Revising from Proximal RNY to Distal RNY

Does anyone have any success stories, Pros and Cons?

I'll just say this right up front. There are not going to be many success stories from folks who've gone from proximal to distal. It's a pretty awful surgery frankly and one that I wouldn't encourage for anyone. You'll be lucky to lose maybe 30ish pounds and you're sure to more than offset that positive with increased vitamin malabsorption. For life.

But I'm not your surgeon and don't know your situation. You may be the exception to the rule and it will work for you. If your surgeon is recommending this particular revision, they should be able to give you a more than adequate list of pros and cons and I'd start there.

Can I ask why you are revising? Because that makes all of the difference. If you're revising for any other reason than mechanical failure, be aware that you'll be forced to face down the regain monster eventually. There just aren't that many options out there.

Also you might consider posting this question in the RnY Forum for more traffic.

Good luck finding the right course of action for your body.

I apologize for the delayed response. Im 6 weeks out, had complications from the 1st surgery and they had to revise my revision. My recovery has been slow but I will be just fine. The good LORD got me.

My gastric bypass failed me. I lost weight very slow over 18 months, never made it to a reasonable goal, and was a very compliant patient with the rules and diet. During my weightloss phase, it was noted that my HR was in the low 40s. I saw a cardiologist and an endocrinologist for my thyroid. After many test, both could not find anything that would cause my low HR. I had nodules on my thyroid and my doctor followed those for 2 years without any changes. I maintained for 6 months, but I was starving, like I've always have after a diet when I lost 40-60 lbs. I tried waiting longer before drinking fluids after I ate, one hour and eventually two, but I was still hungry. So I increased my calories to 1400, then to 1500 a few months later. That's when I slowly regained half my weight loss over 2+ years. And my HR went back up to upper 50s.

I had the distal bypass 5 years later due to metabolic reasons. (My insurance would not pay for a DS due to my GERD) I could not lose weight on a 1200 calorie doctor supervised diet. I had to document my diet and see my pcp monthly for 4 months. It was also documented that as I reduced my calories from 1500, my resting HR also decreased down to low 40s. (My dietitian said I needed 1800 calories to maintain my weight) So my body was going back into starvation mode.

This was a 15 month process, which I was denied by my insurance twice. I did 2 dietitian supervised diets also (about 2 months each). And yes, I continued to gain weight during this process. My surgeon did an endoscopy and found my pouch stoma was normal, and I still have restriction now. Following the rules with always chewing food to mush, not drinking with meals and waiting 30+ minutes to drink fluids does keep the stoma from stretching.

My distal bypass has the pouch with the intestinal bypass of the DS. My common channel is 100cm and my alimentary limb is 250 cm. After surgery, initially I lost 25 lbs much quicker than the first time around, then it slowed down and stopped around 9 months out. I lost all my regain (67 lbs) eating more calories (high protein, moderate fat and low carb) and feeling more satisfied. But my HR is in the upper 40s. I reached back out to my endocrinologist, but I was told my thyroid levels were normal and no change in the nodules. After doing a lot of research over 6 months, I saw a functional medicine MD and was diagnosed with Hashimotos. (Endo MD never checked my antibodies) Currently being increased on NP Thyroid based on labs to get levels optimized.

Here is the daily regimen I was on with the first surgery. All were based on my labs. Protein 90 gms Complex carbs 125 gms Fat 40-50 gms. generic Centrium silver, dry Vit D 5,000 IU 3xday, Calcium citrate 500 mg 3xday, B12 1000 day, and switched to Proferrin ES 3xday 3 months before revision because not absorbing carbonyl iron. For constipation: Miralax daily and 1000 mg magnesium oxide.

Here is the daily regimen I'm on with the distal bypass. Very similar to the DS regimen. All are based on my labs. Protein 150 gms Fat 100-120 gms Complex carbs 75 gms. Two generic Centrium silver, Calcium citrate/Jarrows Bone Up 2400 mg in 4 divided doses, dry Vit D 50,000 IU 3xday, dry Vit A 25,000 IU 2xday, dry Vit K1 1xday, dry Vit E 400 IU 1xday MK-7 100 mcg 1xday, Magnesium glycinate 200 mg 6x day, Zinc 50 mg 2xday, Copper 2 mg 1xday, Primal Dense Ultra Probiotic 2xday. For constipation: Miralax 2xday Konsyl 4tsp.day, prescription for IBS-C. I'm not taking iron because I wasn't absorbing it. I was taking 6xday. I had first iron infusion a year ago. (I had anemia before any wls due to heavy periods. Proferrin ES did bring my levels up before the revision)

I don't get on this forum like I did 7 years ago. I'm on 4 FB private DS groups. There are a couple of distal bypass groups, but it's not as informative, so I left both. I have checked to notify me if anyone replies.

Hey!! I apologize for the delay. I am 6 weeks out from 2 surgeries (complications). My heart rate went the opposite way it was as high as 170. But I'm home now and recovering. I am praying that it works.

There are plenty of people who have done very well revising from proximal to distal. There are a few FB groups that have a lot of activity where you'll get a variety of opinions. I'm schedule for a distal revision on 6/12/19 - and as someone noted below - the tool is one thing, I have to get my mind right!

Keep researching, find a good revision specialist and go for it!

Thank you!!

I have had a revision to my original RNY to a distal RNY with a success of over 200 pounds lost. A lot has to do with how well your surgeon does the revision and how well you work it.

Ok, I'm 6 weeks out and I've lost some weight. But I'm still healing. But when you day work it, you mean working my out?