JohnnyMadison

11 hours ago, Christina.Rose said:

I'm too afraid of rerouting my intestines etc.

For some of us with GERD (acid reflux) caused by a VSG sleeve, the alternative to re-routing intestines is Barrett's Esophagus which carries like a 1% per year risk of Esophageal cancer. Sleeves create a pressure system where acid is much more likely to spew up and out. I really wish I had done RBG in the first place vs. having to get revised to it, although I kept off my weight with the sleeve the reflux, which was new after I got it, was a miserable situation for 7 years.

Your headline and first post are misleading. They imply / state you have GBP and are wondering if that can be revised. I would edit them to clarify you have band and want revision to GBP. That is very common here for the reasons you outlined later in the thread. But the title and first post seem to state you already have GBP so that's why the responses are confusing.

Oh yeah, I had just progressed into Barrett's but they think it's early stage and reversible. So insurance approval was rapid. I was rejected for LINX because they don't approve it for that if you have Barrett's, they want something more permanent and less experimental. Revision to GBP is such a different experience. I get full on 2 TB of dense Protein but something like Soup or pureed ground turkey with taco seasoning I can already have like 6 ounces. It really just depends on what's going to camp out in the pouch and what's going to slide through, so it's a bit easier to "trick" than a sleeve that would get full with liquids or anything else. They really aren't prepared to deal with people under 30 BMI getting GBP so I went to all the classes (and got asked who I was there supporting). After VSG and abdominoplasty (excess skin), the scar tissue made my incision pain much higher (I also had a hernia repair and I'm guessing you will need that too). And since they don't alter or VSG except for making the pouch, you will be hungry. It gets better each day but revision is for sure harder, especially when, in my case, I was fine with my existing weight but was miserable with GERD (which I never had pre-sleeve) and it's like I just want the GERD fixed I don't want to go through a whole transformational process again.

I was sleeved in 2012 and revised to GBP on 12/16/19 (3 weeks ago) at a 28 BMI. I was at close to my pre-sleeve goal weight but not my post-op maintenance weight, but still relatively fit. I have surprisingly lost 17# in 3 weeks which is a faster # and % of BMI than my sleeve -- and I was 320# then! So yeah you are going to lose weight. I don't know when it will stop since I'm 3 weeks out. I don't want to lose more than 10-15#, and I'd be fine stopping here since I'm almost under 25 BMI already. I get it, I hate how drawn I looked after rapid weight loss. I read somewhere on here that Peanut Butter was how one woman maintained post-op with a restricted capacity. I had a larger pouch and less bypassed than typical but that doesn't really help much the first few months when everything is inflammed. I am making a homemade egg drop Soup most nights to get my calories over 1200 and it's good.

It's true that GBP (revision) patients maintain at least a 10% or more weight loss than sleeve, so theoretically revision is just giving yourself a better chance. I revised for acid reflux and "only" had regained ~ 25# of 130# lost and was still < 30 BMI at revision. But I will say that losing the 17# I have lost since 12/16, which is a higher rate as a % and # as compared to sleeve, has made me much happier. With that said, I'm only 3 weeks out so I'm actually scared I will lose more than I want and look like an old man again with that drawn face. And then I'm scared that I'm going to regain as well. I guess I'll never be happy. Listen, our stomachs/bodies often betray us and make us hungrier than we need to be. And the food supply is stacked against healthy eating. So if you can get a revision to keep more weight off then I would do it whenever you are ready. It's a tough, tough, battle out there. If you have acid reflux, however, I wouldn't hesitate to revise sooner than later. I developed Barrett's Esophagus which is miserable to get at 44 and I'm hoping will go away with some healing.

I was revised from VSG to RNY due to horrific GERD and Barrett's Esophagus a week ago today. I had kept off 105# of an initial 125# weight loss but due to two hip surgeries stalling my running, had regained about 20# in year 6. But overall I was still happy with permanent weight loss. I had an abdominoplasty in 2013 where they pulled me pretty tight. Since discharge, the vast majority of my pain has been along the part of my incision adjacent to the abdominoplasty. Surgeon says this is common. Anyone else experience this?

