In responce to my last post!!

Guate Wife
on 1/19/09 9:42 am, edited 1/19/09 9:47 am - Grand Rapids, MI
Shame on you -- actually attempting to provide facts  -and-  take the time to put it into perspective for her situation.  I guess she told you -- now that you have successfully managed to be a DS success story, slink away and enjoy life.  No need to help others as you were helped.... unless you can promise to only spread rose water around.

Chaps my ass, really.  What, are we a customer service department here?  Is someone getting paid to offer all of this information? 
I was busy all weekend, so I never saw, nor responded to, her previous post.  I have no idea what the questions were or how they were answered, but I certainly wouldn't EVER slap a hand that I am asking for help from -- especially considering that more help will be needed in the future, a LOT more.

Guess I had the wrong idea -- I had no idea that people that frequent this font of wisdom actually owed me something, spoon-fed the way I wanted to hear it.  As an adult, I just assumed that it was content I was seeking, and I never really felt ungrateful for it if the tone wasn't to my liking.

  


       ~ I am the proud wife of a Guatemalan, but most people call me Kimberley
Highest Known Weight  =  370#  /  59.7 bmi  @  5'6"

Current Weight  =  168#  /  26.4 bmi  :  fluctuates 5# either way  @  5'7"  /  more than 90% EWL
Normal BMI (24.9)  =  159#:  would have to compromise my muscle mass to get here without plastics, so this is not a goal.


I   my DS.    Don't go into WLS without knowing ALL of your options:  DSFacts.com

pepling
on 1/19/09 1:30 am - Independence, MO
I got a little ticked at a response I got recently too (first time for me) but I figured he was just being a wise*ss, thought he was being cute.   So I ignored it.   Most of the wise*sses on this board mean well and are pretty funny though. 

Just let things roll off your back.  Not being able to see facial expressions, gestures and hear tone etc. leaves alot of room for misinterpetation and I think everyone here means well even if that doesn't always come across clearly.

It's okay.  This too shall pass........

hugs,
pepling

Down 140 lbs!

 HW ~  340
 SW ~  330
 CW ~  199
 GW ~ 140

I'm a DSer
on 1/19/09 2:22 am, edited 1/19/09 2:57 am
I would like to contribute my input to your thread.

3/4 of my stomach wold be removed and some feet of my intestines and I will only utilize approx 3 ft of that.

1/2 to 3/4 of the stomach that is the bottom portion of the fundus is removed. The part that is removed is not actually needed, since the stomach main purpose is to hold food and then release it at a certain rate with the contribution of the pylorus value, as it is naturally suppose to do and the stomach helps break down the food into smaller pieces for easier digestion. These are 2 functions that are removed or not used when you have a RnY and a stoma in place, in which causes the food to slide through to the intestine with no control and a possible cause of dumping and food getting stuck. Another function of the stomach is it starts digestion and since we do have our stomach and it is intact (just smaller), it still has its fully normal function on what it is suppose to do, hold food, digest it to break down to smaller piece, then move along to the small intestine at a controlled pace. RnY do not and no longer have this function and why they have to chew, chew, chew their food to mush. DSer do not have to chew their food to mush since our stomach can still do that for us.

The vertical sleeve stomach (that is not alter or created into a stoma as in the Rny) and allowing the pylorus valve to be intact (which is detach with no working ability for the RnY) helps a DSer maintains the normal function in the emptying the food contents of the stomach to the duodenum at its normal controlled pace and for better food tolerance. DSer have a normal functional stomach that remains untouch, with the only exception of having the bottom portion of their stomach removed and the grehlin which is the hormone that causes hunger (head hunger, binging, etc). The pyloric muscle between the stomach and small intestine being intact and not removed as it is with the RnY, allows the stomach contents (in which the entry and exit ports are untouched and again only the bottom stomach sac (fundus) has been removed compared to the RnY that is a stoma that acts as a tunnel for food to slide through) to start their digestive process before food enters the intestine. This preservation eliminates the symptoms of dumping syndrome, marginal ulcers, strictures and blockages. 

