Reversing RNY: Best Surgeons??

Let me state first that I am NOT trying to discourage ANYONE from having RNY gastric bypass. All surgeries carry risks, but my case is a rarity. This is NOT meant to scare. Only 3 in 1000 have this.

I have a rare complication called Post-Bariatric Hypoglycemia (PBH) that manifested 8 years post-op. I'm under the care of gastric bypass surgeons, endocrinologists, cardiologists, gastroenterologists, and internal medicine. After 20 hospitalizations in 2018, with 8 of them ending with me being admitted, I've had countless tests performed. Dietary modifications and medication management failed, so my doctors are all in agreement that my surgery needs to be reversed. Though there are significant risks to consider -including the possibility that reversal will not correct my hypoglycemia- my current condition can be life-threatening, as it's getting increasingly worse and more difficult to manage.

I was a poster child for RNY surgery, with many obesity-related conditions, all of which resolved after surgery (including my T2 Diabetes). At 5'10", I was 280 at my peak weight. After 7-8 months, I had gone down to 165lbs. I kept my weight off. However, in March 2018, I had emergency surgery to remove food that was lodged in my gastric pouch. Shortly afterwards, I developed PBH.

MANY doctors perform RNY but very FEW ever reverse them, so I am aware of the risks even when performed by a surgeon experienced with reversal. I am looking to put together a list of doctors who have had success in reversing RNY gastric bypass so that I may research my best options. Please post a response if you know of a surgeon or surgeons who successfully reverse RNY. I live between NYC and Philadelphia, but am willing to travel anywhere in the US to have the best surgeon perform my reversal. PLEASE DON'T RESPOND WITH A HORROR STORY ABOUT REVERSAL. I am aware of the risks, but my life is at risk right now and reversal one of my only options.

In your situation - you may consider experienced surgeons who have been doing RNY to DS revisions. That revision - starts by reversing RNY and then creating sleeve and DS bypass.

I think in US Dr. Kesheshian in CA - I heard he is the best to do reversal of RNY then creating DS from that. You may ask people on DS forum for any other recommendations.

I recommend you contact Dr. K for a video consultation if you don't live in Southern California. He's a great bariatric surgeon and does a lot of surgeries to resolve complex abdominal conditions. I had surgery with him this summer for issues my physicians in another state weren't sure how to tackle.

Ara Keshishian, MD, FACS, FASMBS

10 Congress St, Ste 300

Pasadena, CA 91105

Phone: 818-812-7222

I don't really know anything about the condition, but I did recall a YouTube vlogger talking about her experience with it. I went back and searched for the channel in case it's of interest to you. Here's one of her videos, but I'm sure she has more recent ones: https://www.youtube.com/watch?v=rUElqlUU3D4. You could watch some of her videos and maybe get in touch. Best of luck to you.

If it were me, I'd be on a plane to California to see Dr. Keshishian.

Thank you, all, for your feedback! It's good to know there are options! Although I'll travel to CA if that's my best option, I read on this site of a Dr. Stephen Raper at UPenn in Philly ... which is only an hour drive for me. Still, if anyone else knows of a good doctor for reversal, please let me know.

Another vote for Dr. K. Also on the same level for such complex revisions is John Rabkin in San Francisco, David Greenbaum in NJ and Mitchell Roslin in NYC.

I had my RNY reversed and changed to a DS on 8/15/18 due to severe hypoglycemia and dumping. It was becoming very serious (I had to have Glucerna tablets everywhere). I've had full sugar drinks since surgery (Dr Approved) and I haven't had any issues since the revision. BTW Dr Keshishian was my surgeon, I wouldn't let anyone else touch me with a surgery this delicate. I self paid, and it was worth every penny!

Thank you, Rose! I've seen Dr. K's name quite a few times on this site. I'll need to look into Dr. K. So glad to hear you can have full sugar. Even 5 grams of sugar in a small can of V8 causes my sugar to spike then drop. I can't wait for this nightmare to be over!

Vinfin7,

I feel your pain.. I have had reactive hypoglycemia since 1980.( from symptoms). My tolerances also keep changing and is more difficult to manage. I had a surgery that included RNY-pouch in 1990's. It was not recommended with those who had hypoglycemia but had no official dx. After WLS, peoples tolerances are Off the board, ie.. everyone has different "issues", some come in multiples.Each body response is individual to you. I am glad that there are doctors who specialize in assisting those who have difficulties like you are having.

When I began having severe reactions, I did a diet diary to search for hidden carbs, thru evaluation... I found I was consuming up to 10 grams of carbs at a meal/and over one hour.as part of my prescribed diet. ( had to drop that amount to half /so 5 grams...and begin there.) 10 gm. was enough to make me drop then..

.When one has very low levels in the morning on arising, it does not take much of a drop to produce severe symptoms. getting up in the night for a spoon of peanut butter helps my days start and proceed better. until i became dairy intolerant I also used cheddar cheese...and maybe one saltine...

It takes a minimum of 3 days to stabilize my sugars, but once past that 3 days maintaining is much easier.Then I found for me adding half or even 1/4 servings of carbs to be the easiest way to find a tolerance.

Until you have your surgery to fix.. be a label reader and stay within what YOUR body tells you to maintain. Having low sugar episodes is not a joking matter. I have passed out several imes and even had a seizure caused by low sugar. Gathering the information is usually the hardest part, you have begun this part of your journey.. blessings to you.