Hello!

[MamaEssie]

Hello!!
I am almost 3 years out from a RNY. I lost down to 137 and had some regain. I am currently about 165. However, I have had major issues with ulcers. 5 months after my original surgery we did a revision to remove my first batch of ulcers, and they made some changes to my pouch and Stoma to try and eliminate future ulcers. 6 weeks later they were back. In December 2016 I had a vagotomy performed and at that point, my ulcers healed and have been dormant since. Unfortunately, they are back now and my surgeon says that a complete reversal of my RNY is my only option at this point. I am not going to do that unless I feel like it is my only choice and I am REALLY sick at that point. I have gone through SOOO much to get this far just to have it all undone makes all the pain and suffering worth... nothing! I have seen some research where some surgeons will revise to a DS due to RNY complications, my BMI is only 28 so I wouldn’t be approved for weight loss purposes, and to be honest I would only really want to lose like 30lbs at this point. I am in N.C. and my surgeons are really great- but I need to find someone who will actually talk through ALL my options with me not just what seems the easiest. So I am on a mission for information. If any has any suggestions I would greatly appreciate them I contacted a surgeon in CA who does a lot of revisions, but I need $200 for a phone consult I don’t have at the moment. I have hit my max OOP for the year so if I could do it the week after Christmas that would be AMAZING!! I just wish I could find someone amazing closer to home!

Thanks for any info or advice in advance!!

 

[Larra]

Hi and welcome! I'm sorry you have been through so much, and not even done with the problems yet.
I'm guessing the surgery you hope to consult in CA is either Dr. Keshishian or Dr. Rabkin. Both are very experienced with the DS and with complex revisions of RNY to DS, so either would be an excellent choice for advice and recommendations, even if you don't have surgery with them. My concern, just off the top of my head and not being a DS surgeon, is that you've had a vagotomy and that means your pyloric valve no longer has the nerve supply that tells it to open or shut. Not a problem with your RNY, as your pyloric valve is bypassed and not being used anyway, but a potential problem if your RNY is reversed, as that would restore the usual pathway through the pyloric valve to get food out of the stomach. Did your NC surgeons say anything about this?
I think you are wise to seek other opinions before taking such a drastic step. I hope you will soon be able to cobble together the money for the consult.

 

[MamaEssie]

Hi and welcome! I'm sorry you have been through so much, and not even done with the problems yet.
I'm guessing the surgery you hope to consult in CA is either Dr. Keshishian or Dr. Rabkin. Both are very experienced with the DS and with complex revisions of RNY to DS, so either would be an excellent choice for advice and recommendations, even if you don't have surgery with them. My concern, just off the top of my head and not being a DS surgeon, is that you've had a vagotomy and that means your pyloric valve no longer has the nerve supply that tells it to open or shut. Not a problem with your RNY, as your pyloric valve is bypassed and not being used anyway, but a potential problem if your RNY is reversed, as that would restore the usual pathway through the pyloric valve to get food out of the stomach. Did your NC surgeons say anything about this?
I think you are wise to seek other opinions before taking such a drastic step. I hope you will soon be able to cobble together the money for the consult.

Interesting!! Nope!! I have never had any mention of the pyloric valve. Thank you!!! It is the surgeon who did the vagotomy who is saying I need to have the reversal. I don’t want it AT ALL!! However, I have heard that often the vagus nerve eventually heals itself, so i am wondering if this is what has happened at this point, would make sense for the 18 months or so of no ulcers when before I couldn’t even go 2 weeks without them developing. And yes. I couldn’t spell his name but Dr. K is the one I am looking at getting the consult with. I also have been reading some papers that a surgeon at Duke which is only about 90 minutes from me has recently published, and he may be able to give me some advice- or even perform the surgery if I feel he is confident. The crazy thing is- my hospital is where everyone in the area sends their problems- but I am a problem that isn’t easily fixed and I also am not the patient that will fade away into her misery in silence either, so I may be the first one that keeps coming back- with no known cause and no fixes. However, I think it is more common than most want to believe. I am however, compliant with everything they have asked me to do and I don’t have any of the risk behaviors they can point it at. I researched myself all my other meds and worked with my dr’s to get off anything that said ulcers could ever be a very very MINOR complication. So I feel like- if they are going to take a chance on a procedure that they need a patient that is ON IT! It could be me. Oh well! I appreciate you responding and for your insights! I have spent so many hours reading message boards. So great to learn from others experiences.

 

[harrietvane]

Is the Duke surgeon Dr Sudan? If so, I'd go with Dr K simply because of the ease of administration. I tried to get to consult with Dr Sudan when I had my surgery, and it was impossible to get past email with the front desk gatekeepers. From everything I've heard, Dr K and his team are a lot more responsive.

 

[JackieOnLine]

Hello and welcome!
sorry to hear you have had so much trouble and I hope you can find out what you need and get it done. I know it is at least possible to get a DS even with only 30 pounds to lose.

you sound smart, organized and like someone who gets things done so you got that going for you.

 

[southernlady]

Welcome MamaEssie

 

[hilary1617]

Hi and welcome MamaEssie !