2 years and 4 months out Update

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.

Not sure I'm following. ARe you saying that a 120 CC and a 150 AL equals a 270 AL? If so, no, that doesn't make sense. The numbers are separate. But if you indeed have a 270 AL that sounds pretty on target.
 
@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? No you just said your AL is 150cm.

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...
Well we don't know what it means because he didn't measure your small bowel. The whole point of the HESS Method is to get your CC at around 10% of the Total small bowel length and the Alimentary Limb (AL) at 40%. That then makes your Bilopancreatic Limb (BPL) 50% of the total SBL. I am not sure why that is the equilibrium but that is what Hess found (Dr Gary Anthone hypothesizes that it doesn't really matter the balance of CC to AL but that the sum of the two just needs to equal the BPL length).

So when I talk Hess and preach about it, well CC & AL lengths were very close to your's (100cm CC & 150cm AL) yet my total SBL was 725CM so it should have been 100 & 275. This put my absorbing limb length at 34%, not 50% so I was very malnourished as common sense tells us. Since we don't know what your small bowel length was but you are not under weight and a little heavier than you would like, we can only surmise that your total SBL was much shorter than mine. If you had 500cm total SBL your absorbing intestine length would be 270/500 = 54%. That being said we don't know.

I just have to tell you that it pisses me off to know end that these DS surgeons don't take the extra 15 minutes to measure the SBL (That is how long Dr K says it adds to the procedure) and then optimize the DS for every single patient. There is absolutely no reason not to do it.

Hope this makes sense to you, and it does kind of stink not knowing what your total length is.
 
Not sure I'm following. ARe you saying that a 120 CC and a 150 AL equals a 270 AL? If so, no, that doesn't make sense. The numbers are separate. But if you indeed have a 270 AL that sounds pretty on target.
If his AL is 270 and 120 CC that would be 390cm.....since he said he was 5'11 and I am 6'2 with a 725cm SBL it would make sense that his would be a bit shorter than mine on average so that would put him "overabsorbing" per HESS. Just using my SBL 390/725 = 54%......that would make sense with his results.
 
Not sure I'm following. ARe you saying that a 120 CC and a 150 AL equals a 270 AL? If so, no, that doesn't make sense. The numbers are separate. But if you indeed have a 270 AL that sounds pretty on target.

I did not write the op report so I can only guess as to what it means but it is the only thing that makes sense.

Op report verbatim:

"A 120cm common channel was measured, and hemoclips were applied to the mesentery to mark that spot. An additional 150cm of bowel proximal to this were then measured out for the alimentary limb, and the bowel was divided."

The rest is standard DS speak....
 
I did not write the op report so I can only guess as to what it means but it is the only thing that makes sense.

Op report verbatim:

"A 120cm common channel was measured, and hemoclips were applied to the mesentery to mark that spot. An additional 150cm of bowel proximal to this were then measured out for the alimentary limb, and the bowel was divided."

The rest is standard DS speak....
You have a 150cm AL. The report is saying that he measured 270 cm and then cut that into two pieces of 125cm for the CC and 150 for the AL.
 
I did not write the op report so I can only guess as to what it means but it is the only thing that makes sense.

Op report verbatim:

"A 120cm common channel was measured, and hemoclips were applied to the mesentery to mark that spot. An additional 150cm of bowel proximal to this were then measured out for the alimentary limb, and the bowel was divided."

The rest is standard DS speak....

Then, no, it doesn't sound like you have a 270 AL. It sounds, as it says, like you have a 150 AL AND a 120 CC. Definitely cookie cutter. You likely have a very long BPD.
 
Then, no, it doesn't sound like you have a 270 AL. It sounds, as it says, like you have a 150 AL AND a 120 CC. Definitely cookie cutter. You likely have a very long BPD.
BPL I think is what you mean, so I would agree that he likely has a long BPL. The opposite end of the tail for normal distribution of the cookie cutter DS. I am on the malnourished side and he is on the didn't lose as much as he wanted side.
 
