My surgeon does the cookie cutter approach. 100 cm CC, 150 cm AL and the 46 French bougie. I questioned him about this before surgery because I had some concerns after reading about common channel lengths on the various forums. He told me that people are more alike than different and that in his 25 years of doing bariatric surgeries and keeping up with the studies, he believed that even with different starting length of intestines, patient weights and heights, and different physiologies, a basic configuration worked. I am not saying he is right, how would I know, I am just telling you his thoughts behind the cookie cutter approach.
My point to all of this is, could there be more going on with your extreme weight-loss than common channel and alimentary limb lengths? Some other underlying health issue in combination with your DS? I am sure that it could very well be that you are just a special case and that your DS is completely "super charged". I just worry that an adjustment will not be enough. Maybe more of your villus were destroyed in the process than usual and they haven't grown back and won't grow back? What if you have some other kind of wasting disorder?
I am sorry if I am pointing out the obvious especially, if you've already covered all of this in previous threads.