Re: Alimentary Limb - Please Answer!

[Guest guest]

Sherry, I'm sorry I didn't answer before. My total intestinal length

was 675cm. My alimentary tract was 250cm, of which 100cm was common

channel. The remaining 325cm is the biliary limb.

If you'd like, I'll email you a copy of my weight chart so you can

see the rate of weight loss I have had. Let me know.

I'm down to 156 now, at 21 months post-op, from my pre-op weight of

299. I reached my low weight at about 18 months post-op, and my

weight has stayed remarkably steady for the past 3 months.

M.

---

in Valrico, FL, age 38

Starting weight 299, now 156

Starting BMI 49.7, now 26.0

Lap DGB/DS by Dr. Rabkin 10-19-99

http://www.duodenalswitch.com

Direct replies: mailto:melanie@...

[Guest guest]

Sherry, I'm sorry I didn't answer before. My total intestinal length

was 675cm. My alimentary tract was 250cm, of which 100cm was common

channel. The remaining 325cm is the biliary limb.

If you'd like, I'll email you a copy of my weight chart so you can

see the rate of weight loss I have had. Let me know.

I'm down to 156 now, at 21 months post-op, from my pre-op weight of

299. I reached my low weight at about 18 months post-op, and my

weight has stayed remarkably steady for the past 3 months.

M.

---

in Valrico, FL, age 38

Starting weight 299, now 156

Starting BMI 49.7, now 26.0

Lap DGB/DS by Dr. Rabkin 10-19-99

http://www.duodenalswitch.com

Direct replies: mailto:melanie@...

[Guest guest]

Sherry, you might also want to post this to the DS_PostOpFriends

mailing list. I know that lots of post-ops are not active on this

list anymore, and some of them may have some good insight for you. To

join that list, go to this URL:

http://groups.yahoo.com/group/DS_PostOpFriends

M.

---

in Valrico, FL, age 38

Starting weight 299, now 156

Starting BMI 49.7, now 26.0

Lap DGB/DS by Dr. Rabkin 10-19-99

http://www.duodenalswitch.com

Direct replies: mailto:melanie@...

[Guest guest]

Sherry, you might also want to post this to the DS_PostOpFriends

mailing list. I know that lots of post-ops are not active on this

list anymore, and some of them may have some good insight for you. To

join that list, go to this URL:

http://groups.yahoo.com/group/DS_PostOpFriends

M.

---

in Valrico, FL, age 38

Starting weight 299, now 156

Starting BMI 49.7, now 26.0

Lap DGB/DS by Dr. Rabkin 10-19-99

http://www.duodenalswitch.com

Direct replies: mailto:melanie@...

[Guest guest]

>

> Sherry, I'm sorry I didn't answer before. My total intestinal

> length was 675cm. My alimentary tract was 250cm, of which 100cm

> was common channel. The remaining 325cm is the biliary limb.

Oops -- I should clarify. My total intestinal length was 675cm. My

alimentary tract is comprised of a 250cm food tract and a 100cm

common tract. The remaining 325cm is the biliary tract.

[Guest guest]

>

> Sherry, I'm sorry I didn't answer before. My total intestinal

> length was 675cm. My alimentary tract was 250cm, of which 100cm

> was common channel. The remaining 325cm is the biliary limb.

Oops -- I should clarify. My total intestinal length was 675cm. My

alimentary tract is comprised of a 250cm food tract and a 100cm

common tract. The remaining 325cm is the biliary tract.

[Guest guest]

Hi Sherry:

>

> I'm so upset because when I eat a piece of bread and you eat

> a piece of bread, *I* absorb more calories from it than you

> do because my alimentary limb is longer because of my surgeon

> being snatched out from under me (without my knowledge) on the

> day of surgery!

I don't blame you at all for being angry that they switched surgeons

on you without your knowledge. This strikes me as, at a minimum,

EXTREMELY unethical.

With that said, I think you're needlessly worried about the

alimentary limb length. But before I get into that, I want to make

sure we're talking about the same thing.

The alimentary limb carries food from the stomach and delivers it to

the " common " limb. According to Dr. Hess, (who created the surgery

we commonly refer to as " the DS " ), the alimentary limb should be 40%

as long as the original length of the entire small intestine.

Dr. Hess' followup study includes 342 women. (I'm ignoring the men

because you're a gal.) Among those 342 women, the pre-op lengths of

their small intestines ranged from 473 cm to 997 cm, with an average

length of 707 cm. Using Dr. Hess' 40% rule, this means that he left

these 342 women with alimentary channels ranging from 189 cm to 398.8

cm, with the average patient receiving an alimentary channel length

of 282.8 cm. Your length of 250 cm is well within this range.

Also, you should note that most docs who perform the surgery by lap

don't measure the small intestine. Instead, they use a " standard "

length for the alimentary limb. I'm not sure about the rest of them,

but I'm pretty sure that the New York docs led by Dr. Gagner use a

250 cm standard common channel. This is exactly the same length as

your common channel.

I say all of this advisedly, because I don't know how long your small

intestine was prior to your surgery.

HTH

Tom

Panniculectomy, Dr. Anthone, 11/10/2000

Open DS, Dr. Anthone, 03/30/2001

11/10/2000 . . . 386

03/30/2001 . . . 360

04/19/2001 . . . 338

05/03/2001 . . . 328

05/18/2001 . . . 316

06/03/2001 . . . 301

06/15/2001 . . . 299

06/25/2001 . . . 293

07/03/2001 . . . 286

07/16/2001 . . . 278

108 Ugly Pounds, GONE FOREVER!!!!!!!!!!!!!!!!

USC DS Support Group: <http://groups.yahoo.com/group/ds_usc>

[Guest guest]

Hi Sherry:

>

> I'm so upset because when I eat a piece of bread and you eat

> a piece of bread, *I* absorb more calories from it than you

> do because my alimentary limb is longer because of my surgeon

> being snatched out from under me (without my knowledge) on the

> day of surgery!

I don't blame you at all for being angry that they switched surgeons

on you without your knowledge. This strikes me as, at a minimum,

EXTREMELY unethical.

