My 2016 DS Journal

Okay, I lied. A liquid diet for 12 days sucks. Period. And I'm not even through day 1 yet. Gah!

I have jumped through all other hoops, including a visit with a cardiologist. He ordered an additional stress test. Soooooo, I have that this week. Does anyone know how they will accomplish this with someone who can't walk?
You're not going to like it. They will raise your heart rate with drugs. Sorry!
 
Okay, I lied. A liquid diet for 12 days sucks. Period. And I'm not even through day 1 yet. Gah!

I have jumped through all other hoops, including a visit with a cardiologist. He ordered an additional stress test. Soooooo, I have that this week. Does anyone know how they will accomplish this with someone who can't walk?
Yeap, they give you a medication that speeds up your heart while you lie there. Mine felt like my heart was gonna jump thru the wall of my chest and yet I still pass every time. I haven't EVER been able to do the walking stress test the three times they've done it (all pre-op).
 
Okay, wow, that sounds horrible. Not looking forward to that at all. Is it possible they would let me hobble along on the treadmill? I'm guessing no?

@galaxygrrl That is an awesome mantra. I am repeating that to myself daily. Hourly. Actually, by the minute. I'm hungry.
 
@galaxygrrl That is an awesome mantra. I am repeating that to myself daily. Hourly. Actually, by the minute. I'm hungry.

So, I did a liquid diet for 9 months. The first 4 days are the worst. This is how i talked myself though it. Each day that passed, I thought about how much longer i need to do it, but not in terms of a daily count down, but nore on how much I have done. So, lets use your 12 days.

After day 2, you only have to do that 5 more times. (2days x 5 tim4s). After day 3 you only need to do it 3 more times, etc. Hope that helps.
 
You're so clever, @galaxygrrl! That does help. I'm going to remember that.

I keep telling myself that it will get better. I'm sure it will because my body will just eventually shut down. Kidding. I think my body will eventually adapt. I am such a whiner -- I'm not a POW, for crying out loud. I know it could be way worse.

That said, I did lose 3 pounds in one day, so maybe I can just keep doing this and scratch the DS? Kidding, again!
 
Okay, I lied. A liquid diet for 12 days sucks. Period. And I'm not even through day 1 yet. Gah!

I have jumped through all other hoops, including a visit with a cardiologist. He ordered an additional stress test. Soooooo, I have that this week. Does anyone know how they will accomplish this with someone who can't walk?
Yes. If it's not an exercise stress test then they do it with drugs. Not pleasant.
 
Really all, it's going to be an hour at the most right? Don't make this worse than it is. Trace, don't worry about it. Think about being able to run in the playground with your kids.
 
Well, I'm not really sure what all I'm in for. This is a two-day thing? Two hours on two consecutive days? WTF?
 
Okay, I am home from my final consultation and pre-op class. And I am full of questions! Well, just one.

Srikanth really seems convinced that the 150cm CC is ideal. He told me that I would be far more likely for adverse effects if we went with 100cm. Don't a lot of you have 100cm CC's?

I don't want to argue with the man -- he's very nice, and very caring, and I'm sure he's an excellent surgeon. However, I am really scared that I won't lose enough weight with the 150cm CC. He said he uses a 34 French bougie, which is quite small, right? I would like to think that would make up the difference, but if it's really the malabsorption component that makes the DS so wonderful, wouldn't I rather focus on a shorter CC? He also makes the AL 150cm.

Do I pursue this further or stick with 150cm?

*I didn't even bring up Hess again. It doesn't seem like it's his cup of tea anymore.
 
I have a 100cm cc, which is Dr. Alverdy's standard length. I have found myself to be completely in control of my weight like I imagine "normal" people to be. If I want to lose weight, all I need to do is dial down carbs and the weight melts off.

I like where I am (size 12/14 down from 30/32) because at around size 10, my skin tends to dangle and I am not about to get PS to remove it. At this size, my curves fill out my skin suit pretty well. Also, for reasons unrelated to DS, my doctors want me to maintain a bit of padding/reserves.

At the end of the day, I say, it's best to put energy in picking an experieced, vetted, highly competent surgeon and then trusting him/her with the cutting. That said, it's important to set ground rules for what to do / not to do if contingencies arise once you are on the table, if there are preferences...
 
