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Hello all I have an apt coming up with a surgeon to discuss a revision from sleeve to rny I have acid reflux and I've gained quite amount of weight back can anyone tell me the process from when you first meet with the Dr to the surgery I already know my insurance will approve it and I have changed my diet back to plan that I was originally given and haven't made progress in weight loss which was a requirement of my insurance and nothing helps the acid reflux thank you in advance for the information I just want to be prepared for what the surgeon may say or do 

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Each surgeon may be different as every patient is different but my revision process was really simple. No hoops at all to jump through really. I did have an endoscopy which the surgeon used to take measurements of my viable stomach tissue so he could plan my surgery. Mine was a very old surgery and with no previous records still available, the surgeon wanted to visualise how that surgery was done and just how much damage there was. Plenty it turned out! Other than that the only thing I had to do was a pre-op liquid diet. No pysch, no dietician, no pre-op classes. Once the surgeon decided I needed the revision, he just listed it and I waited for the call to say it was booked. With my surgeon revisions are only done when deemed a medical necessity. Regain isn't an acceptable reason so I guess that's why the usual pre-op education etc isnt required.

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I had surgery in 2015 so I had a scope then and I have acid reflux pretty bad in the past year which has lead me to re gain I'm wondering if when I have my apt if it will be smooth and just him scheduling me and waiting for approval 

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There isn't a way to say this that won't come off as judgemental, but it needs to be said.....Reflux does not cause weight gain.....what we put in our mouths causes regain!!!! Believe me when I say I know how much easier it is to eat food that is comfortable going down and unlikely to come back up. Unfortunately that easier food tends to be highly processed carbohydrate. Food that your digestive system doesn't have to work so hard to break down. I've certainly been there and done that. I was in a situation for a long time before my revision where I couldn't eat meat or vegetables without the knowledge that a whole lot of pain was going to follow. Not just reflux but unrelenting abdominal pain. For a while there I just lived on highly processed carbs that were easily broken down in my gut because just the thought of acid washing through my nose at night was too much to bear. That's how bad my reflux ended up becoming. I knew I had to turn things around because I needed foot surgery that I couldn't get due to my BMI being over 30. I ended up living on meal replacement shakes simply to satisfy my nutritional needs while losing weight, because other foods that were healthy just weren't tolerated by me. The point here is that you need to accept it is your diet that has caused your regain, and this needs to happen before your revision surgery. Reflux on its own is enough to get approval for a revisional surgery. Unlike first time WLS, you don't need to meet a BMI criteria for revisions. Your surgeon will decide whether the extent of your reflux will justify the surgery. For most your weight is irrelevant so you can start to work on getting that regain off now before you go under the knife again. In fact there are some surgeons (and mine is one of them) that will see regain as a reason to NOT do a revisional surgery, as it shows non-compliance with diet guidelines which he sees as wasting his time which could be better used on first time WLS patients.  

It is worth saying here that revisional surgeries are no walk in the park. They are more difficult for surgeons to perform, plus they carry approximately 10-20x the risk of most post-op complications. Leaks being the most common. Many surgeons will also only perform revisions as open surgeries, making recovery longer, harder and much more painful. I was very lucky that my surgeon was determined to try and finish mine laprascopically, so he pretty much just had me on his schedule that day as his other listed patients were warned he may well have to cancel them. My surgery took two surgeons 4 hours to complete. The best advice I can give you is to do your research on revisional surgery, and make sure the surgeon you choose has good experience with revisional surgeries. Know the risks, and do everything you can to mitigate them.

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On 10/16/2017 at 4:27 AM, Rlsavona said:

I had surgery in 2015 so I had a scope then and I have acid reflux pretty bad in the past year which has lead me to re gain I'm wondering if when I have my apt if it will be smooth and just him scheduling me and waiting for approval 

I agree with Aussie H above... consider the true, honest causes of what has made you overweight up to this point. No surgery can make you skinny, only your head can. By that I mean that if you don't deal now with the psychological, or "head issues" of what drives you to eat, you will certainly remain overweight.

Gastric bypass will fix your heartburn problem, but it's only a tool. exactly like the sleeve is-- they only work, if you work. They only do their jobs if you do yours. 

Believe me I know this can be so difficult.

As far as your insurance or surgeon goes, they are most likely to still require from you what they'd require from other patients- labs, tests, and perhaps some demonstration of an ability to lose some weight or stay on a plan. I'm sure they will make clear though what the requirements are.

Whatever happens, I wish you the best, friend, and hope you keep us updated. There's a lot of support here.

:-)

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I had the GS last October and suffered really badly with an Acid Reflux which I Never had before I had the Op. I’m having my revision with Dr Dillemans in Brugge and I’m having a Gastric Bypass to cure my Reflux. 

How long does it take to stop the acid? 

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1 hour ago, Greystone said:

I had the GS last October and suffered really badly with an Acid Reflux which I Never had before I had the Op. I’m having my revision with Dr Dillemans in Brugge and I’m having a Gastric Bypass to cure my Reflux. 

How long does it take to stop the acid? 

I never had a sleeve, but I had severe reflux for years before my gastric bypass. Have not had acid trouble a single day since. I hope it’s the same for you!!!

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Awwwww brilliant thanks for getting back to me!!! I have my op next month and I can’t wait to get rid of the acid reflux!!! 

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5 hours ago, Greystone said:

I had the GS last October and suffered really badly with an Acid Reflux which I Never had before I had the Op. I’m having my revision with Dr Dillemans in Brugge and I’m having a Gastric Bypass to cure my Reflux. 

How long does it take to stop the acid? 

I am having issues with reflux since the sleeve from the very first night after surgery and am on my 3rd medication Dexilant.  What meds were you taking for yours?

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8 hours ago, Greystone said:

I had the GS last October and suffered really badly with an Acid Reflux which I Never had before I had the Op. I’m having my revision with Dr Dillemans in Brugge and I’m having a Gastric Bypass to cure my Reflux. 

How long does it take to stop the acid? 

Reflux stops from Day one. With bypass the main part of the stomach where acid is produced is below the staple line so that is bypassed. While the stomach still produces acids it doesn't enter the digestive system until about a metre into the intestine (i.e. after the lower join). This is enough to stop reflux. That said it is only the case with the RNY bypass....the Omega Loop bypass will put the acid straight back into the stomach as the intestine is looped back up to the new pouch rather than joined in lower down.

You may need to factor in that it is the stomach acid that breaks down the coatings used on extended release medications. Without that being available in the stomach anymore after RNY, the effectiveness of extended release medications can be significantly reduced. I've taken extended release pain medication for over a year and really noticed the difference. Often doctors will say that bypass makes no difference at all.....but it certainly did for me. If you take any time release meds then it is well worth  discussing this with your doctor before surgery so changes can be made if needed. Not all doctors agree that bypass will make a difference,  you might need to educate them. Personally I'm sick of having to continually remind my doctor of this but I guess it's just par for the course now.

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