DS failure and

 Oh yeah...I guess I did foget about the other part.....whooooops!!

Adele.
Dr. Greenbaum uses the "Hess" method to determine the common channel length. Here is how it's calculated:

Hess Method

You will often hear Duodenal Switch procedure patients using the term "Hess Method" [1] when discussing common channel length. Dr. Hess calculated the length of the alimentary limb by multiplying the total small bowel length by 40%. The remaining 60% of intestine carries the digestive juices through the biliopancreatic limb. The length of the common channel is approximately 10% of the total length of the small bowel. "Hess Method" refers to following Dr. Hess's calculation for determining the limb lengths and common channel length but often other factors are taken into consideration; like the patient's age, weight, BMI and goals. Each patient has a different length of common channel and alimentary loop designed to achieve the best results.

Not all surgeons use the "Hess Method". Some surgeon's instead use a standard measure for the common channel, 100 cm and 150 cm are often used.

You don't give a lot of information about what you *did* change to lose weight.  The DS is the best WLS out there, but it's not something that you should expect to be eating anything you want to lose the weight either.  I ate very Atkins-like until I was at goal, restricting carbs to under 50 grams a day. Ididn't eat sugar, bread, pasta, rice, or processed foods while I was losing.  Once I got to goal the DS became much less like a diet, and much more like a normal life/diet.  But I would say that I was VERY concerned with what I ate while I was losing.  I don't understand where people get the idea that they'll not have to change anything, get the DS, and then just lose, lose, lose. As kick ass as that would be, it's just not a reality.  You may have low carbed, but you didn't exactly specify.  It sounds more like you thought the surgery would be the thing to get you to lose the weight.  Am I reading you right?  Have you made protein first a priority in your post DS life, only eating everything else once you've gotten in your protein?  Do you know about your required vitamin intake?  I have a million questions, I guess it would be easier to help you if we knew more.

Your surgeon isn't one I'm familiar with.  Were you one of his first DSers?  Do you know who he proctored under?  I'd be concerned about going back to him for the revision if a revision is what you choose to do.  I'm sorry you have had a rough experience.  I know you don't like the idea of "dieting" but it would be worth a shot to avoid surgery.  Are you willing to try anything possible to avoid surgery?  Our group could give you some great pointers in how to lose again, as there are many here who have lost their own regain.

Lori

 I totally agree with lori, I am not too sure if you were following your "Surgeons guidelines" or not, or what you were doing as far as dietery habits, but yes I can gurantee if you eat an atkins style diet it should re-start your weight loss.  Don't give up.  And it actually happens fairly quickly.  

Just curious about something.  If having to eat adkins like after surgery -- why not just do that prior to surgery and thus avoid surgery all together? 

Not trying to be "argumentative" or anything of that nature.  I do realize we have to get our protein in (and thus adkins-like), but what happens when we are 4-5 months out from surgery and can get our protein in easily?  I mean ... that is when I got into trouble too -- I lost for 4-5 months and then stopped all together.  I'm 3.5 years out now and yes -- I do know my issues (I'm a carbaholic -- is there a 12 step program for that?  haha).

I guess my point is ... I'm now following an adkins like diet and it is HARD (just as hard as it would have been pre-surgery).  It leaves me wondering ... why did I have the surgery to begin with?  Ya know?  I certainly didn't think I would lose weight effortlessly or without modifying my diet -- but didn't think I would have to go to this extreme either.

I am short too (5'3").  I started at 281 lbs. and only lost to about 195.  As of last week, I was back up to 218.  And get this -- my stomach is HUGE (still wearing 2X or 3X tops).  I had hernia repair a year ago and still the stomach is huge.  Sigh.

I've been "low carbing" this week, but for me -- that means under 100.  When I have tried to go to 50 -- well ... I will end up binging within a few days, so I figure 100 was a good goal (FAR less than I was eating over the last several months!!!).   I will weigh again on Monday to see if I'll have to reduce the carbs even more ... but I'm pretty sure I have lost weight this week.

Debbie ~

The answer is that "Atkins" eating without malabsorption doesn't get many of us anywhere to speak of. We need that malabsorption.

Good for you to cut the carbs so much! I know that is a big challenge. I don't think you have to come that close to totally eliminating them, as long as it's a big change from what you were eating. Give it some time to make this your "new normal" way of eating and see how your body responds. One week is not long enough to see real results.

How's your protein intake?

Protein intake is FANTASTIC!  I'm usually around 140 grams per day.  One day this past week, I was lower, so I drank one of my protein bullets (1/2 in the morning for 21 grams and 1/2 in the evening).  That put me back up to 120 for the day or so.

I will admit that when I really got out of control again with my carbs, my protein was probably hovering around 75 which isn't enough for us DS'ers, I know.

I realize one week isn't enough to see true results, but I'm just glad the first week is nearly under my belt because it is getting easier each day. 

I haven't lost any weight to speak of for over 3 years .... so any scale movement in the right direction will make me ecstatic!!  hehe

Debbie ~

YAY YOU! You are moving in the right direction for a long life of good health, and that's what's most important. Hopefully you'll also see some weight loss results.

I think that's why it's SOO important for people to START they're journey after the DS by eating Atkins-like.  It's certainly not as restrictive as Atkins, and I for sure messed up from time to time. But for myself and many others, when eating this way,  we were able to kick-start our metabolisms, establish a good eating pattern by eating the foods that work for our bodies post-DS, and get the weight off before messing around with carbs.  Once carbs work their way into your diet, they are HARDDDD to get out!  But once I was at goal, I was able to eat an ample amount of carbs and still maintain.  I've been at goal since 8 months out and have maintained at or below 145 since then.  I do not believe that this works for EVERYONE, but I do believe it's everyone's BEST chance at losing the weight.  I know there will be some who disagree, but I know that it's working for me.  When I see the scale creep up a few pounds, I cut the sugar and carbs and within a week am always back in my comfort zone of 140-145.  I also know that when eating meats, cheeses, nuts, eggs, and protein shakes that my body not only feels it's very best, but I suffer from VERY little gas issues whatsoever. 

Lori

I really appreciate it when these types of posts are made.  I am early out and eating as low carb as I know how.  The only real carbs I eat are carbs that come attached to something that is pretty high protein (like nuts).

I am thrilled with my loss to date and plan to just stick with what I am doing until I am at goal or going under.

I avoid all flour, sugar, potato, rice, and pasta.  I tried Dreamfields pasta in tiny amounts but it made me vomit (literally).  I find when I get my protein up OVER 100 I am not hungry AT ALL.

Just my .02 as a newbie.

Becky