Question:
How much can be bypassed?

I am having surgery on Dec. 11 and my daughter-in-law just found out I am having 200 cm bypassed. She was very concerned. Let me know how much you have had bypassed.    — Chris B. (posted on December 7, 2003)

December 6, 2003
I had 150cm bypassed which I believe is about 5 feet. This was a distal bypass vs. proximal where not as much intestine is taken. Sounds like you're going to be very distal which works fine for calorie/fat malabsorption but you have to be ultra-diligent in making sure you get ALL the recommended nutrition, vitamins and supplements in daily. I'm 8 months post op and bloodwork is all normal but it is a conscious effort every day to play by the rules. You won't be disapponited! Congrats!
   — Vicki S.

December 7, 2003
Chris, 200cm is longer than the norm but not too drastic. A few RNY's are bypassed everything but about 40" which is actually then known as a common channel rather than amount bypassed. In my personal opinion, I know some will disagree which is their perogative, I do not think anyone with an RNY should ever end up with a common channel as it gets extremely difficult to get in enough nutrients to stay healthy. Maybe if it's a revision but not the first time around. It means a life long committment to 4-6 protein drinks a day plus whatever food they can get in. In my opinion the common channel type surgeries should be left to the DS/BPD as that surgery is designed to be safe with a short common channel. The RNY has such a tiny pouch that I would be scared of starving to death, but that is me. <p>The 200cm will give you more malabsorption and it may create a need to use a protein drink here or there every day for the rest of your life and it might not. There are tons of people in the world living with 150cm and less bypasses and having zero problems with getting in enough nutrition from food and minimal supplements, so personally I would stick with the standard. Your BMI is not that outrageously high so I would question the 200cm bypass. I was a 65.3 BMI and am now a 35.1 BMI, all in 10 months, so 150cm bypass does work. I am extremely healthy and able to do whatever I can. Talk to the doctor and if he or she gives a reasonable explanation as to why they feel this is best. If you are comfortable with the explanation then I would not sweat it, but you will have to be diligent about your supplements and protein etc. It might be that your surgeon does a larger pouch so you can eat a bit more and then combines it with a slightly longer bypass, which would make sense. I was given a 1/2 ounce pouch, so anything longer than 150cm would have been pretty risky. I'm sure it's larger now based on what I can eat, but it's definitely small enough to tell me when to stop eating. <p>Good luck on your surgery and I'll be rooting for you! Come home soon!
   — zoedogcbr

December 7, 2003
I had 157cm bypassed. Sure wish I had had 200cm instead.
   — Danmark

December 7, 2003
I have appx double that bypassed. No way of knowing, since I am very distal and am measured by common channel. I tend to agree that 40" CC might be pushing the limit. I do work hard to stay nourished, and not everyone is willing to. But this is what I was issued back in the olden days, along with a fairly complete set of instructions. I don't have to work as hard at maintaining my wt, however. I avoid milk, sugar & grazing. I use protein shakes to meet my basic needs and to control carb, volume and appetite cravings. I take a lot of vites & minerals. It's ok with ME personally, because I never had a problem putting things INTO my face, the problem was keeping them out. But I am speaking for myself here. By the same token, I have hosted many people with very short bypasses when they have come here to be revised to a more distal procedure (usually 60" these days). Seems to be rather like trying to see into the future to figure what is right for each person. Since I was done 4 years before I was ever on line, there were no choices at all. It turned out to be right for me.
   — vitalady

December 8, 2003
That is definitely distal but not outrageously so. It means, as the others have stated, that you will have to be more diligent about getting in your vitamins and supplements and getting regular bloodwork to ensure that things stay in balance. You may want to ask your doctor if he/she can do 150 instead of 200. Those with bypasses of just 75 cm, or 100 cm, do just as well in losing large amounts of weight. So why have that much malabsorption?
   — Cindy R.

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