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In Canada, for these more complex jobs, one doc to look into is Michel Gagner, who I think is in Montreal. I don't know how that works for you on location or on insurance coverage, but he was in on some of the early DS work and does a lot of complex revisions and procedures, so is worth checking out.

Having PCOS, Late onset congenital adrenal hyperplasia, and endometriosis (amongst other things) they were my reasons for pursuing RNY Gastric bypass surgery. I don’t honestly expect my pcos to get better but perhaps just because my situation is a bit different. Long story short I rapidly gained a lot of weight before being diagnosed pcos. When I hit over 215lbs I desperately fought back. I did a combination low carb calorie counting. It did work slow but steady. I was actually down to 124lbs but being chronically ill and disabled. It was hard keeping it down. Even adding healthy foods like vegetables. It kept sliding up. I fell off low carb for a bit, got back on to get my weight back down. Fast forward to not that long ago (my memory can’t say when) my weight did a drastic jump with no change in diet and I frantically tried to get help. My abdomen was swollen as well. And I was careening back to 200 + despite my efforts. Id swear I’ve got the metabolism of a sloth. And can’t exercise to burn calories. I was totally lost and started investigating bariatric surgery. I wasn’t sure it could even happen. So when finally a endocrinologist referred me to Cleveland Clinic. I knew it was all in on RNY or ... give up. I just wanted a chance at getting my weight under control because my body couldn’t Carry the burden of being over 200lbs at 5’ and with many medical conditions. my rate of loss? I keep my calories fairly low. I have stalls that last a few days. But I’m always worried that it won’t keep going down. Or that I’ll never be able to eat normal food or calories. Of course to me normal would be even 800 calories. Which I did before the surgery. It is frustrating. Plus I’m still struggling with a swollen abdomen. I probably didn’t answer anything. For some people just losing weight can help pcos a lot.

Hi! I have Kaiser too. I’m 3 weeks into the 12 week Weigh Loss class. I’m admittedly not learning much of anything new currently but it helps to keep me doing weekly goals. What I’m really looking forward to is the gastric bypass specific class. I get to schedule that in a few weeks. I have so many questions! In the meantime, I’ve been changing my eating habits and exercises four or five days a week. It’s helping get my habits set. Welcome to the forums! I’ve found great information and support here. I hope you do too.

Are you getting the sleeve, bypass or a revision or would you like to talk about anything else? I'm understanding, my friend is getting a revision on the 24th and we've been focusing on other topics for now. These group can be the support you need...

Thank you all for the question and responses, I was thinking the same thing. I did the liver shrinking diet prior to lapband removal, I have lost and at a 40 BMI. I do have co-morbidities as well. I was wondering as well the what if. I still have 4 more visits w/dietitian. How long after removal of lapband did anyone have the revision to GBP? I was told 3 mths and my doctor has said 6mths. I was hoping to have it done before the year is up d/t paying a very very high co-payment for lap-band removal.

If you still have your gallbladder, a large percentage of people that have gastric bypass surgery end up with gallbladder problems due to rapid weight loss. I had lost a lot of weight before and I’m pretty certain that’s what did my gallbladder in. It wasn’t until I had RNY and they took my gallbladder out that they found it was chronic inflammation. I knew I had an ulcer but no one really believed me until I had the endoscopy, but I still question - how do they know if there are ulcers in the remnant stomach. I had them there prior to surgery. And my gut tells me there’s more to this pain. The hard part is keeping after your doctor until you get answers.

This is a tricky one, as the bypass is difficult to revise. The most common things that are done are basically minor tweaks to your existing bypass - either putting a lapband over the pouch, or tightening up the stoma to try to restore some restriction. Neither seems to have a very good record of success. The most successful thing that I have seen is to revise it to a duodenal switch, but that is a very complex procedure, and there are only a handful of surgeons (maybe half a dozen) around the country who can do it. The other thing that is sometimes done, as the DS is too complex for most, is to convert to a distal RNY, which basically moves the pouch much further down the intestinal tract increasing the malabsorption, but that seems to be more trouble prone than the other alternatives.