With that said, I think you're needlessly worried about the

alimentary limb length. But before I get into that, I want to make

sure we're talking about the same thing.

The alimentary limb carries food from the stomach and delivers it to

the " common " limb. According to Dr. Hess, (who created the surgery

we commonly refer to as " the DS " ), the alimentary limb should be 40%

as long as the original length of the entire small intestine.

Dr. Hess' followup study includes 342 women. (I'm ignoring the men

because you're a gal.) Among those 342 women, the pre-op lengths of

their small intestines ranged from 473 cm to 997 cm, with an average

length of 707 cm. Using Dr. Hess' 40% rule, this means that he left

these 342 women with alimentary channels ranging from 189 cm to 398.8

cm, with the average patient receiving an alimentary channel length

of 282.8 cm. Your length of 250 cm is well within this range.

Also, you should note that most docs who perform the surgery by lap

don't measure the small intestine. Instead, they use a " standard "

length for the alimentary limb. I'm not sure about the rest of them,

but I'm pretty sure that the New York docs led by Dr. Gagner use a

250 cm standard common channel. This is exactly the same length as

your common channel.

I say all of this advisedly, because I don't know how long your small

intestine was prior to your surgery.

HTH

Tom

Panniculectomy, Dr. Anthone, 11/10/2000

Open DS, Dr. Anthone, 03/30/2001

11/10/2000 . . . 386

03/30/2001 . . . 360

04/19/2001 . . . 338

05/03/2001 . . . 328

05/18/2001 . . . 316

06/03/2001 . . . 301

06/15/2001 . . . 299

06/25/2001 . . . 293

07/03/2001 . . . 286

07/16/2001 . . . 278

108 Ugly Pounds, GONE FOREVER!!!!!!!!!!!!!!!!

USC DS Support Group: <http://groups.yahoo.com/group/ds_usc>

[Guest guest]

>

> I need to know how long most of them are made these days. It

> would be comforting to hear of someone who started at my

> weight (420) who made it down to goal with a 250cm alimentary

> limb. But I don't think that's gonna happen. I think I

> need a revision and that's INFURIATING. And I don't use that

> word lightly.

No offense taken at all!

I don't know what the 'average' pre-op length is, but I do know that

most surgeons use a calculation by measuring your 'guts' vs.

determining how much weight you need to lose, to come up with the

measurement that is supposed to be optimum for your case. I know my

alimentary limb (common tract, where the food and bile mix, prior to

voiding) is 100cm, according to my surgical notes sent to my pcp.

Colleen - Iowa

Dr. Buchwald U of MN

1-15-01 DS

-80#

[Guest guest]

>

> I need to know how long most of them are made these days. It

> would be comforting to hear of someone who started at my

> weight (420) who made it down to goal with a 250cm alimentary

> limb. But I don't think that's gonna happen. I think I

> need a revision and that's INFURIATING. And I don't use that

> word lightly.

No offense taken at all!

I don't know what the 'average' pre-op length is, but I do know that

most surgeons use a calculation by measuring your 'guts' vs.

determining how much weight you need to lose, to come up with the

measurement that is supposed to be optimum for your case. I know my

alimentary limb (common tract, where the food and bile mix, prior to

voiding) is 100cm, according to my surgical notes sent to my pcp.

Colleen - Iowa

Dr. Buchwald U of MN

1-15-01 DS

-80#

[Guest guest]

I thought 250cm was standard for the alimentary limb. I seem to see that number

alot and when I was in consult with Dr. Heap that is the number he gave me.

Reading thru all of Dr. Baltasars papers, he does a 250cm also. i think that is

the norm. The common channel is where they are changing the length. Mine will

be 75cm. Some surgeons do 100cm. Why are you thinking you need a revision?

I've been following your loss due to your weight being the same as mine

(although I'm 5'8) and because you're in Washington like me...and you've done

fabulous. I can tell you're upset. I wish I could help you more.

" Sherry " wrote:

>Ok, I'm very upset right now. Mainly at the situation that put

>me here with the Surgeon scandal that happened the day of my surgery,

>but also because it seems people on here can't stop fighting long

>enough to answer my question.

>

>Some of you answered with " you've lost 105 pounds and that is great;

>just remember to get your protein first, vegetables second and

>avoid carbs " . Now, I know your hearts were definitely in the

>right place, but that is seriously not what I asked and I REALLY

>need to know.

>

>PLEASE, how long is your alimentary limb?? I would especially

>like to know this from Dr. Welker's patients. Also, how long

>is it before they shorten it in surgery, if anyone knows??

>

>I'm so upset because when I eat a piece of bread and you eat

>a piece of bread, *I* absorb more calories from it than you

>do because my alimentary limb is longer because of my surgeon

>being snatched out from under me (without my knowledge) on the

>day of surgery!

>

>If I could eat all protein & vegetables and avoid carbs, I

>wouldn't have needed this surgery in the first place. Carbs

>are absorbed in the alimentary limb and to find out that mine

>is longer than it should be is upsetting.

>

>I need to know how long most of them are made these days. It

>would be comforting to hear of someone who started at my

>weight (420) who made it down to goal with a 250cm alimentary

>limb. But I don't think that's gonna happen. I think I

>need a revision and that's INFURIATING. And I don't use that

>word lightly.

>

>Please don't take offense to anything in this post. It's not

>meant to inflame. I'm just trying to express how angry and

>upset I am and that I *need* answers, please!!

>

>-Sherry (Lake Marcel, WA)

>BPD/DS Feb. 2, 2001

>self-pay

>5'5 " / 315 pounds / 33 years old

>Lost 9 pounds in pre-op weight loss efforts

>Have lost 96 pounds since surgery!

>Total of 105 pounds gone forEVER!

>http://www.fluffynet.com/wls/

>

>

>----------------------------------------------------------------------

>

[Guest guest]

I thought 250cm was standard for the alimentary limb. I seem to see that number

alot and when I was in consult with Dr. Heap that is the number he gave me.

