I FINALLY Got my Surgeons Report….

[robs477]

I know you guys may be growing a little weary of hearing my concerns, but I really don’t have a good feeling about any of this at all and haven’t had for a very LONG time. Call it my "Intuition" a "Gut feeling" lol...so to speak, or just my over engineering analyzations, or maybe just being a big ole milk sob cry baby, whatever....BUT...This may be the proof in the pudding so to speak. And….I’m really NOT too encouraged by what I’m seeing. Experts, PLEASE read this and give me your opinions. I’m trying to interpret the % of CC ratio to AL & BP limbs and it appears to me to not be good. It’s hard to tell from the way this report is written, BUT, it looks to me like the good Doctor just measured 110 cm from “terminal ileum” and then another 140 cm up from that junction to create the AL length???? If I’m interperating this correctly, then there is no flippin way I meet 10/40% ratios of the Hess methods.

As a matter of fact, it appears to me like my numbers are ALMOST just like Scott’s.

This is a direct “Cut & Paste” from one of Scott’s recent posts:

“The second being the Hess Method where the total small bowel length is measured and then the patient is given roughly a 10% of the total SBL CC & then and AL of roughly 40% of total SBL. I was given the former with a CC of 100 CM & AL of 150 CM. My total SBL was not measured.”

Scott was given a CC of 100 CM & AL of 150 CM. As best I can tell, mine was CC of 110 CM & AL of 140 CM, ALMOST EXACTLY the same, total length of 250 CM which IS THE SAME. All that being said, it also appears to me as though there is no total SBL listed as measured in the report, so it may be really difficult or impossible to draw any conclusion based on percentages??? BUT, again, I'm certainly NO expert!

Please see attached report and comment when you can, thxs Rob

 

[DianaCox]

You can - or don't have to - get anxious about this or not. I personally don't believe this should be of any significant concern.

The vast majority of us have measurements in tha range. My limb lengths are 100 cm cc/250 cm total (i.e., same as you) total alimentary tract. And I never got near "normal" weight (150 lb would be a BMI of 25 - I weighed 169 for 30 seconds).

Stop obsessing about things you can't control and pay attention to the slope of your weight loss curve. If necessary, consider slowing it down with Creon.

 

[DSRIGGS]

Yeah, the truth is you don't know about ratios because it wasn't measured if it isn't in the report. You are three inches shorter than me so data suggests you should have a fairly significantly shorter total SBL as compared to me. This means your ratios could be within "hess ranges".


BTW, Marshall measured my CC at 100 and AL at 150. Dr K measured them at 125 and 200, so there can be significant variation between different folks doing the measurement. I wouldn't hang to hard on those numbers.

As we have discussed I think your best course of action is monthly or bi monthly labs to make sure your numbers aren't diving and relying on how you feel. I know it is a tough concept to mentally digest, but weight really is secondary to both of those parameters. If you start feeling poorly and or your key values start dropping (H&H, copper, zinc, albumin and Tot protein) then I think adding in creon would be prudent. Just my opinion.

Again I felt like hell and was very dizzy on verge of passing out before I started creon. Now I waited too long and didn't catch that my hospital labs had tanked after my hernia surgery (still hold Dr Marshall and team responsible for the week in the hospital as a result of ignoring or missing those numbers) so in retrospect I should have been started on CREON earlier...but I just didn't know. You are on top of it so I see no danger for this happening to you.

Easier said than done, but try to stop thinking about this if you can. Stress can create its own issues with nutrition and weight loss.

 

[robs477]

You can - or don't have to - get anxious about this or not. I personally don't believe this should be of any significant concern.

The vast majority of us have measurements in tha range. My limb lengths are 100 cm cc/250 cm total (i.e., same as you) total alimentary tract. And I never got near "normal" weight (150 lb would be a BMI of 25 - I weighed 169 for 30 seconds).

Stop obsessing about things you can't control and pay attention to the slope of your weight loss curve. If necessary, consider slowing it down with Creon.

"Obsessing".....Muah??? I really "resemble" that.. ! OK, Mom, wont say another word about it .

 

[robs477]

Yeah, the truth is you don't know about ratios because it wasn't measured if it isn't in the report. You are three inches shorter than me so data suggests you should have a fairly significantly shorter total SBL as compared to me. This means your ratios could be within "hess ranges".


BTW, Marshall measured my CC at 100 and AL at 150. Dr K measured them at 125 and 200, so there can be significant variation between different folks doing the measurement. I wouldn't hang to hard on those numbers.

As we have discussed I think your best course of action is monthly or bi monthly labs to make sure your numbers aren't diving and relying on how you feel. I know it is a tough concept to mentally digest, but weight really is secondary to both of those parameters. If you start feeling poorly and or your key values start dropping (H&H, copper, zinc, albumin and Tot protein) then I think adding in creon would be prudent. Just my opinion.

Again I felt like hell and was very dizzy on verge of passing out before I started creon. Now I waited too long and didn't catch that my hospital labs had tanked after my hernia surgery (still hold Dr Marshall and team responsible for the week in the hospital as a result of ignoring or missing those numbers) so in retrospect I should have been started on CREON earlier...but I just didn't know. You are on top of it so I see no danger for this happening to you.