I have 100cm too and I think the decision is a balance in your current health and your age. Younger age means slightly longer channel because you have more years to experience any effects of malabsorption and you may want to become pregnant down the road. The greater the starting weight or the presence of diabetes means a shorter channel because you want to maximize initial weight loss. I started at 286 lb, with diabetes, and was 54 years old. I have more or less maintained around 150 lb over 11 years eating anything I want except too many carbs and diabetes hasn't returned. And sugar is my enemy, but the length of the channel doesn't help you with that. Now, in hindsight, I would have chosen a 150 cm channel if it meant I wouldn't have bone and teeth problems and occasional iron deficient anemia, but at age 65, I can't necessarily blame them on the channel length. It's not meant as a pun, but you have to go with your gut on this decision.
 
I have 100cm too and I think the decision is a balance in your current health and your age. Younger age means slightly longer channel because you have more years to experience any effects of malabsorption and you may want to become pregnant down the road. The greater the starting weight or the presence of diabetes means a shorter channel because you want to maximize initial weight loss.
I've seen young people (under 30) with a shorter common channel. There are diabetics with longer common channels (esp the SADI/LoopDS/SIPS crowd). There is no rhyme or reason to how long some surgeons decide.

It SHOULD all be done by the Hess method which would be best for EACH person but too many surgeons feel that is too time consuming.
 
I don't want to argue with the man -- he's very nice, and very caring, and I'm sure he's an excellent surgeon. However, I am really scared that I won't lose enough weight with the 150cm CC. He said he uses a 34 French bougie, which is quite small, right? I would like to think that would make up the difference, but if it's really the malabsorption component that makes the DS so wonderful, wouldn't I rather focus on a shorter CC? He also makes the AL 150cm. Do I pursue this further or stick with 150cm? *I didn't even bring up Hess again. It doesn't seem like it's his cup of tea anymore.

Interesting - my sleeve is bigger than 34F, and I only have the VSG currently. Intentionally done due to the fact I always intended to revise later after my health improved. I'll ask Headley when I see him next post endoscopy and ask what size he used for me in particular. I'm short so my stomach is (sadly) short. I just can't get a short lady break, heh. Having said that, the differences are sort of minuscule if you actually look at them up close. (I asked to see them pre-op.) Also, stapling method matters, too, so it may be 34F, but the sleeve winds up larger than the bougie for obvious reasons. Each surgeon doesn't necessarily staple the same. I am curious now if there's a difference between hand stapling vs. DaVinci, vs. lap - I'll add that to my nerd literature search. Er, sorry for the tangent.

I know little of CC size, other than reading too many surgical papers, so I won't comment on that. While I'm not a surgeon, I am a therapist, and we often (much like surgeons) end up mirroring those who train us and where we are trained. My theoretical orientation is not one commonly used, however I developed this way of thinking due to my training, and it is how I conceptualize clients and their issues. Surgeons are similar, and often medicine moves more quickly than they sometimes keep up with. In my case, I am integrative and change what I do to match a person's needs and pathology. It's hard to do, though. There are some techniques I don't use at all. In that case I refer out if I can, because I believe clients deserve the best care they can get, and I know I am not necessarily the best therapist for every client. In fact, it's impossible to be the best healthcare provider for everyone, because everyone has unique needs, even if they similar to others. Surgery is much the same way. I send people out for 2nd opinions all the time and consult. If he is a good doctor he will not be the least bit offended. It sure beats revising later...
 
I've seen young people (under 30) with a shorter common channel. There are diabetics with longer common channels (esp the SADI/LoopDS/SIPS crowd). There is no rhyme or reason to how long some surgeons decide.

It SHOULD all be done by the Hess method which would be best for EACH person but too many surgeons feel that is too time consuming.

If they think it takes that much longer... ehhh. I don't know that the Hess method tacks on that much more time. You're already positioned to do it (they usually reposition us on the table for measuring bowels) even without using Hess. Heck, they are already measuring... this isn't that much more. I assume Hess can be done laprascopically, but I imagine it requires a bit more skill for that. It may be surgeons don't want to do it because they aren't sure it can be completed without doing it open.

I will ask my surgeon in a few weeks for my revision appointment because I am a nerdy and tactless pain in the ass.
 

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