Common Channel and Roux Limb?

Kristi- It doesn't matter about the money changing hands or that he's a Colonel. The doc is working for you- he'll actually be serving you. And he IS getting paid, even though you are not handing over any of your own money. I am an enlisted wife so I know what you're feeling, but in this case, the doctor IS working for you. If you are afraid or nervous to ask him important questions, then maybe you're not ready for this. A free surgery is NOT worth your life. The doc's rank does not trump your right to know everything and to decide if he is right for you. Just because he accepted you doesn't mean YOU have to accept HIM. Ask questions until you are satisfied and stop worrying about ******g him off.  

That's one school of thought for how to do things, yes. Many people do very well with it. I like my "modified Hess version" results and think it's a smart way to do it.

I do not believe either method has really been shown to have "best" results. I'd want published studies showing any such thing before I'd let a doc get away with making such a statement. But I wouldn't fire the doc over it.

For most people, a 250 cm total alimentary limb is not very much total space for food to be touching, so that means pretty darned high malabsorption. Remember, it's not JUST the common channel that counts.

To use my own guts for comparison: My total small intestine length was just shy of 7 meters, so I'll round to that (it was 690-something, I believe). With the Hess method, the alimentary limb is 40% of total length, 280 cm. My common channel is 75 cm or about 11% of my total intestinal length.

If it had been done standardized in the way the Col. does his, I would have had 30 cm less total alimentary limb and 25 cm more common channel. Sounds to me like it just might possibly kind of all balance out in the end. I dunno.

You remind me of myself.  I was also very curious about how many DSes mine had done, but I didn't have the balls to ask that.  I did ask how long she had been doing the DS, and, if I recall correctly, she said around three years, but much longer for other weight loss surgeries.  I did write up two long questions I had for her, one having to do with my desired common channel length (I wanted 100 cm) and sleeve size, which I turned in with my long forms that were required before I could see her, so she had already read it when I got to an appointment with her. (My second question/request had to do with my desire to be back on my psych meds as soon as possible post-op.)  Mine was a virgin DS though, so not as complex as yours.

I think his use of the words "uniformly great results" is an exaggeration and bravado, but I think the numbers sound normal for the DS, although I admit I don't know much about the alimentary part.  I have seen enough people on the board in the past few years who got a DS with Dr. Martin that I am pretty confident in him.  At the same time, I don't recall any of them being revisions.  If you find the courage, you could write "I was wondering if you could tell me an estimate of how many duodenal switch surgeries you have done, and how many gastric band-to-DS revisions you have done."

This reminds me.  I also wanted to know who she learned the DS from.  I asked it on the phone once while I was talking to a bariatric nurse of the practice.  I was uncomfy bringing up the sort-of "competition" (Dr. Anthone, who I was also thinking of), and I asked if Dr. Berntsen learned the DS from Dr. Steward (a former partner in the Topeka practice, known to do the DS, but who had recently moved out of state) (I am talking about Brent Steward, not Dr. Stuart in Denton, TX).  I was told that some of the surgeons here went to Omaha to a watch a DS surgery there, so, I knew she meant Dr. Anthone (I don't remember if she said his name first or I did), but after she said that, then I felt free to say "oh, yes, I have also watched his seminar-on-DVD."  I don't remember exactly how the conversation went after that, but it was okay.
*Yes, Dr. A. was not and isn't the only DS surgeon in Omaha, as Dr. Sudan used to be there, and now Dr. Forse is there, but the nurse and I were both referring to him.

I was sort of in the same boat as you, as my insurance (Medicare) does not pay the DS surgeon well, so it's no prize to get me as a customer, and I didn't have any bargaining power.  I had a lot of anxiety over it, but things turned out okay for me and the DS.

I don't think that comment sounds like exaggeration or bravado at all. He quite possibly HAS had uniformly great results. Remember that the definition of WLS success is 50% EWL, and it's unusual that any DS does only that much, or less.

Okay ladies....thanks for your words of wisdom....I grew a pair last nite and emailed him my questions!  He hasn't responded yet....but I'll let you know when he does! 

Unfortunately, I had to delete this post due to privacy concerns.

Good to hear this, Kristi.
Dont be intimidated, this is your life and your body.  The questions you're asking are reasonable.  If you dont get good answers you have other options, even if it doesnt seem that way now.  It's better to put off your surgery if you need to than to make a bad decision.

Surgical experience is obviously important for your own safety, but also on the outcome of your surgery.  Does he have the experience to know how to measure limbs, and how those measurements work in conjunction together and with stomach size?  How do his patients do overall losing weight?  A DS isn't a DS - meaning there are different techniques suturing, limb lengths, the sleeve staple line, everything.

Someone told me the other day that even a little bit too much tension suturing somethng caused someone unbelievable ulcer problems at a connection in the surgery.  That's why experience is so important.  Safety of course is paramount, but there are also many things to consider that you will be living with for the rest of your life.

Unfortunately, I had to delete this post due to privacy concerns.

Thanks so much Shelli!!!!!!!!!!