Reading thru all of Dr. Baltasars papers, he does a 250cm also. i think that is

the norm. The common channel is where they are changing the length. Mine will

be 75cm. Some surgeons do 100cm. Why are you thinking you need a revision?

I've been following your loss due to your weight being the same as mine

(although I'm 5'8) and because you're in Washington like me...and you've done

fabulous. I can tell you're upset. I wish I could help you more.

" Sherry " wrote:

>Ok, I'm very upset right now. Mainly at the situation that put

>me here with the Surgeon scandal that happened the day of my surgery,

>but also because it seems people on here can't stop fighting long

>enough to answer my question.

>

>Some of you answered with " you've lost 105 pounds and that is great;

>just remember to get your protein first, vegetables second and

>avoid carbs " . Now, I know your hearts were definitely in the

>right place, but that is seriously not what I asked and I REALLY

>need to know.

>

>PLEASE, how long is your alimentary limb?? I would especially

>like to know this from Dr. Welker's patients. Also, how long

>is it before they shorten it in surgery, if anyone knows??

>

>I'm so upset because when I eat a piece of bread and you eat

>a piece of bread, *I* absorb more calories from it than you

>do because my alimentary limb is longer because of my surgeon

>being snatched out from under me (without my knowledge) on the

>day of surgery!

>

>If I could eat all protein & vegetables and avoid carbs, I

>wouldn't have needed this surgery in the first place. Carbs

>are absorbed in the alimentary limb and to find out that mine

>is longer than it should be is upsetting.

>

>I need to know how long most of them are made these days. It

>would be comforting to hear of someone who started at my

>weight (420) who made it down to goal with a 250cm alimentary

>limb. But I don't think that's gonna happen. I think I

>need a revision and that's INFURIATING. And I don't use that

>word lightly.

>

>Please don't take offense to anything in this post. It's not

>meant to inflame. I'm just trying to express how angry and

>upset I am and that I *need* answers, please!!

>

>-Sherry (Lake Marcel, WA)

>BPD/DS Feb. 2, 2001

>self-pay

>5'5 " / 315 pounds / 33 years old

>Lost 9 pounds in pre-op weight loss efforts

>Have lost 96 pounds since surgery!

>Total of 105 pounds gone forEVER!

>http://www.fluffynet.com/wls/

>

>

>----------------------------------------------------------------------

>

[Guest guest]

Thanks. The reason I'm worried about it is because someone else

who had the same surgeon/surgery problems I did is having trouble

losing. Her common channel is 100cm and her alimentary is 250,

and she went to Dr. Welker who told her they BOTH need to be

shortened in a revision. And had she had the Dr. she wanted, they

would have both been shorter to begin with.

The other reason I'm upset is because my weight loss is not where

it should be, even though it has been " not bad " up til now. The

" milemarker " indication is that one should have lost have of what

expects to lose from this surgery by the 6 month mark....

Well, I started at 411 (after losing 9 pounds in pre-op weight

loss efforts). My *very conservative* goal weight is 180 pounds

because I figure I will have about 30 pounds of excess skin to

be removed & I am 5'5 " tall. Seems like a very reasonable goal

weight to me...

So 411 - 180 = 231 Thus 231 is what I should be able to reasonably

expect to lose from this surgery. Half of that is 115.5. I'm at

315 right now, which means I've lost 96 pounds since surgery.

So to lose half the weight I expect to by 6 months out, that means

I need to lose 19.5 pounds by August 2nd. I know there is no way

that is going to happen. Especially since I haven't lost a pound

since July 6th.

The alimentary limb is where carbs are absorbed, from what I

understand, and I am more of a carb person than a " fats " person.

I feel that if my alimentary limb were shorter (as apparently

it would have been if I'd had the surgeon I picked) that my

weight loss would be on target, instead of lagging some, as it

seems to be doing.

The reason I want a lot of people to answer about what their

alimentary length is is to see if I am correct in my theory,

or just in a state of plateau-induced wacko-ness.

I am trying to increase my protein intake and " watch " my carbs

a little better, but I fear denying myself too much of anything

or I will just get right back into the " diet mentality " and

wind up suffering in the long run physically, physiologically,

mentally & emotionally.

Yes, I think I'm a big baby when it comes to plateaus, but I

also think I have a good reason for asking the questions I'm

asking. I just " wanna know " !

Thanks so much for your reply, I appreciate it!

-Sherry (Lake Marcel, WA)

BPD/DS Feb. 2, 2001

self-pay

5'5 " / 315 pounds / 33 years old

Lost 9 pounds in pre-op weight loss efforts

Have lost 96 pounds since surgery!

Total of 105 pounds gone forEVER!

http://www.fluffynet.com/wls/

>

> >Ok, I'm very upset right now. Mainly at the situation that put

> >me here with the Surgeon scandal that happened the day of my

surgery,

> >but also because it seems people on here can't stop fighting long

> >enough to answer my question.

> >

> >Some of you answered with " you've lost 105 pounds and that is

great;

> >just remember to get your protein first, vegetables second and

> >avoid carbs " . Now, I know your hearts were definitely in the

> >right place, but that is seriously not what I asked and I REALLY

> >need to know.

> >

> >PLEASE, how long is your alimentary limb?? I would especially

> >like to know this from Dr. Welker's patients. Also, how long

> >is it before they shorten it in surgery, if anyone knows??

> >

> >I'm so upset because when I eat a piece of bread and you eat

> >a piece of bread, *I* absorb more calories from it than you

> >do because my alimentary limb is longer because of my surgeon

> >being snatched out from under me (without my knowledge) on the

> >day of surgery!

> >

> >If I could eat all protein & vegetables and avoid carbs, I

> >wouldn't have needed this surgery in the first place. Carbs

> >are absorbed in the alimentary limb and to find out that mine

> >is longer than it should be is upsetting.

> >

> >I need to know how long most of them are made these days. It

> >would be comforting to hear of someone who started at my

> >weight (420) who made it down to goal with a 250cm alimentary

> >limb. But I don't think that's gonna happen. I think I

> >need a revision and that's INFURIATING. And I don't use that

> >word lightly.