None of the intestinal tract with the DS is removed. The intestine is divided into 2 tracts. One tract is for food processing known as the food or alimentary limb and absorbs the protein and peptide hormone. It also controls your metabolism to supress carbs with the contribution of the peptide hormone that is ingested to reduces the amount of carbs that is converted to and stored as fat. Due to the mechanics of this limb, it also does not allow 80% of the fat and 50% of the calories to be stored in your system (meaning it is malabsorb). The other tract known as the digestive limb is for the digestion process for the flow of the bile and pancreatic juices from the liver and pancreas to be digested.

The 2 limbs meet together at the bottom, and beginning of the large intestine. This is known as a common channel. The common cahannel varies from DSer to DSer. Average is 100cm, but it may be personalized and range anywhere from 50cm to 150cm (base of the patient health's, history, etc.). The length of the common channel will determine how much malabsorption level a DSer has. The shorter the common channel, the more malabsorption a DSer will have, the longer the common channel, the less malabsorption a DSer may have.


I also think it is not wrong to think that it is unlikely for 100% of DS'ers to be successful and NO one EVER fail or gain, but my fear/fears are what if it didn't work for ME what do I do than? 

Carbs is what affects a DSers in their success to weight loss, not calories or fat from food, so the range of obssessing, counting or making decision what food should I eat that will cause me to gain weight is less of concern compare to other WLS.

Keep in mind, as per my surgeon:
 
DSer malabsorbs on average 40% of the complex carbs
RnY malabsorbs on average 0%

DSer malabsorb on average 80% fat and this amount will stay constant with time
RnY malabsorb on average 35% fat and may be lower with time
 
DSer malabsorb on average 50% of the calories
RnY malabsorbs on average 0%

DSer and RnY both malabsorb 0% from simple carbs.

I lost weight at a slow steady pace and met goal at 14 months. Now, after 2 years, my metabolism is at turbo drive and able to lose weight more easily with no effort at all, eventhough I am now eating more. I do not want to lose anymore weight and would prefer (due to my body frame) to stay at 140 lbs and not go below that. Right now, I am 128-130 lbs. My surgeon recommended enzyme pills and up my carbs more (I was intaking 150 carbs daily, now I range higher than that). This means I can eat anything and not even worry about the carb intake, especially simple carbs. If I am still losing too much weight that I go underweight, the surgeon with perform a malabsorption control study to see what is the actual malabsorption level my body is having. The surgeon may also perform a revision to lengthen my common channel to help stop losing anymore weight. If a DSer is unable to lose weight, the common channel may be shorten. The revision for a DSer whether to lose more or stop losing weight, is usually an overnight stay at the hospital and altering the length of the common channel, compare to a RnYer who needs a revision and is a complicated surgical procedure

Therefore, if  you are a DSer and want to lose more weight, curb the carbs as a first step. If you are a DSer and do not want to lose anymore weight, increase your carb intake and also may need to take enzyme pill to help as well. One important thing is, you must touch base with your DS surgeon for follow-ups and according to his findings will medically recommend what is appropriate for you. The metabolism of a DSer due to the switch portion is very powerful and does most of the work for you without too much effort on your part.


WHAT IF The stomach being removed and the fact that the surgery is not reversible(NO, I don't plan on have anything reversed ) but WHAT IF GOD forbid addtl research comes out years from now saying that this or that are issues caused  b/c of malab.

With the DS, the stomach is not removed, only the bottom portion of the fundus that is basically a food storage bag. A DSer has to be deligent with their bloodwork lab and carry out what needs to be done by adjustments of their vitamins and supplements. If their blood work shows deficiencies after medical evaulation and still showing low level or extreme low levels after vitamins and supplement therapy and determine by the surgeon their malabsorption level is too high causing constant deficiencies over a period of time, their common channel can be lengthen. The common channel determines the amount of malabsorption a DSer will have. That lengthening or shortenig of the DS common channel is known as a DS revision. A RnY revision can go from anywhere to a reversible or takedown in placing all your parts back together (minus the pouch they created) and hope the pylorus valve does work when reattached to revising it, to another surgical procedure whether another RnY or to a DS. RnY to a DS or distal RnY revision is a huge surgery, compare to a DS to DS revision operation which is just varying the length of the common channel. The bottom portion of the stomach sac or fundus that has been removed for the DS is not a crucial or essential muscle that is needed. The purpose of the stomach is to hold food and with the DS, you do hold an amount of food in the stomach that start the digestion to be broken down. Only difference is, it is not a larger volume that can be held as before when you were non-op or an thin person who never had WLS. The DS reversal is placing the 2 limbs back into 1 intestinal tract.


