July2004

Apollo Overstitch - Endoscopic Revision

26 posts in this topic

Has anyone had an endoscopic revision, particularly the Apollo Apollo Overstitch?

I had RNY in 2004 (354 lbs) and got down to 215 lbs 2.5 years later. It's been an upwards climb since then (286 lbs). My insurance won't cover a revision because I have lost more than 50% of my excess weight at two years post-op (tried getting band over bypass). I know that Mexico is an affordable option, but because the complication rates are higher with a revision, I'm leery about going through that, particularly in a foreign country.

I recently found a surgeon who does the endoscopic revision at an acceptable self-pay price. I've been through the diagnostic testing, and my EGD shows my pouch is still in good shape but my stoma is 5cm...5 times what it should be! I'm thinking that by making my stoma smaller, I will have an easier time getting and remaining full on healthy foods. Right now, heavy carbs is the only thing that keeps me from always being hungry!

I am not looking for a miracle, and I know it will be a lot of hard work on my part. I am realistically hoping to reach 215 lbs again, anything else would be a bonus. Does anyone have any experience at all with this? I've read the studies, and I see a lot of negative comments from people who never had it done...I am looking for real-life experiences, good or bad...just the truth.

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Heavy carbs seems like the LAST thing you would want to be eating.  Carbs generally make you hungry, not full.

 

I assume you have tried using lots of protein instead.

 

Good luck on your situation.

GAviv likes this

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Unfortunately, with a stoma my size, most foods gush (surgeon's word) straight through into my small intestine, never hanging around in my stomach. Protein foods leave me hungry...sticky foods like bread and pasta fill me up faster because they gum up the stoma. I can eat healthy and always be hungry, or I can eat crappy but not be hungry. I'm hoping a stoma revision will be able to reverse that...

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Any update?

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Bambinari, I am scheduled for Jan 12. Today is the first day of a week on a clear liquid diet. I have pre-ops tomorrow, just an EKG and some lab work.

The surgeon calls for a week of clear liquids to mentally prepare for after the revision. So far today, the only slip I've had is a small amount of beef jerky and one tablespoon of cottage cheese. Personally, I think a week is a bit drastic for someone who has everything gush out of their pouch, but whatever. At least my liver will be shrunken should there be a complication that requires opening me up!

I will update after surgery.

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Thanks for the update!  I found my insurance will cover this, but I have to have been "compliant" with the eating and exercise.  I would have been compliant except I've been hungry all the time!!!!

 

Is yours self-pay or is the fact that you are basically a tube all the way through, covering it?

 

I hope you go through it all well!!!!

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Self-pay. At two years out, I lost over 50% excess weight, and that is more than insurance allows for revision. They will cover mechanical failure, but a stretched stoma does not qualify. The nail in the coffin is that they consider an endoscopic revision investigational/experimental.

I figure if this doesn't work out, I will start saving my money and hope for an insurance miracle to revise to a DS. I'm just not really liking the high rate of complications, so I'm going less invasive first.

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My stoma is pretty wide now I have barely any restriction and my Dr. mentioned a procedure like this but first he wanted me to try   working with the team of Dr.s  to get off the excess weight first. At his office I am seeing him, nutritionist, exercise guy, and counselor he also put me on a appetite suppressant My currant weight is only 172 but i did get down to 162 so the scale was going up. He said he wanted to to do this stuff first before we talk about another procedure because 1 yr ago he did put a Silastic ring  on my bypass but food was getting stuck in the ring twice they had to go in and  remove food.  So in June they removed the ring

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nsw, that's great that you have a team of supportive professionals to help you! Your weight gain is relatively minimal (and I know, it sucks whether it's one pound or 100!), so hopefully you will find success with non-surgical means.

Update: pre-ops today. None of the nurses or anesthesiologist could figure out why I even needed the testing done. I didn't have it before my endoscopy two weeks ago so they figured it didn't make sense this time. I assume that since I'm self-pay, the doctor was going to give me my money's worth ($4900, incidentally). EKG computer "diagnosed" a borderline ecg with possible left atrium enlargement, but the nurse and anesthesiologist said that it looked fine and went on to explain how to "translate" the lines. Since I don't have shortness of breath, tightness in my chest, or even a high dose of blood pressure medicine, I'm not going to worry about it until AFTER the cardiologist tells me I should worry.

