Question

I am in need of a revision so of course the first surgery that came to mind was the DS.  I found a doctor who performs them and takes my insurance so I went in for a consult.  He told me that he will first perform an EGD with Sclerotherapy.  Which is basically where they inject the pouch with the same soloution that is used in getting rid of varicose veins.  He told me that if he finds that my pouch is too big for this procedure to benefit me then we would discuss the revision to DS.  Well, upon during further research on this surgeon, I find out that he is not on the list of DS surgeons found on DSfacts.com.


What should I do?  I want this done but I can not just trust my life/health with just anyone.


Advice?


Thanks in advance

Sounds like money making bull**** to me. IMNSHO.

Yeah....


Thanks for breaking it to me gently....LOL  I just want this so bad.  There are only two other doctors in GA who perform them and neither of them accept my company's self funded insurance.  I just want the DS and it is the hardest thing in the world right now.  I don't want to settle for the RNY again but I guess I will have to....I really hate this crap.

***hugs** and sorry it's all so blunt. You are in the hardest category, and the one that is expanding the fastest.....The number of people who are discovering the hard way that RNY is **** is expanding exponentially, way way faster than the options for REAL revisions are expanding. Beware of surgeons who say they can "fix" your RNY by "fixing" your stoma or "improving" your malabsorption. There are big hard questions to ask these surgeons in order to understand what they are really offering. Bottom line is that most of them are just blindly following the exact same paths that didn't work the first time and giving patients a WORSE option than they started with.

This is oh, so maddening for everyone on the receiving end and for those of us who are not surgeons but know better. It's going to take a fair amount of time for the message to get across that the DS is the way to go, and longer still for surgeons to get "converted" to the DS AND then to learn the RNY to DS revison.

I think that we are entering a new phase of bariatric medicine, one where the RNY is slowly dying, like the other procedures before the RNY....but insurance and the media are making this death far more public and widespread than the death of other procedures.

My advice to you is to take your time, even if you are gaining weight and feeling the awful effects of your surgery gone bad, before jumping in to other options. It's very very complicated :-( .

Have you read up on the JIB and what happened to people long term who had that procedure? It might make you grateful that you "only" had the RNY and the subsequent failure.

Again, please hear my empathy along with my warnings to proceed very slowly, carefully and thoughtfully from here. There are much worse things than regaining all your weight.

Elizabeth,

What questions should I ask?  Because I **** you not, my surgeon told me the exact same thing you just said to be aware of.  He also told me that there is a problem with the RNY because more than 25% of RNY patients are coming back to their surgeons for revisions.  I think that number is too damn high.  But truth be told, I had gotten approval for a revision 9 months out from my original surgery.  I did not have it done because my then surgeon required a mandatory $1200 program fee which I did not have. (he has since "lowered" it to $800).  So I have been having issues with this RNY since I first got it.....I lost 9 whole pounds my first month out....

Welllllll.....My first question would be to insist upon exact revision details. The vast majority of surgeons who claim to give a revision to RNY do something that is widely called "ERNY." They either don't touch the "pouch" or make the "pouch" smaller and then bypass more to the smal intestine for stomach contents.

This is HORRIBLE for several reasons.

1. That "pouch" is wayyy too small to ever get in enough hydration or nutrition to accomodate the change intestine.

2. You still have that piece of **** stoma that should be outlawed yesterday.

3. The small intestinal bypass maximizes macronutrient malabsorption but does not do nearly enough to improve caloric malabsorption.  So basically you get the worst of all worlds. But most surgeons pooh pooh this issue, because they don't KNOW what happens when you bypass x part of small intestine versus y part of small intestine, or they don't believe it or don't care. They also tend to pooh pooh the stoma issue. Think about it. If you could have NORMAL stomach anatomy versus stoma **** which would be better? This is a no brainer.

Could it be possible that he is new to the DS and not on the list yet? Are you sure he preforms the DS?

You know, i never thought about that.  I was pointed in his direction by someone on the GA forum board.  I did call his office today and asked if he actually does them and was told he did.  So I just went with that.  I have an appt on 09/09/10 and I will get a better understanding.

Thank you!

Ya know if this was about a virgin DS I might grudgingly say okay, let's stop and see what his qualifications are. But it's about RNY to DS revision, which is OH so freaking complicated. I cannot in good conscience allow anyone who posts here asking about surgeons to just wander off to someone who is not a known entity for this particular procedure.

I know....I know.....this is why I asked this question in this forum.  I know you guys would know.  Sadly, I do believe I am going to have to conceed and just take my chances with a RNY revision.  I don't want to but I can not just have anyone in my belly that is not as experienced as he or she should be.   I am going to be hopeful that I can get my pouch small enough to do me some good and I can have my hip replacement and get my life back.  I still want this DS though!