Seeking knowledge

February 5, 2004

In a message dated 2/5/2004 7:22:53 PM Central Standard Time,

Tops@... writes:

1) I have a few specific questions that I could not answer. Do we

have ANY of our duodenum NOT bypassed and able to absorb

nutrients?

@@@None of our Duodenum is bypassed that is why B12 isn't as big a problem

for us as opposed to RNY pts

2)It was my understanding that B12 is not generally an issue for DS

patients, why is that?

@@See above...LOL. There are several micronutrients that are absorbed in the

duodenum. b12 is the most common. It is also the source of the intrensic factor

3) Is it a " given " that DS patients will have iron absorption

issues? Their nutritionist seemed to think so.

@@@Iron is VERY much and issue for RNY pts. I had my first sets of infusions

in 1999 or 2000...Long before my DS revision. about 1/2 of the RNY pts I know

have iron issues and about 1/3 have to be supplemented IV.

I was made very welcome they want me to come back I just suddenly

have this urge to really know my DS stuff. Where do I go to get the

right information?

@@@

Start with Dr. K's web site. His chart is a wealth of information. All of his

web site is. You can do a medline search or go to Elle's web site with a

load of Good DS info. the best one is here

http://www.growley.com/mywls/appeal/research-appeal.html and here is the link

to all her web pages....

http://www.growley.com/ I think you will find more than enough info with

references. Hope this helps!

in Bama

VBG 1982 (lost from 433lbs to 270's)

VBG to RNY1996 revision(Lost from 343 to 299)

RNY to DS revision Dec 2002 -down 118 lbs so far (377.7 to 259.4 and still

going

Homepage address- http://hometown.aol.com/mdl1031/myhomepage/profile.html

Many thanks to Dr. K willing to take on a 3rd timer....LOL

February 5, 2004

> 1) I have a few specific questions that I could not answer. Do

we

> have ANY of our duodenum NOT bypassed and able to absorb

> nutrients?

***** We do have a functioning partial duodenum left. Our duodenum

is divided just above the POINT where the liver bile enters the

bowel. This section, that the bile is flowing into, becomes the

bilo-pancreatiac loop...If I recall correctly most people are left

with a 3-5 cm functioning duodenum which " can absorb " nutrients. I

want to add...the division of the duodenum at the " correct " spot is

VITAL to the operation. If the duodenum is not divided properly it

will " die " and the only thing left to do is give the patient the old

BPD version of the surgery which leaves them without a pyloric valve

or duodenum.

> 2)It was my understanding that B12 is not generally an issue for

DS

> patients, why is that?

*****in order to utilize B12 you need the " intrinsic factor " found

in the stomach....RNYers lose their intrinsic factor when they only

have a pouch...DSer still have a functioning stomach which includes

the intrinsic factor, therefore we can still process B12. Keeping

in mind that even NON-dsers can become B12 deficient, therefore we

are not immune to the possibility.

> 3) Is it a " given " that DS patients will have iron absorption

> issues? Their nutritionist seemed to think so.

*****NO. It is not a given. Our iron absorption is compromised

because we only have a partial duodenum...but with the RNY it is

completely bypassed. With the DS it is easier to become Iron def.

than the general population, therefore we suppliment...but

remember...You don't have to have the DS to be Iron def....some

people are just more prone to it than others.

And In my opinion the Distal RNY is the most nutritionally dangerous

procedure they are currently doing. It combines too much mal-

absorption with too much restriction. In other words they use the

aspects that can cause the MOST problems from both the DS and The

RNY and put it together in one surgery. Yikes!

Hope this helps.

Jo

February 5, 2004