bikewash

4.5 months post rny

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G'day from sunny Queensland excuse my spelling there is no spell check here

I am 4.5 months out from R N Y  weight down from 104 kg to 78.5 kg

The reason for my bypass was due to 5 failed fundos which I wrote to you about previously.

while doing the bypass my surgeon found my asoph had a very severe bend almost a knot

the bypass was successfull but 4 days out surgeon had to go inside again due to unbearable  pain  he said he cleaned me out inside ? also after 6 weeks a stretch was performed by endoscopy which made things a bit better prior to that I could not eat or drink

I am still unable to eat most solids I am living on soup I do however drink (sip) aprox 2 litres of milk a day

My surgeon said it is my age (62) which will take more time for me to fully recover.

I suppose my Question is, is this normal

Thank you Dr Callery

 

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Dear Bikewash,

 

Revision surgery is always more challenging and carries a higher complication rate than primary surgery. I can only imagine how much scar tissue was present after so many failed fundoplication surgeries. I can't comment about the specifics on your case, but if you are working with a qualified bariatric or general surgeon and gastroenterologist, I'd rely on their advice and encouragement.

 

As a rule, there is very little choice this soon after revision surgery but to continue conservative management with endoscopic dilation as needed. Trying to reoperate now may be fraught with danger. If you need nutritional support, a G-tube could be inserted into the bypassed portion of the stomach.

 

If you remain nutritionally crippled, at some point your surgeons may consider going back. It might be possible to reverse your gastric bypass, or they might advise removing the remainder  of the gastric pouch and bringing the roux limb up to the esophagus. Either would be difficult and potentially dangerous surgery, but would restore your ability to eat. If the bypass were reversed, you might well have renewed reflux problems, and you would probably regain weight. Patients who have total removal of the stomach maintain weight loss to a greater or lesser extent. If the roux limb is long enough, they usually don't have problems with bile reflux. They can do quite well.

 

Best of luck to you with this most challenging problem.

 

Dr. Callery

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