Spunkycat likes this

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Update: Surgery tomorrow. Survived the clear liquid diet, though I admit not being 100% compliant. I did NOT eat any junk food or carbs, but with a stoma my size I was hungry all the time and started craving protein. On the upside, I have lost 8lbs, have more energy, feel more alert, and haven't had any headaches (been getting them a lot lately). I may never return to solids again! Okay, not really...

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Update: Surgery went well. Surgeon says my stoma is now less than 10mm with only two sutures needed.

General anesthesia is awful, definitely not the same stuff they use for simple procedures like a regular endoscopy. Woke up puking and was groggy all night. I was able to tolerate liquids, though I only had about 2 oz last night.

Today (first day out), I returned to work. I'm kind of weak and shaky, like a newborn colt, but I have a desk job, so it's not been a big issue. I've only taken in about 10 oz of liquid (it's now noon). I'm nervous about overdoing it, and it seems like very sip I take fills me up more and more to the point where I feel like I've eaten a whole pizza. So obviously, I haven't been hungry. Surgeon said that it might be a few days for the swelling to go down enough for me to get in all the liquids. Throat still hurts and I keep coughing up "stuff."

This had SOOOO better work because I do NOT want to go through general anesthesia again unless it's an emergency!

I think I will just keep updating this thread periodically in case there is ever anyone who is looking at the same procedure. It's such a new and uncommon procedure that there's not a whole lot out there just yet.

Brooke Danielle likes this

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Please keep me posted because I am very interested in this for the future. I know my stoma is very wide.  Thanks

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Update: The anesthesia finally wore off yesterday afternoon. I recommend taking at least 48 hours off of work for this surgery, though I did go back after 24. My throat stopped hurting this morning, but now I'm 3 days "backed up," if you catch my drift. There has been no shift on the scale since surgery, but I'm not concerned. I'm only taking in MAYBE 300 calories a day and half of that is an Isopure protein water (which is chalky but doesn't taste too horrible).

As far as liquids go, they are going in a little at a time. Nowhere near the 64oz I'm supposed to get in. I know the liquids are going down because they aren't coming back up, but I'm in a perpetual state of fullness and it can be uncomfortable. Sometimes I do feel hunger twangs (after all, my stomach still works), but one or two sips and I'm full again. With jello, I've discovered that 2 oz is all I can handle. Of course, I'm realistic and I know that eventually I'll be able to take in my actual pouch allowance. But for now, I'll take advantage of that 2 oz limit. I admit that I have licked the seasoning off of exactly two Doritos and one cracker. I have also had maybe a 1/2 tsp of peanut butter and 1/2 tsp of cream cheese, thoroughly melted down to nothing before I swallowed. I've been really careful about not having anything solid head through my stoma, though I was told if my meds were smaller than an m&m I could take them without crushing.

I know it's a lot of detail, but I like to be thorough because that's what I was looking for. I hate to leave any stone unturned...

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Update: 1 week post-op, down exactly 2 lbs since the day of surgery. The swelling in my stoma seems to be gone now as the liquids aren't sticking around for long anymore. Thankfully, I'm on full liquids now which includes pudding and yogurt. 1 container of Greek Yogurt was plenty, didn't leave me stuffed but I wasn't hungry. I slipped up and ate a few bites of soft food (chicken salad), but I'm committed to sticking with the liquids because I don't want to disrupt the sutures.

I am hopeful that once I'm done with soups (one more week, can't wait!), the scale will cooperate a little better. My body is a sponge, holds onto excess water like crazy. It's not unusual to see an 8 pound drop when I cut back on salt, and soups are LOADED with sodium, so I believe that eventually I will be rewarded with a bigger loss at some point. i am encouraged because these two pounds means that my 11 from pre-op are not coming back.

Moving forward....

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Update: 1 month post-op, down 6 lbs since the day of surgery. I would have loved to have lost 10 lbs the first month, but I am quite happy with the loss.

