Hi Guys,

Posted the other day about my sister's dilemma. Went to see Dr. Gary Anthone (always a pleasure to hear him talk) great human being. Rehash she was 425 down to 315-325 after 1 year with sleeve (200) would be great, just stopped losing weight after 6-7 months. Has some hormone and autoimmune disease issues and has certainly made poor food choices as well, but felt the surgery should have worked better for her year one.

Talked about everything going on, he said adding the DS to the sleeve in place at this point, she wouldn't see a big loss of weight and would probably be disappointed. He said she would need to add some restriction along with the DS. But he's not a fan of re-sleeving and thinks the Dr. that did the first sleeve didn't (hug) the bougie along the staple line and left to much stomach. The original Dr. used a 40 bougie, I had a 32 and she could out eat me at 7-8 months, I'm 10 years out and still have good restriction. She can still eat half of what she used to BTW. So he felt converting the sleeve to a pouch would be better.

So he gave her three options.

1: Get a Panniculectomy, $8-10K?he estimated 35-40 lbs. Her original Bariatric surgeon thought 40-45 lbs. Get some relief and more mobility from a plastic surgeon, then add a bypass with new restriction later.

2: Get a Laparoscopic Roux-en-y with one of the other surgeons he works with, about $24K convert sleeve to a pouch. We know the Roux-en-y will lose it's bypass effect overtime so there is a downside and Get plastics later.

3: Get the DS with him (open procedure) $32-35K and convert sleeve to pouch but do a DS hybrid of sorts would be most effective he mentioned, resolve the diabetes altogether hopefully. Probably help keep the weight off the most long term. Get Plastics later.

She's self pay for all of this and the last option would be a doozee financially, current employer doesn't pay for WLS. Time off not a problem can work from home. But even self pay for WLS hospital said 3-6 months supervised weight loss. Don't really wanna weight that long.

She has a couple appointments with plastic surgeons and another Bariatric surgeon. Anybody been through something similar and what did you do or how would go about it. She needs both knees replaced and mobility is really becoming an issue. Any thoughts are welcome.

Thanks,

Bubba

High B6 is bad

high B12 is no biggie

Are you taking dry D3? I need to take 100k daily to keep my D around 100, you may need to add another.

My multi does have some but I wouldn't expect it to be enough to cause it to spike that high. I'm more over curious if anyone has heard of symptoms of high Bs.

B12 = >2000pg/mL (Standard is 211-911pg/mL)

Folate = >20ng/mL (this is in range)

Vitamin B1/Whole Blood = 255 nmol/L (Standard range is 70-180nmol/L)

My nutritionist said that my gut bacteria could be producing Bs somehow so she has me taking a probiotic to try to normalize it. Just looking at Bs as a contributor because the symptoms I've been trying to track down seem to be coming up empty on the causes.

You'd think that since vitamin B is water soluble it would have normalized with as much as I pee...

Could you talk about specific vitamin B levels? The one you listed sounds like B12 which doesn't cause a problem at high levels. However, something like elevated B6 might be a cause for concern. I'm not an expert on the B's but those 2 come up quite often in discussions.

It's pretty hard to talk about B's as a group.

As to lowering, are you taking a multi vitamin? You may have to start looking at food sources. Not sure what else people have done in your situation although I've seen other people not supplement and still have high levels.

Pete