Looking into RNY to DS revision

[mamadawny]

I have given my insurance info to Dr Stewart's office and am kind of freaked out. I had my RNY 11 years ago, self pay. It was not a success. My surgeon made the outlet too large. I started at 353 and after 1.5 years had lost about 80 lbs. I had to have a second hernia repair and my doctor bypassed more intestine to try and make up for the large outlet. I probably lost a bit more, but not much. With the extended RNY I luckily didn't gain weight but never made it close to my goal (to get under 200lbs).

So, here I am, not really worried about weight loss, but worried about the fact that I can no longer take Nsaids due to a marginal ulcer in my pouch, and I happen to have rheumatoid arthritis. Not a good thing when I have a flare. The other issue is my large opening allows all food to just dump into my intestine causing severe dumping issues. I am down to eating meat and veggies. I have lost more weight, but am miserable.

I talked to one surgeon that wants to do a band over bypass on me, but with the RA, I'm afraid I would reject the band. I have seen another surgeon who informed me that all of my issues are my own fault for taking Nsaids and eating carbs which I should NEVER eat again after having a RNY anyway. I am reading the stories of others who have had this surgery and I want to cry, because I am afraid to hope I could have the same success. I thought I would with my RNY and all it bought me was trouble.

Does anyone know if its possible to do a RNY to DS revision lap, or is it always open. After having 3 hernia repairs to finally get a good outcome, I am terrified of being opened again. By the way, my current weight is 225...the last 50 lost via being too sick and miserable to eat! lol

[larra]

Only your potential surgeon can answer the question about whether or not your revision could be safely done lap. My guess would be that open would be the safe method, but it's really for the surgeon to say. I understand your desire to not have open surgery again, but your safety has to be the most important concern.

The most important thing I can say here is that the problems you have experienced and still experience are NOT your fault. You had no control over the size of your pouch or the size of your stoma. The fact that extending your RNY (sounds more like a distal RNY rather than ERNY, though of course I don't really know) didn't help isn't surprising either. It usually doesn't help much. And you certainly didn't cause yourself to have RA or the marginal ulcer.
The idea that band over bypass is somehow going to help is ludicrous. I'm glad you didn't go along with that. Your operation is broken, whether it started that way or not. It needs replacement, not tinkering. You are fortunate to have found Dr. Stewart, who has lots of DS experience and an excellent reputation. I hope he's able to help you, and I hope you'll hang around here and let us know what happens as you go along.

Larra

[mamadawny]

Thanks Larra, I will certainly stick around. I have no idea how long this process will take at this point. I'm not in a huge hurry. I have already been on a medically supervised diet for going on the second month, which will help if my insurance requires that. I feel kind of silly, but I'm so weepy today. Starting this process brings all of the trauma from the failed RNY, hernia repairs and misery back....and the guilt. My husband paid for my original RNY when we didn't have insurance and he didn't want me to do it, but I thought it was the big SOLUTION. Boy, was I wrong. I think my RNY is more distal, I thought thats what an extended RNY was? I doubt the gas/pooping could be any worse with the DS, at least I won't have to deal with the unpredictable dumping.

[PrettyGirlBounce]

Hi there. I'm Lisa and I just wanted to let you know that you are not alone. There are several RNY to DS revision-ers on this forum and it is an AMAZING place for support. I know you may be feeling scared but we are here for you and the DS just might be the best decision you have ever made...especially in light of the NSAIDS issue.

My personal feelings are the sooner, the better. My one marginal ulcer turned to numerous ulcers and the majority of them were in my remnant stomach where they remained untreated and caused multiple bouts of internal bleeding, blood transfusions and hospitalizations.

I am 10 weeks out from my revision now and my quality of life has drastically improved - I can't even begin to put it into words. It was not an easy recovery and I'm not going to sugar coat it, but every last moment was well worth it.

Here is my story if you care to read it (clink on link and scroll down to my post). I wrote this very early out from surgery and it is very detailed. Please know that we are all here to support you no matter what you choose.

weightlosssurgery.proboards.com/index.cgi?board=general&action=display&thread=106&page=11

One more thing...PLEASE, I beg you, do not consider the band-over-bypass. It exacerbated my already existing problems and ruined my life...in all honesty, it almost took my life.

[Paula]

I was able to have my RNY to DS lap, but I haven't had the number of previous abdominal surgeries you have had. Each surgery we have creates adhesions and scar tissue which makes subsequent surgeries more difficult. There is also the outside risk that a previously planned lap surgery has to get converted to an open when you are on the table and under anesthesia.

I think Larra said it best, so Ill just say I echo what was said already.

I too lived for years with the shame and guilt over feeling like I was a failure because I couldn't make my RNY work for me. My surgeon said at my consultation that the RNY is a good surgery, but its not the best tool for everyone.

[Deleted]

Cross posting...

Hi I had revision from RNY to DS. It was open. RNY was my first surgery and was LAP. DS was my second surgery it was open. My Dr. only does open revision surgery. I was terrified but it honestly ended up not being an issue for me. I had other compications the open incision was numb and not an issue. It sounds like you know what to expect. All you can do is talk to Dr. Stewart, an excellent Surgeon, and discuss your fears and options. I think he will want to see everything going on in your gut though. I am happy to answer any questions you have. There are a few of us on this board. Many visit infrequently but they will chime in eventually.

Good luck to you.
Whit

[goodkel]

Since you already have issues, an open surgery is probably the best idea.

I would want the surgeon to be able to get a good look at everything and perhaps repair previously unknown problems.

I, too (and always), agree with Larra.

Read PrettyGirlBounce's post about her experience.

And, mostly, hang in there!

[Girlrocker]

Hi and welcome, you are in the best place possible to get information and support. I had my RNY to DS revision in December 2012, my RNY was in 2002. It is a very short list of vetted surgeons who perform this revision and Dr. Stewart is one of them. I had Dr. Keshishian, I live in southern California (originally from Chicago), 20 minutes from his Glendale location.

I concur with what's been said here, regarding your specific situation, multiple surgeries. This revision is a big, complex surgery and I have been fortunate beyond anything I could imagine to have had a smooth ride, recovery and reaching goal weight. My RNY was not great for me either, I had complications a week out, month in the hospital, second surgery, more problems and out another 2 months. Worse, to go through all of that and still be 200 lbs was killing me.

What I learned through this process thanks to my amazing surgeon was that I didn't fail, my RNY failed me. While I know many success stories, and same with the band, I honestly could not recommend either. The DS is a far superior procedure regarding a smaller stomach/malabsorption to the RNY. I wish I could have had the DS to start with, but it wasn't possible with my insurance at the time. And there was NO WAY I would put a band on my RNY, which I felt was a failed surgery I didn't want to keep, not to mention the numerous problems with the band and why the gastric sleeve (the stomach portion of the DS) has gained in popularity.

There is a really good post here by Dr. Mitchell Roslin on the keynote speakers board, about whether the patient fails the surgery or if the surgery fails the patient.

weightlosssurgery.proboards.com/index.cgi?board=speaker&action=display&thread=3804

I can't speak to what your road will be, in light of the surgeries you've had. But I can tell you that after all I went through with my RNY I was ready for whatever came my way. Ask your surgeon questions, keep coming here and asking as well.

[mamadawny]

Wow! You guys are totally amazing! Thank you for responding to my post. I feel so much better knowing I have such wonderful support from those who understand where I have come from. HUGS!!!