Feeds:
Posts
Comments

Posts Tagged ‘bariatric’

My first case this morning with another surgeon was cancelled – which was disappointing, but I still had a great day in the operating room with Dr.  Ham and Dr. Abril.  This time I was able to witness a bariatric surgery, so I could report back to all of you.

Dr. Ham (left) and Dr. Abril

I really enjoy their relaxed but detail oriented style – it makes for a very enjoyable case.  Today they performed a sleeve gastrectomy** so I am able to report – that they (Dr. Ham) oversewed the staple line (quite nicely, I might add).  If you’ve read any of the previous books, then you know that this is an important step to prevent suture line dehiscence leading to leakage of stomach contents into the abdomen (which can cause very serious complications.)  As I said – it’s an important step – but not one that every doctor I’ve witnessed always performed.   So I was a pleased as punch to see that these surgeons are as world-class and upstanding as everything I’d seen already suggested..

** as long time readers know, I am a devoted fan of the Roux-en-Y, but recent literature suggests that the sleeve gastrectomy is equally effective in the treatment of diabetes.. Of course – we’ll be watching the research for more information on this topic of debate. I hope further studies confirm these results since the sleeve gives patients just a little less of a drastic lifestyle change.. (still drastic but not shot glass sized drastic.)

Dr. Ham

They invited me to the show this evening – they are having several clowns (that are doctors, sort of Patch Adams types) on the show to talk about the health benefits of laughter.  Sounds like a lot of fun – but I thought I better catch up on my writing..

I’ll be back in the OR with Los Doctores again tomorrow..

Speaking of which – I wanted to pass along some information on the anesthesiologist for Dr. Molina’s cases since he did such a nice job with the conscious sedation yesterday.  (I’ve only watched him just yesterday – so I will need a few more encounters, but I wanted to mention Dr. Andres Garcia Gutierrez all the same.

Advertisements

Read Full Post »

Another example in the realm of surgery where easiest doesn’t equal most effective: gastric banding (lap-band). This is one of those procedures highly touted in American medicine – and heavily advertised on television as an ‘easy’ way to lose weight..

First, let’s get some things clear – the ‘easy’ mentality needs to go away in medicine, and so does the pushing of this concept with patients.. None of this; not surgery, weight loss drugs, or conventional treatment is easy for the patient..It’s all hard work, so don’t mislead your patients – that sets them up for failure..

In the article linked here (from the LA times, February 2011) the two doctors interviewed do their best to avoid answering the easy/ effective question. “I let the patient decide,” which is a royal cop-out. Patients come to doctors for expert opinions and recommendations not wishy-washy information that doesn’t present the facts and evidence. The picture accompanying the article is disturbing as well, since it’s captioned as a patient awaiting lap-band.. The patient is clearly morbidly obese – yet is undergoing the least effective option available!

What makes this frustrating to me – is that in talking to patients – is that it’s usually such a long road to even get to bariatric surgery.. Contrary to popular belief and tabloid reporting, the majority of overweight people don’t jump to bariatric surgery.. These patients spend years (sometimes decades) dieting, gaining and losing weight..
This isn’t always the case in other countries where surgery is more readily available – but in the USA where insurance coverage or lack there of, usually dictates care – bariatric surgery is usually the end of a long, frustrating road..

I know I’ve discussed this before on the site – but I feel that there needs to be transparency in treatment options – and that we need to do away with the ‘easy’ concept whether it’s bariatric surgery, stents or even medications.. Don’t sell people easy – give them safe, proven and effective.

I’ll be updating the article over the next few days with links for more information – and hard facts about surgical options and obesity surgery.

Related Articles: Free full-text links: (my titles, the actual titles are a bit longer)

1. It’s Not Easy – a study looking at the patients perspective, and perceptions before and 2 years after bariatric surgery.

2. Current treatment guidelines and limitations – a discussion of current treatment guidelines in the USA and Canada

3. German study with 14 year outcomes after gastric banding – this is a nice study because they use terms that are easily understood for laypeople – and shows decent outcomes for patients with this procedure

4. Single port bariatric surgery – this has been a hot topic over at the sister site. This article discusses the most recent innovations in surgical techniques for bariatric surgery.

5. A review of the current data (2008) surrounding bariatric surgery, obesity, and diabetes and the cost of care.
This is a particularly good article (reviews often are) because it gives a nice summary of multiple other studies – so intead of reading about eight patients in Lebanon or some other small group – you are getting a good general overview..also it gives a good idea the scope of the problem..

I’m trying to collect a wide range of articles for patient education; unfortunately, since surgeons in Latin America are on the forefront of bariatric surgery – a lot of the most interesting articles are in Spanish and Portuguese (or paid articles). i haven’t posted the translations since they are secondary source and all of the other citations are primary source.

Read Full Post »

In honor of the Latin-American Bariatric Surgery Congress, currently in progress in Cartagena – (since I couldn’t make time in my research to go) I am posting a brand new article about bariatric surgery and the severely obese. It seems American medicine is finally starting to catch up, and take notice..

It’s hard concept out there – and I still have trouble with it myself, sometimes.. In our society, it seems we are too busy blaming ourselves, and others for being overweight and attaching labels; ‘lazy’, to really see how fundamentally things need to change to improve our health as a nation.