Tough one because it's nobody business but it's also not anything to keep shameful about. The first time around, with VSG, when I lost 135#, I did tell people and I didn't care. I even told my boss and his wife ended up having it done as a result of my feedback through him. Plus talking about it openly and living normally as a WLS patient helps destigmatize some of it. So there are two really good reasons to share plus people are often not judging us as much as we think. But YMMV and I loved all the support I was given along the way. I didn't want to become that person on my FB feed whose obviously had WLS and is going through dramatic transformation but then only speaks of "lifestyle change."

For revision, I am not sure if I will tell people since I was revised for GERD only and kept 115# of the 135# off, mostly gained 20# after having to have my left hip replaced twice (recalled implant) and the inactivity that resulted from that (previously had been running 20 miles per week). I have a 28 BMI and if I go below a 20 BMI, which is about 30#, then I would say something but as for now I simply told work I had a hernia repair and surgery for GERD. Hopefully I don't lose more than 25-30# so I have to make this decision.

I had gastric sleeve revision to RNY on Monday (today is Wednesday). This was due to uncontrollable GERD which caused Barrett's Esophagus and a a hiatal hernia . The total procedure was ~ 3 hours. I have had my left hip replaced (twice, due to a recall) and VSG. The RNY was for sure the most painful of all. I believe it was mostly due to the surgical gas and it is dissipating (Gas-X did seem to help). Swallowing is already better without the hernia and I haven't had a lick of acid reflux which is amazing after a 7 year battle post-VSG. I had kept most of my weight off (5'11" / 205#) and so they didn't bypass as much of my intestines as normal and they made the pouch bigger. While I didn't have to do a pre-op supervised diet, because insurance treated it as a GERD-related procedure, I still had to do the group sessions at the hospital which was a repeat of all I know. For me the battle was accepting that I needed revision, I viewed it as a failure of the original WLS which was not the case -- I had kept 100#+ off for 7 years. But there is just that perception.

29 minutes ago, Lauren87 said:

Thanks, JohnnyMadison and SorryNameTaken!

This is going to be an interesting journey--since my last post, the certificate of medical coverage came out for our plans (local government employee, uniform benefits... a blessing and curse!) and they are covering bariatric surgery and the only requirement is to have a BMI over 35 and to be considered medically necessary. So, this is either going to be really easy or really hard, but I won't know what kind of approach we're taking until I can start the program. There is no language in there regarding revisions, which does give me a pause, but if I meet the requirements and they prior-authorize the work, then I assume we're good to go. That's what I'm hoping, anyway.

P.S. JohnnyMadison, nice to see another Wisconsinite present--I presume you're also in Madison? Small world? Did you go through UW for your revision? I have only heard positive things!

Yes, I am in Madison and getting revision done at UW! I was scheduled 11/11 but am selling old house on 11/1 and closing on new house on 12/2 and didn't want to do it while living in in a corporate apartment, nor did I want to move into new house with possible post-op restrictions. So I rescheduled to 12/16.

The code on my pre-authorization paperwork for the procedure is just for RNY. It doesn't list revision and when I look up the CPT it just describes the procedure. So perhaps revision is a modifier to the original code so that's why no language about it. With your plan if you meet the requirements it looks pretty good. My plan had a comorbidity requirement but I also didn't meet the 35 or 30 BMI so maybe that's why they did it as a non-bariatric reason, even though I am obviously a bariatric patient.

Good luck! I am going through Dr. Greenberg. The facility is just a few miles from both of my houses so I am grateful for all that. I had my original VSG done in Mexico because work didn't have WLS coverage at the time. All of the pre-op nutritional sessions and all that are annoying but at least I don't have to do the supervised diet like most of the people having surgery in my groups. Being on a restricted diet with my original stomach was torture. It is much easier for me with a sleeve and ironically I don't have to do it.

I'm in Wisconsin and can only speak to my experience for VSG>RNY revision insurance approval. I had really bad GERD and my endoscopies showed Barrett's. So Blue Shield (my employer is in CA) approved it immediately for GERD and did not impose any pre-operative requirements such as monitored weight loss, etc. So my recommendation would be to pursue it for complications and not WLS if you want a quick approval.

