SCLEROTHERAPY

I am just inquiring about this procedure.  I am at a loss as what to do.  I am post op RNY and have gained #55.  I had a baby last January and continue to gain.  I do suffer from severe reactive hypoglycemia.  I can eat a whole lot more than normal after gastric bypass.  I had a revision from a VBG in Nov 04 for severe reflux and weigh more now.  I don't have any restriction that I felt when I have the band on.  I was wondering do all bariatric surgeons do this procedure or should I say can they??  I don't think mine does, nor does he want to deal with me anymore.  I think he is just disquested with my weight gain.  All he tells me to do is increase my exercise.  I walked 4 miles a day before bariatric surgery, and ran to get down to goal.  I can't run anymore, I have ruined my knees and back from it and have low back pain.  Any help would be appreciated, from anyone who has had it done or anything else to get them back on the losing track. Kourtney

Hi Kourtney, I have just read and then reread your post several times, and read what you have on your profile trying to understand your situation.  It seems that you got pregant in less than six months from your RNY revision, right?  So you never had the time to get used to how your were going to have to eat and exercise for the rest of your life before you had to focus on eating healthily for your pregancy.  I don't know anything about a VBG and how the restriction feels with eating, but with RNY, especially over time, you can eat a much larger amount of food.  It still always comes down to just because you CAN eat a lot of food, SHOULD you?  With the RNY you still have be extremely careful with those food choices, and make sure they are healthy ones. You also have to think about the weight that non-WLS women gain during their pregnancies, and how they have to struggle and work to get it off after the baby is born.  It is hard for all women (except maybe for celebreties with their trainers).  I remember the time after each of my daughters were born.  I gained only a modest amount of weigh with each pregnancy, but put on about 50 pounds in the six months *after* they were born.  Each time.  Having a newborn is wonderful and exciting, but can also be stressful and the perfect time to snack all day long.  I know I coped with learning how to raise a newborn by eating Hershey's kisses all day.  My babies drank chocolate flavored breast milk.  My point here is the weight loss after pregnancy is often difficult and RNY won't make it magically disappear. You speak of wanting a sclerotherapy procedure, but how do you know you need one?  I don't know of any way to determine stoma size without an endoscopy.  There may be, I just don't know.  This could be why your surgeon is not willing to recommend this to you, as he does not believe you need it.  My surgeon told me last week that even if you do have sclerotherapy, it is not a permanent solution.  He reminded me my RNY is a temporary tool to learn how to eat properly and exercise.  I have been diagnosed with severe osteoarthritis in my knees, yet can still find ways to exercise.  Running may be out of the question for you, but what about walking, putting your daughter in a stroller and going for a walk.  Lifting weights at  home or working with resistance bands.  There are some excellent DVDs out there that you wouldn't even have to leave home to do.  You could do them while your daughter slept. These have not been the words you have wanted to hear.  You can lose the weight again, but you will have to work for it.  Go back to the basics of protein, low glycemic vegetables and fruits, lots of water, and exercise.  I fully recommend getting the South Beach diet book, as I believe that is a healthy way to eat for the rest of your life.  Do not eat sugar.  Do not eat refined flours or grains.  If you do this, you wil take back control of your eating and lose weight. Best of luck to you, and enjoy every moment of that precious baby, she will grow up! Debra M.

I had the schlerotherapy procedure done two weeks ago - and this was my second one in two years...it is NOT a revision, so it is not a permanent solution.  The first time I was not really prepared for it...my doctor scoped me just to see what was going on - it had been four years since my surgery - the stoma was a little larger than it should have been, so she did the schlerotherapy as a procaution.  It reduced the amount I could eat for a few days - but since I did not commit to eating smaller portions and not to drink with my meals - I was right back to my normal eating habits after a week.  The reason I had it done again two weeks ago - was because I had too many "odd" things happening at the same time.  I had gained 7 pounds in about a week, I was having acid reflux, lots of gas (uggh!) and foods that made me feel full pretty quicky (ie rice) all of a sudden were not.  So I called my surgeon and asked to be scoped - since she knew I had been thru it before and she trusted that I knew my "system" she agreed.  I also told her to be "aggressive" with the amount of injections - because I was determined to do it right this time - so I wanted the stoma to shrink as much as possible. The past two weeks have been a revelation to me - besides the fact that I have lost 12 pounds!  I have completely changed how I eat.   I have kept myself to alot of soups, or blenderized foods for the past two weeks - AND NO DRINKING WHEN I EAT!!!!! It amazed me to realize that I had "forgotten" what full felt like!!!  Since I had been drinking with my meals,  food was never filling up my pouch.  I would just eat until the dumping kicked in - and that usually took alot!  Not drinking with my meals has drastically reduced the amount I eat - I now feel that uncomfortable feeling again when the pouch is full - amazing!  But I know that I have to work on keeping it this way - no pushing it!  Because I know that I can eat my way thru this again - and I am committed to not do that!! So I guess what I'm trying to tell you - is don't think of schlerotherapy as being the answer to all your problems - it's another tool - you still have to do the work!! Good luck!

I found out more information about the new procedure.  It's called Stomaphyx.  It is not available in the USA until about June.  It has been used in Europe for some time already. The device has fastner legs that are attached endoscopically to reduce the size of the stoma and pouch.  This is a permanent solution, like a revision but at a fraction of the cost. Dr. Barry Fisher in Las Vegas will be performing this procedure this summer.  He has taught other surgeons how to perform gastric bypass surgery and is a skilled surgeon.