Malabsorption further out post-op

wings
on 9/3/11 2:10 am - Fort Myers Beach , FL
I am 20  months post DS.  I have lost 185 pounds whi*****ludes 14+ skin removal from panniculectomy/anchor cut TT.

So  I am 5.5 wks post plastics now.  One of the nurses in the hospital looking up my DS so she could understand me and my care better  (I appreciated that so much) said she read somewhere that we began to absorb more as our DS matures and I should start  cutting back on the fat.  

I have had a horrible time with food since my PS 5.5 wks ago and I seem to not want to eat but only a few bites so I upped my protein shakes to 200 grams a day.  Now I make these shakes with water and 1/4 cup heavy cream.  I try to eat a fried egg and some bacon from time to time and salad drenched with drsg but I don't eat a whole lot. 

Today I am proud to say that I clearly still malabsorb the fat because I have orange slicks  lol.  I know these are uncomfortable and you better not trust a fart for any reason especially during this time lol.  This proves to me that nothing has changed and MY DS CONTINUES TO DO ITS JOB..  

I hope I can lose the last 30-40 pounds to hit goal and for some reason I believe I will.  So if you think your DS stopped working then work your DS.  Up your fat intake and watch it happen. 

Carla

P,S I am a proud alive and kicking farting orange slicker DSer.  LOL
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Julie R.
on 9/3/11 2:40 am - Ludington, MI
 Well, I know that I'm five plus years out now, and I'm still malabsorbing fat (and maintaining) JUST FINE.      My five year check-up is in three weeks, so my cholesterol will also tell me if my malabsorption has decreased or not.
Julie R - Ludington, Michigan
Duodenal Switch 08/09/06 - Dr. Paul Kemmeter, Grand Rapids, Michigan
HW: 282 - 5'4"
SW: 268
GW: 135
CW: 125

(deactivated member)
on 9/3/11 4:39 am - San Jose, CA

I doubt very much whether your cholesterol level reflects much if anything about your malabsorption.

Dietary cholesterol - even if eliminated almost entirely - constitutes only a small fraction (I think I recall a number like 20%) to blood cholesterol.  It is my understanding that humongous improvement in our blood cholesterol levels has to do with the correction to our metabolism created by the switch portion of our surgery - i.e., the food not touching the distal duodenum/jejunum.

Therefore, I don't think cholesterol levels reflect malabsorption of ingested cholesterol much if at all.

What WOULD tell you is if you measured the fat in your stools - measure what you eat, vs. what's in your poop, like Gagner did.  My understanding is that intestinal adaptation to short bowel syndrome peters out after about 2 years, and then it stays pretty much the same.

Julie R.
on 9/3/11 5:07 am - Ludington, MI
 Thanks for clearing this up.   I was under the impression, mistaken or otherwise, based on comments by Vitalady, that our fat malabsorption could be determined by our cholesterol levels, thus relating to our vitamin D.....so.....low D equals low cholesterol.    That's been the case with me.  My D is low, my last cholesterol was 88.     Peraps I lost something in the translation.
Julie R - Ludington, Michigan
Duodenal Switch 08/09/06 - Dr. Paul Kemmeter, Grand Rapids, Michigan
HW: 282 - 5'4"
SW: 268
GW: 135
CW: 125

(deactivated member)
on 9/3/11 5:49 am - San Jose, CA

Vitamin D is synthesized from cholesterol in our bodies.  If you are relying on endogenous synthesis (i.e., from sunlight), and your cholesterol is low, I would guess that you would have trouble getting your D3 up due to lack of starting materials.  But I don't know how low cholesterol levels would negatively affect the uptake of exogenous (oral supplementation) sources of D3.  If anything, I would suspect low cholesterol would cause MORE uptake of vitamin D3 or any cholesterol-like molecule, because the body (assuming it perceived the cholesterol levels as too low) would want to be MORE efficient at extracting cholesterol from dietary sources.

