2 years and 4 months out Update

BrianChesteen

Glad to be a Loser!
Joined
Jan 10, 2014
Messages
155
Location
East TN
Hey folks,

Been MIA here for a while. Been busy with work, life and trying to stay physically as active as possible.

Trying to get back on track as my lowest weight was 194lbs for about 5 minutes 9 months out. Now my body has settled with floating around the 210-215lb mark.

I am very active physically. I run many miles per week. Have ran 5 half marathons and 2 full marathons and dozens of other races.

My struggle is definitely diet. I own the fact that I know I eat stuff I should not. I am also convinced that Dr. Boyce did not do me any favors by leaving me with only a 50% sleeve reduction and a 120cm CC. Future patients of his need to fully discuss this with him to ensure you don't get blindsided like I did.

I had a bit of a setback back in December due to the fact that even with losing 135lbs and becoming very physically active including running full marathons, I had to get another stent implanted in my heart's LAD artery. This was a blow to my self confidence! I now have 3 stents at 45 years old....

Hope all is well with the fellow original charter members of this site and the newer members as well!
 
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Hello. We aren't all that far apart in our time of DS surgery. My original was September 2013 and I have since been revised because my surgeon ducked me up royally by giving me an AL about half as long as it should have been. Consequently I was severely malnourished and had a revision last August to lengthen my absorbing channels.

How long are your Alimentary and Bilopancreatic limbs? It isn't just you CC that absorbs. Your AL could be too long and cause insufficient weight loss/maintenance.
 
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I am sorry that you had to have another stent put in your heart. Couldn't the problem be caused from before you had bariatric surgery? I know that a lot of us will suffer from damage done previous to our surgeries. Like my shitty joints!

It must be very frustrating to have put a few pounds back on but, I believe it is completely normal to experience "bounce-back". I myself am fighting a bit of the battle of the bulge right now. Makes me nuts!! I am not very active and I love to eat. I still eat too much garbage. Sweets never were much of an issue pre-DS. Now, I can't seem to leave them alone. I need to get myself back to the basics--protein, protein, protein!

It is so good to have you posting again. Welcome back!
 
Hello. We aren't all that far apart in our time of DS surgery. My original was September 2013 and I have since been revised because my surgeon ducked me up royally by giving me an AL about half as long as it should have been. Consequently I was severely malnourished and had a revision last August to lengthen my absorbing channels.

How long are your Alimentary and Bilopancreatic limbs? It isn't just you CC that absorbs. Your AL could be too long and cause insufficient weight loss/maintenance.

Have no idea since Boyce did not include this info in his op report.

NOTE: CORRECTED BELOW
 
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Hi @BrianChesteen , glad to hear from you and thanks for the update. Stents notwithstanding, it seems you are doing very well physically. I've always admired folks who can run distances. You must be incredibly fit. :)
 
194lbs for about 5 minutes 9 months out. Now my body has settled with floating around the 210-215lb

That's exactly 10% which is the standard bounce-back so it sounds like you're perfectly normal. Odd that you stopped losing at 9 months out though. What is your BMI now and what was your original goal weight?

And don't beat yourself up too hard about the junk. If any of us were capable of consistently eating a perfect paleo diet, most of us wouldn't have submitted to the DS in the first place. Your running is impressive and you deserve a lot of credit for that. A marathon? You have a strong will.
 
Have no idea since Boyce did not include this info in his op report.
Since he doesn't do the Hess method that doesn't surprise me that the BPL or total SBL isn't on the report. The common channel and alimentary limb lengths should be.

Regarding sleeve size I have never heard of a 50% of old stomach for the sleeve. The largest sleeve I had heard of was around 6 oz. I suspect mine is about 12 oz now after stretch, but I also believe that with a DS that the stomach doesn't account for any of my weight loss or gain. The small intestine is what I believe controls the weight with my DS. That and type of food ingested.

Anyway, I am not sure what your height is and your associated BMI is at 210, but that doesn't sound like a terible weight ....asuming you aren't 5'2.
 
That's exactly 10% which is the standard bounce-back so it sounds like you're perfectly normal. Odd that you stopped losing at 9 months out though. What is your BMI now and what was your original goal weight?

And don't beat yourself up too hard about the junk. If any of us were capable of consistently eating a perfect paleo diet, most of us wouldn't have submitted to the DS in the first place. Your running is impressive and you deserve a lot of credit for that. A marathon? You have a strong will.

Since he doesn't do the Hess method that doesn't surprise me that the BPL or total SBL isn't on the report. The common channel and alimentary limb lengths should be.

Regarding sleeve size I have never heard of a 50% of old stomach for the sleeve. The largest sleeve I had heard of was around 6 oz. I suspect mine is about 12 oz now after stretch, but I also believe that with a DS that the stomach doesn't account for any of my weight loss or gain. The small intestine is what I believe controls the weight with my DS. That and type of food ingested.

Anyway, I am not sure what your height is and your associated BMI is at 210, but that doesn't sound like a terible weight ....asuming you aren't 5'2.

My current BMI bounces around between 31-32. My goal weight is 175lbs. I am 5'9".

Here is a graph of my weight loss:

My Weight Chart:


My OP report only shows the CC length and mentions the 50% stomach reduction. No bougie size or capacity mentioned. Imagine my aggravation with Boyce after receiving my report. While he may be a good safe cutter, his non standard approach and failure to follow the standards and not clearly communicating this with people like me are very frustrating.

