My 2016 DS Journal

[Munchkin]

Intestines are motile. Like earthworms. We could take the 20 best surgeons in the world and tell them to measure a 100cm CC on the same patient and come up with 15 different measurements. Maybe 20.

I have been around DS world since the early 2000's. Getting close to 20 years. During that time I have known 5 people who had to be revised for nutritional reasons. 4 legit cases and 1 who was probably a nutbag(not Scott BTW). And I know of 10 times that many people who never lost all the weight or haven't been able to keep it off. Now I'm not saying the DS failed, because it didn't. These people are overweight or obese but definitely in a better place than if they had never had the surgery. After all, O is a whole lot better than SSMO. And the bariatric community says 50% EWL is a success.

You are tall and that is in your favor but you are also mobility impaired and that works against you. If I was in your place I would lobby for the most drastic DS I could get. Period. I would make a case for a shorter CC than 150CM. I have known people who were too thin for a couple minutes but most are able to adjust their diet, they don't end up with more surgery. And years down the road...most of them wish they weighed a little less. I would be trying to get down to a 100cm CC for sure.

I know of a lot more cases like me. I asked for a 50cm CC and the doc wanted 100. We compromised on 75. Sounds really short, doesn't it? Not short enough. I was probably right asking for 50. I am still fat and I have never had any deficiencies or needed infusions, etc. I look like an average old bag. I would probably be much happier if I could have afforded plastics to get rid of all the worst bits. I am very healthy but I am still fat. I probably needed Scott's DS!

Bottom line, do what you have to do to get this done! Lobby to get the best DS you can but whatever you get is going to be a vast improvement over life today! If the doc wants a diet, lose a couple pounds. Do what needs to be done to get the show on the road!

 

[DuodenalSwitchaRoo]

I had Hess method. Common channel is 70cm. Im still fat and have deficiencies....Im working on that...constantly lol.

However, my case is unique having started near 650lbs AND being a 2 stage DS-sleeve first then a DS 3.5 years later. Soooooo YMMV as I know some who have had non Hess and are thin and there are people like me who had Hess and are still chunky monkeys!

 

[trace]

It's sooooo helpful to me to hear your thoughts and experiences, @Munchkin and @DuodenalSwitchaRoo. I laughed out loud at the nutbag comment. Ha!

I will definitely speak to my surgeon a lot more about this. And keep you all posted, of course.

 

[DSRIGGS]

I had Hess method. Common channel is 70cm. Im still fat and have deficiencies....Im working on that...constantly lol.

However, my case is unique having started near 650lbs AND being a 2 stage DS-sleeve first then a DS 3.5 years later. Soooooo YMMV as I know some who have had non Hess and are thin and there are people like me who had Hess and are still chunky monkeys!

You aren't fat you knucklehead.

I think there are a couple of things to remember. You are a little deficientry now because of that huge slice to get of that fucker Ernie and you are healing, and doing a damn fine job I might add. You also had two things working against you if you wanted to be pencil thin. Your starting point and the two step switch as we know make it harder to get uber low weight......but you are freaking rock star with what you have done and are absolutely gorgeous. I really love your citizen day pictires from your outfit, to your hair, your make up and most importantly your beautiful smile and awesome fucking attitude #

Anyway I think you and I are both examples that a long CC doesn't mean we won't lose weight because with my 125 cm CC I ended up a twig, and the 70 cm CC fir you didn't make you look like emaciated twin. It points out, IMO how important the Alimentary limb is as well. BTW what is your AL and total small bowel length. I know Dr K errors to the the lose a little less side with his Hess DS because as he says this about health and that Barbie figure and good health don't necessarily go hand and hand for those of us needing a DS so he feels it is his obligation to leave people healthy rather than lose that last pound.

Anyway, it is very true that the standard limb DS works well for many especially women because women tend to have shorter small bowel length as compared to men so the standard limb lengths match up well to that shotree bowel length. Unfortunately it didn't for me. MY passion is that even if I am in that 5% at risk is that we matter too and every effort should be made to mitigate risk.

 

[trace]

Endoscopy tomorrow at 4:30. And I am allowed no solid food after 6 pm tonight. Ack! I am beginning to think I'm totally not cut out for weight loss surgery. I'm going to be so damn hungry all the time! Um, that's why I want WLS!

 

[galaxygrrl]

You aren't fat you knucklehead.

Anyway I think you and I are both examples that a long CC doesn't mean we won't lose weight because with my 125 cm CC I ended up a twig, and the 70 cm CC fir you didn't make you look like emaciated twin. It points out, IMO how important the Alimentary limb is as well.

You have said this multiple times and I don't really get it, so can you please help me understand?