Easier said than done, but try to stop thinking about this if you can. Stress can create its own issues with nutrition and weight loss.

I KNOW....ALL good advice. I will go ahead and just shut up about it. Its just that my GD collar bones and rib bones etc are all poking through my stretched over skin like some starving, wretched, scurvy dog . Never seen no shit like that before. It just doesn't seem normal. BUT...anyway, enough said, I will just wait it out, nothing else I could do anyway. Thxs for your esteemed advice!

 

[southernlady]

I KNOW....ALL good advice. I will go ahead and just shut up about it. Its just that my GD collar bones and rib bones etc are all poking through my stretched over skin like some starving, wretched, scurvy dog . Never seen no shit like that before. It just doesn't seem normal. BUT...anyway, enough said, I will just wait it out, nothing else I could do anyway. Thxs for your esteemed advice!

That part is REALLY hard...but as you get further out, you do get some redistribution. And remember, YOU are looking at your reflection with "fat" eyes. If a stranger who doesn't know you or your doctor says you are too skinney, then listen. Otherwise tell your "fat eyes" to STFU.

 

[DSRIGGS]

That part is REALLY hard...but as you get further out, you do get some redistribution. And remember, YOU are looking at your reflection with "fat" eyes. If a stranger who doesn't know you or your doctor says you are too skinney, then listen. Otherwise tell your "fat eyes" to STFU.

No doubt. My bones have been popping for two years now but my face is coming around and not looking so haunt. Even with me being still below target (176 this morning).

You will redistribute eventually, Rob.

 

[Munchkin]

In the big scheme of things this is nothing health wise compared to morbid obesity. Relax. Take a deep breath and continue on! Losing a bit too much isn't a bad thing!

 

[robs477]

That part is REALLY hard...but as you get further out, you do get some redistribution. And remember, YOU are looking at your reflection with "fat" eyes. If a stranger who doesn't know you or your doctor says you are too skinney, then listen. Otherwise tell your "fat eyes" to STFU.

Really wise advice Liz, especially the "fat" eyes part. I was MO, almost the same weight for my whole adult life of 37+ yrs. To "wrap my brain" around collar bones and ribs poking through my clothes is as foreign to me as a football bat! The brain is just not catching up..lol

 

[robs477]

In the big scheme of things this is nothing health wise compared to morbid obesity. Relax. Take a deep breath and continue on! Losing a bit too much isn't a bad thing!

Very true also, thxs

 

[DSRIGGS]

I KNOW....ALL good advice. I will go ahead and just shut up about it. Its just that my GD collar bones and rib bones etc are all poking through my stretched over skin like some starving, wretched, scurvy dog . Never seen no shit like that before. It just doesn't seem normal. BUT...anyway, enough said, I will just wait it out, nothing else I could do anyway. Thxs for your esteemed advice!

You will get there my friend. I will find a pic of my boney and furry body and post to make you feel better about your's!

 

[Marquis Mark]

Have no idea if it will help you, but here's my surgeon's report just for reference... I have to admit, I don't understand 80% of it.

 

[DianaCox]

Here's what I don't understand reading your op report - perhaps he misspoke, but he says he intended to make the alimentary tract 260 cm, but then said that he measured the small bowel "from the ligament of Trietz [which is on the duodenum] to approximately 260 cm point" - that sounds like he measured in the WRONG direction (it should be 260 cm from the cecum).

Other than that, it seems like a somewhat eventful procedure without anything really bad going down - had to get the gastroscope because the NG tube wouldn't pass easily, and having to open you up because of a twist at the common channel anastomosis, both of which were dealt with without further incident.

 

[Marquis Mark]

Here's what I don't understand reading your op report - perhaps he misspoke, but he says he intended to make the alimentary tract 260 cm, but then said that he measured the small bowel "from the ligament of Trietz [which is on the duodenum] to approximately 260 cm point" - that sounds like he measured in the WRONG direction (it should be 260 cm from the cecum).

Other than that, it seems like a somewhat eventful procedure without anything really bad going down - had to get the gastroscope because the NG tube wouldn't pass easily, and having to open you up because of a twist at the common channel anastomosis, both of which were dealt with without further incident.

Thanks for the analysis. I'll email Dr. Belzberg and ask about that. I know of three other people who had their DSs with him and none of them have had any problems. I'm fine, too (other than the fissure which isn't his fault) so hopefully it was just a mispeak. He literally works 100 hours/week (by choice) and does 10 surgeries a week so I can definitely see that happening.

Rob, sorry to hijack. Maybe you should email your doctor in Texas and ask. That way, when he responds, his answer will be documented.

 

[sheribearmama]

Thanks for the analysis. I'll email Dr. Belzberg and ask about that. I know of three other people who had their DSs with him and none of them have had any problems. I'm fine, too (other than the fissure which isn't his fault) so hopefully it was just a mispeak. He literally works 100 hours/week (by choice) and does 10 surgeries a week so I can definitely see that happening.

Rob, sorry to hijack. Maybe you should email your doctor in Texas and ask. That way, when he responds, his answer will be documented.

Mark, was there any outcome after reaching out to Dr. Belzberg?