His response to my queries after the fact were to the tune of "He believes that leaving a DS patient with a larger sleeve ensures that there are less malnutrition issues down the road." He stated that he decides CC length based on his experience and the patients starting BMI not by using any established method.

Trust me I am much happier at 210-215 vs 340 but I would love to have lost more and don't want to lose sight of my original goal.
 
My current BMI bounces around between 31-32. My goal weight is 175lbs. I am 5'9".

Here is a graph of my weight loss:

My Weight Chart:


My OP report only shows the CC length and mentions the 50% stomach reduction. No bougie size or capacity mentioned. Imagine my aggravation with Boyce after receiving my report. While he may be a good safe cutter, his non standard approach and failure to follow the standards and not clearly communicating this with people like me are very frustrating.

His response to my queries after the fact were to the tune of "He believes that leaving a DS patient with a larger sleeve ensures that there are less malnutrition issues down the road." He stated that he decides CC length based on his experience and the patients starting BMI not by using any established method.

Trust me I am much happier at 210-215 vs 340 but I would love to have lost more and don't want to lose sight of my original goal.

He said, "Leaving a DS patient with a larger sleeve ensures that there are less malnutrition issues down the road?" That makes virtually no sense. Leaving them with a longer CC sure, but the sleeve? No. As long as it's not ridiculously small.

I wonder if what he did is at least partially responsible for your weight loss stopping at 9 months?

Given that you're a 31-32 BMI, I'm especially impressed that you run marathons!

I don't know what you can do about the extra 40 pounds at this point. Of course, I'm sure you can find a doctor to resleeve and/or shorten your common channel (the second one being the better option, I think), but I doubt insurance would pay for it. And many doctors will say no regardless as your BMI is no longer critically over. But I can certainly understand how frustrated and perhaps even cheated you feel.

You might be able to get Esquerra in Mexicali to do it. I'm sure it will be less than the $9,000 charged for a virgin DS.

Best to you...

MM
 
His comment was that being able to eat larger meals helped prevent long term malnutrition issues.

I did not know enough then to question this bull hockey.

I paid $27K out of pocket for it so yes I do feel a bit taken! There is no more $ in the coffers for any sort of revision.

I know I could lose the 40 lbs if I resorted to significantly altering my diet. I am already very physically active...
 
He said, "Leaving a DS patient with a larger sleeve ensures that there are less malnutrition issues down the road?" That makes virtually no sense. Leaving them with a longer CC sure, but the sleeve? No. As long as it's not ridiculously small.

I wonder if what he did is at least partially responsible for your weight loss stopping at 9 months?

Given that you're a 31-32 BMI, I'm especially impressed that you run marathons!

I don't know what you can do about the extra 40 pounds at this point. Of course, I'm sure you can find a doctor to resleeve and/or shorten your common channel (the second one being the better option, I think), but I doubt insurance would pay for it. And many doctors will say no regardless as your BMI is no longer critically over. But I can certainly understand how frustrated and perhaps even cheated you feel.

You might be able to get Esquerra in Mexicali to do it. I'm sure it will be less than the $9,000 charged for a virgin DS.

Best to you...

MM

Mark,

"I think", being a key part of your statement. Brian already told us that he doesn't know how long his AL or BPL measure. Say he has a 550 cm total SBL, a 125cm CC and a 275 cm AL then the problem is just as much with the AL as the CC. That would put him over on both the CC and AL absorption. BOTH OF THOSE CHANNELS ABSORB nutrients (carbs especially absorb well in the AL, more so than protein).

That being said in my opinion, Brian's BMI and weight are not that bad and I personally wouldn't go through another surgery to lose 30 pounds or so.

Brian I would be ticked at Boyce as well. You might be on the opposite end of the spectrum as compared to me. I malabsorb too much and you may not have lost enough absorption. These Docs need to use science so that outcomes are personalized and guaranteed as much as possible. The technology/methodology is there and some choose not to use it.
 
@DSRIGGS , Sorry it had been a long time since I read my operative report and after I went back thru it, I do see that Dr. Boyce did call out the AL in addition to the CC. My AL is listed as "measured out" at 150cm. My CC is listed as 120cm CC "was measured". I assume the total of 270cm is what I want to use for the AL length?

So what does that mean for me other than it seems Dr. Boyce was guessing that a slight increase in the industry standard numbers would be good for me long term? Since he apparently does not believe in the HESS method, I will most likely never know what my numbers should have been if he did use the HESS method.....

Is there a way to estimate total SBL by height? I am 5'9" short...
 
No way to go by height. Everyone's different.

Sounds like he did a cookie cutter because unless your total small bowel length is unusually (and I mean unusually short) 150 for the AL is too little. The average SB for a male is about 600. So 40% of that would be about 240, not 150. Then to use 120 for the CC but 150 for the AL makes no sense at all if it were Hess. A Hess would be approx 40% AL, 10% CC and 50% BPD. So I think he meant he "measured it out" as a cookie cutter, not a Hess.

Regardless, there are people who seem to do just fine with your measurements and if your labs are coming back OK that's a good thing.

Labs are fine (but I am serious with the vits) and since I stopped losing at 9 months, I assume it is safe to say that my AL is not 150cm... Pretty sure the 150cm needs to be added to the 120cm for a total of 270cm AL with a 120cm CC.

Boyce has stated many times to many people that he does not follow the HESS method.

Sure wish I had been more educated back before surgery!
 

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