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Surgeon: Dr. Peter Crookes, USC University Hospital, Los Angeles, CA
by Margie:
MARGIE'S STANDARD DISCLAIMER: I do not make a recommendation for any particular type of WLS; I only know what seems best for me. However, people should be able to freely discuss any and all types of WLS with their surgeons. As we all know, not everyone, including medical professionals, is always up-to-date on information. If a surgeon is not willing to discuss and learn, run away! As you will probably notice, I believe in doing my homework before actually putting any project into motion. And I read every scrap of material on DGB/DS, WLS revisions, surgeons, their locations, and am always looking for more even now. I devoured every post here from my local WLS support list and from the Duodenal Switch list every morning and every night for months. There weren't all that many surgeons performing RNY gastric bypass in 1986-87. It was as scattered as the DS surgeons are today. My surgeon was Dr. Warnock in Wichita Falls, TX way back then. A good man and a good surgeon to this day. My pouch was created about 4 oz., and the bypass was extremely proximal, hardly a bypass at all, but these were the RNY standards at the time. The RNY standards have changed over the years, and are more aggressive in restriction now. In 1977, at my wedding, I weighed 170. In 1987, 18 months after my third child was born, I weighed 248 at the time of my RNY surgery. I don't remember the time frame exactly, but I lost for almost two years down to 163 at my lowest, and stayed around 175 for a couple more. I was satisfied with this loss and didn't feel strongly about losing any more. Then very slowly I began to see the weight come back. It is just as true now as it was when I decided to have the surgery in the first place that I just want to be satisfied when I eat, I just want to feel full. It's a driving force, and very difficult to fight. By 1994 I was 244 again, clinically depressed, and began medication for that. I believe that the weight coming back caused it. In 1995 I was on phen-fen for a while; it was wonderful, that driving force went away and I lost 30#, but we all know what happened in 1996 with these meds. I reached a high of 289 in late 1995. In early 1996, through weight-training and a good coach for three months, I lost 20#, gained muscles and improved health, and became an exercise believer. You can't not exercise. I maintained a weight of around 270 by myself for about three years, until my revision date. This gave me a great deal of self-confidence that I never had before. I had honestly believed I was doomed to gain forever and have a family history to prove it. But I knew, and my doctors knew, that I would have to live on lettuce and exercise six hours a day to make any further progress; my body is just that way. Why did I choose this revision? I'd already learned that a revision to a more distal bypass would get me losing again. I started checking into actually doing this when I lived in Raleigh, NC and saw Dr. Rutledge for a gastritis problem. He told me about the revision possibilities that he could offer. I learned what I could about it, and decided to pursue it with him, but my insurance would not cover lap surgery for it and that's what Dr. Rutledge does, so it seemed a dead end at the time. Anyway, it became a moot point when we moved back to Texas last summer. After we got settled in, I started investigating my options here in Austin. Guess what? No WLS surgeons at all in Austin! So, I turned to the internet as usual. Came across the DS website and discussion list. Found out that revisions to DS from RNY were possible. I also got confirmation that revisions to DS from other WLS types have been successful in the weight-loss way too. Several people were willing to share their details. This meant that I could get the distal bypass I needed and get rid of my RNY pouch. I literally reeled from the wonderful possibilities this presented to me! No more "stuck" feelings. No more "stomach full of stones" for hours. No more painful stomach aches and praying to vomit to end them. In the last year or two, I actually learned to induce vomiting, which was the lesser of two evils. Of course, vomiting led to red spots around my eyes and swollen eyes the next day, but ending the stomach aches became worth it. I had automatically avoided foods that I knew would cause stomach problems, but couldn't always predict what would happen at any particular time. Rice, pasta, and potatoes would give me stomach aches and heartburn almost always. Steak, chicken breast, white turkey, etc., would too. I knew that if I didn't have to live this way anymore, that's what I wanted very much. I also have done my homework in my own head -- I am different twelve years later -- I'm older, wiser, am more compliant, have teenagers instead of toddlers (hmmm, is this better or worse?), have the same ever-lovin' husband that just wants me to be healthy and happy whatever I decide, and have embraced exercise instead of avoiding it. I am very healthy considering my size and how long I've been this big (I both bless and curse my genes), but as I watched my beloved mom these days I saw what was coming for me if I didn't act. I WILL NOT hang around on the fringes of living for the rest of my life. I saw a second chance to make my one unfulfilled dream come true, and I went for it! So far, so good! The revision surgery went extremely well for me. My insides were happy from day one. Or at least this was my perception because the RNY life was what I had to compare it to. I now have just a small stomach, no staples, no stoma, no problems. I do not have a pyloric valve because after twelve years of inactivity, couldn't be sure that it would still work properly. I understood this before surgery and am delighted with the outcome. I can eat about the same amount now as before my revision. About 2/3 of a 1/2 lb burger along with a few fries. I still don't drink liquids with meals, more of a leftover RNY habit than anything else. The big difference is what I can eat. I can eat all the rice I want now. I can eat mac and cheese all day long if I want. I really missed baked potatoes and eat 'em often now. I eat slabs of meat. Well, I exaggerate, but compared to having little to none before, it seems that way. A hamburger patty goes down happily now instead of hanging around for hours on end. It's true that people that have WLS revisions tend to lose more slowly than others. Our wonderful, calorie-conserving, extremely efficient metabolisms learn to live and even thrive (aka pack on fat for the coming famine) on less food. And when the original WLS was done years ago, like mine, the body has years of practice and becomes VERY GOOD at it. It's more important for us that for WLS virgins to add exercise to break up the metabolism functionality of years before. It is simply a physiological phenomenon, not bad luck, and it can be managed and changed. No it's not fair, but no one ever said life is fair, did they? It took me some time to come to terms with this, but once I accepted that slow is just fine, things are really looking up. My baggy jeans and loose rings (I wear my wedding rings on my middle finger now) tell the tale. I look forward with gusto to the rest of my life. Winter, 2001: Winter, 2002:
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I don't hesitate to tell my story because anyone considering WLS should know as much as possible about the types of WLS, how WLS technology has changed over the years, and possible outcomes.