RNY reversal and revision to the Sleeve

snowball24life
on 11/21/15 10:54 am - NY
RNY on 05/21/13

I had the RNY on May 21, 2013. I lost 160 pounds, and felt and looked healthier than I ever have. After the first year, I started suffering from severe hypoglycemia, and between my Endocrinologist and Bariatric Surgeon, we changed my diet, tried medications, changed my routine, etc, to no avail, and even gained 30 pounds back because of the changes made in my diet. 

So, the two doctors decided yesterday that on December 14th, I will be having my RNY reversed, and then have the sleeve done (all at once) to try and combat the hypoglycemia. Even then I was told I may need to have part of my pancreas removed, which could make me a diabetic again. 

I'm not going to lie and say I'm not nervous. As my surgeon said he will be attempting the surgery laparoscopic, but because of prior abdominal surgeries (RNY, Peterson Hernia repair, 2 c-sections) he may have to cut me open which would involve a longer recoup time. I'm also afraid of any more weight gain as I NEVER want to be 400 pounds again, so I know I still need to work the program for life. 

Has anyone had a reversal of the RNY to a revision to the sleeve, and if so, how was the maintenance phase, did it cause or correct sugar/insulin issues, and how difficult was it to retrain your mind and body from the RNY to the sleeve? Thank you for all and any input. 

    

Marianne H.
on 11/29/15 6:51 pm - Alanson, MI
Revision on 03/31/15

I have.  I underwent the same procedure on 3/31/15. I suffered a leak.  This was repaired postoperative day 1. I did five for a while but then developed strictures.  I've had 6 egd balloon dilation sessions since June. I also now have gastroparesis and severe gerd. This is rough either way.  I still have low blood sugars if I take in too much sugar at once too.  I'm looking at being reversed back to a RNY. The surgeon tells me this is my only option.  

Bibo
on 12/20/15 6:49 pm

So this is my question....Is all that worth it?  My doc is pushing a reversal on me for hypoglycemia. I am NOT wanting the diabetes/asthma cancer mobility issues sleep apnea etc to come back again...I topped out at 500 plus pounds.....I am thinking I will leave well enough alone and deal with the occasional low blood sugar rather than try to reconvince the doctor about reversal and then redoing another RNY later. I have medicare also so I am pretty sure that there will be no second shot at a second RNY. I have had many balloon dilations already too. Feeling pretty frustrated. Also I need a colostomy cause my colon has basically stopped working. Don't really want weight regain on top of all of it.  I also had ulcers after the RNY....don't want another one. I am really thinking just leave well enough alone at this point, even though they might have the technology to do the reversal, is the quality of life doing all those surgeries really worth it?

    

hipswishingvinegarball
on 12/20/15 10:55 pm

It would make absolutely zero sense to get RNY, then reversed, then get another RNY. Not only that, but that sounds like insurance would fight it for good reason. 

I think both the DS and sleeve are better options for numerous reasons, but the problem is, once you have RNY, getting the sleeve or DS just became much more complicated, and actually not within the skill set of most surgeons. 

If it were me, I'd think I'd just try to make the best of the RNY once I had it. Just a mention, but I suspect you know, avoid all NSAIDs with RNY, or you risk ulcers in places that cant be treated, like the remnant stomach.

If by chance you do consider a revision, I would not even consider any surgeon other than Kesheshian in CA. Good luck. 

Bibo
on 12/20/15 11:00 pm

Yeah, I don't want to get it reversed. My surgeon just went to some workshop and wants a Guinea pig for the latest thing in surgical "saves"....im saying screw that ......I was told three years ago that this was a known risk and nothing could be done about it, period. I will wait a few years and see if the pharmaceutical industry has a solution for it that doesn't involve me having major surgery. Might go consult with that doc you mentioned just to get my surgeon of my a$$ though...

    

MsBatt
on 12/1/15 3:38 pm

If you're seriously worried about regain---and since you once weighed 400 pounds, it's a very rreal possibility---you might want to look into getting a complete Duodenal Switch, not just a Sleeve. The DS has a Sleeved stomach, plus an intestinal bypass similar to, but more effective than, that of the RNY. The DS has the very best long-term, maiintained weight-loss stats, especially for those of us who've had a BMI greater than 50.

Bibo
on 12/23/15 8:57 pm

I asked about that....I got the ulcer cause my skin is very fragile...I have ehlers danlos, which was not diagnosed until I lost all the weight. My body doesn't make collagen, so any surgical thing is very risky. I really can't believe that my surgeon even mentioned revering it, but my blood sugars have been in the 30 to 40 range and I am incredibly strict with my diet. I have noticed that my sugars drop when I am stressed. Thats really the only correlation  I heard that the hypoglycemia could be treated with a jtube?  Not a big fan of more surgery here. Interested in quality of life

    

hipswishingvinegarball
on 12/24/15 10:16 am

Reactive hypoglycemia is VERY common the further out you get after RNY, which is one of the reasons I like sleeve or DS, because retaining your pyloric valve helps. Surgery does carry risks, especially revisions, which is why I think there are only 1 or 2 surgeons I'd even talk to about it. 

You mentioned above your surgeon doing something experimental? Do you know if he calls it a loop or sips? I don't think I'd be signing the dotted line for being a guinea pig either. We do this just trying to get healthy, not prolong the misery. 

Marianne H.
on 12/27/15 10:41 am - Alanson, MI
Revision on 03/31/15

There is no guarantee that putting your pyloric valve back into play will fix this.  Don't do it. I am sick enough that I wouldn't recommend anyone do this.  I've had a PICC line with TPN . I have significant gastroparesis and I need more surgery.  My surgeon also tells me that there likely is damage to the beta cells in the pancreas when RNY causes hypoglycemia.  That would explain why I dextrose causes me to have low blood sugars too.  More surgery isn't always the answer! 

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