Concise info and Dr. Lutrzykowski

[Guest guest]

Aviva,

I read all the emails but rarely post anything

myself. I wanted to thank you for taking so much info

and putting it into one concise note. Sometimes I

feel overwhelmed by everything. While I'm in the

typing mood I wanted to say I have an initial consult

with Dr. Lutrzykowski in MI on Aug. 17. According to

my information, he has the same training, trained with

the same person, and has performed virtually the same

number of DS surgeries as Dr. Keshishian in CA. I was

surprised to find the woman I talked to in Dr. L's

office was shocked I wanted to come from KY to MI for

surgery. She just couldn't comprehend the concept. I

told her there weren't many docs who did this surgery

and a lot of patients have the procedure done out of

state. She asked how I would handle follow-up after

surgery and I said it was my understanding that most

people are followed by their PCP according to the DS

docs requirements with occassional visits to the DS

doc. Am I wrong or is this just one DS doc who has

not yet been overwhelmed by consult requests?

Sharon in KY

--- aviva@... wrote:

> Thanks to all of you who replied, especially with so

> much detailed

> information. It's extremely helpful and I appreciate

> it.

>

> First of all, I'd be proud to sit next to any of you

> on the bus!

>

> The things I am hearing and reading confirmed my

> initial

> understanding - that the odor and BM unpleasantness

> is something that

> may occur immediately post-op, generally adjusts

> itself to normal

> (i.e., even normal s**t doesn't smell like roses)

> after a while

> (seems to be about 6 months for most), and can often

> be mitigated or

> minimized through some dietary adjustment (lactose,

> fats) or by using

> products like Devrom or Beano.

>

> From other reading - I see that this isn't something

> specific to

> BPD/DS, it's an equal opportunity annoyance for

> RNYers, too,

> especially the more distal ones.

>

> Also, the question of chronic BM problems in the

> long term has been

> minimized since the " DS " was added to BPD, and since

> the common

> channel was adjusted to about 100 cm. The additional

> length of the

> channel still allows good weight loss and also

> allows improved

> absorption of certain nutrients, meaning - inter

> alia - less BM and

> odor problems in the long term as the nutrients that

> would otherwise

> cause problems are, instead, properly absorbed.

>

> The odor emanating through the skin sounded like an

> urban legend (at

> least as far as being a side effect of BPD/DS), and

> I guess that's

> what it is. I can understand the reasoning, perhaps

> this indeed does

> occur in certain severe disorders, but I didn't see

> any testimony

> about it happening with a lot of BPD/DS patients.

>

> As far as bad breath, you also have to take into

> account the

> possibility of ketosis, which is most probably

> occurring at least in

> the immediate aftermath of the surgery, when we are

> concentrating on

> protein and losing weight fast. If the Atkins-ers

> can handle it, so

> can anyone else. S'Mints, anyone?

>

> As far as Fobi, I am getting the impression - from

> your reports and

> from what I've read - that it is an extraordinarily

> complex and

> complicated procedure with results and an outcome

> that don't really

> justify all the trouble, as far as I can tell. Seems

> to me equally

> effective (at least, and even better) outcomes can

> be obtained, with

> a far better post-op quality of life, with BPD/DS.

> Including being

> able to eat like a normal person, including keeping

> weight off in the

> long term. Fobi also doesn't save you from the same

> BM/odor syndrome,

> to the extent that it will make an appearance. And

> all that extreme

> restriction, including the dumping that's built into

> RNY in general,

> seems so punitive, I would only be able to

> understand choosing it if

> there were really no other viable alternatives.

>

> Okay, please, if I'm wrong, set me straight.

>

> Thanks again!

> Aviva

__________________________________________________

[Guest guest]

Aviva,

I read all the emails but rarely post anything

myself. I wanted to thank you for taking so much info

and putting it into one concise note. Sometimes I

feel overwhelmed by everything. While I'm in the

typing mood I wanted to say I have an initial consult

with Dr. Lutrzykowski in MI on Aug. 17. According to

my information, he has the same training, trained with

the same person, and has performed virtually the same

number of DS surgeries as Dr. Keshishian in CA. I was

surprised to find the woman I talked to in Dr. L's

office was shocked I wanted to come from KY to MI for

surgery. She just couldn't comprehend the concept. I

told her there weren't many docs who did this surgery

and a lot of patients have the procedure done out of

state. She asked how I would handle follow-up after

surgery and I said it was my understanding that most

people are followed by their PCP according to the DS

docs requirements with occassional visits to the DS

doc. Am I wrong or is this just one DS doc who has

not yet been overwhelmed by consult requests?

