Nick is wrong; Nick IS the Taliban!

[Guest guest]

I'm sorry, Nick. Everytime I think about that Taliban post I bust

out laughing. Still do, even when I think about the responses to

that post: " Nick, you're not at all like the Taliban, " etc.

But guess what? You ARE wrong about one thing. (You can tell that

I'm very proud to have gotten you on this one!) Ready? OK, let's

jump back a little, and I'm gonna use response to something

you said:

NICK said: However, when you said " the DS gives more duodenal space

before the 'switch', " you fail to take into account that DS surgeons

vary substantially in how much of the duodenum they leave attached to

the pylorus. The range is from 2 to 5 cm. with the NY surgeons

tending to the shorter size. This presents issues in absorption of

vitamins. When you talk about taking 3 ADEKs, that is completely

foreign to some of us in the west. Dr. K leaves a longer piece of

the duodenum and recommends only one multivitamin and 1500 mg. of

calcium per day. This is a much easier regimen to follow, at least

for me. This might well account for why you see supplementation as

more of a challenge than I do.

NO! I spoke with Dr. Gagner about this in his office yesterday, and

he said that he (and the people who he's trained) LEAVES AS MUCH

DUODENUM AS HE POSSIBLY CAN. In my case it was about 4 cms., but he

didn't have the operative report back yet in my chart to verify

this. This jives with his other conservative practices and

philosophies. So according to the man himself, the NYC doctors do

exactly the opposite of what you claimed: ***they tend toward the

longer size, not a shorter one.***

TERESA said: I am taking 3 [ADEKs] because I am still within the

first year post-op and that is what is recommended. My labs have

been great so I don't think anyone has seen the need to reduce them.

However, there are others who are Dr. Gagner's patients who do NOT

require as many.

I don't know about this. I thought all his patients took the 3 ADEKs

automatically, mostly as an insurance precaution, though it could be

overkill. Then again, ya know how I feel about these tablets!!

TERESA said: Now, the absorption of fat soluable vitamins occur

mainly in the COMMON CHANNEL not the duodenum.... The duodenum is

involved mainly in calcium absorption. So, my taking ADEKS has to do

with my malapsorption in the common channel (and I have a 100 cm

common channel), not necessarily whether I have a difference of 2 cm

of duodenum. The calcium absorption might be different but I really

don't know what impact 2 cm of duodenum could have on this...

OK, no one disputes this, right? So, the length of the duodenum left

in tact has nothing to do with ADEKs or multivitamins so much as it

does with calcium absorption.

Lastly then: I demand that you, Nick, and you, , be careful

with each other. I will not ALLOW two of my very favorite people on

this board to descend into nastiness with each other. No, Nick, I'm

not advocating niceness at all costs. I'd never do that. Just be a

little more careful, please.

Love to you both,

(who's feeling smug because I've proven Nick wrong!)

<see: happy and triumphant dance, with alternating grimaces of

post-op incisional pain>