Re: Re: Fw: any comments? Chris H

[Guest guest]

Hey

Just wanted to let you know how much I appreciate

your post. You truly know how to make others

understand some of the complex procedures and

terminology we encounter. Your a true Blessing

BE HAPPY

--- chull1@... wrote:

> Judie,

>

> It is possible to reverse the RNY, but it is a

> difficult procedure.

> To revise the RNY to a BPD/DS is even more

> difficult, but it has been

> done succesfully. Dr. Anthone refuses to do it any

> more because he

> feels that it is just too risky.

>

> It is true that the gastrectomy for the DS is not

> reversable.

> However, the gastrectomy is much less restrictive in

> nature than the

> RNY. The intestinal part of the BPD/DS IS

> reversable. Those that

> have required intestinal reversels have done very

> well living with

> only moderate restriction and no malabsorption.

> Generally the

> reversals are needed on people who loose too fast,

> though occasionaly

> the side effects of the malabsorption are not

> tolerable. For those

> that loose to fast, they end up very close to ideal

> weight after the

> reversal. For those that are reversed due to side

> effects, they end

> up still moderately obese after the reversal. This

> is why doing the

> gastrectomy alone can be but is generally not

> effective. Only those

> that lost too much weight with the malabsorption do

> really well

> without it. Unfortunately, it is difficult to

> predict ahead of time

> who will loose to much weight. There are some

> correlations.

> Generally the ones that loose to much weight are

> female with a

> starting BMI under 45. Women have been shown to

> require reversals at

> a dramatically hire rate than men. Smokers have

> also require a high

> rate of reversal. Some patients become anneorexic

> and require

> reversal for that reason. In very rare

> circumstances, kidney or

> liver problems requires reversal.

>

> Hull

>

>

>

> >

> >

> > This is from the OSSG Hungry group.....for those

> who are

> knowledgable any

> > comments?

> >

> > Judie

> >

> > > Judie,

> > > Yes, some of that is true, but one of the

> selling features of

> > > the RNY is that it can be reversed.

> Realistically, it is a

> difficult

> > > surgery and it will never be the same as it was

> before we started

> > > tampering with the GI tract, but the fact is, it

> can be reversed.

> > > The pyloris does continue to function as long as

> the remnant

> > > stomach is in there. It has to open and close to

> release the

> gastric

> > > acids and gastric juices that are continuously

> being produced

> inside the

> > > remnant stomach. Yes, if it has been a real long

> time the pyloris

> may be

> > > slow to function, but there are drugs that help

> that and if you

> are

> > > having problems as a result of having had the

> RNY and you need to

> have

> > > it reversed, you are more than willing to deal

> with the reversal

> > > problems.

> > > In our practice, we have had 2 reversals out of

> 850 patients.

> > > One was a woman who was unable to adjust to the

> dramatic eating

> changes

> > > and chose to have it reversed. She has since

> gained all her

> weight back

> > > and more. The other, had ulcerative colitis and

> could not stop

> losing

> > > weight. When she got down to dangerous lows, she

> and the doctor

> opted to

> > > reverse her. She has done fine and has gained

> very little weight

> back.

> > > Very few surgeons, if any, routinely remove the

> remnant stomach

> > > during an RNY. It is necessary in the BPD due to

> the removal of

> any

> > > drainage point from the remnant stomach. It

> would be a blob of

> stomach

> > > sitting in there with no way to release all of

> the acids and

> gastric

> > > juices it is constantly producing. This fact

> makes the BPD

> irreversable.

> > >

> > > I was told by a DC area surgeon, at the ASBS

> convention, that it

> > > is possible to revise an RNY to a BPD/DS. I

> didn't ask him the

> details

> > > of the " how " and wish now that I had. I was just

> amazed that, he

> assured

> > > me, it could be done.

> > > Michele

> > >

> > > Not sure what you mean here.....if in the RNY

> your stomach is

> just

> > > transected then they can put that back together?

> Its my

> understanding

> > > its

> > > not very easy to do that but its possible

> however once the

> pyloric valve

> > > has

> > > not been functioning for a long time its " iffy'

> if it would ever

> work

> > > again.

> > > Some people have their entire stomach removed in

> the RNY so there

> is

> > > nothing

> > > there to revise it to if that's been done.

> > > I dont have a pouch, I have my own stomach with

> 80% removed but

> the

> > > pyloric

> > > valve is intact and functioning as normal....

> > > BPD's as in the Scopanrio method?

> > >

> > > Judie

> > >

> > >

> > >

> > >

> > >

>

>

>

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