Sharon in KY

--- aviva@... wrote:

> Thanks to all of you who replied, especially with so

> much detailed

> information. It's extremely helpful and I appreciate

> it.

>

> First of all, I'd be proud to sit next to any of you

> on the bus!

>

> The things I am hearing and reading confirmed my

> initial

> understanding - that the odor and BM unpleasantness

> is something that

> may occur immediately post-op, generally adjusts

> itself to normal

> (i.e., even normal s**t doesn't smell like roses)

> after a while

> (seems to be about 6 months for most), and can often

> be mitigated or

> minimized through some dietary adjustment (lactose,

> fats) or by using

> products like Devrom or Beano.

>

> From other reading - I see that this isn't something

> specific to

> BPD/DS, it's an equal opportunity annoyance for

> RNYers, too,

> especially the more distal ones.

>

> Also, the question of chronic BM problems in the

> long term has been

> minimized since the " DS " was added to BPD, and since

> the common

> channel was adjusted to about 100 cm. The additional

> length of the

> channel still allows good weight loss and also

> allows improved

> absorption of certain nutrients, meaning - inter

> alia - less BM and

> odor problems in the long term as the nutrients that

> would otherwise

> cause problems are, instead, properly absorbed.

>

> The odor emanating through the skin sounded like an

> urban legend (at

> least as far as being a side effect of BPD/DS), and

> I guess that's

> what it is. I can understand the reasoning, perhaps

> this indeed does

> occur in certain severe disorders, but I didn't see

> any testimony

> about it happening with a lot of BPD/DS patients.

>

> As far as bad breath, you also have to take into

> account the

> possibility of ketosis, which is most probably

> occurring at least in

> the immediate aftermath of the surgery, when we are

> concentrating on

> protein and losing weight fast. If the Atkins-ers

> can handle it, so

> can anyone else. S'Mints, anyone?

>

> As far as Fobi, I am getting the impression - from

> your reports and

> from what I've read - that it is an extraordinarily

> complex and

> complicated procedure with results and an outcome

> that don't really

> justify all the trouble, as far as I can tell. Seems

> to me equally

> effective (at least, and even better) outcomes can

> be obtained, with

> a far better post-op quality of life, with BPD/DS.

> Including being

> able to eat like a normal person, including keeping

> weight off in the

> long term. Fobi also doesn't save you from the same

> BM/odor syndrome,

> to the extent that it will make an appearance. And

> all that extreme

> restriction, including the dumping that's built into

> RNY in general,

> seems so punitive, I would only be able to

> understand choosing it if

> there were really no other viable alternatives.

>

> Okay, please, if I'm wrong, set me straight.

>

> Thanks again!

> Aviva

__________________________________________________

[Guest guest]

I will be having my surgery long distance too. It will be with Dr.

Inabnet at Mt. Sinai in NYC, which is about a 5 hour drive. I was told

that most of my aftercare can be done by my PCP, BUT I will have to

see my surgeon at certain intervals. I think they were: 3 weeks, 3

months, 6 months and 1 year. I am pretty sure of the 3 weeks and 3

months, and not so sure if the other two are right. There were four

specific visits required.

Maggie

BMI 47

> > Thanks to all of you who replied, especially with so

> > much detailed

> > information. It's extremely helpful and I appreciate

> > it.

> >

> > First of all, I'd be proud to sit next to any of you

> > on the bus!

> >

> > The things I am hearing and reading confirmed my

> > initial

> > understanding - that the odor and BM unpleasantness

> > is something that

> > may occur immediately post-op, generally adjusts

> > itself to normal

> > (i.e., even normal s**t doesn't smell like roses)

> > after a while

> > (seems to be about 6 months for most), and can often

> > be mitigated or

> > minimized through some dietary adjustment (lactose,

> > fats) or by using

> > products like Devrom or Beano.

> >

> > From other reading - I see that this isn't something

> > specific to

> > BPD/DS, it's an equal opportunity annoyance for

> > RNYers, too,

> > especially the more distal ones.

> >

> > Also, the question of chronic BM problems in the

> > long term has been

> > minimized since the " DS " was added to BPD, and since

> > the common

> > channel was adjusted to about 100 cm. The additional

> > length of the

> > channel still allows good weight loss and also

> > allows improved

> > absorption of certain nutrients, meaning - inter

> > alia - less BM and

> > odor problems in the long term as the nutrients that

> > would otherwise

> > cause problems are, instead, properly absorbed.

> >

> > The odor emanating through the skin sounded like an

> > urban legend (at

> > least as far as being a side effect of BPD/DS), and

> > I guess that's

> > what it is. I can understand the reasoning, perhaps

> > this indeed does

> > occur in certain severe disorders, but I didn't see

> > any testimony

> > about it happening with a lot of BPD/DS patients.

