RNY and FOBI and LUPUS

Chubbycakes
on 6/15/09 9:56 am
Has anyone had a fobi done with the rny and have lupus and having no problems with it?   My surgeon suggested it for long term results.  I recall that lupus and plastic or lapband dont mix with the immune system.  I would like some imput on this.   Thanks
kimie S.
on 6/16/09 10:06 pm - Belleville, Canada
Please excuse my ignorance but what is a fobi?
Kim
 



 
(deactivated member)
on 7/13/09 1:49 pm, edited 7/13/09 1:50 pm


The Fobi Pouch is a modification of the standard RNY pouch, pioneered by an African surgeon in California, Dr. Mathias Fobi. It was first used as a revision procedure for failed Vertical Banded Gastroplasty (VBG)

The pouch is situated vertically instead of horizonally to reduce stretching,,and is completely cut away from the greater curvature to reduce the chance of the stomach growing back together.  A silastic ring is placed externally to support the stoma and helps reduce stretching.

The lupus issue is with the silastic ring triggering an immune response..  I'm not sure if it does, but that's what helped me to rule that surgery out for myself, because I didn't want to find out!

Jeane
on 7/27/09 7:32 am
 I had a standard RNY.   For several reasons, my doc recommened that over the lap band.  The biggest reason is because i have lupus and multiple sclerosis.
Lap band is contraindicated for anyone with autoimmune illnesses, because of silicone used.  From your description, it sounds like the Fobi Pouch also incorporates a silastic ring - that is silicone.

I may be more sensitive than some about this issue, because I had had 20 year old ruptured silicone implants removed in 2004, after being diagnosed with multiple autoimmune illnesses, having hives and anaphyactic shock, and rashes that would not go away.  I won't get into the controversy there but suffice to say that I suspect some people may be more susceptible to problems with silicone than others.  Additionally, there is a reason the silastic ring is contraindicated for people with autoimmune illnesses.

I wouldn't do it, if it were I.

I just had RNY on July 16.  I did have a complication from infection and just got out of the hospital today. 
                
(deactivated member)
on 7/27/09 8:02 am

Jeane-

It took a while to find a doctor to do any type of WLS on me, especially since I have SLE.

Most surgeons are just plain scared, because of the trauma, and risk of a severe flare.

My surgeon didn't have a problems with it, because my lupus has been stable for the last 6 months prior to surgery.

Of course, there's no telling when it might kick up again.  Hopefully, never.

Jeane
on 7/27/09 8:34 am, edited 7/27/09 8:36 am
 Yes, I can understand.   You've lost quite a bit of weight!   Does the DS have the silastic?  
I would urge anyone with SLE or other autoimmune illness to avoid that - but that's because of my own experience with silicone implants and autoimmune disorders.  And, I have to add that my surgeon told me that silastic (as in the lap band) is contraindicated for anyone with autoimmune illnesses.

I have 3 autoimmune illnesses - SLE, MS and Hashimoto's thyroiditis.
My SLE has been inactive, too, for some time, although I still take plaquenil.  I've also had no MS flareups in years.   

I do think our immune systems are different  - I've had some weird things that people who are not immune-compromised don't seem to get.  So, it is important to be cautious.  When I looked at WLS, I had to weigh those concerns against the health impact of not having the WLS.  It was a no-brainer.

I had the RNY, which does not have any silastic ring or band.

I gained a good portion of my weight just before and after being diagnosed with SLE in 2004.  Someone told me that I couldn't have SLE because people with SLE lose, not gain, weight.  I could gain weight lookimg at food.  

I wish us all well on this journey.  I started walking in the hospital, although the last ER visit didn't thrill me.  I had an infection in the incision site, and just got out of the hospital today.  Now I'm home, with a pic line and home-nursing to come by every day to change and pack the wound (a hole in my abdomen now) and give me IV antibiotics which I still have to take for another two weeks.  

Tomorrow I am getting my long hair CUT.  I can't figure out how to use our shower - it is not walk-in like the hospital's.  I may have to get a hand held spray.  I can't get my right arm wet because of the pic line and can't get my abdomen wet because of the wound.   I'm just looking at the task of bathing and it makes me tired.  I'm walking around with an open hole in my stomach - the surgeon in the hospt had to open up the incision, and dig out the infection and crud.   
It's been just a bit painful.


















                
(deactivated member)
on 7/27/09 9:17 am


Yes, I had my DS February 25 of this year.  I was 5 months out as of Saturday.

There is no silastic anything involved in the DS.

About 75-80 percent of the greater curvature of the stomach is removed  which is the part of the stomach that produces most of the hunger hormone ghrelin. The pylorus is left intact as is the upper part of the duodenum, so, there is a fully functoning stomach .  The "switch" part of the operation makes a separate biliopancreatic channel and ailimentary channel, which meet at the common channel that varies from 75 to 150 cm.  This is where the digestive juices mix with the food broken down by the stomach acid (the smaller stomach still produces acid and churns food, the way it's supposed to) and is the only place nutrients are absorbed. the common channel empties into the large intestine, and is on its way out of the body at that point.

If you have dysmetabolic syndrome,  the DS is the surgery for you!
Jeane
on 7/27/09 9:24 am
I had the plain ol' RNY - no silastic there, either.  

Your weight loss looks phenomenal!   I hope I will just get through this nasty infection ... and get on track..   

I have lost about 10 pounds, but of course my surgery was just ten days ago.



Btw, I like your music ticker.    I'm a jazz and blues fan.


                
(deactivated member)
on 7/27/09 10:56 am


Jeane-

Ten pounds in ten days is great!  That's a pound a day!

Neermind the pre-op class that tells you it's just from the IV fluids...you're the one that still has to lose it. 

I retained about 13 pounds of fluid, but I claimed every bit of it, because I still had to lose it! 

My post-op weight then became my starting weight!

Thanks for the compliment on my ticker.  Unfortunately, they didn't have a saxophone, as that is my favorite jazz insturment.
Jeane
on 7/27/09 11:50 am, edited 7/27/09 12:00 pm
 Charlie Parker, Stan Getz, dolphy, coltrane...
I like jazz piano too.   And vocalists - I particularly liked Nina Simone (vocalist & Pianist).  Yeah, these are the old timers.  I grew up listening to Nina Simone.
Etta James had gastric bypass surgery.   I discovered that only recently.

I have been on IV fluids for the last 5 days in the hospital.  Fluids, antibiotics, and dilaudid.

I'm flooded out.  

And I'll be on IV antibiotics for 2 more weeks.

I wondered before surgery about DS - I understand that the weight loss can be faster.  There are always pros and cons... I think I would have gone with either DS or RNY.  However, my insurance only covered the RNY so that did help me make that decision.
                
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