WHAT IF it is proved that by the removal of the STOMACH,APPENDIX,GALLBLADDER,DS SWITCH ETC. some major issues can effect us later on in life(these are my fears for all WLS) AND than what do I do? At least, If it is RNY I may be able to get my stomach reconnected but with DS what could I do?

Appendix and gall bladder are removed on people who never had WLS. The stomach portion of the DS that is removed, as I stated above is a muscle that is not needed since the only purpose of the stomach that was removed was to hold more volume of food and nothing else. The grehlin that was removed is a hunger hormone. The removal, reversal or takedown of the DS switch can be done by taking the 2 limbs and reconnecting them again to become 1 intestinal tract. Compare the DS reversal to a RNY reversal or takedown, which is removing the pouch that was created from the entry and exit port, reconnect the plyorus valve back to where it was originally, reconnect the blind unused stomach that hasn't been used in awhile (with its grehlin hormone) to the the end of the esophagus and the other end. How complicate is a reversal of a RnY, I would recommend a book by my friend Dani Hart in which she goes into details about the RnY reversal to save her life and how complicated it was. Do research and compare the RnY reversal to a DS reversal.


AS stated before These are MY fears and I feel I am entitled to them. YES, I did ask for advise and  I appreciate all of the information I have received.

I hope my explanations provide a better understanding to your inquiries and fear you may have. My best to you.

Edit to add: the name of Dani Hart book is "I Want To Live: Gastric Bypass Reversal"
HW 305/SW 247/CW 130/LW 115/GW 140
BMI = 23.7  
3+ yrs post-op
stomach = 3.5 oz, common channel = 125 cm
Blackthorne
on 1/19/09 10:13 am - Alpharetta, GA

"WHAT IF The stomach being removed and the fact that the surgery is not reversible(NO, I don't plan on have anything reversed ) but WHAT IF GOD forbid addtl research comes out years from now saying that this or that are issues caused  b/c of malab. WHAT IF it is proved that by the removal of the STOMACH,APPENDIX,GALLBLADDER,DS SWITCH ETC. some major issues can effect us later on in life(these are my fears for all WLS) AND than what do I do? At least, If it is RNY I may be able to get my stomach reconnected but with DS what could I do? "

The removal of the portion of the stomach is not reversible, as you know, however since the function of the stomach remains the same, I do not see how this could cause problems down the road.    It would either cause problems immediately (such as a leak) or it wouldn't cause them at all.   

The intestinal portion of both the DS and RNY are VERY similar and both can be undone.   That's simply rerouting the plumbing again, and the only problem might be scar tissue from going back in again.  

Secondly, yes, it *is* possible to undo an RNY and make it a normal stomach again, however, there are a number of people who have tried to do a revision from an RNY to a DS whose surgeons were concerned that their pyloric valve would not "wake up" since it had been inactive so long.    If you don't use a muscle, it atrophies, and that's exactly what the pyloric valve is - a muscle. 

As for some responders making you feel uncomfortable, this is the internet.   There's no membership qualification here other than interest, and following basic rules of conduct.   I don't believe I saw or responded to your previous post (so I am not speaking of myself), but if you ask to be spoken to like a three year old, it shouldn't be a surprise if one of those responses feels more like a spanking.    Some people here are extremely blunt - it's the nature of the free forum.  If the information is good, take the golden kernal of information they've given you and shed the delivery system (their tone). 

I definitely think you should ask a surgeon who does all types, but I would make sure he/she really DOES do all of them before asking their opinion.   True DS surgeons have done hundreds if not thousands of DS's.   Ask them for a resume before taking their professional advice.  

Otherwise, if they haven't done enough, they cannot speak from knowledge OR experience (since I do not believe there are ANY DS Surgeons who have *had* a DS).   In my mind, that means their  opinion is actually LESS useful than any you would receive here because at least we can speak from experience.    (Please note - we do have a NUMBER of doctors and nurses here who can speak from both).

Good luck with your research.   

--BT

 


 

     Six years postop.       All co-morbidities are resolved.  Lost 101lbs in 1st year.   High wt: 277 Surgery wt:  260.7  Currently:  143lbs.    I'm Blackthorne99 on MyFitnessPal.

Click here to read my blog: Unicorns & Stranger Things
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