Has anyone had previously had a rny and gotten a revision? In the last 2 years o got pregnant and have since put back on the weight even if I'm watching what I'm eating. I feel my absorption is back to normal. Sent from my SM-G960W using BariatricPal mobile app

If you are still having pain, then this was just the first step in tracking it down - abdominal pain is not necessarily from an ulcer. There can also be an ulcer in the remnant stomach which won't show in a normal endoscopy (though the "typical" place for one in a bypass is at the anastomosis between the pouch and intestine,) Pain is not normal and is telling you something. Be a squeaky wheel (and a pain to the docs) until they figure it out. Good luck....

I will be having revision in Summerville in September. Good luck!!!!

I had my sleeve surgery July 8, 2019 and I am off my blood pressure meds already. My dr stopped it last Monday because my blood pressure is perfect without it now. My A1c went to a 7, so technically I was diagnosed with diabetes right before surgery. I was told this would most likely resolve diabetes. My Mother had diabetes really bad so this was a big push for me to stop it in its tracks. My health issues is the reason I had my surgery. I know when they did the endoscopy they did a test for GERD and if you had it they didn’t do the sleeve, they do the bypass. You are young, get started now and enjoy your life. Talk to your surgeon and don’t worry it will all work out.

Most any surgery that you can contemplate, in addition to the basic risks associated with surgery, hospitals and anesthesia, will have some risk of side effects that may be less than desirable, however we take those risks in order to correct a problem that we have created by injury, disease or genetics, with the intent that the result will be much better than what we started with. The various bariatric procedures have different predispositions to consider - conditions that happen more commonly than in the general population. The VSG is predisposed to GERD as the stomach volume is reduced much more than its' acid producing potential, and while usually the body adjusts and corrects the problem, sometimes it doesn't completely. Similarly, the RNY is predisposed to marginal ulcers (typically around the anastomosis) because the part of intestine to which the stomach pouch is attached is not resistant to the stomach acid like the duodenum is (the part of intestine immediately below the stomach outlet, which is bypassed along with the remnant stomach.) Likewise, it is also predisposed to dumping and reactive hypoglycemia owing to more rapid stomach emptying due to the lack of pyloric valve. Usually, these problems don't hit most patients, or don't persist if they do, but sometimes they are long term problems. These are things to consider ahead of time, particularly if one has any relevant pre-existing condition. Another consideration is that the VSG is fairly easy to revise if it does run into a problem that can't be resolved otherwise, while the RNY is difficult to revise or reverse. Another point to consider is that while the sleeve leaves behind a relatively "normal" anatomy, the bypass leaves a blind stomach and upper intestine which is more difficult to examine endoscopically, so some problems may not be diagnosed until they are more advanced and symptomatic. For instance, if one is subject to stomach polyps, that is a pre-cancerous condition that should be monitored, but is difficult to do after a bypass. An pre-op endoscopy is a good idea to understand what is happening inside you, even if your program doesn't require one. On the diabetes front, they both do well, typically seeing 75-85% remission rates (remission is what it is, rather than a "cure" - it can come back, particularly with some weight regain) though the bypass is generally considered to be marginally better. The best results come from the Duodenal Switch which typically shows remission rates in the 98-99% range, but that is a more complex procedure that few surgeons offer. However, if the diabetes fails to go into remission, or comes back, after a VSG, a revision to the DS is straightforward (as the DS uses the VSG as its basis) while revising an RNY to a DS is very complicated, which only a handful of surgeons are able to perform. So, while the VSG may not be quite as good as the RNY in that respect, it has a much more viable "plan B".

Welcome back, though I’ve been gone a while and only just found out you had a surgery! Did something happen to prompt the revision?