> >

> >Please don't take offense to anything in this post. It's not

> >meant to inflame. I'm just trying to express how angry and

> >upset I am and that I *need* answers, please!!

> >

> >-Sherry (Lake Marcel, WA)

> >BPD/DS Feb. 2, 2001

> >self-pay

> >5'5 " / 315 pounds / 33 years old

> >Lost 9 pounds in pre-op weight loss efforts

> >Have lost 96 pounds since surgery!

> >Total of 105 pounds gone forEVER!

> >http://www.fluffynet.com/wls/

> >

> >

> >-------------------------------------------------------------------

---

> >

[Guest guest]

Thanks. The reason I'm worried about it is because someone else

who had the same surgeon/surgery problems I did is having trouble

losing. Her common channel is 100cm and her alimentary is 250,

and she went to Dr. Welker who told her they BOTH need to be

shortened in a revision. And had she had the Dr. she wanted, they

would have both been shorter to begin with.

The other reason I'm upset is because my weight loss is not where

it should be, even though it has been " not bad " up til now. The

" milemarker " indication is that one should have lost have of what

expects to lose from this surgery by the 6 month mark....

Well, I started at 411 (after losing 9 pounds in pre-op weight

loss efforts). My *very conservative* goal weight is 180 pounds

because I figure I will have about 30 pounds of excess skin to

be removed & I am 5'5 " tall. Seems like a very reasonable goal

weight to me...

So 411 - 180 = 231 Thus 231 is what I should be able to reasonably

expect to lose from this surgery. Half of that is 115.5. I'm at

315 right now, which means I've lost 96 pounds since surgery.

So to lose half the weight I expect to by 6 months out, that means

I need to lose 19.5 pounds by August 2nd. I know there is no way

that is going to happen. Especially since I haven't lost a pound

since July 6th.

The alimentary limb is where carbs are absorbed, from what I

understand, and I am more of a carb person than a " fats " person.

I feel that if my alimentary limb were shorter (as apparently

it would have been if I'd had the surgeon I picked) that my

weight loss would be on target, instead of lagging some, as it

seems to be doing.

The reason I want a lot of people to answer about what their

alimentary length is is to see if I am correct in my theory,

or just in a state of plateau-induced wacko-ness.

I am trying to increase my protein intake and " watch " my carbs

a little better, but I fear denying myself too much of anything

or I will just get right back into the " diet mentality " and

wind up suffering in the long run physically, physiologically,

mentally & emotionally.

Yes, I think I'm a big baby when it comes to plateaus, but I

also think I have a good reason for asking the questions I'm

asking. I just " wanna know " !

Thanks so much for your reply, I appreciate it!

-Sherry (Lake Marcel, WA)

BPD/DS Feb. 2, 2001

self-pay

5'5 " / 315 pounds / 33 years old

Lost 9 pounds in pre-op weight loss efforts

Have lost 96 pounds since surgery!

Total of 105 pounds gone forEVER!

http://www.fluffynet.com/wls/

>

> >Ok, I'm very upset right now. Mainly at the situation that put

> >me here with the Surgeon scandal that happened the day of my

surgery,

> >but also because it seems people on here can't stop fighting long

> >enough to answer my question.

> >

> >Some of you answered with " you've lost 105 pounds and that is

great;

> >just remember to get your protein first, vegetables second and

> >avoid carbs " . Now, I know your hearts were definitely in the

> >right place, but that is seriously not what I asked and I REALLY

> >need to know.

> >

> >PLEASE, how long is your alimentary limb?? I would especially

> >like to know this from Dr. Welker's patients. Also, how long

> >is it before they shorten it in surgery, if anyone knows??

> >

> >I'm so upset because when I eat a piece of bread and you eat

> >a piece of bread, *I* absorb more calories from it than you

> >do because my alimentary limb is longer because of my surgeon

> >being snatched out from under me (without my knowledge) on the

> >day of surgery!

> >

> >If I could eat all protein & vegetables and avoid carbs, I

> >wouldn't have needed this surgery in the first place. Carbs

> >are absorbed in the alimentary limb and to find out that mine

> >is longer than it should be is upsetting.

> >

> >I need to know how long most of them are made these days. It

> >would be comforting to hear of someone who started at my

> >weight (420) who made it down to goal with a 250cm alimentary

> >limb. But I don't think that's gonna happen. I think I

> >need a revision and that's INFURIATING. And I don't use that

> >word lightly.

> >

> >Please don't take offense to anything in this post. It's not

> >meant to inflame. I'm just trying to express how angry and

> >upset I am and that I *need* answers, please!!

> >

> >-Sherry (Lake Marcel, WA)

> >BPD/DS Feb. 2, 2001

> >self-pay

> >5'5 " / 315 pounds / 33 years old

> >Lost 9 pounds in pre-op weight loss efforts

> >Have lost 96 pounds since surgery!

> >Total of 105 pounds gone forEVER!

> >http://www.fluffynet.com/wls/

> >

> >

> >-------------------------------------------------------------------

---

> >

[Guest guest]

-

I really appreciate your answers. I crave numbers, figures &

such. It's really good to know how well you're doing with

the same length common channel & alimentary limb that I have.

I started out a lot heavier than you though, and am afraid I

might be more of a carb person than you are. Do you have any

idea how many carbs you get in a day? Have you ever tracked it?

I just like to see where I compare with others. Also, do you

know at what rate you absorb carbs with a 250cm alimentary - is

it about 50%? Just curious.

Thanks for all the info & support. Take care!

-Sherry (Lake Marcel, WA)

BPD/DS Feb. 2, 2001

self-pay

5'5 " / 315 pounds / 33 years old

Lost 9 pounds in pre-op weight loss efforts

Have lost 96 pounds since surgery!

Total of 105 pounds gone forEVER!

http://www.fluffynet.com/wls/

> >

> > Sherry, I'm sorry I didn't answer before. My total intestinal

> > length was 675cm. My alimentary tract was 250cm, of which 100cm

> > was common channel. The remaining 325cm is the biliary limb.

