Wednesday, June 22, 2011

So much news - here's a taste! (more to follow)

I have a lot of stories and updates from last week's meeting of the ASMBS and Monday"s OAC Capitol Hill visit...

Things to give news on:

Essential Health Benefit - next few months are crucial for access to care! - Expect this to be the theme of many future posts.
PLEASE lend your voice - it really makes a difference when legislators hear directly from you!!!

The CHOICE Campaign is one way to have immediate impact Click here to sign the open letter

Rural access to care - new ASMBS President Dr Robin Blackstone is personally involved in making the Center of Excellence system work for patients and programs.

Surgery for Metabolic Disease in Class I Obesity (BMI 30-35), and the limitations of BMI to make individual health decisions
There are large studies underway which likely will deliver the highest level of evidence to support care - but they are not yet completed. Many other studies without true randomization already clearly show benefits.

Duodenal Switch - getting much more exposure in debates and as viable alternative to Gastric Bypass in selected groups

State by state advocacy and networks growing

New national advocacy programs and networks of organizations working together

As we always expect - vigorous exchange of ideas for new approaches and tools - this is maybe more conservative than in previous meetings, but there is still a lot of work going forward

Excellent basic science keynote and public health keynote

Recession seems to be impacting growth, but perhaps less enthusiasm for the Adjustable Gastric Band is slowing some programs, also.

Gastric Plication / Imbrication experience growing - promising data even over several years in some overseas reports

I have several pages of notes, that may just get put up with minimal editing to at least minimize my procrastination! It is a blog, after all, not an epistle!

Forgive me for "dropping names" in future posts, but so many of these folks work so tremendously hard and are so smart - they deserve massive credit!!!! My only worry is incomplete notes - don't want to offend anyone by failing to recognize!

Sunday, June 05, 2011

Canadian First Nations - rising Diabetes rates over 20%

A diabetes epidemic is affecting First Nations people, especially women in their prime reproductive years, according to a new study in CMAJ (Canadian Medical Association Journal). The incidence of diabetes was more than 4 times higher in First Nations women compared to non-First Nations women

First Nations Diabetes in Canada

"What is clear is that the rapid appearance of type 2 diabetes particularly among First Nations people and other indigenous and developing populations has been precipitated by environmental rather than genetic factors," state the authors. "Its long term solution will require effective primary prevention initiatives that are population-based and driven by public health and community initiatives."

Maybe the authors would like to consider the genetic vulnerability of the First Nations ethnic groups, as we are seeing in South Asian ethnic groups... Then we could consider the combination of environment and genetics - acknowledging the complexity of the epidemic.

The community initiatives are building, but only with advocacy.

Male Testosterone recovery after Gastric Bypass

Testosterone recovery in Men

There's an older article on the blog about erectile dysfunction and recovery, this is a bit different, and newer.
One of these is the older article - I didn't dig back thru my old posts to compare...

Utah testosterone study

Boston/Philadelphia Urology study on sexual function

Breast Cancer Death Risk - proven almost 70% worse in Obese

Breast Cancer survival difference

but is this an appropriate conclusion? You be the judge!

She (study lead auhor Christina Dieli-Conwright, PhD ) continued, "With the obesity epidemic on the rise, weight management programs using exercise and diet are vital in cancer prevention and survivorship."

Clearly to withold Weight Loss Surgery in such a patient is discriminatory based on Evidence. That's the evidence that all our insurance companies and hospitals are not mandated (yet) to follow.

Please raise your voice - join the OAC (Obesity Action Coalition), write a letter every week to a hospital board member, an elected official, an HR executive. Retweet! anything helps - and silence kills

Friday, June 03, 2011

Striking Genetics Editorial, and bigoted comments

Genetics editorial

This is a fairly simple editorial to help explain the susceptibility to obesity, but look at the seething hate and ignorance in the comments.

Wow, we have a long way to go. I got real grief from a nurse the other day because she believes the risks are too high. Well, it's better to show 'em than tell 'em! When we get good results over and over, I feel sure she will believe.

Unfortunately, Bellingham has long been neglected for dedicated Bariatric care, so a lot of patients have been "ad hoc" treated. Our docs are generally only seeing a patient rarely, and the treating surgeons are quite varied, from all around the seattle area and even North America - from Ohio to Mexico, even a few who went to Spain.

Wednesday, June 01, 2011

A Long Way to Understanding Obesity

Here is a little secret your doc won't easily give up... We know a LOT about HOW diseases happen, but we don't know exactly why! What is the difference? Well, just because I can't tell you how you got appendicitis - doesn't mean we can't save your life from it.

Not all diseases are preventable all the time, or I wouldn't be up at night taking out appy's! Also, diseases that we have known causes for still happen.

My point is that childhood obesity EFFECTIVE TREATMENT should not wait for full understanding. Keep working on it, scientists, but let's get the multidisciplinary treatment teams together and do something in the meantime.

If your kid needed a life saving kidney transplant, how old would you require him or her to be to prepare and consent for surgery?

Childhood Obesity Research - YAY!