In any case, here is something that sounds like what I recall seeing - not sure how accurate it is, but I think it is pretty much what current SCIENTIFIC thinking agrees on:

http://health.howstuffworks.com/diseases-conditions/cardiova scular/cholesterol/cholesterol2.htm

Blood Cholesterol vs. Dietary Cholesterol

It may surprise you to know that our bodies make all the cholesterol we need. When your doctor takes a blood test to measure your cholesterol level, the doctor is actually measuring the amount of circulating cholesterol in your blood, or your blood cholesterol level. About 85 percent of your blood cholesterol level is endogenous, which means it is produced by your body. The other 15 percent or so comes from an external source -- your diet. Your dietary cholesterol originates from meat, poultry, fish, seafood and dairy products. It's possible for some people to eat foods high in cholesterol and still have low blood cholesterol levels. Likewise, it's possible to eat foods low in cholesterol and have a high blood cholesterol level.

So, why is there so much talk about cholesterol in our diet? It's because the level of cholesterol already present in your blood can be increased by high consumption of cholesterol and saturated fat in your diet. This increase in dietary cholesterol has been associated with atherosclerosis, the build-up of plaques that can narrow or block blood vessels. (Think about what happens to your kitchen drain pipes when you pour chicken fat down the sink.) If the coronary arteries of the heart become blocked, a heart attack can occur. The blocked artery can also develop rough edges. This can cause plaques to break off and travel, obstructing blood vessels elsewhere in the body. A blocked blood vessel in the brain can trigger a stroke.

 

 

The average American man eats about 360 milligrams of cholesterol a day; the average woman eats between 220 and 260 milligrams daily. So how are we doing? The American Heart Association recommends that we limit our average daily cholesterol intake to less than 300 milligrams. Obviously, people with high levels of cholesterol in the blood should take in even less.

 

I'm pretty sure I eat well over the recommended cholesterol amounts, but I have been pretty consistent in my eating for the last 8 years since my DS - this is what my cholesterol levels look like (keep in mind that I was on statins after about 2001 because my CRP was WAAAAY too high and I had my DS 8/5/03):

NameCHOLESTEROL
Standard Range
wings
on 9/3/11 10:50 am - Fort Myers Beach , FL
Julie please let me know what your cholesterol comes back at.  I am watching this very close due to my heart disease. 

Carla
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DianaRR
on 9/3/11 3:40 am - CA
That is great to hear. I wonder why there is so much misinformation out there about our surgery?
(deactivated member)
on 9/3/11 3:57 am
That's actually been a question of mine. Does it decrease over time? I know the RNY does but after the 18-36 mo "honeymoon", does your body start to absorb more?

What about with vitamins, do you take more or less (or the same)?

Every time I hear the orange oil slicks, it brings me back to my Xenical days. I'm anticipating this experience might be similar in that regard!

Sorry to hijack!!!

PS you are doing GREAT! I know you're going to get to goal to- you have a great attitude and are working it!
(deactivated member)
on 9/3/11 5:38 am - San Jose, CA
The body starts trying to overcome malabsorption from the git-go.  The adaptation (i.e., healing of malabsorption) is COMPLETE by about 2 years out.  The honeymoon effect is fading the entire time - it is not static during the first 2 years - every day from the day after surgery, the malabsorption is decreasing.  For proximal RNYers, there is not much malabsorption left after 18 - 24 months.

Now adaptation also occurs in DSers - but we have so much malabsorption, that some improvement over the first 2 years doesn't matter that much.  We still have a lot when the adaptation phase is over.
wings
on 9/3/11 11:00 am - Fort Myers Beach , FL
Thanks Diane

I was hoping you would chime in.  My cardiologist is watching everything to study how my LDL, HDL's etc effects the blockages I already have which were determined to be calcium. 

There are things going on that we are not allowed to try yet but he is looking into everything because someday we will figure out how to clear arteries of calcium.  

Carla
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