From my perspective, down here in Bogota – it’s interesting, because I am seeing Colombians just beginning to start to struggle with obesity – as more and more imported snack foods, and fast foods replace traditional diets. Obese people are still very rare here – and after several months, I can still say I’ve not seen a single super-obese person here, but the ‘chubbies’ are starting to grow in number..

At the same time, by being in such a walkable city, and having access to (cheap!), delicious, ripe fruit every day, I’ve managed to lose over ten pounds with almost no effort.. I’ve been tracking my walking, and I walk about 6 to 10 miles a day with my various errands. But these are things that aren’t readily available – in the urban sprawl of American life.. A week’s worth of fruit for several meals for ten dollars? Not hardly, unless you gorged yourself on bananas every single day..

Surgery as a solution seems drastic to American healthcare providers, myself including.. Removing/ destroying a perfectly functioning organ.. But then – when you look at the drastic effects, and the desperate states our patients are in – Bariatric surgery really is as lifesaving as cardiac surgery for many people.. Until we change society as a whole (which may never happen), we need to help these individuals regain their health,and their lives..

Bariatric Surgery for the Severely Obese

In the meantime, everyone, stay away from soft drinks (all soft drinks, including ‘diet drinks’, juices and fruit drinks, sweet tea) and stick to water, plain tea. Coffee too – if you remember not to load it up with too many calories.. Try it for a month, and I wager you will be unable to go back to the supersurgery drinks you formerly enjoyed out cringing..

Read Full Post »

As some of you know – I took on the coffee challenge in graduate school after a few stupid comments from classmates over my coffee drinking habit (I like about four cups a day).. So as part of a grad school assignment I reviewed the literature surrounding coffee, and the active ingredients in coffee and it’s kin (cocoa) and wrote about the health benefits of the methylxanthines; theophylline, theobromide, and caffeine.. I talked about the use of theophylline to prevent anoxic injury to the brain and to help restore spontaneous circulation in people after brady/asystolic arrest..
I also debunked some of the common myths surrounding ‘theophylline toxicity’ and it’s unwarrented and tarnished reputation.**

** (check the potassium level, everyone – and know that the effective / therapuetic range is actually 5 to 10 not 10 to 20)

Since then I hae been ardent follower of coffee drinking/ health stories..
– We now know it doesn’t precipitate atrial fibrillation – as demonstrated in several very large studies last year..

– It’s protective against diabetes and pancreatic cancer..

and now, ladies – it appears the health effects extend to a stroke benefit as well.. Now, maybe it isn’t all true – but the next time someone makes a smarmy comment about coffee harming your health – here’s some ammo to fire right back at them..

Here’s some links to the story- which was widely reported, and picked up by AP.

Coffee reduces Stroke

http://news.yahoo.com/s/ap/20110310/ap_on_he_me/us_med_coffee_stroke

http://consumer.healthday.com/Article.asp?AID=650753

LA timesNow – just make sure you haven’t ruined it with 300 calories worth of fat and sugar..

Read Full Post »

Everyone knows this already – but finally some scientists sat down and worked it out for the rest of us:  Obesity Kills!

Seems like a pretty timely article: Obesity Increases Risk of Deadly Heart Attacks – over on WebMD..

Here I am in Bogota, spending much of the week with Bariatric surgeons; discussing procedures, outcomes, meeting patients..

Read Full Post »

A select number of autographed copies of Hidden Gem: A Guide to Surgical  Tourism in Cartagena, Colombia are now available on Ebay. 

I’ve had numerous requests for signed copies.  Since I live in St. Thomas, this creates quite the hassle for readers, shipping books back and forth, so I have ordered a few to be placed for sale on eBay, in the travel section.

http://cgi.ebay.com/ws/eBayISAPI.dll?ViewItem&item=170527053422

Read Full Post »

Hidden Gem: The unvarnished truth!

Guide to Surgical Tourism in Cartagena, Colombia

Welcome to everyone who came here after reading about the book in print ads!  This is the book page for Hidden Gem, a new guide book for surgical tourism.  As an independent writer, who is unsupported by large book publishing companies, medical tourism agencies or other large agenda driven corporations – National advertisement and fancy ad campaigns are out of reach.

Don’t be fooled by the lack of hype or flash.  This book has substance, and unvarnished truth.  There are no ads in my book. I didn’t sell space/ pages, or ratings to any company for financial backing, or help selling my book.  I didn’t ask for, expect or receive any favors, freebies, gifts or money from any of the people or places I interviewed for this book. That makes me different from most of the guide books out there! 

 The majority of guide books, especially the large ones, make money by selling ad space/ or featured property space in their books.  The triple AAA star ratings that hotels and restaurants have?  Well, they bought and paid for the ‘priviledge’ of having AAA include them in their books..

This book is also unique because it’s written by a healthcare provider, for consumers. It’s written in everyday language that doesn’t require readers to be doctors or medical personnel to understand.

As a practicing health care provider, I also know that the best health care is unrelated to flashy, expensive ad campaigns, marble floors in hospital lobbies, or gourmet catered meals in private suites.  Marble floors are elegant; catered meals are nice but they won’t improve your health, or prevent you from catching a hospital-acquired infection.  (Though the psychology of marble floors does suggest cleanliness; in reality the general sanitation of a facility is a much more rigorous process that takes place out of the public eye.

With that introduction; let me welcome readers again to my website.  Have a look around, and if this product interests you, click on one of the links on this site, or request it at your local bookstore..

 https://www.createspace.com/3450944

Read Full Post »

Older Posts »