 

The surgeon wants me to eat just 800 calories a day. I think he's nuts. That's not to say that I am not trying to stay within the 800 calories, but it is difficult. We had to put one of our dogs down last week, so being particularly mindful hasn't been easy. Learning to eat for maximum effectiveness has been trial and error. I find that dry, solid proteins (deli chicken, chicken breast) make me absolutely stuffed after 2 or 3 ounces, while 4 ounces of ground been or smoked turkey have me looking for something else to eat. I don't usually eat bread any more, but the other day, I did have a sandwich (not a big one, mind you) and I ended up throwing up. My calorie intake falls between 800 and 1200 most days, though there were a couple of days that I might have reached 1500. For exercise, I'm using a stationary bike but once the weather warms up, I will be walking outside.

 

I know that I have a long road ahead of me, but as long as there is progress, I'm not going to beat myself up. I have the right tools to make this work, and it is completely up to me to take advantage of them.

Bass359 and Brooke Danielle like this

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I just discovered this thread and have found it utterly fascinating. Thanks so much for sharing your experience AND for the updates:)

 

It sounds like the Overstitch is working as it should and you are doing well. That's great! And the recovery certainly appears to be much easier than a "revision." 

 

I know you mentioned you find yourself "stuffed" from dense proteins (that's terrific!) but do you find that you stay full quite a while? Has your general hunger been reduced? I am so happy that this seems to be working for you and am looking forward to future updates:)

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Bug, I do stay full and rarely go looking for a snack. I get physically hungry around meal times, but I won't deny that head hunger hits me in the evening. I still haven't completely recovered from my pet sorrow and now my husband has brought in a very large, very energetic puppy that stresses me out and makes me agitated with him (husband). This was NOT what I needed so early in my second chance, there's still so much head work I have to do...

Bass359 likes this

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Good luck

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Best to you as you devote time to yourself! You deserve it! We all deserve to devote time for ourselves!

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Update: 2 months post-op (yesterday), 11 lbs down

I am still making progress, even if it's not the spectacular progress of a virgin surgery. I feel that I have taken control of my eating habits, though I am still working on the exercise part of the equation. Sweets make me sick (like they did initially), grease turns my stomach, and all things turkey are my go-tos. Turkey sausage, ground turkey, turkey brats...

In December I was 295. Today, I am 269. Slow, yes. Frustrating, sometimes. Emotionally tough, not so much any more. My sister had the sleeve 12/8/14, and she is losing fast. She's almost to my lowest point (she didn't start out as high though). I'm happy for her but mad at myself for being here again. Sure, I mechanicly broke, but still...I know what my sister does has no affect on my progress, so I continue to move forward and remain happy with my choice of revision.

Edited by July2004

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Update: 4 months post-op

The elephant in the room: What does the scale say? 267, though I saw 264 a few weeks ago. I have really been struggling with my addiction to food. I could use a therapist, but it's not in my budget. I've been working hard to recognize the feeling of fullness (turns out being full is NOT when the top of my stomach is stuffed which is how I typically define being full). I've also been re-tooling my eating patterns. That is, instead of eating my three meals and no snacks (which I ultimately end up with anyway), I'm taking my meals and separating out a snack-size portion to spread the calories out and hopefully eliminating the desire for an additional snack. I've been exercising pretty regularly, trying to work up to walk a 5k. I'm up to two miles when I walk outside, but on the treadmill I'm worn out after 30 minutes. I joined a gym, so I'm also adding a little bit of resistance training (very little, after about 3 sets of arms, I'm weak and ready to puke).

My husband will be having the sleeve done in 2 weeks. Now that I'll FINALLY have his full support, I'm hoping this will be easier. I do tease him though, that on the second or third day of his clear liquids I'm brining home a pizza. Serves him right! Maybe he'll finally understand how difficult my struggle has been these past 11 years as I tried to succeed only to be served up temptation. I won't actually do that to him, but it's nice to think about.

My sister is just 4 pounds from onederland, a place I never got before things went all wrong for me. She looks good and I'm coming to terms with her success. My mom recently had the sleeve done (revision from band) and is only 7 lbs from my lowest point. I'm glad she's doing well. At 64 years old, she has struggled since she was a toddler (and I've seen the pictures!). My other sister will be having the sleeve in August. I will probably wind up being the lone fatty in the family...until years later when I FINALLY reach the end of my journey. I'm thinking, though, that this is going to be a very long trip!

