Endoscope Dilema...

Having not sustained the weight loss I had hoped for... I requested an endoscope procedure to check out my RNY that was done in 2007.I am always hungry and never have that feeling of restriction when I eat.  I had hoped the co-director of the Bariatric center that  I had my surgery done at would do the endoscope for an in-house 2nd opinion. Well the answer was "NO"... "there's no magic bullet with weight loss surgery"... stick with your surgeon and let him do the followup "work up". I feel I've lost two years of my life trying to lose weight according to my surgeon's plan for me. Is wanting another opinion or more help to much to ask for? Has anyone else experienced this dilema? Comments are appreciated :-).

Kathy (315 prior to surgery/ lost 81.5 = 233.5/ regained 10lbs 243.5/Goal weight was 145 lbs)

            RNY Surgery was done 8/24/2007

I am not sure the question:
The "no" is for the endoscopy or "no" is for a second opinion?
In any case - did they justify why "no"?

My RNY Surgeon said there is nothing wrong with "his surgery"... but would do an endoscope if it gave me peace of mind . I have lost faith in my surgeon as I have spent the last two years unable to lose my excess weight after my RNY surgery. I was to lose 178 lbs and only lost 81.5 and now have put back on almost 20 lbs of that. I feel no restriction when I eat and am never full. I requested that the co-director of the clinic do the endoscope...for an unbiased opinion as to if there is anything wrong with my pouch. The co-director told me to stay with my surgeon (his partner) ...let him do the endoscope and then if his partner wanted another opinion or for him to consult on the case he would. My question is... I don't want my surgeon doing the endoscope as I feel he's already formed the opinion that nothing is wrong and I dont' feel he'd be objective when he did the endoscope. I was looking for some feed back online here as to 1) when is it time to find another surgeon... and what do you do when you can't find another surgeon willing to do an endoscope on someone that is not a "Bariatric Virgin"... tainted by the hand of another surgeon.  I guess I'm just venting ...as I'm not happy being unable to get a second opinion. My diet /tool is not working and I am seeking guidance to get on the BOTT road with a surgeon I am comfortable with in my corner. Does this make any sense???

It makes sense.  I feel for you.  Unable to trust your RNY surgeon is tough. At this point - could you trust his partner?  Finding a new doc maybe very difficult.  I understand that you are very upset but maybe you can let them do the test and see what they will find out. They probably can take pictures and show them to you. If you do not have restrictions then either the stoma is stretched or you nerves that indicates fullness did not heal properly.  Can be either.
This is a difficult position you are in.
 

Thanks for your understanding. I am so envious of the quote at the end of each of your replies.."this was fast". I wish my weight would have gone away but it didn't. I can relate to your quote again " not easy"... but I'll admit this was way harder than I ever anticipated. I never expected it not to work. Now the sorting out process of just what choices do I have at this point.

I put out an email to another physican assistant from a group near by to see if one of their surgeon's might help me out. I'll see what his reply is. I want an unbiased opinion and will continue my search until I find a surgeon that will be willing to see me. I was hopeful that my surgeon's partener would say yes to my request, but for obvious reasons of not stepping on the toes of his partner I'm sure is why he declined my request.

I too think the stoma at the bottom of my 25cm pouch  is stretched and everything that I consume just drops right into the Roux Limb...which is 100cm long... and causes no dumping what so ever. It's almost like I did not have the surgery at all and everything is like it was prior to the surgery.

At this point I think... should I just discontinue my post bariatric protocol. Should I just return to a program like Weigh****chers and eat the normal diet that I can easily consume. Or is that admitting defeat with potentially very serious and adverse side effects because of the failed attempt at RNY?

There's so much to sort out and consider. The bottom line is I didnt' do the RNY surgery not to improve my health. It's just another crack in life I've fallen into and need to struggle to get out of . Thanks for letting me vent.  I appreciate your comments and understanding.

Kathy,
I read some of your posts from before. And I know you are desperate at this point.

A few things that puzzle me: in one of your posts you mentioned that you eat 60-90 gr of carbs a day.  with app 30 gr per meal.  At that level - even at low calories - I gain weight. 
I am a dumper and I developed hypoglycemia - so I try to eat very different foods: proteins fat and then some carbs with a lot of fiber (50-60 gr +) So my "net carbs" are really low.  If I need to gain weight - the only thing I need to do is to switch calories I eat from fat to carbs and I gain like crazy. 
I know it is not fare.  But now I eat more calories, I am full quicker - and If needed i lose weight or gain.

You indicated that your triglycerides are high = that indicates insulin problem that is caused from too many carbs (too many for you - not another person).
"There is an almost direct correlation between triglyceride levels and insulin levels, although more in some people than others. The way you control blood lipids is by controlling insulin. By getting the insulin levels down, you achieve a reduction in the triglycerides levels. And you get the insulin levels down through diet and exercise." from http://www.healingdaily.com/conditions/triglycerides.htm

You may be a dumper and you may even not know it - your body gets the carbs very quickly and converts that to sugar, then you get an insulin spike - that puts any calories you consumed into your fat cells - and you get hungry again - very, very quickly.  So you eat because you feel like you are starved - and the cycle continues.    I.e. for you 10 gr of carbs - may trigger extra insulin level - that may start the cycle again.   For someone else - that may be 20-or 100 gr. 

I lost my weigh so fast - because I was sick in the process - so I could not eat much.  A few times the only thing I could eat was liquids- with a very little food. 
i know that i am very sensitive to carbs.  And i know I will have to be on a low carb diet for the rest of my life if I want to maintain my weight loss.

Without denying that your inside may not be the way they need to be (you may even have a fistula into the old stomach) When I eat carbs - it feels like I can eat and eat and eat and not feel full.  

It is important for you to get scoped. And if they do not find anything wrong, then you can try changing your diet and trying other things.

I know what works for me. Not calories restriction 9though I have some) but what the calories are coming from,, and when during the day  i.e. i only eat fruits at evening - and I make sure i have fats with them, like PB, or whipped cream, etc.  And only if my weight has been stable.  Ice cream- no way unless it is protein ice cream, crackers (HF, HP) - maybe a few and always with cheese. etc.   If I see my weight creeping back - I limit the carbs for a few days.
Good luck with the endo.

Thanks again for the reply... I appreciate all of your insight into my dilema. It is so true about the carbs... the more I eat the more I do want. My nutritionist suggested eating two carb servings per meal. I was diabetic and on Avandia prior to my gastric bypass. My glucose levels have been normal but I worry with the triglyceride level creeping up I may be in trouble. I enjoyed reading the Triglceride cite that you shared. I buy everything low fat or no fat and sugarfree because of my prior history of diabetes and using Avandia. Now I'm wondering if I'm my own worst enemy... you've got me wondering if I should be eating whole milk products? I may try a week of eliminating carbs to a bare minimum and see if I can get any of this weight off. I wish there was a place to do for a sample diet to follow for a week. I read the daily posts on here for the food choices... but I'm ashamed to list all that I eat in a day. I'm still awaiting word from the PA as to whether or not the surgeon at the other bariatric clinic that I'm familiar with will do the endoscope or radiological testing. Until then I'm trying to mix up my diet some and see if I can curtail the carbs more and have any better results. Thanks again for such a terrific reply.
Kathy