Ye Olde Stoma Thread

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From: tuesdynite@...

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Basically what he said was that the original surgeon placed it very very

close to the esophagus and it is just way too risky and dangerous to do a

surgical

intervention with only about 1 centimeter of working space.

******** I did not have my pouch evaluated with the doctor who did yours,

BUT I do have a very good friend who had the same version of surgery that I

did, horizontal pouch, 75cm proximal, etc. I did have an upper GI wherein

the Radiologist estimated my stoma at 30mm, far above the 17mm max that I

read in one of the pioneering surgeon's papers on pouch function. He stated

emphatically that this needed to be repaired. In the case of the other

person I am talking about, she was told that the staple line was placed so

close to the botton/juncture of the esophagus to the stomach, there was a

compromise in blood flow involved AND, nothing from which to form a pouch on

the left side to get away from the horizontal pouch.

I have said before that when I had this evaluated almost two years ago, I

showed the surgeon the films of the Upper GI and he estimated my pouch to

still be very small, and did not have a lot of good answers as to lack of

restriction, etc., and would not really be as forthcoming as I would have

preferred about a possible revision. As a matter of fact was kind of

offended that I would dare even have his work evaluated. He offered to do a

scope for me, which I probably need, but I passed.

I asked another surgeon to look at the films, and he is rather new to the

business, and gave me the standard, " you are a success, if you keep more

than 50% excess weight off after five years, etc. " He did say something

interesting that I had never heard tho, he said that the health benefits,

i.e., resolution of diabetes, sleep apnea, etc., came with the loss of the

first 30% and that the surgeons are only looking at that. From that

perspective, if one is only addressed physical health issues that I guess it

is.

But we are so much more than that as all these passionate threads reveal.

We are whole people who have been in critical danger for a very long time,

realized or not. We have suffered tremendously in social, personal and

professional settings not even considering the impact of MO on the psyche.

One of the most valuable things I have learned about me is that, I had the

genes for the setup, and I certainly had the environment to trigger it all,

and I am classic when I look back in the pattern I see which leads so many

others to where I am (if they are lucky). It is sad to watch my offspring

act out the same patterns. One knows one is old when they see their children

make the same decisions/mistakes they did.

It is a complicated issue and hopefully one day, the medical community will

learn more and more about how to treat the whole person. The stats reveal

every day the growing epidemic that sweeps our society. The toll from it

all seems to me to be without limit.

I am glad you posted on this subject. I have several times and have not

gotten the feedback/response that seems to be here with us now. I always

considered stomas/revisions,,,or lack thereof,,,to be the dirty little

secret of WLS. Very hard to find anything on the subject in the papers I

have been able to access and I am not sure that the ASBS has anything on it.

Baffling to me!

I am/was really concerned because regaining a lot of weight is really not a

good thing to do for a coronary artery diseased person,,,,already with a

double bypass. Yet, I cannot seem to get a surgeon to serious address the

issue. I am not sure how I have not caved, and I know that loss of this

excess 30 lbs would do more than good things for me. I always tend to say

to me, " well, just cause ya had the surgery does not mean that you cannot

lose, cause ya did with great skill before the surgery, just never kept it

off! Question is do yanna put for the effort? " I think I make the effort

to watch, and have regain more than as much as 15 lbs over where I am, or I

am willing to do it sometimes, but I am not willing to put out the energy to

lose it. That is a fact,,,,, even though I have the plumbing kinda sorta

limping along, tis still me who drives the boat,,,,,,but that is just me.

I hope you can find a balance of all the ingredients that it will take to

give you peace.

Dan Slone

Surgery 5/2/2000