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I suspect that you are headed toward revision, given your lifelong experience with this, but there are always things that should be tried before going for surgical solution. Given your history, I suspect that you have tried most of the various tricks and treatments for GERD, such as sleeping with head elevated, not eating X hours before bedtime, etc. There are some books out there by MDs who specialize in the problem that may give some more insight. One common thread seems to be that dietary fat may be contributory to the problem, so your keto efforts may be working against you if that is the case (OTH it may have little to do with it and is just a throwback to the days when low fat diets would fix anything, much as low carb diets are today's universal solution.) It may be worth a try to shift your dietary balance for a while and see if it has any effect on you, There are also some foods that supposedly help or hinder the functioning of the lower esophageal sphincter, and likewise some medications that target it, so those are things to explore. Given your history, I assume that shifting meds may have been discussed - transitioning from PPI to H2 inhibitors such as Zantac or Pepcid - they are generally somewhat less effective but generally preferable from the long term use perspective. Given that you are still seeing reflux evidence in the EGD even on the PPI, it is unlikely to make a significant difference as symptomatic relief doesn't necessarily mean that the problem doesn't still exist and is doing damage, but it is something else worth considering. Historical curiousity - back in the dark ages, vagotomies were performed, severing part of the vagus nerve to disable some of the protein pump ports as a chronic reflux treatment; this was obsoleted by the introduction of PPIs, but maybe it's time to reintroduce the "old school". Good luck in working through this.....
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I'm thinking about a revision...
mi75 replied to sheetmetalgirl's topic in Revision Weight Loss Surgery Forums (NEW!)
I'm 4 years post VSG and also looking at a RNY revision. I had significant GERD all my life. With my surgery I lost about 90 lbs, regained 40. have lost the majority of that using Keto but still, the GERD remains. Surgeon says RNY revision will cure the GERD. I want off of meds, which I've been on for 15 years. I understand the decision to consider a revision. There are many vets who have revisions for various reasons. -
Anyone not need plastic surgery?
mi75 replied to TexasMommy80's topic in Gastric Sleeve Surgery Forums
I definitely need plastics, and have every intention of getting it done. It's not about vanity, it's really about comfort. I have skin everywhere and I deal with infections, skin breakdown, etc. I don't want to use shape wear because it makes me sweat, making the skin problems worse. I'm 4 years out from VSG and have persistent GERD so I'm actually looking at a RNY revision first, then once I get to final goal I'll look into plastics. Definitely breast reduction and tummy tuck, everything else I'm ok with. -
I have relost a 40 lb regain since November using Keto. it was fairly easy but I'm still working toward goal, and actually facing a possible revision to RNY because of persistent GERD. I'm 4 years out VSG and would do it again in a second.
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Alex, 4 years after VSG I too am fighting a serious persistent GERD. I actually was diagnosed with Barrett's about 5 years ago which was one of the precipitating factors for my initial surgery. My surgeon really felt that with my weight loss the GERD would resolve. It did some, but returned with a vengeance. Of course I struggled with some regain but have pretty much lost all of that and the GERD remains. So I too face a revision, to RNY. I am a bit nervous but at the same time I'm excited to return to acute bariatric patient status in the hopes that my GERD will disappear. Good luck!
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I had some regain and really struggled with losing it, but finally got back on track with Keto in November and have successfully lost all but 7 lbs. I'll hopefully be back at my low weight in about 3 weeks. However, I never officially met goal so I actually have another 25 or so to go to that. I'm struggling with persistent severe GERD and have had it my whole life. I'm looking at a possible revision to RNY which actually sort of excites me because I feel like it will help me relieve the GERD permanently. I'm still down 60 lbs of my surgical loss and feeling good, but continue to work to the goal.
