RNY Revision

vli814
on 7/22/14 12:41 am

At what point do you know you need some sort of revision? In August it will be 6 years since surgery. Up until last year I was able to keep all my lost weight off. Within this past year I have gained 30 pounds. Going back to basics has not worked for me. I have kept track of everything I eat, kept the carbs down and protein up. I don't drink with meals.  I never feel restriction of any kind any more. I am hungry all the time. It seems like starting last year I feel as if I never had surgery at all.

What do doctors look for when approving someone for some sort of revision? Having had absolutely no complications from day one of surgery I am concerned with absorption and restriction. Any and all ideas, suggestions and experience is very much appreciated.

Jooliaghoulia
on 8/10/14 12:33 pm

Sorry to hear you're struggling. I know several docs offer interventions that are not what would be considered full revisions. One is sclerotherapy, where a sclerosing (sp?) (scarring) agent is injected into the pouch's exit, thereby tightening it to early post-op specs. I had it done 3x as the first 2 didn't take. the 3rd resulted in a 25lb loss of 30 i'd regained. unfortunately it didnt last with me, and after about 2 years i'm looking into a repeat or another revision. Im at 30 lbs over again, myself. 

Dr Joseph Kuhn performed mine, but he recently passed away. If you are interested, try his partner, Dr. Henke for a reference in your area. We are in Dallas.

This was about 5 years ago and it was very new then; they may have fine tuned it or come up with a better solution. They were very on top of new procedures and ideas for re-gain without revision surgery so they might be a good place to start.

Cicerogirl, The PhD
Version

on 8/11/14 12:27 am - OH

The surgeons where I am who do revisions (many do not), and the one surgeon for which I work part time who does some revisions, want to know what changed that is at the root of the weight gain before they will consider any kind of revision because a revision might not solve the problem.

It varies a lot by physician, of course, but based on the doctors I know: if you have truly not changed your eating or exercise habits (some doctors ask for food and activity logs, others don't bother), the doctor will want to do some lab work and will probably want to do an EGD.  The lab work will help  determine whether there are other things (thyroid or estrogen levels, for example) that might be contributing to the weight gain, and the scope will allow him/her to see what your pouch and stoma look like to know if either one of them is enlarged beyond what would be expected at 6 years out (and whether there is anything that can be done to address it if they are... the stoma tightening procedures are notoriously UNsuccessful).

Also, it is not just a question of the surgeon agreeing to do the surgery, but also of the insurance company approving it.  The insurance company will want evidence that there is some type of "mechanical" failure and that a revision will address the problem.

Lora

14 years out; 190 pounds lost, 165 pound loss maintained

You don't drown by falling in the water. You drown by staying there.

Maycas72
on 5/4/15 9:27 am

I have a friend that had a Rouen-en-y surgery she is over a year out, she recently almost died due to being so malnutrition that eat was eating her muscles. She can't even walk she has to rebuild her hole life. She is in a home health care facility now. Her surgeon offered to reverse this surgery but what are the cons of surgery? Is there higher risk then having any abdominal surgeries? Any information please need help!!

thanks

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