>

> Oops -- I should clarify. My total intestinal length was 675cm. My

> alimentary tract is comprised of a 250cm food tract and a 100cm

> common tract. The remaining 325cm is the biliary tract.

>

>

[Guest guest]

-

I really appreciate your answers. I crave numbers, figures &

such. It's really good to know how well you're doing with

the same length common channel & alimentary limb that I have.

I started out a lot heavier than you though, and am afraid I

might be more of a carb person than you are. Do you have any

idea how many carbs you get in a day? Have you ever tracked it?

I just like to see where I compare with others. Also, do you

know at what rate you absorb carbs with a 250cm alimentary - is

it about 50%? Just curious.

Thanks for all the info & support. Take care!

-Sherry (Lake Marcel, WA)

BPD/DS Feb. 2, 2001

self-pay

5'5 " / 315 pounds / 33 years old

Lost 9 pounds in pre-op weight loss efforts

Have lost 96 pounds since surgery!

Total of 105 pounds gone forEVER!

http://www.fluffynet.com/wls/

> >

> > Sherry, I'm sorry I didn't answer before. My total intestinal

> > length was 675cm. My alimentary tract was 250cm, of which 100cm

> > was common channel. The remaining 325cm is the biliary limb.

>

> Oops -- I should clarify. My total intestinal length was 675cm. My

> alimentary tract is comprised of a 250cm food tract and a 100cm

> common tract. The remaining 325cm is the biliary tract.

>

>

[Guest guest]

Tom-

I really appreciate your well-thought-out reply. I discussed with

my Surgeon the fact that my body was SO EFFICIENT at making &

storing fat that I wanted the slightly smaller common channel, etc.

In some ways I think I'm overly-worried about it, and in others

I see the very real figures in black & white that I have not lost

as much as I should have at this point. (I need to lose 19.5 pounds

in the next 2 weeks in order to have lost half of my excess weight

by the 6 month mark).

I've been driving my husband crazy speculating about it, so I

guess it's only fair I do the same thing to ya'll. LOL

Thanks for your reply.

-Sherry (Lake Marcel, WA)

BPD/DS Feb. 2, 2001

self-pay

5'5 " / 315 pounds / 33 years old

Lost 9 pounds in pre-op weight loss efforts

Have lost 96 pounds since surgery!

Total of 105 pounds gone forEVER!

http://www.fluffynet.com/wls/

>

> Hi Sherry:

> >

> > I'm so upset because when I eat a piece of bread and you eat

> > a piece of bread, *I* absorb more calories from it than you

> > do because my alimentary limb is longer because of my surgeon

> > being snatched out from under me (without my knowledge) on the

> > day of surgery!

>

> I don't blame you at all for being angry that they switched

surgeons

> on you without your knowledge. This strikes me as, at a minimum,

> EXTREMELY unethical.

>

> With that said, I think you're needlessly worried about the

> alimentary limb length. But before I get into that, I want to make

> sure we're talking about the same thing.

>

> The alimentary limb carries food from the stomach and delivers it

to

> the " common " limb. According to Dr. Hess, (who created the surgery

> we commonly refer to as " the DS " ), the alimentary limb should be

40%

> as long as the original length of the entire small intestine.

>

> Dr. Hess' followup study includes 342 women. (I'm ignoring the men

> because you're a gal.) Among those 342 women, the pre-op lengths

of

> their small intestines ranged from 473 cm to 997 cm, with an

average

> length of 707 cm. Using Dr. Hess' 40% rule, this means that he

left

> these 342 women with alimentary channels ranging from 189 cm to

398.8

> cm, with the average patient receiving an alimentary channel length

> of 282.8 cm. Your length of 250 cm is well within this range.

>

> Also, you should note that most docs who perform the surgery by lap

> don't measure the small intestine. Instead, they use a " standard "

> length for the alimentary limb. I'm not sure about the rest of

them,

> but I'm pretty sure that the New York docs led by Dr. Gagner use a

> 250 cm standard common channel. This is exactly the same length as

> your common channel.

>

> I say all of this advisedly, because I don't know how long your

small

> intestine was prior to your surgery.

>

> HTH

>

> Tom

>

> Panniculectomy, Dr. Anthone, 11/10/2000

> Open DS, Dr. Anthone, 03/30/2001

> 11/10/2000 . . . 386

> 03/30/2001 . . . 360

> 04/19/2001 . . . 338

> 05/03/2001 . . . 328

> 05/18/2001 . . . 316

> 06/03/2001 . . . 301

> 06/15/2001 . . . 299

> 06/25/2001 . . . 293

> 07/03/2001 . . . 286

> 07/16/2001 . . . 278

> 108 Ugly Pounds, GONE FOREVER!!!!!!!!!!!!!!!!

> USC DS Support Group: <http://groups.yahoo.com/group/ds_usc>

[Guest guest]

Tom-

I really appreciate your well-thought-out reply. I discussed with

my Surgeon the fact that my body was SO EFFICIENT at making &

storing fat that I wanted the slightly smaller common channel, etc.

In some ways I think I'm overly-worried about it, and in others

I see the very real figures in black & white that I have not lost

as much as I should have at this point. (I need to lose 19.5 pounds

in the next 2 weeks in order to have lost half of my excess weight

by the 6 month mark).

I've been driving my husband crazy speculating about it, so I

guess it's only fair I do the same thing to ya'll. LOL

Thanks for your reply.

-Sherry (Lake Marcel, WA)

BPD/DS Feb. 2, 2001

self-pay

5'5 " / 315 pounds / 33 years old

Lost 9 pounds in pre-op weight loss efforts

Have lost 96 pounds since surgery!

Total of 105 pounds gone forEVER!

http://www.fluffynet.com/wls/

>

> Hi Sherry:

> >

> > I'm so upset because when I eat a piece of bread and you eat

> > a piece of bread, *I* absorb more calories from it than you

> > do because my alimentary limb is longer because of my surgeon

> > being snatched out from under me (without my knowledge) on the

> > day of surgery!

>

> I don't blame you at all for being angry that they switched

surgeons

> on you without your knowledge. This strikes me as, at a minimum,

> EXTREMELY unethical.

