for ulcer, to gage pouch size, and to address any other issues that he may see.  My doctor determined that my pouch was in fact stretched and I also had a hiatal hernia.  A hiatal hernia is where part of my stomach is pushed up over my diaphragm.  Which causes the heartburn and acid reflux.  When I met with the dietician she talked to me about my food choices and had me keep a food diary stressing the fact that I must remain completely honest.  So I was.  If I had chips I wrote it down.  If I had cookies I wrote it down.  If I did fast food I wrote it down.  The basic consensus was my diet was carb heavy.  For example I would be yogurt to work everyday for breakfast.  It was dannon low fat strawberry so I figured I was okay but it has to many carbs.  I should have been choosing dannon Greek low-fat yogurt.  Which I totally hate Greek yogurt!!! I would have a sandwich with two pieces of whole wheat bread when it should have been an open faced sandwich.  I would make chicken alfredo with regular pasta.  Those are some examples.  Basically I was consuming empty calories!! So we talked about how I could tweak my diet and also incorporate some healthy convenience meals.  We also addressed eating out and how I could work around that. After all was said and done I met with my doctor and he explained to me about my hernia and talked to me about the possibility of revision if it was something that I wanted to do as revision surgery carries a higher amount of risks.  I made the decision to go with the revision as I was going to do the hernia surgery either way and I knew that I wanted to be healthy again.  I knew it was going to take more work as weight loss is slower but I was willing to put in the work.  My surgeons plan of action was to first repair the hernia, next to reduce the size of the stretched pouch by trimming it down and removing excess, and finally making the connection between stomach and intestines smaller. My information was submitted to insurance and within 2 weeks I had an approval.  I had surgery on May 2.  My intended hospital stay was 2 nights but my doctor explained to me that it may be longer as I must be able to drink liquids before I will be allowed to leave the hospital. Surgery was completed on May 2nd with out any issues.  When I woke up from surgery I was extremely groggy and tired.  I was not in an extreme amount of pain but keep in mind I have a high pain tolerance and still had some general anesthesia in my system.  They transferred me to my room and the doctor came in to talk to me.  He explained to me that everything went extremely well as surgery did not take as long as they originally anticipated.  He said my stomach was huge more stretched that he had originally realized which was eye opening.  He also said that he made the pouch and connection fairly small as he wanted to provide me with good results this time around. He want me to be at a healthy weight. My connection is now 1/2 in and my pouch is now 1 1/2 ounces.  I was given pain meds (morphine) and basically passed out for a few hours.  My surgery was scheduled at 12 and I was out by 1:30 ishh. I slept until the next time they came in to check vitals which is every 4 hours and administer pain meds.  They also gave me a blood thinner shot in my stomach everyday as well.  The first day I was on strictly IV liquids to allow the swelling to begin to go down.  I was able to get up and walk around the halls for a good 5-7 minutes after that I called it a night.  I was waken every 4 hours so that they could check my vitals.  The pain wasn't extreme but I was receiving pain meds every 4 to 6 hours.  The next day the doctor came in to check up on me.  He stated I would start liquids.  I received the same thing for breakfast, lunch, and dinner everyday.  A pitcher of water, chicken/beef broth, sugar free jello,  and (2) 1 ounce protein shakes usually strawberry and caramel. As soon as I began trying to drink liquids it was a nightmare.  Nothing would go down or stay down.  Everything was coming back up.  Even my saliva that we naturally swallow.  It was so wrong.  I can't say I was puking more like regurgitating.  I was spitting out major slime balls.  It was pretty bad. I would feel my pouch fill up with nasty saliva to the point to where it would hurt if I didn't relieve that pressure. So gross.  I wasn't able to do any liquids on my own that day so I was kept on IV fluids again.  I love water.  I wanted to drink a glass of water so bad but I couldn't.  I also continued with the pain meds every 4 to 6 hours.  I pushed myself to walk around the hospital every 2 to 4 hours for at least 5-7 minutes as my nurses told me it would help my recover. I was able to take a shower and be more comfortable. The next day I was scheduled to be released but I wasn't able to because I was not drinking liquids.  I was disappointed but understood so I worked even harder to drink liquids but it was not happening.  The doctor explained that with all the work that he did and new size of my connection, I was probably basically swollen closed.  Being on IV meds ads too the swelling as well but given the situation I had no choice.  My day went pretty much the same as the previous day.  I impressed the nurses with how active I was being but had very little progress in the liquid department.  The next morning the doctor came in and told me if you can keep some things down today I will work up your release papers and send you home.  She was impressed that I was out of bed and more active than a lot of patients.  So once again I set out hoping to cram in the liquids same story but it was getting a little easier.  I still had the nastiness come out but I noticed it did calm down some when I drank warm broth.  So in the end I was discharged and was able to go home.  They asked me before I left if I was able to keep my liquids down. I did lie and say I was good.  I think I was over being in the hospital.  I thought maybe it's the water because I drink bottled and it's only certain ones. Maybe I needs to try other sugar and calorie free drinks.  So for the trip home I bought sugar/calorie free powerade and some water.  Same story.  Nothing was staying down and home was 200 miles away.  I remember thinking what did I do. I should have stayed. I am going to get dehydrated.  So at one of our stops on the journey home I decided to get some hot herbal lemon tea.  I was able to keep it down mostly with very little regurgitation.  I was sooo pumped. When I finally arrived home it was such a relief to be home because as I previously stated I am a single mom.  Being at home changed things for me dramatically.  I was able to use the bath room that night #2 specifically.  I didn't have any action at all while in the hospital. I was able to drink water and hold it down.  I don't know if the tea helped me or I was just stressed honestly.  I was just happy that things were flowing once again. It's like a switch was turned off.  I decided to take 2 weeks off.  I was initially going to take 1 but after speaking with the doctors assistant I decided it was best to do 2.  My reasoning behind this is because surgery is hard on your body and the after effects of being on general anesthesia linger within your body.  After my lengthy hospital stay time I definitely needed to rest up.  I would take the kids to school and get in some daily walking.  I was taking pain meds maybe 3 times a day. I was prescribed liquid hydrocodone w/ Tylenol.  I found myself to be more sore and less in pain unless I over exerted myself.  I made sure to rest up and take a nap every single day as I knew soon I would not have that luxury.  I was able to drink liquids fine even protein shakes.  No problem tolerating dairy.  Overall my recovery has been excellent.  I definitely was almost regretting it when I was stuck in the hospital.  I came back to work on Monday.  I have done okay.  I think I have taken pain meds once this week.  Swelling is completely gone.  Incisions are looking great.  I have been moved to soft food after my 2 week check up.  That is quite a struggle as some things don't agree with my pouch so I have to continue with protein shakes.  Weight wise I have lost about 25 pounds.  I had a freak out because I gained 5 back in one weekend but it was because of 1 major thing.  I was not getting in enough liquids therefore my body began retaining water and I was extremely constipated.  Now that I am back at work I can concentrate on getting in my 64 ounces of water per day and I am doing a lot better.  I feel good and I am excited and ready for my changes.  I am supposed to change to regular foods on the 27th (1 month visit) but I don't see that happening.  My progression will be very slow due to the size of my connection but I am okay with that.  As far as cravings I get some as I love, love, love Mexican food but I know I can't eat those things at this point and I do not want to hurt myself.  My little pouch lets me know right away if something is too big to be passed through. I am taking a chewable multivitamin, a Flintstone vitamin w/ iron, biotin,  an acid reducer, and my blood pressure meds until my blood pressure if stabilized.  

