Starting the process - questions

FrenchRed

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Jan 15, 2017
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I'm off to my first visit at the bariatric surgeon's office today at the U of MN to do the initial consult. I'm only meeting with the PA and Nutritionist. I will validate if the surgeons (Ikramuddin or Leslie) are still doing the traditional 2 anastomoses DS. One question I will ask if they do a standard configuration or follow the Hess method of measuring. If they only offer a standard configuration for all patients, is that enough of a concern to consider looking elsewhere?
 
I'm off to my first visit at the bariatric surgeon's office today at the U of MN to do the initial consult. I'm only meeting with the PA and Nutritionist. I will validate if the surgeons (Ikramuddin or Leslie) are still doing the traditional 2 anastomoses DS. One question I will ask if they do a standard configuration or follow the Hess method of measuring. If they only offer a standard configuration for all patients, is that enough of a concern to consider looking elsewhere?
Ask them why they don't do the Hess method if they say they don't.

But even the Hess Method isn't enough if measured differently. Okay, pretend your small colon is a slinky. Do they just 'lay' it out to measure or do the stretch it a little or a lot. A slinky can fit in a very small area when fully retracted. But out of the box, that sucker can stretch.
 
I'm not a purist about the Hess method. If your surgeon does cookie cutter with reasonable measurements, as mine did, you should be ok. If they are making an excessively long common channel for everyone, that is not ok. I would call "reasonable" anything from 100 cm to 125 cm, maybe 150 for a really lightweight. Or maybe 75 for someone with a terrible metabolism and a lot of weight to lose, but I wouldn't want anything shorter than that for anyone.
But given the amount of variability of length of small intestine, Hess method is probably the best approach.
 
I called the UofM and they said they no longer do the DS surgery. FrenchRed, let me know what you find out today. And can you give me a contact phone number if they do the DS. Maybe I got the wrong office. I have relatives in MN and it would be convenient to be able to go there if they do the Hess Method.
 
I had my appointment with the U of MN. The practice there has moved away from doing DS surgery. It used to be a large part of their practice in the past, but now they do mostly VSG or gastric bypass. When I asked if they would still be willing to give me a DS as an informed, educated patient, I was told they only did 1 or 2 last year, and I'd have to meet with the surgeon to discuss whether they would let me have a DS. I was told that Dr Leslie would be more amenable compared to Dr. Ikramuddin. I was also told at the patient support group I went to later that evening, that Dr Leslie may require me to go on Orlistat to experience the side effects of that medication to prepare me for living with a DS. I'm very concerned that while they used to support DS, that currently is not the case. On the other hand, when I met with the nutritionist, she was very informed and supportive of working with me as a post DS patient. In addition, if they would do a DS, it would be a traditional DS. I'm trying to digest what I learned and make a decision. I'm going to look into the program at Mayo Clinic, so if anyone has experience with the bariatric surgeons there I'd appreciate hearing about it. I believe they still offer DS as an option.

Of course, all of this feeds into my concern about whether DS or VSG is the right choice for me. Just as I was feeling good about going with DS, I get this info. Yikes!
 
Making you go on Orlistat is ridiculous. Those are not symptoms that the vast majority of us have, and it seems almost cruel to induce them to scare you. If you take your calcium and listen to your body and its reaction to your diet, the overwhelming chance is that you will have no 'poo problems'.
 
That is ridiculous. Orlistat. They should be ashamed. Just in case you might want to contact Mayo and find out if they do the real DS. Rochester isn't that far if you live in Minneapolis.
 
Hi @FrenchRed, I had a standard cookie cutter 100 cm common channel 2 anastomoses DS and am very pleased with the result. My DS experience is nothing like being on Orlistat. That's horrible and makes me doubt how that entire practice thinks of its patients. Wishing you all the best on your journey!
 
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