>

> With that said, I think you're needlessly worried about the

> alimentary limb length. But before I get into that, I want to make

> sure we're talking about the same thing.

>

> The alimentary limb carries food from the stomach and delivers it

to

> the " common " limb. According to Dr. Hess, (who created the surgery

> we commonly refer to as " the DS " ), the alimentary limb should be

40%

> as long as the original length of the entire small intestine.

>

> Dr. Hess' followup study includes 342 women. (I'm ignoring the men

> because you're a gal.) Among those 342 women, the pre-op lengths

of

> their small intestines ranged from 473 cm to 997 cm, with an

average

> length of 707 cm. Using Dr. Hess' 40% rule, this means that he

left

> these 342 women with alimentary channels ranging from 189 cm to

398.8

> cm, with the average patient receiving an alimentary channel length

> of 282.8 cm. Your length of 250 cm is well within this range.

>

> Also, you should note that most docs who perform the surgery by lap

> don't measure the small intestine. Instead, they use a " standard "

> length for the alimentary limb. I'm not sure about the rest of

them,

> but I'm pretty sure that the New York docs led by Dr. Gagner use a

> 250 cm standard common channel. This is exactly the same length as

> your common channel.

>

> I say all of this advisedly, because I don't know how long your

small

> intestine was prior to your surgery.

>

> HTH

>

> Tom

>

> Panniculectomy, Dr. Anthone, 11/10/2000

> Open DS, Dr. Anthone, 03/30/2001

> 11/10/2000 . . . 386

> 03/30/2001 . . . 360

> 04/19/2001 . . . 338

> 05/03/2001 . . . 328

> 05/18/2001 . . . 316

> 06/03/2001 . . . 301

> 06/15/2001 . . . 299

> 06/25/2001 . . . 293

> 07/03/2001 . . . 286

> 07/16/2001 . . . 278

> 108 Ugly Pounds, GONE FOREVER!!!!!!!!!!!!!!!!

> USC DS Support Group: <http://groups.yahoo.com/group/ds_usc>

[Guest guest]

Dear Sherry:

I am also 250cm and it took me 19 months to lose all my weight not one year. I also have to tell you I still don't own a scale and during those 19 months I only weighed myself once a month at the most and if I was ever on a plateau I am not aware of it as I did not worry about it. I trusted the surgery to do what Dr. Anthone said it would and it did.

I ate lots of protein and never denied myself anything I wanted including carbs but then as now I still crave protein first, I eat any veggies I have a taste for, I eat potatoes or yams or rice of some kind for dinner each night and I eat something sweet everyday although I had no taste for sweets until I was around 19 months out except for regular Coke.

Try to relax and give your body a chance to do what it is supposed to do then if there is a problem then you can decide on your next step.

Huggles,

Tiger Lake

Female

160 lbs. BMI 21.7

224lbs gone

165 1/2 inches gone

6' -- 53yrs young

Dr. Anthone@USC So. Calif.

Open DS

Surgery 1/13/99 384lbs BMI 51.21

Last Visit 4/20/99 315.5 BMI 42.07

7/19/99 274.8 BMI 36.64

9/03/99 259.3 BMI 34.54

10/04/99 252.4 BMI 34.02

10/25/99 231 BMI 32

12/17/99 217.5 BMI 30.2

01/19/00 211 BMI 28

02/20/00 195 BMI 26

04/08/00 182.9 BMI 25

Hernia repair on 06/07/00 Dr. Anthone

Tummy Tuck & Breast Reduction Dr. Downey

06/07/00 160 BMI 21.7

01/08/01 164.3 BMI 21.7

Total Weight Loss! 224.1lbs GONE!

Total inches lost 154.5

[Guest guest]

Dear Sherry:

I am also 250cm and it took me 19 months to lose all my weight not one year. I also have to tell you I still don't own a scale and during those 19 months I only weighed myself once a month at the most and if I was ever on a plateau I am not aware of it as I did not worry about it. I trusted the surgery to do what Dr. Anthone said it would and it did.

I ate lots of protein and never denied myself anything I wanted including carbs but then as now I still crave protein first, I eat any veggies I have a taste for, I eat potatoes or yams or rice of some kind for dinner each night and I eat something sweet everyday although I had no taste for sweets until I was around 19 months out except for regular Coke.

Try to relax and give your body a chance to do what it is supposed to do then if there is a problem then you can decide on your next step.

Huggles,

Tiger Lake

Female

160 lbs. BMI 21.7

224lbs gone

165 1/2 inches gone

6' -- 53yrs young

Dr. Anthone@USC So. Calif.

Open DS

Surgery 1/13/99 384lbs BMI 51.21

Last Visit 4/20/99 315.5 BMI 42.07

7/19/99 274.8 BMI 36.64

9/03/99 259.3 BMI 34.54

10/04/99 252.4 BMI 34.02

10/25/99 231 BMI 32

12/17/99 217.5 BMI 30.2

01/19/00 211 BMI 28

02/20/00 195 BMI 26

04/08/00 182.9 BMI 25

Hernia repair on 06/07/00 Dr. Anthone

Tummy Tuck & Breast Reduction Dr. Downey

06/07/00 160 BMI 21.7

01/08/01 164.3 BMI 21.7

Total Weight Loss! 224.1lbs GONE!

Total inches lost 154.5

[Guest guest]

I'm very interested in your answer...I also am a carb eater so if this is true

I'll have to talk to Dr. Baltasar about it. I don't want to run into the same

thing if there is a way to do something before hand. I'm sorry you're so

stressed. I know things like this can be very disheartening. Hang in

there...You are doing great!

AJ

" Sherry " wrote:

>Thanks. The reason I'm worried about it is because someone else

>who had the same surgeon/surgery problems I did is having trouble

>losing. Her common channel is 100cm and her alimentary is 250,

>and she went to Dr. Welker who told her they BOTH need to be

>shortened in a revision. And had she had the Dr. she wanted, they

>would have both been shorter to begin with.

>

>The other reason I'm upset is because my weight loss is not where

>it should be, even though it has been " not bad " up til now. The

> " milemarker " indication is that one should have lost have of what

>expects to lose from this surgery by the 6 month mark....