> >

> > As far as bad breath, you also have to take into

> > account the

> > possibility of ketosis, which is most probably

> > occurring at least in

> > the immediate aftermath of the surgery, when we are

> > concentrating on

> > protein and losing weight fast. If the Atkins-ers

> > can handle it, so

> > can anyone else. S'Mints, anyone?

> >

> > As far as Fobi, I am getting the impression - from

> > your reports and

> > from what I've read - that it is an extraordinarily

> > complex and

> > complicated procedure with results and an outcome

> > that don't really

> > justify all the trouble, as far as I can tell. Seems

> > to me equally

> > effective (at least, and even better) outcomes can

> > be obtained, with

> > a far better post-op quality of life, with BPD/DS.

> > Including being

> > able to eat like a normal person, including keeping

> > weight off in the

> > long term. Fobi also doesn't save you from the same

> > BM/odor syndrome,

> > to the extent that it will make an appearance. And

> > all that extreme

> > restriction, including the dumping that's built into

> > RNY in general,

> > seems so punitive, I would only be able to

> > understand choosing it if

> > there were really no other viable alternatives.

> >

> > Okay, please, if I'm wrong, set me straight.

> >

> > Thanks again!

> > Aviva

>

>

> __________________________________________________

>

[Guest guest]

I will be having my surgery long distance too. It will be with Dr.

Inabnet at Mt. Sinai in NYC, which is about a 5 hour drive. I was told

that most of my aftercare can be done by my PCP, BUT I will have to

see my surgeon at certain intervals. I think they were: 3 weeks, 3

months, 6 months and 1 year. I am pretty sure of the 3 weeks and 3

months, and not so sure if the other two are right. There were four

specific visits required.

Maggie

BMI 47

> > Thanks to all of you who replied, especially with so

> > much detailed

> > information. It's extremely helpful and I appreciate

> > it.

> >

> > First of all, I'd be proud to sit next to any of you

> > on the bus!

> >

> > The things I am hearing and reading confirmed my

> > initial

> > understanding - that the odor and BM unpleasantness

> > is something that

> > may occur immediately post-op, generally adjusts

> > itself to normal

> > (i.e., even normal s**t doesn't smell like roses)

> > after a while

> > (seems to be about 6 months for most), and can often

> > be mitigated or

> > minimized through some dietary adjustment (lactose,

> > fats) or by using

> > products like Devrom or Beano.

> >

> > From other reading - I see that this isn't something

> > specific to

> > BPD/DS, it's an equal opportunity annoyance for

> > RNYers, too,

> > especially the more distal ones.

> >

> > Also, the question of chronic BM problems in the

> > long term has been

> > minimized since the " DS " was added to BPD, and since

> > the common

> > channel was adjusted to about 100 cm. The additional

> > length of the

> > channel still allows good weight loss and also

> > allows improved

> > absorption of certain nutrients, meaning - inter

> > alia - less BM and

> > odor problems in the long term as the nutrients that

> > would otherwise

> > cause problems are, instead, properly absorbed.

> >

> > The odor emanating through the skin sounded like an

> > urban legend (at

> > least as far as being a side effect of BPD/DS), and

> > I guess that's

> > what it is. I can understand the reasoning, perhaps

> > this indeed does

> > occur in certain severe disorders, but I didn't see

> > any testimony

> > about it happening with a lot of BPD/DS patients.

> >

> > As far as bad breath, you also have to take into

> > account the

> > possibility of ketosis, which is most probably

> > occurring at least in

> > the immediate aftermath of the surgery, when we are

> > concentrating on

> > protein and losing weight fast. If the Atkins-ers

> > can handle it, so

> > can anyone else. S'Mints, anyone?

> >

> > As far as Fobi, I am getting the impression - from

> > your reports and

> > from what I've read - that it is an extraordinarily

> > complex and

> > complicated procedure with results and an outcome

> > that don't really

> > justify all the trouble, as far as I can tell. Seems

> > to me equally

> > effective (at least, and even better) outcomes can

> > be obtained, with

> > a far better post-op quality of life, with BPD/DS.

> > Including being

> > able to eat like a normal person, including keeping

> > weight off in the

> > long term. Fobi also doesn't save you from the same

> > BM/odor syndrome,

> > to the extent that it will make an appearance. And

> > all that extreme

> > restriction, including the dumping that's built into

> > RNY in general,

> > seems so punitive, I would only be able to

> > understand choosing it if

> > there were really no other viable alternatives.

> >

> > Okay, please, if I'm wrong, set me straight.

> >

> > Thanks again!

> > Aviva

>

>

> __________________________________________________

>