I just have to tell you that it pisses me off to know end that these DS surgeons don't take the extra 15 minutes to measure the SBL (That is how long Dr K says it adds to the procedure) and then optimize the DS for every single patient. There is absolutely no reason not to do it.

Hope this makes sense to you, and it does kind of stink not knowing what your total length is.

Makes sense and I gotta tell you that it pisses me off as well. $27K out of pocket pisses me off.

Sad thing is while Boyce is a great "safe" cutter, he has a huge reputation in this area as being one of the best at what he does but in reality it seems that in my case he did not take the time to give me the best numbers he could have given me based on real hard proven data.
 
Makes sense and I gotta tell you that it pisses me off as well. $27K out of pocket pisses me off.

Sad thing is while Boyce is a great "safe" cutter, he has a huge reputation in this area as being one of the best at what he does but in reality it seems that in my case he did not take the time to give me the best numbers he could have given me based on real hard proven data.
My original DS Surgeon, Stephen Marshall is Director of Trauma for OSF St Francis Hospital in Peoria which is the only Level 1 Trauma center outside of Chicago and has nearly 700 beds (huge hospital). He did a hernia repair on me and a potentially life saving trauma surgery on my oldest son (after I knew he fucked me up). He has a great reputation and three of my friends had surgery with him and great outcomes. That being said, both guys are 5'6 and the lady is 5'4'sh so it makes sense, but he FUCKED ME UP.

He is a really good surgeon, but as director of trauma for a large hospital system he doesn't dedicate himself to Bariatrics and I paid the price for it.

You have a right to be pissed.

I would file suit against Marshall if I though I could win but in conservative Peoria I had an attorney that told me there is no way you win a malpractice case in this town unless somebody and even than chances are you will lose. :poop::frown:


BTW, Dr K says all the time, "It is what the science tells us". In other words, follow the data!
 
Sad thing is while Boyce is a great "safe" cutter

Safe and effective are two different things. The surgeon who did my original sleeve erred, I believe, on the side of caution and left me with a huge sleeve which I was, of course, blamed for stretching out. While it's true I had zero problems afterward, I never came close to the expected weight loss. I went back to him (Kaiser) and he offered to revise me to an RNY, but then I did some research and came to the conclusion that the DS would be better for me. Fortunately, another doctor at Kaiser does the DS and I was given no hassles about wanting a revise (which, to me, was a tacit admission that the first guy was too conservative).

Frankly, I wish the original sleeve had worked because the DS is still more draconian then I wanted to go, but it is what it is.

I can absolutely understand your frustration. Seems you have a few choices:

1. Explain you're out of money and ask the doctor nicely to do your revise pro bono (highly unlikely, but you can ask)
2. Sue the doctor to get your money back so you can get a revise elsewhere. Sometimes, the insurance company will settle as it's cheaper than going to court, but, of course, you probably need some claim. In California small claims court covers up to $10,000 and it's cheap, easy and lawyer free. Check with Diana Cox. She knows about all this (but I think that would be tough)
3. Save up some more money and get a revise.
4. Go on a paleo diet.
5. Accept that you're not where you dreamed of being, but you're in a much better place than you were.

Best to you...

MM
 
Safe and effective are two different things. The surgeon who did my original sleeve erred, I believe, on the side of caution and left me with a huge sleeve which I was, of course, blamed for stretching out. While it's true I had zero problems afterward, I never came close to the expected weight loss. I went back to him (Kaiser) and he offered to revise me to an RNY, but then I did some research and came to the conclusion that the DS would be better for me. Fortunately, another doctor at Kaiser does the DS and I was given no hassles about wanting a revise (which, to me, was a tacit admission that the first guy was too conservative).

Frankly, I wish the original sleeve had worked because the DS is still more draconian then I wanted to go, but it is what it is.