>

>Well, I started at 411 (after losing 9 pounds in pre-op weight

>loss efforts). My *very conservative* goal weight is 180 pounds

>because I figure I will have about 30 pounds of excess skin to

>be removed & I am 5'5 " tall. Seems like a very reasonable goal

>weight to me...

>

>So 411 - 180 = 231 Thus 231 is what I should be able to reasonably

>expect to lose from this surgery. Half of that is 115.5. I'm at

>315 right now, which means I've lost 96 pounds since surgery.

>

>So to lose half the weight I expect to by 6 months out, that means

>I need to lose 19.5 pounds by August 2nd. I know there is no way

>that is going to happen. Especially since I haven't lost a pound

>since July 6th.

>

>The alimentary limb is where carbs are absorbed, from what I

>understand, and I am more of a carb person than a " fats " person.

>I feel that if my alimentary limb were shorter (as apparently

>it would have been if I'd had the surgeon I picked) that my

>weight loss would be on target, instead of lagging some, as it

>seems to be doing.

>

>The reason I want a lot of people to answer about what their

>alimentary length is is to see if I am correct in my theory,

>or just in a state of plateau-induced wacko-ness.

>

>I am trying to increase my protein intake and " watch " my carbs

>a little better, but I fear denying myself too much of anything

>or I will just get right back into the " diet mentality " and

>wind up suffering in the long run physically, physiologically,

>mentally & emotionally.

>

>Yes, I think I'm a big baby when it comes to plateaus, but I

>also think I have a good reason for asking the questions I'm

>asking. I just " wanna know " !

>

>Thanks so much for your reply, I appreciate it!

>

>-Sherry (Lake Marcel, WA)

>BPD/DS Feb. 2, 2001

>self-pay

>5'5 " / 315 pounds / 33 years old

>Lost 9 pounds in pre-op weight loss efforts

>Have lost 96 pounds since surgery!

>Total of 105 pounds gone forEVER!

>http://www.fluffynet.com/wls/

>

>

>>

>> >Ok, I'm very upset right now. Mainly at the situation that put

>> >me here with the Surgeon scandal that happened the day of my

>surgery,

>> >but also because it seems people on here can't stop fighting long

>> >enough to answer my question.

>> >

>> >Some of you answered with " you've lost 105 pounds and that is

>great;

>> >just remember to get your protein first, vegetables second and

>> >avoid carbs " . Now, I know your hearts were definitely in the

>> >right place, but that is seriously not what I asked and I REALLY

>> >need to know.

>> >

>> >PLEASE, how long is your alimentary limb?? I would especially

>> >like to know this from Dr. Welker's patients. Also, how long

>> >is it before they shorten it in surgery, if anyone knows??

>> >

>> >I'm so upset because when I eat a piece of bread and you eat

>> >a piece of bread, *I* absorb more calories from it than you

>> >do because my alimentary limb is longer because of my surgeon

>> >being snatched out from under me (without my knowledge) on the

>> >day of surgery!

>> >

>> >If I could eat all protein & vegetables and avoid carbs, I

>> >wouldn't have needed this surgery in the first place. Carbs

>> >are absorbed in the alimentary limb and to find out that mine

>> >is longer than it should be is upsetting.

>> >

>> >I need to know how long most of them are made these days. It

>> >would be comforting to hear of someone who started at my

>> >weight (420) who made it down to goal with a 250cm alimentary

>> >limb. But I don't think that's gonna happen. I think I

>> >need a revision and that's INFURIATING. And I don't use that

>> >word lightly.

>> >

>> >Please don't take offense to anything in this post. It's not

>> >meant to inflame. I'm just trying to express how angry and

>> >upset I am and that I *need* answers, please!!

>> >

>> >-Sherry (Lake Marcel, WA)

>> >BPD/DS Feb. 2, 2001

>> >self-pay

>> >5'5 " / 315 pounds / 33 years old

>> >Lost 9 pounds in pre-op weight loss efforts

>> >Have lost 96 pounds since surgery!

>> >Total of 105 pounds gone forEVER!

>> >http://www.fluffynet.com/wls/

>> >

>> >

>> >-------------------------------------------------------------------

>---

>> >

[Guest guest]

I'm very interested in your answer...I also am a carb eater so if this is true

I'll have to talk to Dr. Baltasar about it. I don't want to run into the same

thing if there is a way to do something before hand. I'm sorry you're so

stressed. I know things like this can be very disheartening. Hang in

there...You are doing great!

AJ

" Sherry " wrote:

>Thanks. The reason I'm worried about it is because someone else

>who had the same surgeon/surgery problems I did is having trouble

>losing. Her common channel is 100cm and her alimentary is 250,

>and she went to Dr. Welker who told her they BOTH need to be

>shortened in a revision. And had she had the Dr. she wanted, they

>would have both been shorter to begin with.

>

>The other reason I'm upset is because my weight loss is not where

>it should be, even though it has been " not bad " up til now. The

> " milemarker " indication is that one should have lost have of what

>expects to lose from this surgery by the 6 month mark....

>

>Well, I started at 411 (after losing 9 pounds in pre-op weight

>loss efforts). My *very conservative* goal weight is 180 pounds

>because I figure I will have about 30 pounds of excess skin to

>be removed & I am 5'5 " tall. Seems like a very reasonable goal

>weight to me...

>

>So 411 - 180 = 231 Thus 231 is what I should be able to reasonably

>expect to lose from this surgery. Half of that is 115.5. I'm at

>315 right now, which means I've lost 96 pounds since surgery.

>

>So to lose half the weight I expect to by 6 months out, that means

>I need to lose 19.5 pounds by August 2nd. I know there is no way

>that is going to happen. Especially since I haven't lost a pound

>since July 6th.

>

>The alimentary limb is where carbs are absorbed, from what I

>understand, and I am more of a carb person than a " fats " person.

>I feel that if my alimentary limb were shorter (as apparently

>it would have been if I'd had the surgeon I picked) that my

>weight loss would be on target, instead of lagging some, as it

>seems to be doing.

