Complications - Page 2 - ThinnerTimes

LQQkn · 09-03-2007, 06:02 PM

I know you are sincere, trying to bring to light some of the questions that were asked.. I wish there were answers for this stuff, it doesn't exist as far as I know. I've been to 7 different bariatric doctors, all shake there heads and literally throw their hands up and say "I don't know" that's the part that is frustrating. I truly am happy that you are not experiencing any real bad stuff. Thank you for your response. Janie

LQQkn · 09-03-2007, 06:12 PM

Dyann,

Pretty much agree with your post, only thing I would say is how would patients end up with malabsorption issues because they had not quite 100 lbs to lose, as opposed to someone who has more? I'm not a doctor you are.. and so if it does correct me. But I can't see how it would factor in.. and in the two cases I know for sure, myself and Paige I can say that both of us had over 100 lbs to lose, and I had two co morbidity's.. not sure how many Paige had. Unfortunately yes we are TESTs and blazing the way for others.. not sure I like to be a guinea pig... but I guess I am.

Dyann wrote:

Just as a casual observer, and I have no data to support this, I feel the some of the ones who have problems with losing too much and severe malabsorption are the ones who barely met criteria. Maybe those who have 80-90 pounds to lose should not have this procedure and should have a lap band, even if you have a co morbidity?? I don't know the answer and unfortunately we are the test patients and blazing the trail for those who come after us.[/quote]

Dyann · 09-03-2007, 06:17 PM

Here is a link to the society. I forgot at the last meeting, they voted to change their name to reflect the wide range of issues that affect the patients. ASMBS (American Society for Metabolic and Bariatric Surgery)

http://www.asbs.org/

Dyann · 09-04-2007, 03:47 AM

Quote:

Originally Posted by LQQkn

Dyann,

Pretty much agree with your post, only thing I would say is how would patients end up with malabsorption issues because they had not quite 100 lbs to lose, as opposed to someone who has more? I'm not a doctor you are.. and so if it does correct me. But I can't see how it would factor in.. and in the two cases I know for sure, myself and Paige I can say that both of us had over 100 lbs to lose, and I had two co morbidity's.. not sure how many Paige had. Unfortunately yes we are TESTs and blazing the way for others.. not sure I like to be a guinea pig... but I guess I am.

1. The length of the limb of your bypass is one determinant of how much malabsorption you have. That allows the weight loss, but also the deficiencies. So those with less to lose may need a shorter limb.

2. Over time, your body compensates for the bypassed limb. That is why dumping eases, weightloss slows or stops, and some nutritional supplements can be stopped as you can also eat more and get nutrition from food. The villi in your intestines get larger and make a greater absorptive capacity. Not like the surgery never happened, but still improved. For those who are at the lower end of weight loss needs, our bodies may not compensate in time and the weight loss happens fast and they are left with a situation of continued loss beyond the healthy range. Some may never compensate and have severe issues, others do quickly. The weight loss phase is about 18 months to two years. Those who lose it all in 6 months are not at a point where they can physically eat enough to maintain weight and proper nutrition.

As I said, I have no data, it is just a thought out hypothesis which needs to be studied. Most research clumps us all together. They need to subcategorize us to find common threads. We see here, men lose at different rates. Should studies be separated into men and women?? Should they study based on starting BMI complication rates??

Only time will tell

Squishy · 09-04-2007, 04:49 AM

This is getting very interesting. The points about separating patients into more subcategories seems particularly important.

One thing I wondered about is how whether a person is an endomorph, ectomorph, or Mesomorph might effect the outcome.

Isn't it true that endomorphs have several more feet of intestines? If so, then a longer limb would have less long-term effect than it would for an ecto or meso. So maybe those who do not have the ability to absorb what they need are ecto or mesos.

I'm not a doctor...and I didn't even stay at a Holiday Inn Express last night

, but if everyone is lumped together in the research, and some of us have several feet more intestines than others, then it seems logical that this could be a contributing factor for success.

Thoughts?

-Mike-

Dyann · 09-04-2007, 06:01 AM

Quote:

Originally Posted by Squishy

One thing I wondered about is how whether a person is an endomorph, ectomorph, or Mesomorph might effect the outcome.

Isn't it true that endomorphs have several more feet of intestines? If so, then a longer limb would have less long-term effect than it would for an ecto or meso. So maybe those who do not have the ability to absorb what they need are ecto or mesos.
.

Thoughts?

-Mike-

Endomorphs are the typical apple shaped body type. It is the more dangerous distribution of fat and the more difficult to operate on. Usually men have this distribution and that is one of the reasons men have higher complication rates. I have never heard of the length of the intestines varying between body types.

LQQkn · 09-04-2007, 07:48 AM

I'm starting to like this thread now... it's getting interesting and I would welcome any thoughts from others.. I promise I won't take your head off

Thanks for the clarification Dyann on the intestines.. it makes sense would love to find out... Thanks again.. Janie

Squishy · 09-04-2007, 10:25 AM

Quote:

Originally Posted by Dyann

I have never heard of the length of the intestines varying between body types.

Hmmm...That was something I remembered from biology class (which was a long time ago, so I could be wrong). I did a couple searches and found a search result that contained the following:

"endo- morphs to have longer intestines than individuals low in endomorphy."

When I tried to open the link, it turned out to be a subscription-only access, but it had the following source information.

Comments on "The Varieties of Human Physique"
Howard V. Meredith
Child Development, Vol. 11, No. 4 (Dec., 1940), pp. 301-309
doi:10.2307/1125699

I found other references to longer intestines in endomorphs, but I would not necessarily consider those sources to be reliable enough to quote. Mostly I found the comments on bodybuilding websites.

Dyann, do you have access to any doctor-information databases that might confirm or disclaim it? I'll keep searching.

)

-Mike-

paige52 · 09-04-2007, 01:21 PM

but someone pointed this thread out to me....

First to correct Janie... I didn't have 100 pounds to lose and that along with Dyann explaination about how long it takes the body to adjust (18 to 24 months) is part of the reason I'm having trouble. For whatever reason my bypass was supposed to be 100cm.. I think that's the 'normal' length but now we have figured out its about 125... which again looking at Dyann's post makes sense that I have serious malabsorbtion issues.

The only comorbitities I had were a previously failed gastric stapling with silic ring surgery. It did last me 15 years or so and I had zero complications with it originally. The surgeon I went to, to have it repaired said "Oh just revise to a RNY, it's basically the same thing and will last longer this time".... Having had such a good experience I said "sign me up" and had no difficulty getting approval from Insurance. I didn't even have to attend the seminars and do all the regular pre-op stuff that all of you went through becasue I was a repeat. What a huge mistake... huge.

To Mike... excellent questions... In reagrds to teh one about chronic nausea and vomitting... sometime sthere are no answers. That's where I sit att he moment. Most of my complications have been pin-pointed to cause and effect with the exception of the chronic nausea. My surgeon said sometimes it gets better and sometimes it doesn't. With my weight loss and malabsorbtions issue to date, I'm not giving it another 6 to 12 months to settle down... I've already had TPN and its' nto a fun game to play for maybe it will get better in the long run...

I enjoyed reading this thread...

Debz · 09-04-2007, 05:28 PM

Wow, Paige, I didn't know you had a previous surgery. Can I ask which one it was? I only ask because I too am a second timer...