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Pursuit of DS revision may be coming to an end....

Discussion in 'Revisions' started by Toya C, Jul 8, 2017.

  1.  
    Toya C

    Toya C Member

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    Good evening,

    Two weeks ago I had a CT scan of my stomach (with contrast), specifically the unused portion to determine existing blood supply. Yesterday I had an endoscopy. After waking from my very short nap the surgeon informed me that the endoscopy went fine but after reviewing my CT, it appears I do not have a good blood supply going to the other side of my stomach. Basically, the surgeon would not want to use any portion of the remaining stomach if there is a risk of it dying, leaving me a gastrointestinal nightmare.

    I admit I am a slow processor, so there was no rapid fire Q&A session. The conversation was directly after the endoscopy meant only to be a brief update. The rest of this discussion is to be continued at the next visit. Funny, my mother was with me and actually got a little happy when she heard he could not do the surgery (SMH). Had to break it to her later that I may not be done pursuing this procedure.

    After that announcement the surgeon moved onto other procedures, a distal RNY(?) and some transoral stitch... kinda stopped listening while maintaining an appearance of being engaged. I am not interested in any other procedure. The distal sounds like a bowel moving nightmare and more restriction seems ineffective. My pouch is already smaller than the average (non-bariatric) person, even if stretched & that is no longer working.

    If the revision cannot be done, it cannot be done and I can accept that but there is something irking me.... I'm not sure what it is. I am left with these questions-
    1. Is this really about a "high or reasonable likelihood" of stomach death? OR
    2. Is this about the surgeons' comfort level with RNY>DS revisions? OR
    3. Both "1" & "2"
    4. Would a seasoned RNY>DS revision surgeon look at my CT scan and come to the same conclusion?

    AGAIN, I certainly don't want the surgeon operating ON ME if it's outside of his comfort level. Nor am I interested in compromising my quality of life simply to take a chance. It is absolutely the right and responsibility of a surgeon to weigh the risks and tap out. But I don't want to be a sold a bleak outcome based on personal discomfort.

    The idea of not being revised does make me wanna have a mini adult temper tantrum but I don't have time for that. Dr. K keeps coming to mind but I cannot afford his program fee +travel +lodging, which brings me to Dr. Ayoola, on whom I pushed the pause button after deciding to pursue a surgeon in closer proximity. Should I even schedule a follow-up appointment with the current surgeon? Perhaps he will have a change of heart by our next visit... hmmm, that might be concerning.

    Thoughts please...
     
  2.  
    DianaCox

    DianaCox Bad Cop

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    Who is the surgeon? If it's the one in your profile, I've NEVER heard of him/her as a DS surgeon at all, much less as an RNY to DS revision surgeon. There are only about 5 of them in the US I would allow to touch me.

    Contact Dr. Keshishian in Glendale. Find a way to pay for it - this is not something you want to cheap out on - borrow if you have to. Ayoola also has a good track record. I would NOT go to Greenbaum - he's too risk-averse.
     
    Toya C and Settledownnow like this.
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    Toya C

    Toya C Member

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    @DianaCox the surgeon is Dr. Fernando Bonnani.
     
  4.  
    DianaCox

    DianaCox Bad Cop

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    He's a decent DS surgeon but I'm not sure of his expertise in revisions. I'd get at least one second opinion. This is going to determine how you're going to live the rest of your life.
     
    hilary1617, Toya C and Spiky Bugger like this.
  5.  
    Larra

    Larra Well-Known Member

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    I would also recommend a second opinion with a DS surgeon with extensive experience with RNY to DS revision. Dr. Bonnani has a good reputation as a DS surgeon, but I don't know the extent of his experience with this very specific revision. Dr. K does consults over the phone for a reasonable fee and could also review your CT scan, which from what you've said is the basis for the idea that your blind stomach has a poor blood supply. I find this surprising because the normal stomach starts out with an excellent blood supply, though of course some of it is inevitably damaged with any operation on the stomach.
    A second opinion doesn't commit you to anything. If you decide not to have the revision, that's where things end. And I agree with you completely about not having one of those endoscopic stitch procedures. I have yet to see any study that shows significant weight loss from them. Just a waste of about 10K, as they are not covered by insurance and that's about the going rate. Distal RNY also has not been shown to improve things much.
    Not everything can be fixed, but you have nothing to lose by getting a second opinion.
     
    hilary1617, Charris, Toya C and 2 others like this.
  6.  
    southernlady

    southernlady Administrator Staff Member

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    I agree with a second opinion...find the funds to get that second opinion from someone like Dr. K. It won't cost you that much and will help. If he says it can't be done, you will be able to settle your emotions knowing one of the best revision surgeons has spoken. IF Dr. K says it can be done, find a way to get to him so he can do it.
     
    hilary1617, Toya C and Settledownnow like this.
  7.  
    Settledownnow

    Settledownnow Well-Known Member

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    The RNY to DS is a big operation. Do not go cheap, as @DianaCox mentioned. Do the consult with Dr. K. to get the answers to your questions. If Dr. K. can do it, make a plan to save the money, borrow, or get new health insurance coverage. It is not unusual for people to have to wait a year or two to get the funds or get new insurance to make the WLS happen.
     
    Toya C likes this.
  8.  
    Munchkin

    Munchkin Full of Fairy Dust

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    2nd opinion! Always verify!
     
  9.  
    Toya C

    Toya C Member

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    THANK you all for your input! I agree with the 2nd opinion and will schedule a consultation with Dr. K asap.
     
    hilary1617 and Charris like this.
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    Larra

    Larra Well-Known Member

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    Great! Let us know what he says.
     
  11.  
    Toya C

    Toya C Member

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