Anyone had a conversion from sleeve to bypass?

[lisylooby 9]

Sorry I've posted this in two forums as I wasn't sure where to put it :-)

Hey everyone, just wondering if there are any other sleevers who had to be converted to a bypass due to complications? I've had a pretty bad 8 months with complications from my sleeve and never actually progressed to solid food. My surgeon was concerned that I was dehydrated, malnourished and losing too much weight so she converted me to a gastric bypass.

Gastric sleeve surgery was on 16 November 2015.

So after my surgery I was pretty much vomiting up after my puree meals. The nurse at the hospital told me it was my own fault for eating too quickly (I ate 2 teaspoons over about 30 minutes), and since then I blamed myself every time I vomited. I rang the surgeon a couple of weeks after going home and said I was still regularly being sick and feeling hungry because nothing stayed down. Her advice was to cut down my intake even more and said I was having head hunger. So I listened to what she said and things didn't get much better. At one month from the operation, she sent me for a barium swallow as she was suspicious of a stricture. The swallow showed narrowing in the sleeve, but the surgeon decided to wait and see if it resolved itself after the swelling from surgery went down. This wasn't communicated to me so again I thought there was nothing wrong except for how I was eating.

Fast forward to March of this year and the vomiting is getting worse - I felt pain whenever I ate and then an almost passive regurgitation of food and lots of mucus (Sorry for TMI). I even vomited in my sleep and aspirated, which was awful. I talked to the surgeon again and she did another swallow exam which showed a very tight stricture. So I had a gastroscopy during which it was dilated. I did it without sedation, just pain relief, but it was terribly painful.

One week of relief after the dilation, then the same symptoms came back. So about 6 weeks after the original dilation, I was having it again as the stricture was back. I am a doctor so it was frustrating missing so much work for these investigations - I had to travel to another city to have it done.

Fast forward again to early June, and the symptoms are there again! This is when the surgeon decided to admit me to hospital because I was getting too unwell and dehydrated. The gastroscopy showed I actually had TWO strictures - one at each end of the sleeve - and these were dilated. But the symptoms didn't go away and another barium swallow showed that there was still an obstruction. This led to an oesophageal manometry study, which confirmed that I had a torsion in the sleeve. This meant that when I ate, it was twisting on itself and effectively blocking the food and making it come back up. I was relieved this was found - turned out I had 2 rate complications in one. I was beginning to think that my symptoms were in my head after they kept happening after the dilations!

On the 8th of July, I had the sleeve converted to a gastric bypass to basically bypass the torsion and enable me to eat again and get back on track. This was a horrendously painful surgery and I recovered slowly. I then got an obstruction of the distal anastamosis a few days later as it twisted and stuck to itself, resulting in blockage. Had to go back to theatre a week after the conversion to fix it. I am still in hospital as I type this (5 weeks here) but am hopeful to be discharged tomorrow!

This whole process has been really tough emotionally. I keep thinking "I never signed up for a bypass" but I didn't have a choice - it was bypass or slowly starve to death. The diet sounds very restrictive and I worry about dumping, although I am not much of a sweet tooth. I think the main fear is being isolated - unable to eat with my family/friends. I know it will get better eventually, but it's really sad. I have talked through this with the health psychologists at the hospital which has been helpful. I feel a lot of regret for having the original surgery, but there was no way anyone would predict that I would have such a bad run with complications. My surgeon said she's only ever had one other patient she had to convert from sleeve to bypass.

Stats wise: I'm 24 years old. Started at about 250 pounds. I'm 8 months out now and have lost 78 pounds, giving me a weight of 170 pounds and a BMI of 25.5. It obviously slowed down when I was unable to take solids, because I was given total parenteral nutrition (food through an IV which worked out to be about 2000 calories a day). But I'm happy with the loss, not happy with all the complications and having 7 gastroscopies, 5 barium swallows, 3 dilatations and 2 extra surgeries. My goal weight would be 150 pounds

Sorry for such a long post, but it would be great to hear from anyone who has had complications with the sleeve - strictures, torsion, leaks, conversion to bypass etc. It would be great to have some support as it's been quite a whirlwind for me. Thanks so much :-)

[James Marusek 5,244]

I am sorry to hear that you had such a rough go. I hope things will stabilize and improve for you in the near future. I am 3 years post-op RNY gastric bypass surgery. This article describes my experience with the operation during the Weight Loss phase. http://www.breadandbutterscience.com/Surgery.pdf The second article describes my experience with the Maintenance phase. http://www.breadandbutterscience.com/Surgery2.pdf

[SassyNanny 311]

Wow! What a nightmare for you? In so glad that you are doing better now. I had an uneventful sleeve done Nov 18 2015. It's been great and I'm down 89 pounds. I want to just tell you that when you are out with friends no one will notice what you do or don't eat. Eventually you will be eating more normalized foods and you will be comfortable eating out. You probably not plan on hanging out with 20 somethings that drink to excess because that is something you won't be doing. Best wishes on continued success. You have been very brave. Hang in there, you will be to goal and maintenance soon. It will be your own new norm.

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[AmusedMuse 15]

@@lisylooby, I hope you talked with your surgeon about what the nutritionist said about you eating too quickly. It is poor practice to make such generalizations, especially when the patient is in a professional field and likely to be following directions. I also hope it is smooth sailing for you from here. What a lot you've been through!

[codame 1]

I converted from a sleeve to gastric. But before that I had the band which didn't work for me. Then sleeve which I loved after having the band but caused painful reflux problems which is why I converted to gastric. I'm 5 days out so far so good. I'm feeling quite blessed after hearing your story.

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