2 weeks beyond surgery still hungry 2,200 calories a day what's wrong?

[winklie 518]

I'm sorry you're going through this. Doctors definitely do mess up sometimes. I had gastric sleeve surgery in September 2014, but stopped losing weight three months post-op. I was always hungrier than everybody else in my support group who had the surgery around the same time as me and I always told the nutritionist that I could eat more, which she said was good and that it meant I was recovering faster. I moved to a different part of the country for school in August 2015 and started seeing a new facility for my continued care. The new doctor wanted to get familiar with my stomach and ordered an upper G.I. and an endoscopy. He saw that my stomach was the same size as someone who had never had the surgery and the endoscopy showed I had an hpilori infection. The new doctor put me on antibiotics immediately and began discussing my options with me. I have opted for a revision surgery to switch my gastric sleeve to a gastric bypass, which I'm having on Dec 15 (currently on pre-op liquids only). When I had to submit my paperwork to the insurance to pay for this new surgery, I had to get my surgical report from my previous surgery. In that report I noticed that my previous doctor knew I had that same infection (it tested positive from the stomach sample) and did nothing about it- and didn't even tell me I had it. My new doctor was shocked that I had this untreated infection in my stomach for almost a full year. He said that the inflammation from this infection is what could've caused the inflammation in my stomach to make it as big as it is now. He also said he couldn't believe the other surgeon wouldn't treat this because it puts me at a high risk for Post-op ulcers. I contacted my old doctor to see what he had to say and I got a standard reply from the hospital that shifted the blame away from them. They said it was not a standard procedure to notify people or treat them for this infection, even though every Bariatric Health professional I've talked to since then has said that's crazy. All in all, I am trying to Move on and focus on my new surgery. My new doctor explained that I won't have the same weight loss now as if I had had this surgery the first time, but I'm hopeful. Another disappointment from my previous surgeon is that he told me that I should get gastric sleeve, even though I wanted gastric bypass, because he said they don't do gastric bypass anymore unless the patient has diabetes, which I didn't have. So I went with the gastric sleeve because of his recommendation, but now my new surgeon has explained that that is simply not true and that gastric bypass is actually the more successful and clinically proven long term weight-loss solution, whether you have diabetes or not. So I feel your pain having to deal with dumb doctors and I hope you find someone to help you correct the problems. I also hope you find peace with it and know that any weight-loss failures are not your fault. I wish you the best with your health and would be happy to answer as many questions as I can about revisions if it comes down to that for you. Cheers. ~H

According to the latest statistics I could find, in 2014, there were 190,000 bariatric surgeries in the United States. 100,000 were sleeves, 50,000 RNY GB and the rest was a mix of bands and revisions from bands to RNY GP, which oddly enough if I read the data correctly, more conversions from band to bypass are done than bands. The sleeve is a quick and easy operation with minimal complications. The problem is that it is still (in medical terms) new. There is no 10 year data or studies. The RNY GP was developed in France in the 1960's. It is a well understood procedure, that has been honed over the years to be as effective as possible. Read the history on it, it's actually amazing all the revisions the surgery has gone through over the years.

[megs2484 3]

I finally got caught up on this as I just had my gastric bypass on 12/9, but have been following this thread since it first started. Any updates from the appointment on the 8th?

[Dallas Powell 23]

Dr. Douchebag, LOL that's funny! Yea that's exactly the way I feel about him.

I had my meeting with him. I think he has been reading this thread. I told him the bariatric forum I go to is huge. He said yes it is big. Interesting considering the fact that not once did I ever tell him which bariatric forum I go to. Which lead me to believe that him or his assistant searched for it and found it.

He was wishy washy about it. He agreed that it was big. He then showed another still slide of it and said from this angle it looks like the normal size. I told him don't bother looking at that one because that is not a slide where my stomach was distended from the thing they make you drink. Those are the only slides that will accurately show how big it is. And he said yes those were big. I reminded him how he said my stomach was folded back in further clarification and that was why it was difficult to create the pouch. I said is that why it is much bigger because he wasn't able to see all of it. He said yes that may have been part of the problem. I could tell he really didn't want to give a firm answer on anything. Like he was trying to protect himself legally.

I also asked him about how the thickest stuff they gave me which was supposed to go down and stop for a while in the stomach before going into the intestine. This thickest stuff passed right through the stomach like it want even there. This is one of the things that Winklie had mentioned. How he is supposed to taper down the bottom of the stomach where it meets further down with the intestines. I questioned the surgeon about that.