>

>The reason I want a lot of people to answer about what their

>alimentary length is is to see if I am correct in my theory,

>or just in a state of plateau-induced wacko-ness.

>

>I am trying to increase my protein intake and " watch " my carbs

>a little better, but I fear denying myself too much of anything

>or I will just get right back into the " diet mentality " and

>wind up suffering in the long run physically, physiologically,

>mentally & emotionally.

>

>Yes, I think I'm a big baby when it comes to plateaus, but I

>also think I have a good reason for asking the questions I'm

>asking. I just " wanna know " !

>

>Thanks so much for your reply, I appreciate it!

>

>-Sherry (Lake Marcel, WA)

>BPD/DS Feb. 2, 2001

>self-pay

>5'5 " / 315 pounds / 33 years old

>Lost 9 pounds in pre-op weight loss efforts

>Have lost 96 pounds since surgery!

>Total of 105 pounds gone forEVER!

>http://www.fluffynet.com/wls/

>

>

>>

>> >Ok, I'm very upset right now. Mainly at the situation that put

>> >me here with the Surgeon scandal that happened the day of my

>surgery,

>> >but also because it seems people on here can't stop fighting long

>> >enough to answer my question.

>> >

>> >Some of you answered with " you've lost 105 pounds and that is

>great;

>> >just remember to get your protein first, vegetables second and

>> >avoid carbs " . Now, I know your hearts were definitely in the

>> >right place, but that is seriously not what I asked and I REALLY

>> >need to know.

>> >

>> >PLEASE, how long is your alimentary limb?? I would especially

>> >like to know this from Dr. Welker's patients. Also, how long

>> >is it before they shorten it in surgery, if anyone knows??

>> >

>> >I'm so upset because when I eat a piece of bread and you eat

>> >a piece of bread, *I* absorb more calories from it than you

>> >do because my alimentary limb is longer because of my surgeon

>> >being snatched out from under me (without my knowledge) on the

>> >day of surgery!

>> >

>> >If I could eat all protein & vegetables and avoid carbs, I

>> >wouldn't have needed this surgery in the first place. Carbs

>> >are absorbed in the alimentary limb and to find out that mine

>> >is longer than it should be is upsetting.

>> >

>> >I need to know how long most of them are made these days. It

>> >would be comforting to hear of someone who started at my

>> >weight (420) who made it down to goal with a 250cm alimentary

>> >limb. But I don't think that's gonna happen. I think I

>> >need a revision and that's INFURIATING. And I don't use that

>> >word lightly.

>> >

>> >Please don't take offense to anything in this post. It's not

>> >meant to inflame. I'm just trying to express how angry and

>> >upset I am and that I *need* answers, please!!

>> >

>> >-Sherry (Lake Marcel, WA)

>> >BPD/DS Feb. 2, 2001

>> >self-pay

>> >5'5 " / 315 pounds / 33 years old

>> >Lost 9 pounds in pre-op weight loss efforts

>> >Have lost 96 pounds since surgery!

>> >Total of 105 pounds gone forEVER!

>> >http://www.fluffynet.com/wls/

>> >

>> >

>> >-------------------------------------------------------------------

>---

>> >

[Guest guest]

I had my surgery on May 11th, my alimentary limb is

75cm,

I think you meant your common channel...I dont think anyone has an alimentary limb that short...LOL

~~* AJ *~~

BMI 59

Surgery date 7/24/01

going self pay - Dr Baltasar Spain

Check out the

Bellingham Support for WLS

WWW.lookin2bthin.homestead.com

[Guest guest]

I had my surgery on May 11th, my alimentary limb is

75cm,

I think you meant your common channel...I dont think anyone has an alimentary limb that short...LOL

~~* AJ *~~

BMI 59

Surgery date 7/24/01

going self pay - Dr Baltasar Spain

Check out the

Bellingham Support for WLS

WWW.lookin2bthin.homestead.com

[Guest guest]

In a message dated 7/17/01 10:23:42 PM, duodenalswitch writes:

<< I'm very interested in your answer...I also am a carb eater so if this is

true I'll have to talk to Dr. Baltasar about it. I don't want to run into

the same thing if there is a way to do something before hand. I'm sorry

you're so stressed. I know things like this can be very disheartening. Hang

in there...You are doing great!

>>

Sherry: Sometimes I worry about this, too --- eating carbs and all. I was

a real heavy carb eater as a pre-op (no pun intended LOL). Now, I focus on

protein and really don't have room for an excessive amount of carbs like

before. I do eat them, though. My situation is different from the original

poster's, though - I have lost 50 pct of my excess weight (about 70) at five

months out, even though it has seemed pretty slow up to now. I want to get

down to 170 and started at 307. I'm now 236.... about 70 more lbs to go,

man! AGH The halfway point is the worst!!!!

I'm not totally sure whether or not certain people's body's will utilize

carbs more efficiently (i.e. - store them) even after the DS. But, I do know

that I had only lost 15 lbs at three weeks out (whereas others had lost

20-25) and I mainly ate PROTEIN with a passion. I had little if any carbs

(absolutely no room for it!). So, I know that my loss was not as fast as

others to begin with and the carbs were not even an issue at that point.

I also have a 250 alimentary/100 cm common channel. I have been very

satisfied with my loss and rate of loss (my skin has adjusted really well,

I've felt great for the most part). BUT, I can obsess about it and wonder

whether it will just 'slow down' or 'stop' whenever I'm on a plateau. My

body really tends to fight the surgery and hangs on for dear life. Then, I

get an extremely rapid loss for a few days and level out... once again. Sigh.

I think you have some good questions -- I wish there was some more research

about this topic and how carbs are processed, etc. You can try the real

protein-intensive approach and see if it works... I'm not *totally* convinced

that it's what one eats. I think each body really reacts differently and

will go at it's own rate regardless.....

all the best,

lap ds with gallbladder removal

January 25, 2001

five months post-op and still feelin' fabu!

pre-op: 307 lbs/bmi 45 (5'9 1/2 " )

now: 236 (and still goin' down????)