I can absolutely understand your frustration. Seems you have a few choices:

1. Explain you're out of money and ask the doctor nicely to do your revise pro bono (highly unlikely, but you can ask)
2. Sue the doctor to get your money back so you can get a revise elsewhere. Sometimes, the insurance company will settle as it's cheaper than going to court, but, of course, you probably need some claim. In California small claims court covers up to $10,000 and it's cheap, easy and lawyer free. Check with Diana Cox. She knows about all this (but I think that would be tough)
3. Save up some more money and get a revise.
4. Go on a paleo diet.
5. Accept that you're not where you dreamed of being, but you're in a much better place than you were.

Best to you...

MM
Unfortunately there is no way you win that lawsuit on the basis that he didn't lose enough weight. You have to prove that Boyce violated a standard of care and the cookie cutter is an ASBMS certified standard of care (shouldn't be but it is).

I would bring suit against Marshall for the shit he caused me with his negligence but I know I can't win because he has patients who do fine and as I said cookie cutter as flawed as it is, is an approved standard of care.
 
Unfortunately there is no way you win that lawsuit on the basis that he didn't lose enough weight. You have to prove that Boyce violated a standard of care and the cookie cutter is an ASBMS certified standard of care (shouldn't be but it is).

I would bring suit against Marshall for the shit he caused me with his negligence but I know I can't win because he has patients who do fine and as I said cookie cutter as flawed as it is, is an approved standard of care.

I pretty much know that, but was saying that if the claim is tiny, the insurance may pay it off rather than go through the expense. There's also small claims. If the Dr doesn't show, you win. Of course, you will need to find something, however small, on which to base your claim.
 
I pretty much know that, but was saying that if the claim is tiny, the insurance may pay it off rather than go through the expense. There's also small claims. If the Dr doesn't show, you win. Of course, you will need to find something, however small, on which to base your claim.

I don't have the energy to go thru all that but the basis of claim would be pretty easy since what he advertises on his website is not what he actually does.
 
I pretty much know that, but was saying that if the claim is tiny, the insurance may pay it off rather than go through the expense. There's also small claims. If the Dr doesn't show, you win. Of course, you will need to find something, however small, on which to base your claim.
An attorney won't go to the expense of filing a case they know they would lose so you would have to do it on your own. If you aren't an attorney that won't work.

I know this because we attempted to file suit against one of Dr Marshall's partner who cut Cameron's vagus nerve causing him severe gastroparesis. He never bothered to tell us that and we only found out after getting a copy of the surgical report 18 months later. There were other serious issues like piercing his pleural lung space twice during surgery and not telling us about it only to make Cameron suffer for 2.5 days before they did anything about his chest pain and breathing issues and finally doing an xray to see tons of blood on his left lung....they finally put in a chest tube and he was there another 7 days I believe. Because cutting the vagus nerve was considered a known risk of the surgery it ended up being the judgement of the attorney who had a Dr review the case (this took 45 days and a lot of expense on their part) that the case was not winnable so the attorney declined to file. He was not the only attorney we consulted.

The idea that this country is fraught with frivolous medical malpractice suits is absolute BS, well at least in conservative downstate Illinois. As I said, if an attorney doesn't feel that he/she can win a case where they are only paid if they win, they are't filing. It is sad. This Dr caused serious physical and mental issues to Cameron and was a negligent POS, but nothing we can do about it other than stay the hell away from him.
 
I don't have the energy to go thru all that but the basis of claim would be pretty easy since what he advertises on his website is not what he actually does.
As I just told Mark, it isn't as easy to prove as you think. Even if the guy was in the wrong. You know how biased this country is against fat people thinking that they are just lazy slobs, so if it somehow got to trial a good attorney would blame you saying that it was your fault (we know that isn't true) and the jury would probably believe him.

and you are right , it takes a lot of time and energy on your part to file suit.

The only remedy I see is contacting the office and stating your discontent and that you want something done about it. If they do nothing threaten a lawsuit and if you know any attorneys get one to draft a letter asking for all records involving your case.
 

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