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1-800-Get-Thin President Quits – Oops

Robert Silverman, the marketing director and president of all of the 1-800-Get-Thin campaigns has resigned.  

Not surprising.

Hey, maybe bloggers won't be poked to remove posts anymore?  Heh.  

 

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LA Times - 

The president of the 1-800-GET-THIN marketing company, which has blanketed Southern California freeways and television and radio stations with ads for Lap-Band weight-loss surgery, said he has resigned "to pursue other career opportunities."

In a news release Thursday, Robert Silverman said that his resignation was effective Tuesday. He had served as the firm's president since February 2010, the release said.

"I believed in the mission and I believe that I was assisting individuals [to] overcome their battle with obesity, which has reached world-wide epidemic status," Silverman said in the release.

The 1-800-GET-THIN campaign had come under increasing scrutiny after the deaths of five Lap-Band patients since 2009.

In December, the Food and Drug Administration sent warning letters to the marketing company and its affiliated surgery centers, saying the ads for Lap-Band weight-loss surgery were misleading because they did not adequately display warnings about risks of the surgery.

The California Department of Insurance also has confirmed it is investigating the surgery centers affiliated with 1-800-GET-THIN for possible insurance fraud. In February, Lap-Band manufacturerAllergan Inc.said it had halted sales of the weight-loss device to all firms affiliated with the marketing company.

In addition to his role as president of 1-800-GET-THIN, Silverman, a lawyer, had represented the firm and its affiliated surgery centers in several lawsuits. He said in an email to The Times that he no longer represents them.

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Intervention – Julie – Alcoholism After Weight Loss Surgery – Gastric Bypass

On last night's Intervention – Julie.

 

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A gorgeous 40 year old mother of two, who happens to to be about seven to eight years post gastric bypass postop.  She also, happens to have a little big problem in her smaller body.

"Julie often turned to food and alcohol to find comfort in tough times. She had gastric bypass surgery when her weight ballooned, but now she spends her son's child support money."

On alcohol, a lot of alcohol.  You see…

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First thing you must note, Julie started drinking at six months post surgery.  

This is extraordinarily dangerous.  Your surgeon told you to be careful for a reason.

Alcohol + early gastric bypass = possible brain damage and Wernicke's encephalopathy.   Wernicke's can occur even without the aid of drinking heavily, do not help it along.

Gastric bypass triggers impaired vitamin intake in the best of situations, and pairing this with alcohol abuse can increase the risks of things like thiamine or Vitamin B1 deficiency.  Typical people have a hard enough time metabolizing, removing nutrient intake and adding alcohol is a very bad idea.  Don't do it.  Don't take advice from internet peoples, but don't do it.

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Also note that alcohol really messes you UP post op –

 If you aren't one of the gastric-ally enhanced like your super enhanced *sarcasm* blogger here, let me explain something to you:  

  • Diet coke and rum, and I'm on stage.  
  • A few sips of a martini and I'm holding walls.  
  • I'm pregnant in one half-glass of wine.  

Alcohol is a different beast with a short gut.  Your mileage may and should and will vary, but for most of us, alcohol hits our systems FAST, HARD and feels like it leaves just as quick, even if it doesn't – – which can lead "us" to drink more.  

It can be a sick cycle, and the longer I live with my own super enhanced system, the more I realize how much it's all quite interconnected.  (Hello, carbohydrates, let's get shitfaced!)  I'm not an expert in any way, I just live with it, watch others deal — and read about it daily.  (And, damn it if my opinions aren't changing.)

I'm not really blogging about Julie here, you see.  I feel like I/we can't judge.  Because, you know what, she is any one of us.  It would not take much to jump on that slip and slide of transfer addictionfor any of us, and who are we to judge that?  (As I sat with my heavily buttered toast and ATE FOOD during this episode, right?)  

Transfer addiction can hit ANY OF US if we aren't dealing with our triggers…

…To over eat, drink, compulsively shop, gamble, ludicrous hobbies that suck up ALL time and money,  taking off to do stupid shit, (Yes, I Am Talking About You, CUT IT OUT, what you're doing is totally destructive though you don't see it, and you probably won't see this anyway…) overusing the internet *coughIknow,* obsessions, sex addictions, etc…so forth, so on and yadda yadda yadda, this list, really has NO END…  And, we all know someone who has a problem.  And, yeah.  

My Name Is Beth And I Am Addicted To Caffeine, Simple Carbohydrates And Online Gratification Via Instant Results Via ADHD Brain With A Side Order of Seizure Disorder.

Also:  who's to say what addictions and compulsions are truly destructive vs. not?  I mean?  Sure, I use the net too much, but… what if I was knitting so much that my house was full of yarn?  <g>  There are things to consider here.  Also: addicts will rationalize everything to make their addictions seem okay for THEM.  *beam*  Am I NOT right?Any of us who ever used food to deal with emotional reasons or anxiety is at risk to transfer to something else, or continually cycle back to heavily buttered carbs.  We substitute WHAT-EVER we can to get the same effect in our BRAINS.  It's just a cycle of fail until we can fix what's broken to begin with!  If you have ever said, "As soon as I lose the weight, things will be better -" that's a sign that they won't.  Start working on it yesterday.