My DS is pretty Non Hess. My small intestine was 6.9 m and now my CC is 100 CM and my AL is 150 CM

 

[DSRIGGS]

You have said this multiple times and I don't really get it, so can you please help me understand?

My DS is pretty Non Hess. My small intestine was 6.9 m and now my CC is 100 CM and my AL is 150 CM

There is a belief by many in the DS community that the cc is the only absorbing channel and that is because the digestive enzymes aren't in the AL. Even without the enzymes the AL does still absorb nutrients and vitamins, especially carbs but still protein as well not at the rate of the CC but still important. Hess and other smart guys figured out that for optimal DS weight loss and not too much loss, that the CC + AL should equal roughly 50% of the total small bowel length. We all have different small bowel lengths so that means that same length cc and al that might work for is different than for me. I was given a 100 cm cc and 150 cm AL when my small bowel length is 725cm. That put my absorbing path length at roughly 35% and it was because the AL was too short. My 100 cm cc was plenty long.

So for you the the 100 and 150 lengths could be just right. SBL is correlated to height so you likely have a shorter sbl than I do, assuming you aren't 6'2. If your total sbl is say 500 cm than your ratio would be 50% of small bowel absorbing.

My opinion on why the standard limb length works for most is that a large majority of DS patients are women and generally at a height that probably has an average total sbl in that 450-550 cm range so the limb lengths kind if end up near or cat that 50% number without doing hess.

By the way for me my AL length in feet was roughly 4.5 feet to short. That number to me paints a picture as to just how short it was. That is much more jaw dropping when expressed as feet not cm.

Hope that makes sense and helps.

 

[DSRIGGS]

Also on my theory as to why standard limb length works for many another data point. Two friends also had ds with marshall my surgeon fir virgin ds. They have done very well. Why? They are both only about 5'5. Almost a foot shorter than me so there small bowrl is likey much shorter as well and the standard limb lengths used by Marshall..same as yours...lines up much better to their small bowel length.

 

[galaxygrrl]

OK, thanks for that! So, my SBL was 6.9 meters according to my surgery report and my CC is 100 CM and my AL is 150 CM. But, I'm only 5'3 so I'm not sure what to make of all of this. It does not sound like I fall into the guideline of the hess method, but I'm still having trouble following this all.

Thanks for your help.

 

[DSRIGGS]

So your SBL was 690 cm so he didn't do Hess on you and this goes to show that height alone can't be used to guarantee a l correct guess on SBL . I am 6'2 so statically I am likely to have a much longer sbl than you at 5'3. MY sbl was only 725 cm so just a tiny bit longer than you. My cc and al was made at 100 and 150 cm respectively.....so you have the same and absorbing tract of 250/690 = 36%.

Please keep a tight eye on labs, especially your albumin and total protein numbers.

 

[galaxygrrl]

Thanks! I've been a bit obsessed with protein because, well, I want to be healthy, but I don't want to lose my hair and some how, in my head, I've connected lots of protein with NOT losing my hair - based on nothing at all.

Btw, I knew I was off. I thought I had the world's largest stomach, but turns out, I had the world's longest sbl for being 5'3.

 

[DSRIGGS]

Thanks! I've been a bit obsessed with protein because, well, I want to be healthy, but I don't want to lose my hair and some how, in my head, I've connected lots of protein with NOT losing my hair - based on nothing at all.

Btw, I knew I was off. I thought I had the world's largest stomach, but turns out, I had the world's longest sbl for being 5'3.

So how far out are you from surgery now? 4 months? How mucheck have you lost since surgery?

 

[galaxygrrl]

So how far out are you from surgery now? 4 months? How mucheck have you lost since surgery?

Last Friday was the start of week 7. I'm down 35 pounds. I lost the first 20 in two weeks. And the 4 weeks to lose 15 pounds. I'm getting about 60 to 70 grams of protein a day. I'm at 229. I want to be 200 by new years! - the 50% mark.

I'm still learning how to eat. It's been very, well, weird.

 

[DSRIGGS]

Last Friday was the start of week 7. I'm down 35 pounds. I lost the first 20 in two weeks. And the 4 weeks to lose 15 pounds. I'm getting about 60 to 70 grams of protein a day. I'm at 229. I want to be 200 by new years! - the 50% mark.

I'm still learning how to eat. It's been very, well, weird.

7 weeks so not quite as far as I was thinking. 35 pounds is good and you should break 200 by the new Year. You are losing at a reasonable pace so that is good.

 

[galaxygrrl]

7 weeks so not quite as far as I was thinking. 35 pounds is good and you should break 200 by the new Year. You are losing at a reasonable pace so that is good.

I feel so lucky to have found this surgery and this forum. Each week gets better and better on learning my new body and also not having my body freak when I eat something. I just want to be thin now!!!!