His answer to that is we really don't know exactly how big to make that. I could taper it down so tight that food can't get through. We have tried that with lab band patients he says. We've constricted the band so tight that hardly anything gets through. And we don't like to do those anymore because they end up failing. The people are still hungry he says. They didn't get the part cut out like they do with the sleeve that creates the Ghrelin. So their hunger hormone is still raging and they want to eat. They end up eating low density high calorie foods like shakes. He then says how great the gastric sleeve is. They were pushing that sleeve from the start. Pushing it hard. I decided against it due to the research I did confirming that the bypass when done right is the gold standard.

So he wrapped it up saying he is still my doctor and he doesn't want to see me get hurt. He again talked about how terribly dangerous it was to have the revisional surgeries. And to beware of several different revisional surgeries that doctors are out there pushing. Like this laser one where they burn both sides of the bottom of the stomach to taper it off and make it smaller, and several others. He said they aren't tested well.

He then said he has no idea what will actually fix the problem. He repeated the problems of making the stomach smaller and still being hungry due to the old stomach being there producing Ghrelin. And tapering down the bottom more and repeated the lap band peoples problem. He said we could take out the old part of the stomach. And then said he didn't know.

I asked him if he calculated the actual size of the stomach from the measurements that the technician gave. The technician said the Dr. would calculate it. But he didn't. I told him that he advertises that he does them at 2 tablespoons or 30cc's. He said no he doesn't advertise that. He said that is just general education. I asked him why it's on Carilion paper in a Carilion binder. That's the name of the hospital. And if they have their logo stamped all over it it gives people the impression that that is the way they like to do them. He said he is going to change that.

I also asked him about he hernia at the top of the stomach and reminded him that I didn't have one before because he tested for that. He pulled back up the X Rays and he said yes he sees that he typed that but it doesnt' look like one to him. He said it's bulged a little but he doesn't think it's a hernia. But he doesn't know for sure.

He ended off with he will do whatever I want to do. If I want a referral to one of his fellow bariatric surgeons then he would give me one. Clearly that would be stupid to go to someone he very well could know to get their opinion.

I haven't done anything yet. I know now for sure this will be dragging into next year. He said it is very dangerous to redo the surgery within 3 months of having it anyways.

So I guess I'm going to Johns Hopkins, Duke or somewhere further away since he was talking about the referral he would send me to is at the University of Virginia.

My GF who had the botched surgery as well, not as bad as me but still bad, asked the surgeon for one of those upper GI X Ray tests that I had. Because she has been watching what she eats, is about 4 months post op and lost 50 lbs and stopped losing weight and has gained back 5. She can eat almost as much as me. The surgeon's blocker girl answered that it's her fault. That the stomach has not stretched out since the surgery. Because it takes 2 plus years to do that. So she said that it is the right size and it has to be that she is eating wrong. And that she needs to contact the nut. That's all these people do is talk about how it's your fault. I just found out one of my best friends had their lap band done by Dr. Lucktong. He's fatter than he has ever been and he was made to believe it's totally his fault and there is no surgery that could ever help him because he is a stress eater. So he feels like he is a failure. I'm trying to let him know that it's the surgery that's the failure not him.

[Cervidae 2,389]

Ugh, what a nightmare! This guy doesn't even deserve the title of doctor. Not only did he screw up monumentally but now he's trying to cover his ass from all angles instead of fixing his botched work. not only is he an awful doctor but he's an awful person. I hope you have much better luck and professionalism with your next surgeon!

[newmebithebypass 713]

dude i live in md i can tell you first hand go to hopkins they are the best they have the best doctors the best training and the best aftercare you will be treated awesome and not like a child that doesnt know anything because you happen to need surgery to fix an issue i highly recommend hopkins run dont walk

[SassyNanny 311]

Again. So sorry this happened to you. Will your insurance pay for another surgery to correct? Will you get a by pass done like you originally wanted? Any lawsuit will take forever to resolve.

I don't understand their ad about making the tummy hold 2 tablespoons. With the original swelling it holds very little but long term should hold 1-1.5 cups. Down from the preservers 4-6 cup capacity. Two tablespoons would not sustain life ongoing. Your Dr is a piece of work. I hope your GF gets a second opinion and gets a test done too. 50 lbs is a size able weight loss Stalls happen. I hope she visits the nutritionist and gives her food plan a tweak. It might but her weight loss back on track. Please keep us posted.

[winklie 518]

@@Dallas Powell

I have been meaning to get around to replying to this post for like a week, sorry Dallas. However, the Doctor is W-R-O-N-G about revisional surgery. Here is a link to the North Shore University Hospital in Manhasset Long Island, they advertise two revisional procedures right on the website. Link here, Note the two bottom choices the StomaphyX procedure and the ROSE procedure. When I was in NY I lived about 3 miles from this Hospital, it is where both my children were born and I have been a guest several times, lol. Not sure where you are, or your resources, but the North Shore-LIJ Health system, is a world class hospital, they are cutting edge, while I had my surgery done here in NH where I live, if practical there is no where else on Earth I would rather be than the North Shore Hospital. Plugging for them was not my intent, my intent was to show you that there are very simple and low risk almost outpatient procedures to fix with is wrong with you. Your surgeon was correct, 10 years ago revision was a VERY big deal. Reducing stoma size was not so difficult, however reducing the size of the Antistomosis was a VERY big deal. Now it's done with an endoscope through your mouth with conscious sedation. So again, don't buy into that ass-wholes BS, look into the procedures listed and then comes the hard part. Getting your insurance to pay for it.

