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Reluctant VSG>RNY Reviser with Lots of Questions



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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.

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Sorry for your struggles and the Barrett's! You are gonna feel SO much better!!!

@GreenTealael Just went through this very very successfully and has been able to mostly maintain her weight! I know she will have good stuff to tell you!!

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I have Barretts as well, and a precancerous Barretts polyp to boot. RNY was the only viable option. Best thing I ever did. No more GERD at all. I will have another endo in a couple of months to check the status of things.

For me, no sugar was a no brainer. I didn't want to risk dumping, and I just feel so much better without it. No great sacrifice there. Alcohol was also a no brainer, as is coffee and soda. I LOVED my coffee, but I am not going to do anything that will risk the anastomosis or cause damage to the pouch or esophagus. I am a GI nurse and I have seen first hand the amazing damage that alcohol can do the WLS tissues. It's pretty horrifying and for me, not a risk I'm willing to take. With a history of tissue changes (Barretts), I'm keeping it clean for the long haul.

Best wishes to you.

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Hi Johnny, we're here to help. I was sleeved in Feb. 2018, then revised to RnY in Oct. 2018 due to reflux. I think it was worth it.

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?

I took 2 weeks to return to a desk job. Pretty much the same as the sleeve and similar pain level.

2. How long before you could work out again? I had other complications that skewed this one, so I won't comment.

3. Did you lose more weight than you wanted? No, I still had about 20# to goal and it took me 4-5 months to get there.

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

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? I have less restriction with my RnY than I did with the sleeve. I am eating 1-2 cup meals now (10 months out).

6. Are bowel movements normal at some point? No problems, in general.

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 enjoy the occasional 1-2 glasses of wine. I can't handle carbonation, though.

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5 hours ago, JohnnyMadison said:

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?

Surprisingly not much pain for me and i was back to normal fairly quickly compared to my VSG but 2 weeks is a good plan!

2. How long before you could work out again?

I got myself up to walk 1 hour after I was brought to recovery, I mostly walk for exercise

3. Did you lose more weight than you wanted?

I was at goal and had been maintaining for about 10 months prior to surgery. I have been mostly maintaining since surgery mainly because I know exactly how to stop weightloss ... Ahem Peanut Butter 😂

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

Resolved immediately, like while i was still in the hospital

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?

This will be trail and error for me as well. I definitely scope out bathrooms where ever I go.

There things I currently no longer tolerate, (none are staples in my diet so im good) but time will tell how it goes. I'm ONLY about 1.5 months post op so no huge revelations from me.

I didn't get a fullness cue from VSG or from RNY until about 10 mins after I stop eating so I mostly stick to portion sizes for my stage. I can handle fluids like before so my hydration levels are not a problem

6. Are bowel movements normal at some point?

Pretty much the same, smells the same, look slightly paler (TMI ... I know) I do have to stay ahead of constipation. Laxatives are usually prescribed (osmotic, stimulant and enemas) if there's issues.

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 don't drink, sorry I'm no help there

I'm very newly revised so im curious to hear others experiences as well

Good Luck 💜

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I'm not a revision so some of this I can't really answer, but as far as what you can eat, I can eat pretty much anything at four years out. I can't eat a ton of fat or sugar at one sitting, though, or I'll feel like crap -- but then again, we're not supposed to be eating that way *anyway*, so...

btw - I went through UW as well

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

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