Rny to Distal Rny Revision

I had my Rny on 3/19/2003 without incident my weight was 296 lbs. I followed everything I was told and loss 100. After a year I lost my insurance and was not able to continue my support, follow-ups. I also experienced a back injury due to a auto accident. Let's just say that over the years I found myself inching close to my former weight. I still eat small portions, chewing my food well, but no longer fell full. I went back to work and regained my insurance, an began with support. So much has changed since 2003. There is more support and defiantly more people in closer proximity to talk to who know and understand. I had a upper GI completed and was told my connection is stretched, and my food runs out of my pouch so fast leaving me empty. I am currently awaiting approval from Blue Cross Blue Shield for Distal Rny Revision.anyone here have the same with success! I respect everyone here but please do not post unsuccessful experiences because I have read them. A lot has changed and I am sure there are successes with all the changes, and research done with all weight loss surgeries.  Thanks! 🌹

I don't know what to say if you don't want to hear anything negative.  All I can suggest is that you look into a revision to a DS.  What concerns me is that you apparently are able to eat a lot.  If nothing is done to fix your pouch all that will happen with a distal RNY is you will malabsorb things like fat and protein.  If your problem is simple carbs, like it is with a lot of us, then it won't do a thing since those are absorbed 100% no matter what surgery you have.  Then what you will wind up with is a lot of trips to the bathroom because if you are eating a lot what goes in must come out, possible gas and diarrhea issues, again from the amount and type of foods you are eating, and a need for a lot of supplements and follow up lab work because you won't absorb a lot of vitamins and protein you need.

WLS is not a cure for overeating and it isn't a cure for food addictions.  If either of those are your problem then I would address them before subjecting yourself to another surgery.

If, after getting help you feel you are ready to have a revision to give you a useful tool that will help you eat right then I would look into a sleeve (for restriction) and if you still need malabsorption, a DS.  But know that many people have been able to out eat those surgeries as well as the RNY and lap band.  What I am saying is no WLS is immune from regain if you aren't able to get a handle on your food issues.  If you blame your surgery for your regain because your stoma was enlarged just remember that you are the one who put the food in your mouth and you are the one who choose the foods, not the surgery.  Many people have been able to lose weight and keep it off without WLS so even if your surgery did have a mechanical failure there was still some responsibility on your part.

I hope you don't think I am being rough.  Maybe that is my style because I failed my first WLS and I had to look at all angles before I was able to make my revision work.  It would be easy to say I failed because my stomach was too big, or because I was on medication that causes weight gain, which was true, but at the end of the day I choose what to eat and the amounts to eat and I put it into my body.  Now that I have good restriction it gives me help in making better choices but it is all up to me as to whether or not I do that.

My surgeon said with distal the also retrim the pouch. The is one person so far up here who had it done and has had success. I was searching to see if there was anyone else to see the outcome. I still eat small portions of the right foods, do not eat the bad fatty foods. I eat and drink more high protein foods, I use my nutrabullit. 

I have what could be called a distal RNY or a DS with a RNY pouch, or whatever.  I just call my surgery a revision or a hybrid.  I started out with a DS in 2002, had a lot of issues related to malabsorption so in 2010 I had a revision to lengthen my common channel from 100cc to 200cc and I also had the (too large) sleeve revised to a RNY pouch.

I could also say that I have had a lot of success with my surgery because I have lost the excess weight and kept it off for about 3 years, but I believe whatever success I have had has more to do with changing my eating behavior then the surgery itself.  Don't get me wrong, I know I couldn't have done this for so long without the surgery but I also made a lot of changes in how I eat and the surgery helps me stick to those changes on a long term basis.  I no longer get hungry like I used to and I am satisfied with smaller amounts of food.  I also have some malabsorption so I eat full fat things and lots of protein, which also helps me from eating the wrong things and keeps me satisfied.

So, what I am saying is that as long as you are very diligent about vitamins and supplements and lab work, and you take advantage of the things your surgery will offer you, like restriction and the ability to eat high fat foods and high protein foods, and avoid simple carbs, which are absorbed 100% no matter what surgery you have, you will be successful.  I did none of those things with my first surgery and I failed miserably, plus I got very sick.  I had to couple the advantages the surgery gave me along with behavior changes.  I don't think I could have been able to change my behavior long term without help, but I also know that if I didn't change my behavior, starting with an honest self evaluation and outside help if needed, then I would be wasting another perfectly good WLS by not using it the way it was meant to be used. 

I have done all of that and more. I also have another physician closer to home who I began seeing for my insurance requested six-month monitored diet exercise. I have learned where I went wrong the first time around. I also found a place where I live to do water aerobics, I am unable to do a lot of traditional walking because of my knees. Before there was no support for us good losers where I live. I had to go 30 miles in one direction and 45-50 miles in the other. I also lost my insurance and could not see anyone without it. Time has changed a lot since then and so have I.

Are you familiar with Vitalady, Michelle Curan? Both she and her husband are about 20 years post-op from distal RNYs. You might want to talk to her before you make your final decision. I've heard her describe the distal RNY as the worst of both the RNY (pouch/stoma issues) and the DS (malabsorption.) There's a reason they went into the vitamin business!

An RNY-to-DS revision is harder to get---not a lot of surgeons perform them. But this is the rest of your life we're talking about, so I would think long as hard before I made my final decision.

Rny is what I had in 2003, Distal is what I am waiting for approval. DS is duodenal switch which is the total malabsorption surgery of them all. No disrespect to you or the Curan's but they had their surgery 20 years ago. A lot has changed, and been updated due to more people having various issues. A lot has changed in the 10 years since I had my rny in 2003. In 2003 I had to go 30 miles in one direction, and 50 miles in the other to find a support group and follow-up care. Now there are support groups, follow-up care right here. Back then they did not push protein  as much as they do now. This is why I was looking for someone who has had Distal in much less than 20 years ago. Thanks. 

The reason I suggested you talk with the Curans is because they both went through some serious medical issues because of their distal RNYs. IN many cases, a distal RNY has more malabsorption than a typical DS. How long is your surgeon proposing to make your common channel? I have a DS, and mine is 90cms.

20 years ago, almost all RNYs were distal, and a lot of people wound up with some terrible deficiencies. That's why most surgeons don't do distal RNYs except in rare cases.

Thanks for always sharing your story, Ladytazz. You are my hero!! 

Thank you! But how can I be your hero when you were already mine? Is that allowed?