Your pre-op endoscope is a very important piece of information. If there is already gastritis, esophagitis, or any any indication of Barrett's, all of which would point to a problem with reflux, then bypass may be a better option. I actually had a Barrett's polyp - a pre-cancerous lesion from chronic GERD. (I never knew my GERD was that bad, but the Barretts and my vocal hoarseness said otherwise.) Anyway, my GERD is completely gone after bypass. I get another endoscope in a few months to check out the situation. I am so glad I went this route. All being said, your endoscope results are important.

did I say bypass patients never develop GERD? I also did not say it ALWAYS improves or cures GERD. I said it USUALLY does.

Usually doesn't mean always. It also doesn't mean that gastric bypass patients never develop GERD. Also how can you claim bypass patients never develop GERD? That's a bit like claiming thin people can never develop type 2 diabetes. Their risk is lower but it's not zero. Interesting read on curing GERD with bypass, btw: https://www.medscape.com/viewarticle/913919 (which is way less optimistic than the 80% I was told a few years back).

the second part of this isn't true - bypass usually improves or even cures GERD. In fact, many sleevers who develop severe GERD (and certainly not all will - but a significant minority) revise to bypass for that reason.

yes - GERD is a possible complication of the sleeve. That's not to say it's inevitable, but it is a risk and therefore, it's not recommended for people who already have pre-existing GERD. Gastric bypass often improves or even cures GERD.

Look into the bypass, one of the best decision I ever made

I had my revision sleeve done 7/3 and I’m in a stand still for weight loss right now. I haven’t lost a pound since I started the purée stage. Anyone else have the problem of a stall? Mine is a week now with no weight loss

Did you and your surgeon ever consider gastric bypass? I think it is possible to develop GERD after sleeve. Bypasd totally eliminated my diabetes and I have halved my high blood pressure medication. I expect to be off that medication soon. I don't believe GERD increases after bypass because there is almost no stomach acid in the pouch, and bypass is a low pressure system, while sleeve is high pressure. I certainly Don't mean to confuse you further. I just wanted to give you an idea of my success with bypass if you hadn't considered it. Of course the decision is totally between you and your surgeon, and I'm sure many people have the sleeve and Don't develop GERD. Good luck with your surgery! Sent from my SM-N960U using BariatricPal mobile app

It doesn't sound stupid at all and it makes a lot of sense. It's important to consider these things before making a decision and not be lured into getting a specific procedure because e. g. your surgeon has a personal preference for it for whatever reason or because it seems to be "the procedure to get" right now or because it promises the "best weight loss possible". Yes, it's absolutely possible. However, this seems to be possible after getting a bypass as well. Unfortunately there are many things to consider before choosing a procedure. GERD, malabsorption, possible food sensitivities...

Alright so, I'm a 29 year old female, I suffer from High Blood Pressure at this age (so upsetting), Diabetes. I have gone through the 6 month program at my clinic and I'm approved for surgery. My A1c is above 8 right now, so I'm just working on getting that lowered to ~8 at my next blood test, and I'm good to go to get sleeved. Now call me an idiot or a coward, but I am scared to get GERD after the surgery. I know, it sounds so stupid, for Christ's sake I have high blood pressure and Diabetes already, but I feel like if I go through something so drastic as to cut out 70% of my stomach, I just don't want to accumulate other diseases like GERD and still be bound to take medications everyday for other diseases acquired - does that make sense to anyone? I want to get this procedure done (And let me tell you, I am soo scared still to do it, but I know it is the best option for me considering my health status), I just feel like let's say I do get GERD, there is all this talk about sleevers down the line getting revisions, I don't wanna be a non-normal person getting surgeries and other procedures done all the time to feel normal. What advice can anyone give me to relieve my nerves? As of right now, I do sometimes get heart burn if I eat something spicy - i don't take any medications for it. I would say it happens 2-3 times a month. Is there a possibility I will get chronic GERD after surgery and I will need a revision done later on in life? Any advice would help me out!!! I'm a confused mess right now....

