Going CRAZY...this is consuming me!!!

This is consuming me! I had a lap RNY on 07/15/2002. I got pregnant 7 months out and had baby in 10/13/2003. I had lost from 272 to about 189 and only gained 12 pounds during pregnancy that I quickly lost after giving birth. I easily maintained my weight for the next year. I had a hysterectomy 10/18/2004. I continued to maintain my weight for another year. Suddenly, it became a struggle. I had been walking but in January 2006 joined a gym and work out 4-5 days a week 1-2 hours at a time. I went for my annual the other day - I weighed 216 pounds. What the?!!! I had been worried somewhat but I think sort of in denial. In retrospect, I can see that in the last 6 months or so, I have been hungry shortly after eating and am eating larger portions. My original goal weight was 140. I never even lost 100 pounds. I didn't mean to get pregnant - I was on the pill and had always had trouble getting pregnant (had PCOS). I am so glad I have my daughter, but I do not want to be FAT. I have an appointment on Tuesday, but all of this is driving me crazy. I am so scared he is going to tell me that IIIII failed and it is TOO bad. I am scared he is going to tell me that I eat too much and stretched my pouch and there is nothing he can/will do about it. I want a revision. When reading my OP report, it sounds as if I was done proximal. From talking to my insurance company, I know that it will be covered if it is deemed medically necesarry. Well, considering that my BMI, I think, is still over 40 and considering that if I gain 15 more pounds or so, I will again be 100 pounds overweight and considering that I am still obese and considering that my knees are starting to hurt again and I am having problems with shortness of breath and have borderline high blood pressure wouldn't they consider it medically necessary?!! I never thought I would be going down this road again. I am so scared of being flat out turned down and gaining all my lost weight back and adding more - I don't want to live like that. I want to go to my doctor's office with "ammo." I want to be prepared and knowledgeable about revisions and why I should have one no matter what. Any advice? Thanks for reading my VENT!

Tomorrow is my appointment - no advice for me anyone??? I am so anxious and worried. Please Thanks.

Hey! You are right. My doctor did point out today (read reply to Kimi about doctor's visit) that he was not happy with my noncompliance as far as vitamins. I do drink tons of water, and he said I could drink soda, too. ? I do feel like I make the best choices as far as my diet is concerned for the most part. Doctor asked if I can eat more than a cup at a time - the answer is yes - that is what starting freaking me out and then, of course, the weight gain. I have never gone to a support group meeting but totally understand the importance of it now and plan on going as soon as I get information on it. I just found out that my first test barium swallow/upper GI is scheduled for April 4th. Three weeks seems like so far away - too much potential weight gain - speaking of weight -- 210 pounds today. I was 216 about a week ago on another doc's scale. I haven't lost any weight, so who knows which is accurate. Doesn't really matter - neither is good. I am WAY too close to being 100 pounds overweight again. Okay, I am rambling on and on and getting upset again. Thanks for your support! I will keep you posted. Tabatha

Your story sounds very much like mine. I had surgery in 2001, lost 130 pounds and maintained it until the middle of 2005. I too began to get very hungry shortly after eating. And I want to stress that this was real hunger, not that "in my head" hunger where compulsive eating comes in. This was real hunger pains...I was always hungry. I went to the doc, he ordered an upper GI which shows that as soon as I eat something, it goes STRAIGHT through my pouch. My stoma has basically quit working and the pouch empties almost immediately. This can be repaired and the doc wants to switch me from RNY to DS since he needs to go in to do a repair. We've sent the information to the insurance company, they just sent me a letter asking for documented proof that I have complied with my doctor's recommended exercise and nutrition program. I just mailed that out today. So hopefully, I will hear some good news on my revision approval in the 2-3 weeks. So basically, one of the bad aspects of RNY surgery is that the stoma tends to fail ( of course , this is not usually heard about when you are considering which surgery to have ). If I had known about the many drawback that people experience as "long term" post ops, I probably would have went with the DS from the beginning. Keep us posted on how you are doing and what the doctor says. Good luck.

Hi Kimi! I know what you mean about being hungry right after eating - maybe that is my problem. Hopefully we should find out soon. I just got back from the doctor's office. I felt so dumb! When he walked in the door, I started to cry. It had been about two years since I followed up with him, and he helped me - saved my life, really - and I failed him. He sounded very positive. He said that he thinks my insurance will cover a revision. He said that if even if my pouch is just stretched (no other problems) he would do a revision. He ordered blood work, a barium swallow, upper GI, and an endoscopy and then I go back to see him in about three weeks. I had the blood work done today. I don't want to get my hopes up though. I do feel a lot better knowing that at least now everything is underway. I am assuming that my doctor would revise the RNY by just making pouch smaller. He didn't mention DS - I have read a little on that and am not sure if it is for me. However, I want it to work this time. This would have to be my last chance. What sort of documentation did you have to show your compliance? Thanks, Tabatha

The documentation I gave them included a copy of the physical fitness participation request for work that I submitted last year (this was where you applied for up to 3 hours of work time to participate in physical fitness activities)...so I gave them that. I also wrote a letter detailing the problems I'd been having. Gave them a copy of my food journal that I kept for 2 weeks and showed by doctor as well as my weight loss journal. I'm not too worried about it because the way I look at it is that they want to make sure that I took good care of my first surgery before they approve a second one. Just as an aside - my doctor (and they all say stuff differently) said that there really is no way to stretch the pouch. I'll probably get yelled at for this but more often it is a case of a stretched stoma, not pouch. He said most doctors make the pouch out of the part of the stomach at the top which just does not stretch. So if you do have a stretched pouch, I would be concerned that they did not create the pouch out of the right part of the stomach. Just my too cents.

Kimmi, Who is your Dr? I live in North AL and am looking at revision. I am 10.5 years out for RNY. I have a stretched stoma that was discovered during a EGD. Mine is 19mm. I was told they are supposed to be about 10mm. I am always hungry and no longer have the restriction that kept the weight off. Thanks, Cindy

Mine is Dr. Maguire from Dayton, OH. He's really good. Not much of a talker, but I'll trade that for some excellent surgical skills. He just got his own wing at Miami Valley Hospital called Premier Bariatrics Surgeons. I don't know how large my stoma is but I can definitely relate to your symptoms.