RNY to DS in Canada.

[Lilbird6]

Hi everyone, I had posted in the Hello thread and was advised to create a new post with the title as above...

I am 3yrs out from my RNY (Jan 2013) here in Ontario.

I had a Candy Cane Syndrome which my surgeon removed just past my 1 yr mark (March 2014).

In May of 2015 had a revision on the pouch and bowel junction for severe ulcers in my bowel.

I presently am doing shakes and yogurt...
I have been tossing my cookies since approx 9 mths out, to start with I think because of the Candy Cane, although even with the removal of it my issues began again once I went back to solid type food.
It was the tossing of my cookies which caused acid to back up from the old stomach and cause the severe Ulcers. which they felt at the time was causing me to have the severe nausea etal.

So even after the ulcer removal surgery I am still not able to keep much in line of solids in... and the nausea is still horrible on a good day.
I have severe Hypoglycemia, and can not do more than 15 carbs in a meal or I have sever rise and then drop in sugars.

Endocrinologist has tried several (5 in total) different drugs to try to help control the Hypoglycemia with no luck but some bad side effects.
Endocrinologist and surgeon are feeling the revision is the only possible route now to give me something of a normal life.

My Dr. is the top guy at our Bariatric Centre of Excellence. At the time of my surgery in Jan of 2013 he had completed over 1000 WLS.
He introduced laparoscopic gastric bypass to the Guelph Hospital program.

I am quite confidant with my surgeon and his doing surgery etal, he would certainly not attempt a surgery he is not capable of preforming.

I am looking for any input on having this revision from RNY to DS due to my ongoing health issues related to my RNY.

Or if anyone had a similar type surgery from RNY to a form of DS... not sure if that is correct... from all I have read they can do a revision from Pouch to Sleeve but the bowel would I think stay as it is now ?? if anyone knows differently pls advise..

Ty all for any input.

 

[bearmom]

I'm hoping someone more informed on revision and Canadian health will pop in, but I have to ask if there is ANY chance that you could self pay and see Dr Kesheshian in California? There is only one surgeon I'm aware of that is currently in Canada that may be capable of that revision, as you are a little more special now after several surgeries, but the surgeon I'm aware of should be considered as extremely questionable as far as methods and ethics at this point. I'm not even 100% sure he's still in Canada, as he's moved around so much due to legal issues.

It looks like some issues cannot be resolved without your own pyloric valve being put back to use, but you have more going on than that.

If you could see Rabkin or Kesheshian in CA, they are the best choices for figuring out and fixing the tougher cases, which you are. Frankly, I don't think I'd even bother with any other surgeon at this point at the risk of more damage that can't be reversed.

 

[Clematis]

what @bearmom said ^^^ especially the last sentence.

If nothing else, consider contacting Dr. K, and sending him all your records for him to give you a second opinion.

Just because your doctor has done 1000 WLS doesn't mean he has the experience to do THIS highly specialized surgery. (I'm sure he told you the candy cane syndrome surgery would fix everything and it has not.) You need to get this done PERFECTLY as it may be your last chance.

 

[Lilbird6]

When Dr. did the Candy Cane it was simply for that ... at the time Hypoglycemia was not a big issue, and we definitely felt the tossing of the cookies was solely due to the Candy Cane. As I would normally only get sick in the evening after dinner.... after all the food I had eaten during the day filled the candy cane .. it had no place to go but back up..

I do know he has another patient whom he is doing a RNY to DS in April. I do not feel he is the type of Dr. who would do a surgery of this nature without prior knowledge or having done it many times...

Regardless I am not going into this lightly.. I fully intend to ask many ????? and know how often or to what degree this has been done by him for sure, or even at this hospital.

*****************************************************************
**Dr. Reed has been involved with Weight Loss Surgery since 1994, when as Chief of Surgery he supported the transition of bariatric surgery at Guelph's St. Joseph's Hospital from a sporadic operation to a hospital program. Encouraged by patients' successful long term weight loss, he brought the program to the Guelph General Hospital when the city's surgical services consolidated in 2000. At that time he was one of only very few surgeons providing weight loss surgery in Ontario. In 2004, with the mentorship of Dr. Nicholas Christou of McGill University, Dr. Reed introduced laparoscopic gastric bypass to the Guelph program.**

Ty so much for all your information. It is appreciated for sure.

 

[DSRIGGS]

I have to be completely Frank and tell you that "I do not feel he is the type....." isn't going to cut it. You need to find out exactly how many RnY to DS procedures he has done, what method he uses (standard or Hess/proportional), what those outcomes have been, and exactly how long will he make your common channel (CC) and Alimentary Limb (AL). Frankly if he isnt revising your bowels you aren't getting a DS.

I can tell you that Dr K has done over 2,000 DS procedures and 500 revisions and he will tell you that exactly what he would do..

Please ask all these questions and don't trust that your surgeon knows what he is doing with a revision just because you think he is a good surgeon. Afterall he gave you the procedure that failed you. I made the mistake of trusting my original DS surgeon and have paid dearly for it.

 

[CaraOC]

I have to be completely Frank and tell you that "I do not feel he is the type....." isn't going to cut it. You need to find out exactly how many RnY to DS procedures he has done, what method he uses (standard or Hess/proportional), what those outcomes have been, and exactly how long will he make your common channel (CC) and Alimentary Limb (AL). Frankly if he isnt revising your bowels you aren't getting a DS.

I can tell you that Dr K has done over 2,000 DS procedures and 500 revisions and he will tell you that exactly what he would do..

Please ask all these questions and don't trust that your surgeon knows what he is doing with a revision just because you think he is a good surgeon. Afterall he gave you the procedure that failed you. I made the mistake of trusting my original DS surgeon and have paid dearly for it.

Damn well said!!!

 

[jillc]

Welcome! @Dawn is from Ontario and had an RNY to DS revision (I think she did anyway, I may be wrong), I think with Dr Hong.

Ontario is the only province that does the DS. I'm from Alberta and self-payed to go to Dr Greenbaum in NJ. My revision was from a VBG to DS though. The exchange rate was getting worse (it was Dec 1/14) but not like it is now!

If you have any questions, don't hesitate to ask me here or PM me.