I heard Nexium help to control your hunger cause of bad heart burn any thoughts would be great thanks

Ok but what if my doctor refuses to switch me (for some stupid reason) to the RNY bypass- can I go elsewhere but still have the 5 months of supervised diet and all the required tests etc count at a different place? Bc if he doesn't either give me a damn better reason than "it'll be ok" or switch my surgery then I am and will go to another hospital. But I'm worried about the months I've already out in this journey! I was prepared for VSG, haven't read up on much of the RNY or anything yet.

Oh no! Thank you for your reply... I'm sorry you are having to have new surgery ?? I'm definitely going to look into my options especially because revision surgery probably won't be possible as I have medicaid insurance and I'm almost positive they only do one surgery per lifetime. Also id be really super bummed if I have to have another surgery and go through it all again when I could've prevented it in first place. Next appointment is Aug 14th and if he doesn't address this I'm getting a second opinion or speaking with the other woman doctor who also works there.

Hi, I had a hernia done as well I'm July 17 th. It's the 2nd week and it has just started to feel better. It will get better soon.

It certainly seems like you have some time to decide on things. Your GERD seems to be reasonably controlled with the medication, it's just when you skip it that you have problems, is that right? It sounds like there is still some room to play with medication, diet and lifestyle tweaks to improve things without going as far as surgery - some have GERD problems that don't respond to any of these things, and they are the prime candidates for the RNY revision.

Keep in mind that every time we go in there surgically, we back ourselves into a corner a little further as far as future options are concerned, so we want to make the most of it if we go for a revision. The RNY, even in its virgin form, imposes limits on future medical treatment options and is difficult to revise should weight problems persist or reoccur or if intransigent side effects crop up (typically the marginal ulcer problem.)

I had the opportunity a couple of years ago to revise, though GERD was more of a sideshow, and at the level that yours sounds to be at - minor level of medication needed to control things, but if I skipped a dose, I would feel it the next day. Recently, I have discovered that if I skip a dose, I don't notice it until I check my pill box the next day and see that I didn't take them yesterday - so symptomatically, things have improved - will have to check with the gastro about making adjustments and following up on that.

The problem that I see with your muscle issue (by your description, it sounds like the muscles controlling the lower esophageal sphincter - the pyloric valve's opposite number) is that it doesn't seem that the RNY revision really addresses that problem directly. It will usually improve the overproduction of acid that can reflux, and reduces pressure in the stomach that can cause some reflux so it can relieve your noticeable symptoms, but doesn't correct the fundamental problem of the sphincter not keeping the stomach contents down. The couple of rare cases of esophageal cancer after RNY that I have seen referenced were a result of the basic problem that you have - the esophagus becoming an overflow stomach - so this is something that you likely will still have to contend with after a revision. You should limit meal sizes (as you should now) and monitor things endoscopically periodically to make sure things aren't deteriorating in there. There are implantable devices and other surgical procedures that are sometimes done to address this problem specifically, and that would be another avenue of investigation for you, as there may be something there that is appropriate for your situation.

Another point is the medications that are needed. Some may be overly eager to revise in order to get away from the PPI medications that are used - there are lots of scary stories on the internet about them, and ideally it is best if we can avoid medication of any kind (but our world is far from ideal.) The problem with this is that many in our RNY community here are also on PPIs to control the RNY's acid related problems - what GERD is the the VSG, marginal ulcers are to the RNY; also, GERD is not unheard of with the RNY, so opting for surgery in preference to medication that works is questionable.

It sounds like some second opinions are in order, both from surgeons and non-surgeons alike. I had one surgeon who was pushing an RNY revision pretty strongly, but other doctors offered alternatives that were worth pursuing, putting off surgery until sometime in the future, if ever. At this point it remains an option, but once the trigger is pulled, it's hard to go back. I will take things slow and monitor things before exercising that option.