Update on RNY & Stomal Stenosis

Hi guys,

On 5th December I had my lapband removed and a RNY performed here in Ballarat, Victoria (Australia). Unfortunately there were complications and I ended up in theatre almost 7 hours (my hands were actually completely numb for two days afterward which was weird).  My surgeon had inadvertently attached my new stomach to the wrong part of my bowel :o( but fortunately they caught it literally right at the very last step before wheeling me to recovery; when they flush the area with fluids to test for leaks or something to that effect.  He had gone in laprascopically and was hoping to complete the surgery that way but his colleague advised him to change to open which is what he agreed to do.

I was in ICU for 3 days and then about another 5 on the ward before I could go home. Around the 23rd or so I started noticing a bit of difficulty with certain foods that I had no problem with prior. By around the 27th I couldn't even keep yogurt down, much less runny (ugh) scrambled eggs. In a nutshell, two different emergency visits and admissions and a bariatric swallow diagnostic later, it revealed I had a stomal stenosis. I had been throwing up so much by then I could have told them that myself.

My original surgeon did the dilation (which he said he'd not had before although he'd heard of them happening - he's a lovely guy and very meticulous but I've since realized he doesn't have a wealth of experience in RNY). He expected the opening to be down to about the size of his pinkie finger but it was like a pinhole apparently. He couldn't even get the scope in at first but then was able to and dilate accordingly. He dilated to about 18mm and said it was all very soft and fibrous so moved very easily once he was in.  I was hopeful but had read it sometimes takes a couple of visits.

He wanted me to eat more soft solids at this point as he said it helps keep the opening well, open, and I tried for a couple of days and was going alright when sure enough.... things started reverting. So here I am and I can't manage eggs again, not sure if I can do the soggy weetbix but will find out this afternoon, but am over puking. It hurts my side and just wipes me out.

It's also frustrating because my dietician and my surgeon have various opinions on what I should/shouldn't be eating at this stage. She still believes only pureed consistency whereas he suggests soft foods inc. chicken. I discovered beef is out for now for sure and I can only have eggs if I go slowly with a hot coffee but I don't want to be doing that just to get protein down as then I feel like I'm just washing it through and it's stupid.

I can do mini cans of baked beans and bananas and some soup so I guess I see my future.

I have a new appt with the surgeon Tuesday for what undoubtedly will be to schedule dilation #2. Has anyone else experienced any of the above and is it more common than not with RNY or am I just unlucky? I wake up with some dull tummy aches which I imagine will settle, espec. as I stop throwing up!

I have had GERD (aka GORD) for several years and treat it with medication but since surgery I get a sensation I would liken to "acid splash" from the lower part of my stomach and it's rather icky. Is this normal? It's after I've eaten. Whilst it doesn't occur every time it's often enough to be a pain. I also don't tolerate yogurt well. It makes me feel unwell and gives me a tummy ache but that might be just trial and error discovering what does or doesn't work for each person.

Anyway, any thoughts, tips or just general words of support would be much appreciated.

So far I'm only down 15 kilos; no idea if this is on par or very slow.

Cheers and thanks in advance,

:)

oh my!!!  This sounds like a nightmare to me..I don't want to scare you & I'm no pro but I would change surgeons ASAP....your dietician knows more about your food...I wouldn't have thought you would be eating all of that now...clear liquids...full liquids..pureed food...then start slow on "real" food.....

I hope you can get answers soon..and get on with this journey 

I am only a few weeks after surgery, so I have very little experience/perspective to share.  But my heart really goes out to you, as you are having such a hard go of it in so many ways!  I was so concerned for you as I read your post.  I do not think all of these things are common, at least not all of them. 

I agree that having a second opinion is a good thing.  I hope you can get better soon.

I agree and believe you should see another surgeon. If this one isn't sure what he's doing, he doesn't need to do more!  Good luck to you. Stay strong and take care of you!

For some people it is very common to need more than one dialation. 2-5 ..over first few weeks, months. 

This is just the way you're body is trying to heal.  Unfortunately. 

My doc uses special method to the stoma to avoid strictures.  

It is a very fine line between stoma too small and closing (strictures ), and stoma that it's too big, and can cause more issues long term (dumping, fast emptying of the pouch, hunger, not enough weight loss, etc..).  

I would rather have small stoma (the oppening between the pouch and small intestines)  than too large one....

Wishing you best..

The need for dilations isn't uncommon.  The info your nutritionist told you is more the norm.  I'm glad that you're seeing a second surgeon.  Make a list of questions that you want to ask him prior to the appointment and bring with you.  You'll make sure that you have obtained the info you want.

Hang in there.  The best of luck to you with the new surgeon.

Oh damned those Lap Bands!!! It seems like your surgeon didn't know what he was getting into with all the scar tissue from the Band.  It is why many docs do us Bandsters in 2 step revisions.  First to clean up the mess and allow us to heal.  Then the revision WLS.

I pray you have a full and speedy healing, recovery, and just an all out better experience the rest of the way.

(((HUGS)))

Layla

L