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Do you still identify as a wls patient?
mi75 replied to Healthy_life2's topic in WLS Veteran's Forum
Yes I do and probably always will. At 4 years out I still say "i'm a bariatric patient". Sadly, I had some regain and had to fight my way back from that and have 7 lbs to go. HOWEVER, when I saw my surgeon last fall we talked about the fact that I still have very persistent GERD, and take a PPI twice a day. I've maxed out doses on 2 of them in the past. As a FNP I'm very familiar with the risks of long term PPIs, so I'm STILL probably facing a revision. I see the surgeon again late July so I'm hopeful that maybe things will turn around before then... -
After 5 months of strict Keto I'm feeling good, have lost all but 7 lbs of regain and restored my overall health. However, at the appointment with my surgeon last fall, he told me if the GERD still persists after weight loss, my only option is revision to RNY. I'm feeling focused and still have another 4 months before I see him again, but I'm still taking a PPI twice a day. I've had an EGD which shows persistent reflux, however no Barrett's or significant scarring right now. I've had GERD almost my entire life due to the way I carry my weight, in fact I had an upper GI series as a baby from such severe reflux! I've been on a PPI for about 15 years and really want to get off of it related to the longterm risks with the drug class. I'm a nurse practitioner so I am very familiar with the research on the subject. I guess this all boils down to the fact that I'm probably still looking at a revision. I'll do what I have to for my total health but really hoping that I can get another 15-20 lbs off before I see him and the GERD is resolved.
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Hello Again, Long Time No See...
animallover1247 replied to LilMissDiva Irene's topic in Gastric Bypass Surgery Forums
Can I ask if you revised from sleeve to bypass because of acid reflux? If so, did it resolve? -
I'm over a year post op from bypass and still have a problem keeping food and drink down. I was on tpn for eight months and now am on a j peg feeding tube. I have had complications every step of the way. I had a lap band in 2005 and removed in 2016 due to slipped and caused severe ulceration so. Gastric bypass done in January 2017 in hospital for ten day due to complications and infection. Went back in hospital in March for over three weeks with mersa. Back in hospital in June for ten days, had pic line put in and tpn started. Back in hospital in August for another ten days with a revision of the entire bypass again due to severe ulcers. Had gall bladder out in October. February back in hospital for over five weeks with pic line infection. Removed pic line and put in j peg feeding tube. Still have severe nausea and pain. Has anyone else been thru anything like this? Any help would be greatly appreciated.
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Hello Again, Long Time No See...
ProudGrammy replied to LilMissDiva Irene's topic in Gastric Bypass Surgery Forums
@LilMissDiva Irene holy moly!! what a way to start the day - seeing you and your smiley face. it's been 6+ years since i was sleeved. not to many of us oldies but goodies around. i remember you helping me and soooo many newbies et. al. you were very inspiring and helpful, and we all loved you glad you are back looking for a little accountability,help. we all struggle at times - glad you are back to your roots (btw, did you know that @Alex Brecher had a revision to RnY )very recently) I was at GOAL for a long time - scale has been moving the wrong way past few months!! , gradually am up 11 lbs!!! (confession is good for the sole) lets meet for drinks, i'm buying. WATER of course!!! - see you around the neighborhood WELCOME BACK kathy -
Anyone have a revision?
Music Teacher replied to J_Mkay's topic in Revision Weight Loss Surgery Forums (NEW!)
My situation was similar to yours. I had the sleeve in 2012 and lost at first but then gained it back while having problems with an eroded band. I had the revision on December 18, 2017 and although I was active, ended up in the hospital in January for a week with bilateral pulmonary embolisms. (I noticed I was having problems breathing while hiking in a local state park two days earlier). I am on Elliquis now and doing great. My starting weight was 243 and I am already down to 181.6 after only 4 months. To me, the sleeve is much easier. After the initial recovery and brief stint in the hospital, it has been smooth sailing. I am careful to follow all of the guidelines and hardly ever feel hungry still. Except for my thyroid, all of my medical issues have resolved themselves so I am only taking the Elliquis and thyroid medicine now. (Oh, and ADHD medicine but that's not weight related). I have to admit, I wasn't as excited this time and was a little skeptical that it would work after my struggle with the band. However, I am so happy with the results now. -
Hey everyone!! I'm a little over 3yrs post OP (3/6/15)...wow that seems like a lifetime ago. I've had struggles over the past year and had a slight regain...about 20-25lbs from my lowest. But my concerns centers around GERD. I have to take omeprazole every single day. If I miss even one day...it's quite literally a fiery hell. I know that GERD is a side effect of complication from vsg, but I see a lot of people having revision surgery for it. So my question is...how do you go about that process? Is it self pay? Does ins cover it? If so, what ins do you have...if that's not too personal? I'm not going to lie...I would LOVE to regain my old restriction...but I'd love to get rid of GERD more. So does anyone have any advise out there? Thanks!!
