I have reached a decision

[DSRIGGS]

The process has begun and as soon as Kristina and I can agree on a date I will be traveling to Pasadena/Glendale (debating Huntington vs Verdugo Hills) for the revision to extend one, if not both branches (AL & CC).

I am 23 months post DS and I have lost 13-16 pounds in the last three weeks (I bounce during the week) and this is on a minimum of 288,000 units of CREON daily to a max of 360,000 (2 with meals one with snacks - not always 100% compliant on creon with snacks). Obviously this isn't going to change significantly at this point.

Depending on the length of my Small Bowel this charts shows the lengths of my current AL & CC and where the Hess method says they should be (FYI - I got a letter in the mail on Saturday morning stating my small bowel length is 8M...but Dr Marshall doesn't measure and they told me that when I called to ask....so I am not buying it)



As you will note from this chart my CC actually appears to be slightly over sized unless my SB is 1,000 CM and I doubt it. I know Dr K won't shorten the CC and he could possibly lengthen it. He will lengthen the AL, of that I am pretty positive.

Why lengthen the AL? Because we do absorb carbs and protein in the AL (more carbs than protein) even though there is no digestive enzymes and it is Dr K's belief (from what he knows about my case) that my AL is too short Additionally, my GI who put me on creon explained that my TP and Albumin numbers could have been low as a result of malnutrition due to NOT getting enough protein ..he explained why but basically you need a certain amount of carbs to cause protein to be absorbed properly and not crapped out (sorry to be graphic).

The idea that I am malnourished without CREON because my AL is too short caused met to scratch my head as I am sure some of you are because it wasn't what I thought I knew about how the DS works. I will keep you posted and let you know what actually happens limb wise and then how it works out for me. So I want people to learn from my experience and although one case it is not the typical DS experience.

 

[Charris]

Well I think if anyone can find out what's going on and fix it. Dr.K can. Like the people with Allstate YOU'RE in good Hands

 

[DSRIGGS]

Well I think if anyone can find out what's going on and fix it. Dr.K can. Like the people with Allstate YOU'RE in good Hands

of that I have no doubt. I have had tons of great conversations with Dr K and he definitely gets the whole deal, not to mention I just genuinely like the guy regardless of what he does. We had some great discussions about life, the constrained medical system that insurance companies have created (effed up mess they created and perpetuate) and some very light hearted discussions as well. He is a super guy.

 

[debbiebobebbie]

I had my revision with him in May. The guy is like Inspector Gadget. Every time you think you know everything about him, he pulls another skill out of his bag o tricks. When my feeding tube clogged, he stood at my bedside forever, explaining to me that he worked as a contractor in college and would use his plumbing knowledge to de-clog me, rather than taking me back to the OR for a new tube. And don'tcha know...he did it! He's such a great guy...and not a bad doctor to boot.

 

[hilary1617]

@DSRIGGS You've made a thoughtful, well-researched decision and I am looking forward to reading positive news in the not-too-distant future about a successful revision and stable weight path.

 

[DSRIGGS]

I had my revision with him in May. The guy is like Inspector Gadget. Every time you think you know everything about him, he pulls another skill out of his bag o tricks. When my feeding tube clogged, he stood at my bedside forever, explaining to me that he worked as a contractor in college and would use his plumbing knowledge to de-clog me, rather than taking me back to the OR for a new tube. And don'tcha know...he did it! He's such a great guy...and not a bad doctor to boot.

Yep.....how many Dr's do you know who would come in to the ER at 6PM on a Sunday and spend 3 hours with you including a local pain block and reading of CT? Yep, did that for our son.

 

[DSRIGGS]

@DSRIGGS You've made a thoughtful, well-researched decision and I am looking forward to reading positive news in the not-too-distant future about a successful revision and stable weight path.

Thanks Hilary!

Hopefully it won't be too long. I have the utmost confidence in Dr K's abilities to diagnose and fix, I so I am very optimistic.

 

[debbiebobebbie]

My bariatric history is long and sad. I've know more than my share of bariatric surgeons, so I really feel like I have something to compare him to. He's just the man. I'v never met a doc more knowledgable and more caring.