Thanks everyone for the replies. They've really helped me.

I had VSG on 11/30/2012 and have kept off about 110# in the 6.75 years since then. I am ~ 25# overweight but right about at my original goal. I'm 5'11" (male), 195#, 34" waist, very fit and active, etc. I was down to 175# when I ran marathons but have had a few hip issues that are now resolved and had a minor regain. I actually really like how I look / feel at this weight as I looked a lot older at the lower end.

I'm pretty happy with my weight loss. But since about 2 weeks out I've had ridiculously bad GERD. I get an annual endoscopy (familial cancer syndrome) and ever since VSG, I have had erosions show up from the reflux. This last time it was diagnosed as Barrett's Esophagus, which is a pre-cancerous syndrome.

I cannot control it fully with meds. I either take 5-6 PPI (200-240mg esomeprazole magnesium) or 6-8 extra strength Zantact (900-1200mg ranitidine). These are of course way above the recommended limits and in the case of the PPI there are long-term risks associated with it they don't want for me as I need good bone density for my hip implant.

The bariatric surgeon (University of Wisconsin) has recommended for years that I convert to RNY and after the Barrett's Esophagus diagnosis, my PCP and the genetic cancer team both strongly recommended it as well. So I'm going to do it despite not really wanting to. I have been approved by my insurer and have an early November surgery date.

I have several concerns, most notably that I don't really have more than 25# to lose or I drop to the < 18 BMI range and I don't want to be there. The surgeon says he will make a larger pouch and a smaller bypass portion but it's still there and I work out all the time so I already know I will lose more than I want in the beginning.

I guess I have a bunch of questions. Feel free to answer any and all if you've had this type of revision:

1. How long did you take off work? I'm told 2 weeks. I usually work from home at a computer. Was there much pain?

2. How long before you could work out again?

3. Did you lose more weight than you wanted?

4. Did it resolve your acid reflux (if that was the reason)?

5. Were you able to enjoy good food at special meals (holidays, etc.) with RNY? I'm terrified of losing ability to have a nice meal with family. What does a normal meal capacity look like at a year out?

6. Are bowel movements normal at some point?

7. Could you drink alcohol again? I'm fine going months without but at some point would like to enjoy a glass of champagne again. I can't right now as carbonation is brutal.

I'm just reluctant even though I know I have to do this. Any re-assurances would be helpful.

I'm now 25 days from surgery and it definitely has improved. I get it now, mildly, if I drink too fast and then if I eat something rough like dry white chicken meat. But it's so, so, much better. I have no idea the cause -- nerve translation, pressure, etc., but it is so much better and gets better each day.

Fatalities is not the reality of things. There is allegedly one patient with an extensive cardiac history who died at home, well after surgery. As I outlined previously, even if it's true, it puts his mortality rate lower than that of most US surgeons and 1 person who dies weeks later does not count as "fatalities" in "Tijuana". It's misleading and most likely posted by a coordinator pushing their guy instead. I'm fine with the poster who walked out, to each their own, but to have a post that tarnishes a good surgeon's name because of a coordinator battle, well it does injustice to the alleged impartiality of the site.

Leelee, I've had experiences with bad nurses. After being told that I needed a picc line because my veins were to weak, a nurse came in with her cocky self assuring me she could find my vein. Well, she did. in the middle off my scan when the contrast was injected, my vein collapsed causing all of that dye to go into my arm. It swelled up to the point where it looked like I was going to burst and I ended up with a blood clot where the vein collapsed.

If I sense that anything is wrong, i'm out. I'm glad that you followed your instinct.

Btw, my last pcp has the old school EKG machine and despite it working fine, it is surely funny to look at.

What I don't like is that this post has the word fatalities in the title and is clearly designed to scare off prospective patients for Dr. Garcia. I feel like the mods should just remove the whole thing.

I haven't checked my BP but that's a great idea, I will do it before and after.

