Got my date and i'm having RNY Worries.

I had the band on 12/2008, did great for 5 years and lost a total of 71 lbs. Then my band slip and I developed gerd, a swollen esophagus and real bad acid reflux. It was so bad that I'd wake me up several time during the night choking on the fluid. Band was removed in 2013, the reflux subsided however the heartburn remains.

Although I tried to maintian my weight, i soon regained and found myself back at step 1 after only a year. I was advised on having the bypass instead of the sleeve because according to my doctor the heart burn or gerd will be much more with the sleeve. I've gone back and fourth with my decision and i'm scared of the side effects the bypass might cause in the future, especially developing hypoglicemia.

I finally made my decision to move forward with the bypass after my co-worker (who never had gerd) told me she suffered extreme heartburn after getting the sleeve 2 months ago. It was so bad she was put on medication and is still suffering. Her story coincides with the medical diagnosis i was given. Even though i am moving forward, I am still nervous and pray all turns out ok.

Any imput on why hypoglycia is developed and is it something we can fully avoid getting? Why does that happen?    

My story is similar to your's in that I also have lap band (placed 2010) and had the same issues with reflux to the point it would wake me up choking. I had most of the fluid removed Oct 2014 due to the issue and they wanted to remove the band then since so many patients are having issues with it to the point they don't even place bands anymore. It took me several months to decide to proceed with having it removed and now I'm going in for surgery in a few weeks to have the band removed and have gastric bypass done. Plan is to do all in one surgery but if there is any issues with the band, scar tissue, or slip, although my upper GI showed it hadn't slipped, then they may have to separate into two surgeries. 

I have the same concerns over dumping syndrome but had been told there is no way to know who will end up with it but the best way to manage is to follow the gastric bypass diet and lifestyle changes. Some patients are able to tolerate sugar after surgery while others have dumping syndrome and can never again tolerate certain sugars or carbs. For me the weight loss will and will be worth any side effects such as this and also a good reminder of what not to eat. 

Can I ask how your band removal went? Did you have scar tissue? I've heard the most painful part of recovery is where they remove the port, was that true for you? 

Thanks for replying Zoey.  I was sore for about a week but it no where compared to the pain I felt after having the band placed.  I have no idea if I have scare tissue although I am assuming I do. I feel something in my abdomen right where the port was. It feels hard and round and at times it causes pain.  I am planning on asking my surgeon to remove any scare tissue that I may have. 

I do agree that having the bypass will keep us on our toes as far as following the dietary guides.  The dumping I'm not worried about as you can avoid it by staying away from certain foods, malnutrition by taking your supplements. What scares me is developing hypoglycemia even though I do everything right.  

In your case, I think that it's great that you are having both procedures done the same day. It will save you from having to suffer twice.  Yet having two procedures makes sense if there's a lot is scarring. 

Good luck and keep me posted.

I had the band in 2007 and lost 100 pounds.  It slipped and I had the band removed in 8/14.  I gained back most of the weight I lost so I decided to go with RNY.  I just had surgery on 5/18/15.  In the past when I would get really hungry I could feel my blood sugar drop.  I have not had that issue since having the RNY.  I have not had any complications and no nausea.  I am only on soft food but not having any issues.  I know each person is different but I am very pleased with my decision to have RNY.  I want to get my life back and I am in that process.  I have not eaten anything with lots of sugar to know if I will dump but I know I am addicted to sugar and need to avoid it no matter what. 

Catherine, thanks for replying. I am glad to hear you are doing well.  I too need to stay away from sweets but mainly its carbs that's my problem. I know the fear of dumping will keep me on check. Good luck to you during your healing stage and beyond.  Keep up the good work. 

I have severe RH... Reactive Hypoglycemia. But Even in my case- that can be controlled by very strict diet. Fortunately, that is the same diet that is recommended for maintenance. Low carbs, proteins and fats. 

If I dortmund stupid, like eat bread, rice or ...cake - 1-2 I would get very Low blood sugars. 

So I don't eat that.  

H.a.l.a B, thank you for your reply. I' m sorry to hear that.  Did you eat bad carbs before you were diagnosed with RH? I'm trying to figure out if avoiding them all together makes a difference? 

There are really no bad carbs good carbs. The carbs are carbs. Some may impact BS faster, but overall carbs are converted to sugars and can cause reaction. 

Starches, fruits, grains - my body does not care where the carbs came from. It reacts. 

Some plain carbs are worse - the processed carbs, cookies and cakes, candies. But mash taters are worse for me than M&M.  Plain 0% yogurt - horrible. And so on. 

Overtime I learnt what I can eat and how much. 

Non starchy veggies, Eggs, meats, fish, fats, nuts - are ok. The rest - not so much. 

Wow! I did further research this morning and it seems even people who have had the sleeve are suffering from this. I recall that when I had the band I would go through dizzy spells, jitters and hot/cold sweats. I wonder if it's just a matter of not following the guidelines instead of a specific type of surgery. 

Thanks again. All this info is definitely helpful. 

RNY - are really prone to RH long term - the farther we are - more and more people  report on having that issue. 

Our body may produce more and more insulin in response to blood sugars. 

But the VSG or even DS report having some issues. 

New Data on Weight Gain Following Bariatric Surgery

Gastric bypass surgery has long been considered the gold standard for weight loss. However, recent studies have revealed that this particular operation can lead to potential weight gain years later. Lenox Hill Hospital’s Chief of Bariatric Surgery, Mitchell Roslin, MD, was the principal investigator of the Restore Trial – a national ten center study investigating whether an endoscopic suturing procedure to reduce the size of the opening between the gastric pouch of the bypass and the intestine could be used to control weight gain in patients following gastric bypass surgery. The concept for the trial originated when Dr. Roslin noticed a pattern of weight gain with a significant number of his patients, years following gastric bypass surgery. While many patients could still eat less than before the surgery and become full faster, they would rapidly become hungry and feel light headed, especially after consuming simple carbohydrates, which stimulate insulin production.

The results of the Restore Trial, which were published in January 2011, did not confirm the original hypothesis – there was no statistical advantage for those treated with suturing. However, they revealed something even more important. The data gathered during the trial and the subsequent glucose tolerance testing verified that patients who underwent gastric bypass surgery and regained weight were highly likely to have reactive hypoglycemia, a condition in which blood glucose drops below the normal level, one to two hours after ingesting a meal high in carbs. Dr. Roslin and his colleagues theorized that the rapid rise in blood sugar – followed by a swift exaggerated plunge – was caused by the absence of the pyloric valve, a heavy ring of muscle that regulates the rate at which food is released from the stomach into the small intestine. The removal of the pyloric valve during gastric bypass surgery causes changes in glucose regulation that lead to inter-meal hunger, impulse-snacking, and consequent weight regain.

Dr. Roslin and his team decided to investigate whether two other bariatric procedures that preserve the pyloric valve – sleeve gastrectomy and duodenal switch – would lead to better glucose regulation, thus suppressing weight regain. The preliminary data of this current study shows that all three operations initially reduce fasting insulin and glucose. However, when sugar and simple carbs are consumed, gastric bypass patients have a 20-fold increase in insulin production at six months, compared to a 4-fold increase in patients who have undergone either a sleeve gastrectomy or a duodenal switch procedure. The dramatic rise in insulin in gastric bypass patients causes a rapid drop in glucose, promoting hunger and leading to increased food consumption.

“Based on these results, I believe that bariatric procedures that preserve the pyloric valve lead to better physiologic glucose regulation and ultimately more successful long-term maintenance of weight-loss,” said Dr. Roslin.

http://www.lenoxhillhospital.org/press_releases.aspx?id=2106