DS explanation for ER situation- Feedback requested

ann M.
on 9/16/11 12:19 am - Northern, VA

I feel the need to better prepare in the event that I am incapacitated in some way.  I came up with a one page document that I will share in google docs with family that would be involved in my care. I will print copies to have in my medical records, as well.  I want the explanation to be concise and understandable to average Joe's, but still thorough enough to be of benefit to my medical team.  The document contains a detailed table of vitamins and dosages. The below is what I came up with for an explanation: 

I had a bariatric procedure called the Biliopancreatic Diversion with Duodenal Switch on 4/2/2009 with Dr Michael Schweitzer at John Hopkins. This procedure is partially restrictive and very malabsorptive.

The procedure included a partial gastrectomy where 2/3rds of my stomach was removed along the greater curvature. My pyloric valve was preserved. This results in poorer absorption of calcium, iron, and B12.

My small intestine has been transected so that I have a bileopancreatic limb and an alimentary limb. The bile from my bileopancreatic limb doesn’t reach the contents from my alimentary limb until the last 100 cm of my small intestine (common channel). As a result, I only absorb approximately 50% of the protein I eat and 20% of the fat. I require 100 to 120 grams a day of highly bio-available protein (whey protein isolate, eggs, animal source protein) to maintain healthy protein related labs. I also must heavily supplement all of my fat soluble vitamins. They must be in dry / water miscible form in order for me to derive benefit.

It is important to note that I can have a partial / total blockage in my bileopancreatic limb that may only be diagnosable through imaging. I would not present many of the symptoms commonly associated with blockages such as vomiting and would still be able to defecate / pass gas as normal.

I would love any feedback or corrections you may have.  Thanks for all who made it through this way long post.

SW / BMI / SIZE:  312 / 49.5 / 26-28W         CW / BMI / SIZE:  159.1 / 25.1/ 10-12 
I need to lose about 2 more pounds for a normal BMI .  I still seem to be slowly losing at over 2 yrs out...so may get there yet.

Lori F.
on 9/16/11 12:23 am - Chula Vista, CA
Dr. Keshishian (dssurgery.com) has some diagrams on his wensite. When I was in his office, he gave me a printed card to keep in my wallet for emergencies. Your verbal description is fabulous- may I steal it? Perhaps ask your surgeon if he has anything already printed. When I got my band, that surgeon also gave me a card for my wallet for emergencies. Just a thought...
Pre-band highest weight: 244
Pre-band surgery weight: 233
Lowest: 199 ( for, like, a day)
CW:
260 (yes, with the band!) 
Current Fill: 5cc in 10cc band
BMI: 49
CarolineM
on 9/16/11 12:35 am
 One minor mistake -- the hospital is Johns Hopkins, not John.
  HW 400   SW 355    CW 178   GW 180           5'10"
        
sandy_mt
on 9/16/11 12:57 am
 Ann-

This is fabulous.  I have thought about things like this, like what if I'm unconscious and have to have medical attention.  I don't know if my husband would be able to tell the doctors about my anatomy accurately.  That's really wise of you to put this together and have everyone aware of this.  

GREAT POST!!!

Sandy
    
(deactivated member)
on 9/16/11 1:11 am
Make sure that they know that the diagnostic imaging needs to be done with contrast.

I keep a card in my wallet with the picture of my surgery.  All of my surgeon's contact numbers are on the back of the card.  I have a flash drive with more detailed information that I carry in my purse. My 2 sons are my ICE contacts and each have a flash drive with the info also.

Michele
wings
on 9/16/11 5:59 am - Fort Myers Beach , FL
Hey Michele where did you get this card?  I would like to print one off and also a dietary needs for DS card would be nice too.

Carla
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(deactivated member)
on 9/16/11 7:41 am, edited 9/16/11 7:45 am
I used the image from www.duodenalswitch,com

After I printed it out, I added my sugeon's numbers on the back and laminated the card.

I don't know of any cards with dietary needs. I will either tell them or one of my boys will. That's where the flash drive comes in handy.

HTH,
Michele
Elizabeth N.
on 9/16/11 1:54 am - Burlington County, NJ
I describe it as "subtotal vertical gastrectomy, duodenoileostomy and ileoileostomy" on my records.

I carry a two page document that outlines my ER-pertinent (and initial-intake pertinent) medical history in a tabled format.

--Name, contact info, insurance info, medical POA info 
--Med allergies/issues
-- My doctors, with contact info.
--Medications and supplements
--Current diagnoses
--Surgeries and procedures

(deactivated member)
on 9/16/11 1:57 am
The text is great, but in an emergency, it's tl;dr (too long; didn't read). Having the text and a pictoral diagram would be helpful.  I carry a laminated card with my surgeon and PCP's names and phone numbers on them.

Hugs,
Ratkity
wings
on 9/16/11 5:58 am - Fort Myers Beach , FL
I am so glad you posted this because after being in hospital for 3-weeks and having to educate every single medical professional that touched about the DS.  I just told my husband I need to simplifiy a document and laminate it to carry for emergency reasons at all times. 

I hope more ppl chime in on this so we all can come up with something to carry. 

Carla
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