I still don't regret the revision. The Overstitch has done what it's supposed to. My pouch is still (and was pre-revision) small, and my enlarged stoma is still the size of an m&m. Regardless of revision type, I would still struggle with addiction and that is something I need to work on. If I had one piece of advice for anyone seeking a revision, it would be to make sure you fix the head BEFORE you fix the mechanics (unless, of course, there are serious medical issues). There's no point in fixing something that's broken if you're just going to let it collect dust.

WendyH and Brooke Danielle like this

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Hi all. I've hug ad this procedure twice. First time in December 2014 on my stoma alone and just had my pouch done on July 1st. Still on pureed though I did cheat today ( which is a big no no with this procedure). I do feel some restriction but nothing like my original surgery. If you're expecting results to be the same as originally, you will be disappointed. Im down 10 lbs but I'm sure if I go back to old habits it will be short lived. Work hard to get to hoal. This P procedure alone won't do it. Also it is. Very easy to tear the sutures by overeating so be careful. Good luck! :)

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Update: 4 months post-op

The elephant in the room: What does the scale say? 267, though I saw 264 a few weeks ago. I have really been struggling with my addiction to food. I could use a therapist, but it's not in my budget. I've been working hard to recognize the feeling of fullness (turns out being full is NOT when the top of my stomach is stuffed which is how I typically define being full). I've also been re-tooling my eating patterns. That is, instead of eating my three meals and no snacks (which I ultimately end up with anyway), I'm taking my meals and separating out a snack-size portion to spread the calories out and hopefully eliminating the desire for an additional snack. I've been exercising pretty regularly, trying to work up to walk a 5k. I'm up to two miles when I walk outside, but on the treadmill I'm worn out after 30 minutes. I joined a gym, so I'm also adding a little bit of resistance training (very little, after about 3 sets of arms, I'm weak and ready to puke).

My husband will be having the sleeve done in 2 weeks. Now that I'll FINALLY have his full support, I'm hoping this will be easier. I do tease him though, that on the second or third day of his clear liquids I'm brining home a pizza. Serves him right! Maybe he'll finally understand how difficult my struggle has been these past 11 years as I tried to succeed only to be served up temptation. I won't actually do that to him, but it's nice to think about.

My sister is just 4 pounds from onederland, a place I never got before things went all wrong for me. She looks good and I'm coming to terms with her success. My mom recently had the sleeve done (revision from band) and is only 7 lbs from my lowest point. I'm glad she's doing well. At 64 years old, she has struggled since she was a toddler (and I've seen the pictures!). My other sister will be having the sleeve in August. I will probably wind up being the lone fatty in the family...until years later when I FINALLY reach the end of my journey. I'm thinking, though, that this is going to be a very long trip!

I still don't regret the revision. The Overstitch has done what it's supposed to. My pouch is still (and was pre-revision) small, and my enlarged stoma is still the size of an m&m. Regardless of revision type, I would still struggle with addiction and that is something I need to work on. If I had one piece of advice for anyone seeking a revision, it would be to make sure you fix the head BEFORE you fix the mechanics (unless, of course, there are serious medical issues). There's no point in fixing something that's broken if you're just going to let it collect dust.

Update: 4 months post-op

The elephant in the room: What does the scale say? 267, though I saw 264 a few weeks ago. I have really been struggling with my addiction to food. I could use a therapist, but it's not in my budget. I've been working hard to recognize the feeling of fullness (turns out being full is NOT when the top of my stomach is stuffed which is how I typically define being full). I've also been re-tooling my eating patterns. That is, instead of eating my three meals and no snacks (which I ultimately end up with anyway), I'm taking my meals and separating out a snack-size portion to spread the calories out and hopefully eliminating the desire for an additional snack. I've been exercising pretty regularly, trying to work up to walk a 5k. I'm up to two miles when I walk outside, but on the treadmill I'm worn out after 30 minutes. I joined a gym, so I'm also adding a little bit of resistance training (very little, after about 3 sets of arms, I'm weak and ready to puke).

My husband will be having the sleeve done in 2 weeks. Now that I'll FINALLY have his full support, I'm hoping this will be easier. I do tease him though, that on the second or third day of his clear liquids I'm brining home a pizza. Serves him right! Maybe he'll finally understand how difficult my struggle has been these past 11 years as I tried to succeed only to be served up temptation. I won't actually do that to him, but it's nice to think about.

