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Debra's Journey

Trying to stay positive

6 posts in this topic

Hi-

I'm almost 4 yrs post op from sleeve. The last few years I have been having really bad acid reflux. I'm not one to go to the doctors  but finally I couldn't take it anymore. I emailed my surgeon, which he prescribed medication which didn't seem to help. After 3 or 4 different medications, I had a swallow test and ultra sound. Ultra sound showed gallstones, but that wasn't what was giving me trouble. My surgeon finally sent me to an GI physician and I had a endoscopy last week, which showed inflammation to my esophagus from GERD.

At the beginning of speaking to my surgeon about the acid reflux I brought up the possibility of revision surgery to RNY, and he is really against it. After the results of the endoscopy, I brought up revision surgery again. Next week I'm scheduled for a manometry and 24 hr pH test. Depending on those results will determined if he will do a revision surgery or not.

I have a few questions. Some days are better than others, what if I'm having a "good" day during this test? Does that matter? If the endoscopy already showed damage to the esophagus, why do another test? I'm really trying to stay positive, but I feel like I wasn't taken seriously in the beginning, and instead of listening to my symptoms, its gets try this or that medication or now do this test.

Has anyone gone through the same tests?

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I also have to have an oesophageal manometry test prior to a revisional surgery. This test isn't about acid, rather it measures the strength of the oesophagus in moving food down to the stomach. I believe it also tests the strength of the oesophageal sphincter. The 24 hr pH test is the one that will test for acidity. To have reflux it's my understanding that the oesophageal sphincter must be weaker than normal to allow upward pressure of the stomach contents. I don't believe that the good day vs bad day will make much difference to the test results, either the weakness is there in the oesophagus or it isn't. 

All my testing so far has come back negative for GERD including a barium swallow. The surgeon tells me that what I experience is regurgitation and that also brings acid back up the oesophagus. I seriously have no idea what the difference is but according to my surgeon revisional surgery isn't worth the risk if the manometry shows the oesophagus movement is weak. 

As for having a surgeon who is really against revisional surgery, I would expect that to be a pretty natural reaction from them. Revisional surgery carries a much greater risk than "virgin" surgery. My surgeon will only do revisional surgery for life threatening medical reasons. He absolutely will not do it for weight regain.  He says the risk of leaks are just too great to warrant unnecessary surgery. He really pushes this risk at me every visit. He says while risk of death about doubles for revisional surgery the risk of leaks is around 20 times higher. While that's okay if you don't get a leak, he says it is a really messy and long recovery if you do. The surgeon's are working with an already (often long term) compromised stomach wall which also has existing scarring. It is so much more complicated for the surgeons second time around.

My advice is to try not to second guess the surgeon and his testing protocol. They know what they're doing and why. If your surgeon decides he won't do revisional surgery on you then he's likely weighed up the risks vs the rewards and decided it's not in your best interests to perform an additional surgery.

Sleevalicious likes this

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Results back in and will be having revision from sleeve to RNY.

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That's good news Debra.

Any idea of a date for your revision?

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Thank you. I'm very relieved and excited to finally start feeling normal again. Surgery is scheduled for 11/14.

Cheesehead likes this

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glad you finally have answers and a date for your revision.  I'm sure another surgery is the last thing you wanted to do, but i'm glad it will help you feel better. 

Debra's Journey likes this

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