newanatomy
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My doctor does not use the Hess method. He told me that we humans are more alike than we are different. Luckily, I have had zero issues with not having had the Hess method.
My doctor does not use the Hess method. He told me that we humans are more alike than we are different. Luckily, I have had zero issues with not having had the Hess method.
Thanks for chiming in, @newanatomy. Do you know the length of your CC?
Chart showing that variation and by heightResults: In our group there was a wide variation of length (630-1510cm), with the average being 998cm. Linear regression analysis showed a statistically significant relationship between bowel length and patient height. (p=.025) Males had a longer intestinal length than females, (p=0.007).
I did not have the Hess method. I have a 100cm common channel and 150cm limb. They used a 38 French bougie on my stomach.
I only "chime" in because, I wouldn't want someone to forgo the life saving procedure that is the DS due to the fact that their chosen surgeon doesn't use the Hess Method. I would bet there are tons of patients out there who have a non Hess DS, all doing fabulous.
I would agree as I'm also had a non-Hess method DS and am doing quite well, TYVM. When Dr. Houston was doing the DS he used a standard size bougie and the 100 cc common channel. I heard that before quitting performing, he went to a bigger bougie, but stayed with the 100 cc common channel. I know of one patient who thought she was losing too much and had him revise her common channel. I'm willing to bet that even if everyone had their DS with the same size bougie and same length common channel, we'd still have some differences in our supplementation routine. For example, I don't take iron after taking it from the beginning and having consistently high results. I'm also willing to bet that those who have to get iron infusions have excellent levels of something I have to tinker with continuously.I only "chime" in because, I wouldn't want someone to forgo the life saving procedure that is the DS due to the fact that their chosen surgeon doesn't use the Hess Method. I would bet there are tons of patients out there who have a non Hess DS, all doing fabulous.
Ask him how he measures the intestine...that makes MORE of a difference than the length for MANY. Example, imagine your intestine being a slinky. It can fit in a very small box for shipping but can extend a LONG way when kids play with it. It can even be stretched so hard, it never goes back to it's original shape.Since he told me he is open to considering a different length for me, but if it's going to be a standard cut rather than Hess, then do I push it?
I agree with everything but your last 3 words. Again the standard limb length can and does work for many. My beef is that the standard limb guys don't measure the small bowel and then make a decision based off of that measurement so they mitigate risk of malnutrition and or insufficient loss. It only takes an extra 15 minutes. A 6'6 man and a 5'6 man absolutely will require different limb lengths.I only "chime" in because, I wouldn't want someone to forgo the life saving procedure that is the DS due to the fact that their chosen surgeon doesn't use the Hess Method. I would bet there are tons of patients out there who have a non Hess DS, all doing fabulous.
Yep definite measurement variation from surgeon to surgeon. What Marshall said was 100 cm was 125 as measured by Dr K so significant difference between those two.Ask him how he measures the intestine...that makes MORE of a difference than the length for MANY. Example, imagine your intestine being a slinky. It can fit in a very small box for shipping but can extend a LONG way when kids play with it. It can even be stretched so hard, it never goes back to it's original shape.
So my surgeon may stretch it out and then measure, your surgeon may just lay it out, NOT stretch it and then measure. That small intestine could be one inch or 10 inches when let go and no longer stretched out.
Bougie size can be misleading too because I am told that some surgeons suture very loosely and some suture very tight to the bougie.I would agree as I'm also had a non-Hess method DS and am doing quite well, TYVM. When Dr. Houston was doing the DS he used a standard size bougie and the 100 cc common channel. I heard that before quitting performing, he went to a bigger bougie, but stayed with the 100 cc common channel. I know of one patient who thought she was losing too much and had him revise her common channel. I'm willing to bet that even if everyone had their DS with the same size bougie and same length common channel, we'd still have some differences in our supplementation routine. For example, I don't take iron after taking it from the beginning and having consistently high results. I'm also willing to bet that those who have to get iron infusions have excellent levels of something I have to tinker with continuously.
The truth is you can't know what is the proper limb length if he doesn't measure your small bowel length. It is a guess.@DSRIGGS Thank you. I totally get what you're saying, and I appreciate your passion! I really do. Everyone's responses are making me just that much better informed.
Thanks for letting me know. May I ask how tall you are? I'm 5'9", and I wonder what that might mean for my ideal measurements. @DS fan
I get it, and I feel that way, too. @newanatomy I guess I'm trying to figure out how to approach this with my doctor. Since he told me he is open to considering a different length for me, but if it's going to be a standard cut rather than Hess, then do I push it? Do I go with his 150cm standard? If I ask for a shorter CC, and things go haywire, then I'm going to be disappointed. But if the 150cm doesn't provide optimum weight loss for me, I'm also going to be disappointed. GAH!
I agree with everything but your last 3 words. Again the standard limb length can and does work for many. My beef is that the standard limb guys don't measure the small bowel and then make a decision based off of that measurement so they mitigate risk of malnutrition and or insufficient loss. It only takes an extra 15 minutes. A 6'6 man and a 5'6 man absolutely will require different limb lengths.
For the record I have two ex coworkers who had their DS with Marshall as well and they did very well. They are both about 5'5 which is 9 inches shorter than me so it makes sense why the limb length was fie for them and not for me.
I also think that Simpler who I believe did your DS is significantly mitigating malnutrition risk because if 100 and 250 are his standard CC and AL lengths that is very likely to not be too short. Marshall does 100 and 150 so he us not mitigating nutritional deficiency risk.