I had my VSG on 11/30/12, so I am 6 days post-op. Incisions healing well, very minimal pain, no problem getting liquids in, no puking, fully hydrated, very gradually progressing into pureed food, had 80+ grams of Protein and 70+ oz of Water yesterday. All going fine.

Here's my issue. When I eat or drink, my ears start ringing. No other symptoms suggestive of a leak (no pain, no temperature, no flush in the face, no nausea, etc.) exist in my body, but of course that doesn't mean I'm not worried about.

This morning I woke up, took my antibiotic capsule and preventative Prilosec fine with a few sips of water and then took a 30 minute walk. I came back and sipped 1 cup of unsweetened Almond milk over the course of 45 minutes. My ears immediately started ringing and now that I'm done, the ringing is slowly fading away and I feel fine.

The only other "unusual" thing is that I have not felt full or hungry since the sleeve. Everything goes down. It does bubble and gurgle but that seems normal. I forgot I had the sleeve and took two huge gulps of water after a massage two days ago, and the pain was very fleeting and minimal. This was probably 3 ounces in two quick gulps.

Anyone else experience ears ringing only when eating or drinking and then it fades?

I was just discharged from MI Doctor a few hours ago, now at the Marriott. I had Dr. Garcia. This is a small, boutique, hospital but it is much better than a surgical clinic, IMHO, because of the multiple nursing staff and various doctors on duty at all hours. It isn't fancy, but the internet is BLAZING fast and they helped me out a great deal. They did leave my IV in too long also and my BP spiked, but it came down when that was pulled. I've been peeing non-stop since then. The only thing I didn't like was the drain but that's pretty common. It is near a major thoroughfare, so bring air plugs although if you go through Ready4Achange, they will give you a "welcome" kit with ear plugs in it.

Experiences posted should definitely be first-hand because things can get changed as they pass from person to person, lost in translation, etc., so if the poster did have a friend with a bad experience with the coordinator, it should be posted by the person who experienced these issues.

I personally like having a coordinator in terms of being able to answer questions, etc. That's just too valuable for me. They also schedule your rides and all of that.

Thank you so much for this reply, it is heartfelt and honest. I am grateful that I have chosen Dr. Garcia. I would, however, not trust A Lighter Me if you paid me. I did get quotes from them but then I read about how they were spreading negative comments about competitors and other surgeons, and that was enough for me. There's more than enough business to go around, focus on your strengths and don't denigrate others in the process.

I'm told that Dr. Almanza has switched from a recovery house to the Hotel Ticuan, and patient satisfaction is much higher as a result.

Legitimate scientific numbers indicate that about .1% of patients die in the hospital: http://www.sciencedaily.com/releases/2009/04/090420170804.htm

Probably outdated information indicates that Dr. Garcia has performed over 2000 WLS, although I believe the number is probably higher. If the statistical models were accurate, then he absolutely should have at least 2 patients who died while in the hospital, and it appears that none have, so he is running ahead of the curve.

The 30 day mortality rate for gastric sleeves in the US is slightly higher at .11% http://www.generalsurgerynews.com/ViewArticle.aspx?d=Obesity+Care&d_id=410&i_id=736&a_id=17274

Dr. Garcia experiencing 1 death within 30 days of surgery for a minimum of 2000 surgeries (probably higher) means he has a mortality rate of .05%, which is less than half of those being treated in the US. Those are great statistics.

This is major surgery and none of us are in picture perfect health. Any doctor who says there is no chance, or no risk, is lying. Dr. Garcia's success rates appear to easily exceed those of his counterparts in the US. I know that I am taking a risk but I'd rather take a chance on wellness than spiral into chronic illness.

I personally think that the mortality rates in the US and Mexico are shockingly low. This is a very unhealthy population.

My guess is that some of the coordinators are in-fighting. Heck, in my hometown we have two hospital systems in protracted litigation, running ads against each other and pulling patients from shared services. So, battles between health care coordinators is not solely a Mexican thing! http://host.madison.com/news/local/health_med_fit/uw-meriter-feud-escalates-into-court-battle/article_93e93688-0cb6-11e1-9396-001cc4c03286.html