Ulcers from non absorbable sutures/ revision

kmsbanr
on 6/27/18 9:55 am - CT
RNY on 04/10/12

Had RNY 2012 did great until I had a GI bleed and massive Marginal Ulcer 1/2015 never found a bleed site but assumed from ulcer. At least 7 sutures and a couple of surgical clips were seen during endo but GI did not take them out. Was transfused and in Intermediate care. I recovered but have had multiple slow to heal ulcers since and another massive bleed in Jan 2017. I have a lot of pain drinking or eating with nausea and vomiting at times no matter what I eat. My GI is worried I could bleed again and not make it to the hospital and has been pushing for a revision since then.

I have been on Max PPI therapy since 1/15 have had iron infusions and now on Pepcid at my request. Zofran was 3xd but was adding to my nausea. Recently had to take it even though surgeon took me off all of my meds and vits but bp, levothyroxine and PPIs etc. No change in my ability to drink and eat which was his hope. I didn't take nsaids at time of first bleed but after suspected TIA I was taking aspirin. I have not taken any since 12/2017 still no change. No smoking either. I have been able to keep my weight up by eating higher calorie foods I would never have eaten in the past but my old bariatric group threatened a G-tube and that was not going to happen. That group removed sutures and the rest fell out over time but new ones continue to migrate in. I don't usually ulcerate where the sutures are. H-pylori always neg. This group refused to do a revision"it's hard" but so is living like this.

My original surgeon was not practicing in the US when I had the first bleed but followed me and kept in touch through all of this. My surgeon told me he used half absorbable and half non absorbable and I am reacting to them. I also had a bad reaction to abdominal mesh for a hernia repair. He is now back and I am currently seeing him after insurance approved out of network at in network cost. He is hesitant on the revision as well because it is more dangerous than original surgery. I would have to endos every 3-6 months forever. I have had at least 15 endos since 2015 and have one tomorrow. He thought he saw another suture coming through but too deep and couldn't get it in April.

I am fed up with feeling crappy all the time and having to inconvenience my kids for rides all the time. At almost 65 it's not the only thing they help me with;). They are great but they have lives too. I may also need a valve replaced sometime and I worry about my anesthesia cards running out.

When we did talk surgery the options: remove pouch so then esophagus connected to jejunum and maybe taking out stomach since no bleed site ever seen. I asked about revising anastomosis and was told no. I asked about convert to sleeve told no. I am worried about straight tube and no gastric reservoir no matter how small. My pouch is not large.

I read about others having revisions for similar reasons and wonder why mine is saying no. He is an excellent surgeon with great stats and I do trust him. I am glad I did this and would do again just without those sutures. I'm puzzled by 4 MDs not wanting to do a revision. Any information or ideas would be helpful. I don't want to do this anymore and am fed up with this situation.

Sorry this is so long and thank you.

        
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