My sister is just 4 pounds from onederland, a place I never got before things went all wrong for me. She looks good and I'm coming to terms with her success. My mom recently had the sleeve done (revision from band) and is only 7 lbs from my lowest point. I'm glad she's doing well. At 64 years old, she has struggled since she was a toddler (and I've seen the pictures!). My other sister will be having the sleeve in August. I will probably wind up being the lone fatty in the family...until years later when I FINALLY reach the end of my journey. I'm thinking, though, that this is going to be a very long trip!

I still don't regret the revision. The Overstitch has done what it's supposed to. My pouch is still (and was pre-revision) small, and my enlarged stoma is still the size of an m&m. Regardless of revision type, I would still struggle with addiction and that is something I need to work on. If I had one piece of advice for anyone seeking a revision, it would be to make sure you fix the head BEFORE you fix the mechanics (unless, of course, there are serious medical issues). There's no point in fixing something that's broken if you're just going to let it collect dust.

I joined Overeaters Anonymous. It seems to be going well. J highly recommend it!

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Update: 7 Months post-op

Kinda lost track of my months last time...I was actually at 5 months. Now, I'm a couple of weeks past 7. Details, details...

Today I'm 259. I've been eating under 50 grams of carbs (usually about 25) and 1000 calroies lately, and I'm up to three miles of walking (when I actually exercise). I've been doing a little jogging, but we're talking 60 seconds at a time at most. Still, it's progress.

I do get full when I eat, but I've realized that I don't realize just how full I am until I stand up. That's when I realize I've actually overdone it. Doing the high-protein, low-carb thing has really cut out all of the cravings. I'm just not sure how sustainable this is because a) I'm getting awfully bored with meat, cheese, and salads and :cool: I'm so very tired and mentally fuzzy. And even though I have been walking quite a bit lately, it is still not in my nature to spend an hour doing something that makes me sweat. I really wish exercise would be something I crave, not something I loathe. Maybe it will finally become a habit...

My husband had his sleeve surgery on June 24 and he's down 40lbs. My other sister just had her sleeve done last weekend. A friend of mine is headed to Mexico next weekend for surgery. I truly will be the lone fatty. I'm doing my best to overcome my feelings of inadequacy. Obviously, if I want to lose weight and be under 200lbs, I can. It's pretty much either put in the effort or shut up. What everyone else does will not be the same as me because I am at a different place in my journey than they are. Still, it weighs heavily on me (no pun intended).

I did speak with the office at my sister's Mexico surgeon about possibly going ahead with a RNY to RNY revision because my mom said she'd pay for it. The office told me that 40% of their patients never have success with that type of revision so I'm leaving that alone entirely.

Ultimately, I'm in a good place right now. This time last year, I was 301. At Christmas, I was 295. Slow progress is better than no progress, and I will always have something to look forward to...

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Update: 8 Months post-op

 

Still 259. This month, it's a REAL 259 and not a no-carb/water-loss 259. I'm eating more carbs (60ishg usually, but I do sometimes find myself closer to 100g) and I occasionally will have something that's not healthy. For example, for dinner on Tuesday night I had a regular-sized hot dog from Sonic. Just a hot-dog. As in NOTHING ELSE. And I was totally fine with that. I've found that though the weight might not be falling off like a typical low-carb dieter might experience, I am no longer craving foods that don't belong in my system. Fast food? Yeah, not really my thing any more. Pasta? Sure I like it, but I'm not freaking out over it. Bread? Rarely do I eat bread, and even then it's just to add a little variety to my "sandwich." Even cookies and donuts that are brought into the work place no longer call my name. In fact, at this moment there is a donut on my desk that doesn't even slightly interest me. On top of the change in my attitude towards food, I've also finally started enjoying exercise. My husband and I walk 3 miles several times a week.

 

I can't promise that this new-found peace with "a healthy lifestyle" will be permanent, but I definitely feel like I'm finally in control of my success and failures. If I want to be healthy, I must put in the effort; if I do not put in the effort, I will fail. It's all on me, and I finally understand that.

Simply blessed likes this

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