Best of luck and keep us posted!

Merry Christmas and lets all pray for Dallas to have a great new year!!

[SassyNanny 311]

That is great updated info Winklie! Thanks for posting. Dallas please keep us posted about your progress in this matter. We are all rooting for you to have a very Happy and Healthy New Year.

[laurah 14]

I had written a long post and hadn't seen your update

Anyway, I hope you get all this sorted out and good luck to you.

Edited December 28, 2015 by laurah

[Dallas Powell 23]

Thanks Winklie! You know your stuff for sure. I'll definitely check their website out regarding those procedures. I greatly appreciate your help. Awesome info!

[Dar200 285]

Thanks Winklie! You know your stuff for sure. I'll definitely check their website out regarding those procedures. I greatly appreciate your help. Awesome info!

we are all rooting for you Dallas. As you can, keep us posted. I hope this year is a very successful and prosperous year for you.

[winklie 518]

@@Dallas Powell

What really rubs my ass the wrong way is the way your surgeon keeps giving you at a minimum bad advice, at worst he is blatantly lying to you. I guess the whole "Do no harm" thing means little to this guy. It's possible he was trained in some third world shite hole and knows the bare minimum about surgery. I chose my surgeon as he was a 14 year Navy combat surgeon. He did four combat tours, combat surgery is about the most intense training a surgeon can get.

I have a good friend of mine in NY who is a GP. We used to golf together, have dinner and just sort of hung out. I have no idea why but we just clicked. Anyway, I was going on one night at dinner about how residents are treated horribly and work for near slave labor wages. He became VERY upset! He explained the whole process of being a resident is to work in the absolute worst possible conditions, and make the right choice every single time. He said the harder the residency the better the doctor. I had never thought of it like that, but he is right. If you can make split second decisions with imperfect information and save lives, the complete control and relaxed atmosphere of an surgical suite must seem like a vacation.

This brings me back to your surgeon, he made a decision or several when he was operating on you. Those choices were obviously not the right ones. It's time for him to man up and explain to you what he did wrong and pay the piper. What he is putting you through is ridiculous. I am a big guy and have no problems intimidating people. You are even bigger than I am. You must be very calm, if it were me, he would be scared shiteless when I saw him. Not that I advocate kicking his ass (although the personal satisfaction is hard to deny) but learning everything you can about the surgical procedure, and asking him technical questions. For example, "Doctor, what was the port size of my antistomosis?" "How long a Roux did you use" "Which surgical procedure did you use to route the alimentary limb?" Answers should be, 10mm, 150 cm and there are a number of routing techniques used to route the interior plumbing. Another interesting question, "How many staples did you use?" I personally have 3400 of them. I nearly fainted when my surgeon told me that. But he explained the logic and it made sense, he went way out of his way to seal off my old stomach to prevent a fissure. If you get some general, I have no idea how many staples I used answer, I would be alarmed. My surgeon, did not even think about it. It is his SOP.

Get out of town find a reputable Doctor at a reputable Center of Excellence and have him scope you and see what is going on inside. Revisions are becoming very common, why? Numbers. RNY GB was the most popular surgery for so long, millions of people have had it done now. Many are 20 even 30 years out, and need a bit of tightening up. It makes sense. Read the history of the RNY GB it is an amazing read, remember this started in the 1960's! Granted a lot of people died, but the surgery is so well known now, there are no variables. Every single one should yield the exact same results simply because of the level of refinement the procedure has gone through.

Lastly consider this, my surgeon explained to me that a RNY GB is, as far as severity, about a major a surgery as open heart surgery. It's major. Very major. Time to get answers, then a lawyer and sue. Sue him for two reasons, one to get money, that is how the legal system dishes out 'justice' second, if his insurance lets this get to court, you stand a good chance of ruining his career, not out of malice, but to save the countless future victims this tool is going to mess up.

If you have the means to get to Long Island, North Shore University Hospital is as good as it gets. Further, if there is ANY complications, some of the best hospitals in the world are within a 40 minute drive. North Shore is NY's ONLY Tier 1 trauma center, well fully ranked, they are tier 1 from neonatal, through all age/sex groups through very old people.

Best of luck to you my friend, please post back and let us know what your next move is.