Also – I must mention it.  I notice the chatter – "OMG HOW MUCH WEIGHTED DID SHE GAINED?!"

The woman was on Intervention because she's drinking herself to death.  Her weight regain is of zero importance.  Priorities:  #1 – Live.  #2 – Stay Alive.

At the close of Intervention last night, we were told that Julie is attending AA and was sober as of September.  I wish her the very, very best.  

Are you out there, Julie?  

PS.  The realization that the individuals on these shows WATCH themselves on TV and how does THAT feel?  *thud*

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Roux-en-Y Gastric Bypass Better Than Gastric Banding For Rapid And Safe Weight Loss

Roux-en-Y Gastric Bypass Better Than Gastric Banding For Rapid And Safe Weight Loss.

Results taken after the six years showed that the percentage of failures (BMI above 35 or reversal of the procedure/conversion) in the GB group was 48.3 percent, compared to only 12.3 percent in the RYGBP group. Those in the GB group were also more likely to face reoperations (26.7 percent compared to 12.7 percent) and long-term complications (41.6 percent compared to 19 percent). 

Joseph Nordqvist. “Roux-en-Y Gastric Bypass Better Than Gastric Banding For Rapid And Safe Weight Loss.” Medical News Today. MediLexicon, Intl., 16 Jan. 2012. Web.
16 Jan. 2012. 


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A blood sugar meter that tracks your patterns? The OneTouch Verio

 

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Niiiiiice.  

This post is absolutely copied from PR for OneTouch, but I am super intrigued by this product.  I want one and I want to play with it.

 A meter that tracks your blood-sugar trends and gives you feedback on predicted lows — highs.  I can see the potential use of this for those of us who have hypoglycemia issues after weight loss surgery.  If I were more aware of my lows or potential lows, perhaps I wouldn't pre-treat so often.  (My pre-treating?  EATING TO AVOID LOWS.  LOL.)  I wonder.

Via Diabetes Health

LifeScan has introduced the OneTouch® VerioTM IQ, a meter that not only tracks and displays blood sugar patterns, but also announces them with messages, such as "Looks like your blood sugar has been running LOW around this time."

The meter, which incorporates what LifeScan calls "PatternAlertTMTechnology," is specifically designed fordiabetes patients who take insulin. LifeScan's reasoning is that insulin users are at greater risk of hypoglycemia than non-insulin users and must monitor their blood sugar throughout the day to adjust for meals and physical activity.

"All meters will tell you your blood sugar level at a particular moment in time, but this is the only one to compare your current result with your previous results and proactively alert you to important patterns you might not even be aware exist," says Michael Pfeifer, chief medical officer at LifeScan, Inc.

The PatternAlert Technology reflects the recommendation by diabetes experts that patients identify patterns of highs and lows that last at least two or three days in a row.

A "High Glucose Pattern" consists of three before-meal highs within the same three-hour window over the past five days. High (before meal) results are preset to 130 mg/dL or above to match current American Diabetes Association guidelines, but can be personalized to any result at or above 100 to 160 mg/dL.

A "Low Glucose Pattern" consists of two lows within the same three-hour window over the past five days. Low results are preset to 70 mg/dL or below to match current ADA guidelines, but can be personalized to any result at or below 90 to 50 mg/dL.

When the meter finds a pattern, a message appears, such as "Heads up. Your before-meal glucose has been running HIGH around this time." Patients may choose to view additional information about each test result in the pattern, such as the blood sugar value, day, time, and type of result (before or after a meal, for example).

A companion OneTouch® VerioTM IQ Pattern Guide is available to patients from healthcare professionals or by contacting OneTouch directly at 888-567-3003. The guide offers possible causes and potential solutions for high and low patterns, based on guidance from leading diabetes experts.

Watch for the OneTouch Verio release on Twitter.

Study – Seizure Increase Not Seen Following Gastric Bypass

I am sharing this particular study because I am a seizure patient following gastric bypass who has a list of about 160 people with a similar issue.  

This makes me happy, relieved even…and a little sad at the same time.  Why?  Because it would be REALLY REALLY GREAT if someone found a definitive trigger for us who have conditions like this.

Seizure Increase Not Seen Following Gastric Bypass

By: MIRIAM E. TUCKER, Clinical Psychiatry News Digital Network

BALTIMORE – No notable increases in new-onset seizure disorder or exacerbations of a pre-existing seizure disorder were seen following gastric bypass surgery in a retrospective case series of more than 1,500 patients from the Mayo Clinic.

Reports of new-onset or exacerbated seizure disorders following Roux-en-Y surgery are often posted on epilepsy patient-oriented Web sites such as epilepsy.com, along with reports of other neurologic complications such as Wernicke-Korsakoff syndrome, polyradiculoneuropathy, myelopathy, and optic neuropathy. However, few previous studies have examined a potential connection between gastric bypass and epilepsy, Dr. Richard S. Clemmons and Gregory D. Cascino said in a poster at the annual meeting of the American Epilepsy Society.