 

[Jen-2]

@DSRIGGS good luck with the revision. I hope all goes smoothly! Will Dr. K do your revision lap or open? Just curious.

 

[star0210]

I'm glad you reached a decision. I really hope this solves all of your issues!

 

[robs477]

Glad you decided Scott. At 4,000 plus calories a day, I don’t see where you have any other options left that are realistic or practical.

I really do need to ask you a couple questions though, for my own self-serving reasons.

1) What was your metabolism like pre-DS? i.e., do you think or feel that it’s changed also?

2) How did you get obese in the first place? i.e., do you think or feel that you became overweight over the years because you had a slow sluggish metabolism or did you just eat a lot of the wrong type foods and ate too many of them, or was it a combination of the two?

The reason I’m asking, is I’m trying to figure out (because of my own situation also), if you were a “Super Absorber” type pre-DS and could live ok on less than 1000 calories a day, (like I was), or more of a normie?

I’m just trying to define if there may be some correlation here between those two different intestinal types and the efficiencies of absorption VS the actual math part, i.e., the CC length which of course equates to having more surface area for absorption???

 

[DSRIGGS]

@DSRIGGS good luck with the revision. I hope all goes smoothly! Will Dr. K do your revision lap or open? Just curious.

We haven't discussed that yet but I see no reason that would keep it from being lap.

 

[DSRIGGS]

Glad you decided Scott. At 4,000 plus calories a day plus up to 360, 000 units of creon (in laymen's terms, a fucking shit pot full) , I don’t see where you have any other options left that are realistic or practical.

I really do need to ask you a couple questions though, for my own self-serving reasons.

1) What was your metabolism like pre-DS? i.e., do you think or feel that it’s changed also? I was a Type 2 diabetic so my metabolism was not good.

2) How did you get obese in the first place? i.e., do you think or feel that you became overweight over the years because you had a slow sluggish metabolism or did you just eat a lot of the wrong type foods and ate too many of them, or was it a combination of the two? I was always big but in high school I was a very good football player and worked out all the time. I was 6'2 220 on graduation. Naturally over the years my activity level didn't keep to that point, and once I became diabetic it became harder and harder to keep the weight off...diabetes is a vicious circle. I was 35 when diagnosed with diabetes and was right around 300 pound for 5 years or so afterwards (really carried it well and didn't look 300 lbs) but over the next 7-9 years I creeped up to my high of 365 (most of that time I was 350).

The reason I’m asking, is I’m trying to figure out (because of my own situation also), if you were a “Super Absorber” type pre-DS and could live ok on less than 1000 calories a day, (like I was), or more of a normie?

I’m just trying to define if there may be some correlation here between those two different intestinal types and the efficiencies of absorption VS the actual math part, i.e., the CC length which of course equates to having more surface area for absorption???There may be some correlation but my gut (no pun intended) says we can't compare our systems before and after since this is such a radical change that happens to our small bowel with the DS. I truly do believe in the science that Dr K uses and the so called Hess Method and do believe it is simple math...with a small caveat that I do believe we all have some level of different absorption ability in our intestines...so yes I do think that ability to absorb plays some role, but my gut says it isn't a huge part....simple length of intestine and limbs after DS makes sense to me. Who knows maybe that is just wishful thinking but after 2,000 plus DS procedures I think Dr K would have noticed trends and adjusted, so I trust in him deeply.

Thanks Rob....see my reply to your questions and comments in bold above.

 

[DSRIGGS]

I'm glad you reached a decision. I really hope this solves all of your issues!

Thanks Star.....

BTW I had a lab draw on Friday (CBC & CMP) and in just two weeks since my last draw my Hematocrit, Hemoglobin, RBC, Platelet Count, Albumin and Total Protein are all diving (anemic again and TP is 6.3 on a 6.3 - 8 range). Just like I thought, my lab values were lagging my weight loss.

 

[DSRIGGS]

Okay so it is finalized. Office visit Monday the 17th and surgery on Tuesday the 18th.