Re: I gave at the orifice, or Steve's wonderful day at the ER

[Guest guest]

Steve,

I cannot help with the questions but would like to say,

Wow, sorry you had to go through that. I watched my husband suffer with

stones he could not pass. Very painful.

I pray they will dissolve and leave you alone.

Angels hover ever near,

DS 4/11/01

Bowel obstruction 4/21/01

Dr Deveney @ OHSU

Starting wt 282

Current wt 222

I gave at the orifice, or Steve's wonderful day at

the ER

> Hi, y'all,

>

> Just a quickie to let you know that I awoke at 5:00 AM to terrible

> pain in the front, lower right quadrant of my torso. That's where

> the biliary limb is surgically connected to the common channel. I

> guessed that it was yet another kidney stone, but was also concerned

> that it could be twisted intestine--which, as most of you know can

> spoil your whole day if not resolved quickly. So, I had Dr. Elariny

> paged. He called me back within five minutes!!! I figured that he

> would already have awakened to get ready for surgery, but he sounded

> as though I had actually rousted him from sleep. He agreed that my

> self-diagnosis of a kidney stone was probably correct, but he asked

> me to go to the emergency room to have some pictures taken just to

> rule out intestinal kinking.

>

> I took Percoset (oxycodone) at home (left over from my DS pain meds).

> It helped the pain considerably, but it was still quite pronounced.

> I hit the ER just at the right moment--close to 6:00 AM. The place

> was deserted, and I was taken right away with zero delay--an hour

> later, and the place was crawling with sick people. I got super

> care, and I knew that I had passed the stone into my bladder while

> waiting to be wheeled in for an X-ray, as the pain eased up 95%. I

> used a urinal, the the nurse filtered the urine and said " Bingo! "

> Three tiny stones. My urine had ben sparse, despite my having forced

> lots of liquids, and it was almost brown (blood from the stones'

> having torn their way through the ureter on the way to the bladder.

> I was discharged by 10:00 AM, and my son and I went to IHOP to

> celebrate with their $2.99 special (2 eggs 2 sausage or bacon, and 2

> pancakes--more than i could finish). Later in the afternoon, I had

> to take another Percoset, as the pain had returned, though not at all

> as intense as at 5:00 AM. So, I had a great snooze in la-la land.

> Oh, the wonders of good drugs! Well, it's off to bed now.

>

> Bottom line concern: I have a urologist appointment on Monday (it had

> already been scheduled); if analysis of the stones points to a

> calcium base, what, if any influence might the dietary calcium

> supplementation have on this? Anybody have any ideas here? Similar

> question about all the animal protein that I have been ingesting

> post-op.

>

> --Steve

> --

> Steve Goldstein, age 61

> Lap BPD/DS on May 2, 2001

> Dr. Elariny, INOVA Fairfax Hospital, Virginia

> Starting (05/02/01) BMI = 51

> BMI on 09/12 = 41 (-63 lb.)

>

> ----------------------------------------------------------------------

>

[Guest guest]

Steve,

Interesting. The JIB procedure had problems with Kidney stones, but

the reports on BPD/DS indicate similar prevalance pre-op and post-op.

I will have to re-read Marceau's paper to see if there is any

relationship between dietary calcium and Kidney stones. I don't think

there is (if I recall correctly). I think it had something to do with

Oxelate? which was somhow associate with the malabsorption, but I

don't recall exactly.

Hull

--- In duodenalswitch@y..., Steve Goldstein <steve-goldstein@c...

> if analysis of the stones points to a

> calcium base, what, if any influence might the dietary calcium

> supplementation have on this? Anybody have any ideas here?

Similar

> question about all the animal protein that I have been ingesting

> post-op.

>

[Guest guest]

Hi Steve,

Feeling better I hope. Did you get to keep the stones? What you

mean....no! That IHOP big breakfast should be renamed the DS

special....yummie. Take care.

Dan

> Hi, y'all,

>

> Just a quickie to let you know that I awoke at 5:00 AM to terrible

> pain in the front, lower right quadrant of my torso. That's where

> the biliary limb is surgically connected to the common channel. I

> guessed that it was yet another kidney stone, but was also

concerned

> that it could be twisted intestine--which, as most of you know can

> spoil your whole day if not resolved quickly. So, I had Dr.

Elariny

> paged. He called me back within five minutes!!! I figured that he

> would already have awakened to get ready for surgery, but he

sounded

> as though I had actually rousted him from sleep. He agreed that my

> self-diagnosis of a kidney stone was probably correct, but he asked

> me to go to the emergency room to have some pictures taken just to

> rule out intestinal kinking.

>

> I took Percoset (oxycodone) at home (left over from my DS pain

meds).

> It helped the pain considerably, but it was still quite pronounced.

