I finally had my Revision Surgery!!!/ X Post

[Guest guest]

I have been on some of the OSSG list on and off for the last 5 years, mostly as

a lurker. When I was reading the story of some who had similar experience as

mine I would get angry. The anger was such that I had to leave the list until I

calmed down or get desperate enough to come back on the list. I could not deal

with my own anger. I finally joined 4 months ago to OSSG-Graduate and

OSSG-revision determined to learn from the groups. I was surprised to see how

many people are in the same boat as I am now. Few years ago I could count by

one hand people who had large Stoma.

I am not much of a writer but thought to write my story as some of you might

relate to it. I apologize for the length of the email. I had lap RNY in Feb

98. The day I left the hospital I could consume large amount of food without

any restriction. I was savagely hungry all the time. I lost 40 lbs in 8

months. I contacted my surgeon many times but no response from him. I had two

endoscopies done by two Gastroenterologists and both told me I have no

restriction. Basically, the stoma is way too large to provide any restriction.

I sent the report to my surgeon hoping he would want to do revision. During

these 5 years I dieted many times, lost some weight and gained it back, the same

yo-yo you all know about. I desperately wanted my surgeon to do my revision as

I was scared another surgeon to do such difficult surgery. I thought my surgeon

knows what he has done in the past and could fix it. How wrong I was!

I have seen several surgeons for the last two years, each one had different

suggestion for me which I thought it was not taking care of my whole problem.

The following is the list of suggestions from each one of them. I traveled to

many states to meet these surgeons.

1. This surgeon wanted to Undo the previous RNY and redo the Proximal RNY by

open procedure. The surgery would take 6 hours and it would be very difficult

procedure. He thought from my surgery report my surgery was not done right but

he was not sure and thought he has to open me to know what went wrong.

2. This surgeon wanted to convert it to Distal RNY without touching my Stoma.

He was willing to do it by Lap. I felt I still would be savagely hungry and

does not solve my whole problem.

3. This surgeon suggested conversion of RNY to DS by open procedure. He said

it is very difficult to convert RNY to DS because where the old pouch and the

new meet is going to be very weak connection and possible leakage problem.

4. When I saw this surgeon I was 240 lbs. He suggested to put Adjustable Band

on my pouch. This would take care of large Stoma problem. He said although I am

100 lbs overweight I am still not obese enough to justify Distal RNY. He was

not willing to change it to medial. I was thinking to go for this procedure but

after I learned the success rate is not that great I didn't want to put myself

through another failure.

5. I saw a Bariatric surgeon at Stanford Medical Clinic. She was extremely

nice and spent over an hour with me even though she was not going to do my

surgery. She said she has never done a revision and she wouldn't want me to be

the first. She thought the only one who could possibly help me would be Dr.

Gagner in New York. She had rave review about Dr. Gagner. It was important for

me the procedure to be done by Lap. I asked her if I could diet and lose the

weight and she gently reminded me " what use " ? " You would gain it all back

again " . After talking to her I was confirmed I need to do the revision.

6. I Saw Dr. Gagner on Oct. 1/03 after waiting for 7 months. The office called

me just few days before and had a cancellation. I took it and made quick plan

to fly to New York taking Red-eye. I thought it would be half an hour consult.

I was exhausted when I finally got to Dr. Gagner's office. I told Dr. Gagner how

I could eat large amount of food without any restriction right after the

surgery. He read my surgery report as I was talking. Here are his comments:

a) He said the type of connection the previous surgeon has done is WRONG. You

can not make small Stoma and Pouch with that kind of connection. I was shocked.

My first surgeon has good reputation on his surgical skill.

I also told him the sever pain I get in my right side under my rib cage. I

vomit all night until it finally resolves itself. I had to go to emergency room

twice. I thought it was my gallbladder but all the tests came negative. He

said this is not your gallbladder but rather the food coming back and we know

now this could cause blockage eventually and nothing could be done about it

unless we sew the Mesentery.

c) He told me I have to do revision and my options are: Distal RNY, Adjustable

band, DS and another RNY. He said he performs all of these procedures by LAP.

I asked him if he has done revision from RNY to DS by LAP as this is very

difficult procedure. He said, he has done it successfully and a paper is coming

out in this regard. I had to see 4 surgeons to suggest 4 different procedures

while he covered all my options in one sentence.

d) He said if he didn't have my surgery report, he would have thought RNY has

not worked for me so he would have advised other methods. But since I never had

a chance with RNY I should give it a try. He said he would bypass more of my

intestine but would not make it Distal. I was 229 lbs at the time of my visit.

I had lost some weight with diet. Basically he was going to close the old Stoma

and the opening of the intestine and make new one. He would make the pouch a

lot smaller than previously. He also was going to sew the Mesentery. All and

all it was going to be a major revision surgery but still easier than DS with

less of risk. The procedure to be done by LAP.

e) He asked me what weight do I want to be? I told him I just want to stop

being savagely hungry all the time. He had an opening for Friday Oct. 3 for the

surgery and this was the only opening he had. Apparently, he had a

cancellation. I was so impressed with Dr. Gagner's knowledge, I trusted him

and his judgment fully. This hardly ever happens to me. I really believe he is

the best.

What I thought to be half an hour of consult ended up to be 9 hours of pre-op

tests. Everything moved so fast, I was dizzy. My brain was not functioning. I

was going through major revision surgery in two days with no family member or

friend and far from home. It was too late to ask for an angel. I wished I had

my lap-top and I could write to this list but I didn't have my laptop and no

time at all. I had to see a Cardiologist for stress test to get clearance for

surgery the same day without any previous appointment. The staff worked hard to

get me going from one place to another.

I think the surgery took about 3 hours. When I woke up in the recovery room I

was very alert. The pain from the surgery didn't seem to bother me but the back

pain was excruciating. The pain med was not working on it. I asked to get up

and walk but I was told I can't do it in the recovery room. I had to wait until

I get to my room which seemed for ever. The Bariatric Bed was great. It was

easy to make it like a chair so I could get into sitting position. Apparently

this bed costs $35,000.00. I walked every hour just to get some relief from the

back pain. I stayed 2 nights in the hospital. Dr. Gagner wanted me to stay 3

nights but I felt good enough to convince him to let me go. He kept reminding

me that I have gone through a major revision surgery but I felt okay. I hardly

used the pain med. 5 days later I saw Dr. Gagner and got permission to fly.

Thanks to Vicodane, my 6 hours of plane trip back was non eventful.

This surgery has been so different from my 1st RNY that I am at awe at all

times. I am hardly hungry any more. I drink my protein drink in the morning

and twelve hours later I remember my second Protein drink. I have lost 22 lbs

in 23 days. I am a very slow loser and he reminded me with revision the weight

loss is a lot slower. With my first RNY I only lost 5 lbs the first month.

I am grateful I didn't do revision with my first surgeon because I would have

never known what went wrong in the first place. Plus my problem would not have

been resolved as I know of people he has revised with the same hunger problem.

Sometimes what we wish is not to our best interest.

I hope my experience is helpful to some of you!

M.

Lap RNY 98

Revision Lap Medial RNY Oct. 3/03