I had RNY in 1990. Back then RNY surgery involved stapling between pouch and stomach, not separation. It was open surgery and I was in the hospital for 7 days. I had no pre-op or post-op nutritional guidance. I was handed a 1-page low-cal diet and told not to throw up. Two follow visits post-surgery were to check the incision and I was then left to my own devices. I learned on my own to take Vitamin and mineral supplements; no one told me. I lost about 75 lbs from a high weight of 319, stopped losing after about six months, but kept the weight off for about five years before starting to gain it all back again.

For the past 20 years, I've yoyo-ed with countless diets and food plans but always return to that same high setpoint. I'm now 73 years old and am going to give it another shot. My knees and hips are shot, I've got a pacemaker, and I figure I'll die within a few years if I can't lose all this excess weight.

I first learned about revision surgery about a year ago, just before COVID hit. This spring I followed up with a hospital bariatric clinic about 2 hours from my home. I've been on a liver-reducing diet for three months. I had a barium swallow a couple of weeks ago that revealed that the staples had given way and there was a fistula between the pouch and stomach, which explains why I stopped losing weight from the RNY. I had an endoscopy today and had a conversation with the surgeon who told me that the leak occurred because of peristalsis of my stomach, not (as I thought) because I ruined it due to up-chucking too often. The new surgical methods are much improved and there is extensive pre-op and post-op guidance and follow-up.

I will have my psych evaluation in two weeks. I'm within 2 pounds of my prescribed pre-op diet, but don't have a surgery date yet for the revision.

I do not want to fail again, so I will probably seek therapy for food addiction even if it is not recommended during the psych evaluation.

Thanks Sunnyway! I will try again and screenshot your progress to her. I wish you only the best!

Update: My surgeon asked for an abdominal CT (I assume to see what mess, if any, my prior WLS surgeries caused), which has been completed. Because my last two EKGs had some irregularities and because I have a pacemaker, he also wanted a cardiology evaluation. The cardiologies wants me to have a chemical stress test and an updated echocardiogram. Office visited completed, and I have to go to the hospital 90 miles away for the tests, perhaps in the next week or so. I am very happy with how thorough the surgeon and cardiologist are being, in stark contrast with my prior WLS surgeons.

If the cardiologist approves the surgery, the paperwork will go to Medicare. When Medicare approves the revision (apparently a slam-dunk with my comorbidities), I will finally get a surgery date.

I've been stalled, going up and down the same 2-4 lbs for since early September, reinforcing why I need this surgery.

Also, I finally got a call-back from the local psychologist-dietitian on whose waiting list I've been on since July. I'll hopefully get an appointment shortly. I did have an evaluation by the clinic's psychiatrist and a tele-visit consultation with another psychologist (who didn't think I needed therapy), but this one is local and I hope can help me develop coping strategies when the cravings appear. They have been an issue for the past few months and will be again after the surgery honeymoon period ends. I know from experience that I am going to need help to avoid regaining.