> I hit the ER just at the right moment--close to 6:00 AM. The place

> was deserted, and I was taken right away with zero delay--an hour

> later, and the place was crawling with sick people. I got super

> care, and I knew that I had passed the stone into my bladder while

> waiting to be wheeled in for an X-ray, as the pain eased up 95%. I

> used a urinal, the the nurse filtered the urine and said " Bingo! "

> Three tiny stones. My urine had ben sparse, despite my having

forced

> lots of liquids, and it was almost brown (blood from the stones'

> having torn their way through the ureter on the way to the bladder.

> I was discharged by 10:00 AM, and my son and I went to IHOP to

> celebrate with their $2.99 special (2 eggs 2 sausage or bacon, and

2

> pancakes--more than i could finish). Later in the afternoon, I had

> to take another Percoset, as the pain had returned, though not at

all

> as intense as at 5:00 AM. So, I had a great snooze in la-la land.

> Oh, the wonders of good drugs! Well, it's off to bed now.

>

> Bottom line concern: I have a urologist appointment on Monday (it

had

> already been scheduled); if analysis of the stones points to a

> calcium base, what, if any influence might the dietary calcium

> supplementation have on this? Anybody have any ideas here?

Similar

> question about all the animal protein that I have been ingesting

> post-op.

>

> --Steve

> --

> Steve Goldstein, age 61

> Lap BPD/DS on May 2, 2001

> Dr. Elariny, INOVA Fairfax Hospital, Virginia

> Starting (05/02/01) BMI = 51

> BMI on 09/12 = 41 (-63 lb.)

[Guest guest]

> Bottom line concern: I have a urologist appointment on Monday (it had

> already been scheduled); if analysis of the stones points to a

> calcium base, what, if any influence might the dietary calcium

> supplementation have on this? Anybody have any ideas here? Similar

> question about all the animal protein that I have been ingesting

> post-op.

Steve, there is an article about kidney stones in Dr. Rabkin's

newsletter right now:

---------

http://www.pacificsurgery.com/Newsletter/newsletter.html

KIDNEY STONES?

Are you taking enough Calcium?

Dr. Rabkin recommends 1800 mg Calcium daily postop for life. Patients

having kidney stones must have them analyzed and if they prove to be

calcium oxalate, this is really because the small intestine is unable to

absorb sufficient calcium, and that calcium is really being diverted to

the urine where it binds with the excess oxalic acid that has been

absorbed. Even some PCP's do not understand the concept of Calcium

absorption being interrupted by fat malabsorption. They will assume the

body has too much Calcium, because of stones being formed and thus might

cut back the patient's intake of Calcium.

Not only is Calcium important, but Vitamin D needs to be at a normal

level for adequate Calcium absorption. A few minutes a day of sunshine

will help most patients maintain a normal Vitamin D level. If Vitamin D

levels are low, and we are checking these preop, sunshine and

water-soluble Vitamin D (Twin Labs Allergy A & D) may be needed. Another

good source of water-soluble Vitamin D in non-fat milk. It is fortified

with " water soluble A & D. "

If Calcium and Iron are taken at the same time, they may interact with

each other and less absorption of both can be expected.

Annual lab values can help us direct any abnormalities our patients

might have. A high alkaline phosphatase is indicative of the bones

working hard to maintain a normal

Calcium level in our body. Bone Density Scans may be indicated preop in

our menopausal women, or any patients in their forties for a baseline

documentation and annually or bi-annually thereafter. Exercise and

resistance training will also help bones stay stronger.

-----

M.

---

in Valrico, FL, age 39

Lap DGB/DS by Dr. Rabkin 10/19/99

Starting weight 299, now 156

Starting BMI 49.7, now 26.0

Starting size 26/28, now 10/12

http://www.duodenalswitch.com/Patients/_M_/melanie_m_.html

Direct replies: mailto:melanie@...

_________________________________________________________

[Guest guest]

Many thanks to , Dan and for their caring and

replies. I especially appreciate the article from Dr. Rabkin's

newsletter that sent.

I am fine today (no more la-la-lane trips on Percoset for me today),

though still feel a bit of lingering soreness in the area of my right

ureter.

Ta ta,

Steve

--

[Guest guest]

Steve..

I'm so glad it turned out to be something simple.. Let us know what

analysis of stones shows, OK?

Glad you're feeling better!

Hugs,

Liane

[Guest guest]

Steve,

What type of calcium do you take ? I wonder if it would help if you take

Cal-Apatite which is supposed to be even more absorbable than Citracal (calcium

citrate) ? I'm still taking Citracal, but I do want to ask Dr K on Friday when I

go in for my consult ?

Anita

Pre-op in Denver

Initial Consult 9/14

>

> I am fine today (no more la-la-lane trips on Percoset for me today),

> though still feel a bit of lingering soreness in the area of my right

> ureter.

>

> Ta ta,

>

> Steve

> --