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Less often done is ESG that is Endoscopic Sleeve Gastroplexy. No outward. cuts on your body, they go down your throat and stitch folds in your stomach to reduce its size. Don't remove 3/4 of your stomach like the vertical sleeve does,no pouch made like you have in RnY bypass, some,people swear it is wonderful, indeed I don't hear of people requesting a revision to something else. There is another called a bilio- pancreatic switch, it is the most radical variety of surgery, not too many general or Bari a trip surgeon's do it but there are a few. Least restrictive is the lap band , but it is gradually being,phased out. And recently I've heard something is done with nerve stimulation/ kind of like a pacemaker, it reduces your hunger.😜
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Can’t make a decision
Strivingforbetter replied to consuelo73's topic in Duodenal Switch Surgery Forum
I had the DS in June of 2017 and have lost about 75 pounds. I'm now a size 10-12. I originally went in for the sleeve, but my doctor recommended the DS because he felt I would keep my weight off better with it. The only time I have issues with gas is when I overdo it with the carbs. Otherwise, I'm like any other person out there. Some people do great with the sleeve and don't regain, but I only had one shot with wls, so the idea of revision surgery of a sleeve to a DS wasn't an option for me. I had one chance to get it right and wanted the wls with the best long-term results. I'm still losing. My goal is to get this last 20 pounds off and then maintain my weight. -
Revision bypass surgery post gastroplasty
RickM replied to Candynorvell's topic in Revision Weight Loss Surgery Forums (NEW!)
You might try the revision forum here on BP or on other bariatric sites, as they may reach a more relevant audience. A couple of resources that I found useful when facing a similar prospect are: https://www.facebook.com/SupportGroupForPartialTotalGastrectomyPatients/ https://www.amazon.com/Art-Eating-Without-Stomach-Gastrectomy-ebook/dp/B00NQZRGV2/ref=sr_1_1?s=books&ie=UTF8&qid=1524198227&sr=1-1&keywords=dr+peter+thatcher -
Was anyone an outpatient for surgery?
SIPS in Seattle replied to biakitty's topic in Gastric Sleeve Surgery Forums
I was outpatient for both my lapband then for my revision band to SIPS. Not sure what enhanced recovery is though. But yes to the out patient question. -
Where are all the 50 something bypass patients?
newlady1 replied to choosehope's topic in Gastric Bypass Surgery Forums
Hi Everyone, I had the sleeve surgery in 2015 at 54 and it was unsuccessful. I may have lost 25 pounds and began experiencing heavy GERD and weight gain. I got very discouraged from the lack of weight Loss and the extra weight gain so I've done nothing the past 2 years relating to my weight. I'm currently 5'2 , weight 232 and 42bmi. I'm 57 and in a better mental place and considering a revision to gastric bypass. I am a little worried to go thru this again but I'm tired of the weight. Has anyone been thru this? Sent from my SAMSUNG-SM-G935A using BariatricPal mobile app -
Where are all the 50 something bypass patients?
Candynorvell replied to choosehope's topic in Gastric Bypass Surgery Forums
I am 56 but having a revision from a banded gastroplasty 25 years ago not the new band procedure and was just told best case scenario is he MAY just MAY be able to save the old upper pouch that is still too small to be anything larger than the size of a marble! I CANT EVEN IMAGINE how that works. Anybody????? Thanks -
First Stall - less than 2 weeks after surgery???