I scoured the forum for tips from people and came up with a revised list of things to try. I'll be adding to this and updating as time goes on but this is a lot to go on and gives me hope as I start my Pureed diet phase this weekend. Enjoy ! 1. Eggface Ricotta Bake (google it) 2. Green bean casserole (bariatric style) with canned chicken 3. Tuna casserole (bariatric style) with green Beans instead of peas 4. Mexican beef with cheese or beans with cheese (too carby for me--made me hungry too soon after eating) 5. Broccoli, spinach or cauliflower pureed with light cream cheese, lemon juice, s/p/g (steam the crap out of it first) 6. Smashed cauliflower with bacon and green onions (put in a food processor) 7. Any Soup or chili made bariatric style 8. Fish in foil pouches with lemon and spices/herbs. 9. zucchini sauteed with onion, tomatoes and herbs and pureed--can add any kind of lean meat.< /span> 10. yogurt/cottage cheese blends with berries. 11. Pureed black Beans with a bit of cheese 12. Yellow Split Pea Soup puree 13. Buffalo chicken Dip puree 14. Broccoli cheese Soup puree 15. Pureed Chicken Salad 16. 4 Cheese mashed cauliflower 17. Hummus - Roasted Red Pepper by Sabra 18. Eggface Cottage Cheese Bake (sub out cottage cheese for ricotta + parmesan + ps mozza shreds + low carb marinara) 19. Cottage cheese flavored with taco seasoning 20. Progresso chicken enchilada soup with mashed cauliflower & ground chicken pureed 21. Scrambled egg with a little milk and topped with a teaspoon of salsa 22. Pureed Italian sausage with a little green and red pepper with Spagetti sauce 23. Applesause (unsweetened) with a sprinkle of cinnamon 24. Pureed Lentil soup with shredded cheese 25. Shiitake mushroom pizza with ground chicken and pizza sauce and cheese on top - all put in blender. Sounds weird but really good https://www.cookinglight.com/recipes/loaded-cauliflower-soup https://www.food.com/recipe/shellys-baked-ricotta-324036

I scoured the forum for tips from people and came up with a revised list of things to try. I'll be adding to this and updating as time goes on but this is a lot to go on and gives me hope as I start my Pureed diet phase this weekend. Enjoy ! 1. Eggface Ricotta Bake (google it) 2. Green bean casserole (bariatric style) with canned chicken 3. Tuna casserole (bariatric style) with green Beans instead of peas 4. Mexican beef with cheese or beans with cheese (too carby for me--made me hungry too soon after eating) 5. Broccoli, spinach or cauliflower pureed with light cream cheese, lemon juice, s/p/g (steam the crap out of it first) 6. Smashed cauliflower with bacon and green onions (put in a food processor) 7. Any Soup or chili made bariatric style 8. Fish in foil pouches with lemon and spices/herbs. 9. zucchini sauteed with onion, tomatoes and herbs and pureed--can add any kind of lean meat.< /span> 10. yogurt/cottage cheese blends with berries. 11. Pureed black Beans with a bit of cheese 12. Yellow Split Pea Soup puree 13. Buffalo chicken Dip puree 14. Broccoli cheese Soup puree 15. Pureed Chicken Salad 16. 4 Cheese mashed cauliflower 17. Hummus - Roasted Red Pepper by Sabra 18. Eggface Cottage Cheese Bake (sub out cottage cheese for ricotta + parmesan + ps mozza shreds + low carb marinara) 19. Cottage cheese flavored with taco seasoning 20. Progresso chicken enchilada soup with mashed cauliflower & ground chicken pureed 21. Scrambled egg with a little milk and topped with a teaspoon of salsa 22. Pureed Italian sausage with a little green and red pepper with Spagetti sauce 23. Applesause (unsweetened) with a sprinkle of cinnamon 24. Pureed Lentil soup with shredded cheese 25. Shiitake mushroom pizza with ground chicken and pizza sauce and cheese on top - all put in blender. Sounds weird but really good https://www.cookinglight.com/recipes/loaded-cauliflower-soup https://www.food.com/recipe/shellys-baked-ricotta-324036