So there is my story in a nutshell from beginning to my current point.  I apologize for the extremely long post but I wanted to cover all areas.  I hope that this information helps someone who is also looking for information.       

Thank goodness you were able to begin to keep those fluids down ! Your story was very interesting and I'm so glad you got a second chance. I can relate with you on a few different levels . My little ones are 2 year old twins, I was revised from lapband to bypass on May 3. I've only lost 10 lbs and that was lost in the hospital and no more since then. Good luck on your journey, don't forget your b12 !!

Oh my goodness twins!!! I bet you are a busy woman.  Thank you for reminding me about my B12.  I definitely don't want any issues to come up with my vitamin levels.  Don't be discouraged by the slow weight loss.  I try not to step on the scale every day but I still do.  I know that my stall will happen soon enough. Not looking forward to that but hey it happens.  Good Luck with you as well.  Maybe we can support each other.  Feel free to let me know if you have any issues come up that you think I can shed light on or if you simply need support.  :)

Thank you Christina , same here . I'm here to support and share in the good bad and ugly . 

Hello MissDizim 

Girl your journey is just what I needed to read. I had my surgery in 2002. The last 5 yrs has been hard. I didn't know anything about revision surgery until I read an article in this online site. I looked up and read a lot. So I looked up my surgeon but he no longer practice just my luck.  You said you went back to work on three weeks? Thank you so much. Now I know what I need to do. Good luck!  

Your welcome! Let me know you need anything.

I had my surgery in 2001 It was text book perfect, and I thought I was over the moon with success in loosing weight.  I am not as young as some of you gals who have posts but this one just hit home for me.  You see I was 6 years a widow, and didn't really want to remarry, I just wanted a relationship.  I didn't have children at home, so it was just me and my dog. and work.  I lost 120 lbs, met a gentleman and got married.  Big wedding and Grandsons walked me down the aisle.

Now I am 70 have gained 40 lbs back, as well as the comorbidities like getting back my diabetics, severe sleep apnea requiring the use of a bi-pap machine and oxygen, thyroid  problems just to name a few.

I feel ashamed and unsuccessful at being able to keep off the weight.  I have also developed a hernia just at the sternum.  I am going through the testing and meet with a doctor tomorrow to see if I am able to have the hernia removed.  He is a bariatric doctor and I really want a revision done. He doesn't seen interested in doing a revision.  He said What I have is what is what I must live with, after the hernia is removed.

I last year I  went through my closet and anything that didn't fit I donated to the group that helps homeless teenagers. Since all I ware are jeans and tee shirts

Again shame has overcome me with the weight gain and that I have almost as many clothes to donate again.

I am open to suggestions, support or what ever from some of you who have gained back your weight.

My husband is very supportive but I am hard on myself for failing to keep the weight off. 

I would see another surgeon ! You don't have to live with what you have . 

I agree with Sheriberi. I think that you should explore your options. Maybe look for a look for a doctor who is more open to revision. I would not feel ashamed it happens. All you can do at this point is be proactive in finding a solution. 

I'm 63 and after over ten years from surgery I've slowly regained 50 pounds. This morning was my nightmare weighing in at 200 

In the past five years I develooed low blood sugar. Not fun I have to eat every two to three hours which hadnt helped the regain. Of course when my blood sugar starts to drop I get overly anxious and will eat anything lots of it. 

Depressing.

i started reading about revision options. Not sure if I can do this because of the low blood sugar but want to research before making the doctors appintment

I had moved out of area so my old doctor isn't covered by my insurance. That's another research I need to do for a new doctor.

am I too old for revision?