Candynorvell replied to nycgirl18's topic in Gastric Bypass Surgery Forums
I am curious as to why gastric sleeve patients are commenting on her dilemma. Aren't they two different procedures and this is specifically for bypass patients or future bypass patients? Just confused as my problem will only be aided by people who have my problem or at least the same procedure. And as a newby I posted my problem and am anxiously awaiting responses significant to my procedure. I can't have the sleeve as I am having a revision done. thanks -
Revision bypass surgery post gastroplasty
Candynorvell posted a topic in Revision Weight Loss Surgery Forums (NEW!)
Can I please talk to anyone out there who has had the revision done from gastroplasty to bypass that has been left with a marble sized stomach? I don't need to hear from anyone that has had the sleeve or anything other than an actual revision that best case scenario leave me a marble sized stomach. How are you eating, what are you eating, how much, how often etc...My Doctor gives this to me as best case scenario and I am shocked as I don't know how life can be sustained with that size of stomach, thanks -
Revision Surgery to a Gastric Bypass
RickM replied to mcetbmb's topic in Revision Weight Loss Surgery Forums (NEW!)
Here is one surgeon's perspective on revisions, though not specifically addressing this particular technique. The general consensus that I have seen regarding the common RNY revision techniques of band over bypass or different means of tightening up the stoma is that they aren't particularly effective, but that they are about the most that can be done without totally revising the RNY to a duodenal switch, which is much more effective but a very complex procedure done by few surgeons. Another thing to recognize is that when you are dealing with a trademark named procedure like Stomaphyx, Lapband, Realize band, etc., is that there is manufactured surgical product involved, with a manufacturer that can provide extensive marketing power in promoting their product, so like with the bands, there tends to be a lot more optimistic over-promotion of the procedure than there is for procedures that don't us a specialized product, like an RNY, VSG or DS. -
Revision bypass surgery post gastroplasty
RickM replied to Candynorvell's topic in Revision Weight Loss Surgery Forums (NEW!)
It can be done, as total gastrectomies are done for cancer and some other extreme gastric morbidities, and what is often done is they make a pouch out of part of the intestine where they join in the esophagus. There is apparently a substantial difference in recovery and adaptation time between a total gastrectomy and a partial gastrectomy, even with a marble sized pouch of stomach tissue - tying the esophagus directly into intestinal tissue seems to be a much bigger deal than taking the stomach tissue at the base of the esophagus and tying that into the intestine. As with any revision, particularly when dealing with potentially odd configurations, I would want to get a second opinion or two, as you aren't dealing with just a straightforward virgin bariatric procedure. A bariatric practice that is associated with a major cancer center would be a good place to start in finding good experience in such abnormal procedures. Good luck in working this out, -
Revision bypass surgery post gastroplasty
Candynorvell posted a topic in Revision Weight Loss Surgery Forums (NEW!)
Hi there, I just had an endoscope procedure to view my stomach. I had the Gastroplasty surgery 25 years ago and am seeking to have the bypass revision done. My Doctor just informed me that there is only about 2-3cm to work with and with best case he could do it leaving my stomach about the size of a marble as opposed to the size of an egg which is the normal size post surgery. Worst case scenario he gets in there and involved and can't get out without removing my stomach. My question is to anyone who has had this revision with the marble sized outcome how can one possibly eat enough to be ok let alone stay alive? He told me to think about it and talk amongst those of you that have done this, surely I am not the only one? Any help, advice would be greatly appreciated as I am at a total loss! Thanks -
Revision Surgery to a Gastric Bypass
mcetbmb posted a topic in Revision Weight Loss Surgery Forums (NEW!)
I had an open Gastric Bypass back in 2001 when my weight was 235lbs. After 1+ years I weighed about 120lbs, but over the years since the surgery, I have gained almost 70 lbs. My current weight is 185lbs+/-. Recently, I read about Revision Surgery for those Gastric Bypass patients who have experienced significant weight gain: StomaphyX revision is a completely endoscopic revision technique[12] used to tighten a stretched gastric pouch using internal sutures or fasteners. It may be used in patients who have had prior Roux-en-Y gastric bypass surgery and have a stretched stomach pouch. Has anyone had Revision Surgery to lose weight post gastric bypass and if so, can you tell me/us about your experience with it? I have an appt with my Surgeon on May 30th so I am hoping I can learn from others before I broach the subject with her. Thank You!