A diagnosis of epilepsy pre-existed prior to Roux-en-Y surgery in 12 of 1,542 patients who were operated on at the Mayo Clinic between September 1997 and September 2007. Those patients were selected from a larger group of 1,776 patients because they had more than 1 year of follow-up, had undergone surgery for morbid obesity, and were aged 18 years or older. Despite evidence that gastric bypass surgery might result in decreased absorption of drugs with high proximal absorption or low pH (Am. J. Health Syst. Pharm. 2006;63:1852-7), 8 of these 12 patients had no decrease in drug levels, based on patient report or on serum testing before and after surgery. One patient who did have a low drug level was suspected of poor compliance. None of the 12 had exacerbations of their seizures.

"Based on the limited data here, there was not a decrease in serum drug levels for valproic acid, carbamazepine, or levetiracetam. … Even patients with significant seizure risk factors did not manifest an exacerbation of seizures," noted Dr. Clemmons and Dr. Cascino, both of whom were affiliated with the division of epilepsy in the department of neurology at the Mayo Clinic, Rochester, Minn., at the time of the study. Dr. Clemmons is currently in private practice in Denver.

Only 5 of the 1,542 patients developed new-onset epilepsy following surgery. Of those, only 3 (1.9% of the total cohort) could be considered to have unprovoked epilepsy. One of the other two patients had a history of meningoencephalitis and had just a single seizure 2 years after surgery that was possibly associated with hypoglycemia. The other one had a seizure in the setting of a stroke 3 months after surgery. None of the five developed intractable epilepsy.

About three-fourths of the patients in the study were female. Their charts were examined for evidence of seizure exacerbation post surgery, defined as an increase in seizure frequency above preoperative baseline where another cause was not identified. Patient questionnaires were used to supplement where data were lacking.

"Based on the reviewed data, there is no clear exacerbation of preexisting seizure disorder following gastric bypass … Most patients with seizure disorder do well following Roux-en-Y," they concluded.

 

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Year of abdominal pain — Hydrogen Breath Testing

Update

Mr took me into Boston today for the Hydrogen Breath testing.  I thought I took to be there super-early, turns out I waited in the wrong part of the GI unit for an hour before realizing it. 

I had to drink a lactulose solution, and puffed into a bag with a syringe on it.  My air was injected into a super cool gas analyzer machine and that's that.

I think I passed — or I failed?  I watched the numbers of the machine during each breath sample collection and I saw an increase in the numbers, however the tech said that she didn't see "much change."   So, bacteria may not be my problem.  Interestingly, the drink triggered more pain.  Thanks!  I don't DO 'OSES for that reason.

322513_284005378310544_105130816198002_837133_1095045421_oSmall Bowel Bacterial Overgrowth Syndrome (SBBOS) or Small Intestinal Bacterial Overgrowth (SIBO) – the patient is either given a challenge dose of glucose, also known as dextrose (75-100 grams), or lactulose (10 grams). A baseline breath sample is collected, and then additional samples are collected at 15 minute or 20 minute intervals for 3–5 hours. Positive diagnosis for a lactulose SIBO breath test – typically positive if the patient produces approximately 20 ppm of hydrogen and/or methane within the first two hours (indicates bacteria in the small intestine), followed by a much larger peak (colonic response). This is also known as a biphasic pattern. Lactulose is not absorbed by the digestive system and can help determine distal end bacterial overgrowth, which means the bacteria are lower in the small intestine. Positive diagnosis for a glucose SIBO breath test – glucose is absorbed by the digestive system so studies have shown it to be harder to diagnose distal end bacterial overgrowth since the glucose typically doesn't reach the colon before being absorbed. An increase of approximately 12 ppm or more in hydrogen and/or methane during the breath test could conclude bacterial overgrowth. Recent study indicates "The role of testing for SIBO in individuals with suspected IBS remains unclear." [2]

The excess hydrogen or methane is assumed to be typically caused by an overgrowth of otherwise normal intestinal bacteria.

Tomorrow is marked with the most exciting of several tests in an attempt to narrow down my year of abdominal pain. This test could show the presence of Small Intestinal Bacterial Overgrowth — which is somewhat common in those who've got lower gut issues and also in those who have had gastric bypass or who have had abdominal surgeries.

Bascially — I breathe into a bag every so many minutes for a few hours.  The samples are collected and tested for the presence of excess gases.  'urp. Reading about these tests, and watching test videos and the excessive use of the word METHANE only brings to mind … cows.

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If I get a positive result on this test — I am starting a post bariatric energy company.  <sarcasm intended> There are far too many of us with broken guts who could probably power up our own houses with malabsorptive misfirings.

Hydrogen Breath Testing

The hydrogen breath test is used to identify lactose or fructose intolerance, or an abnormal growth of bacteria in the intestine. It is used to diagnose a lactose or fructose intolerance, which is the inability of the body to digest and or absorb lactose, the sugar found in dairy or fructose, the sugar found in a number of foods (fruit, vegetables, soda, etc.). Hydrogen breath testing can also be used to diagnose intestinal bacterial overgrowth. A breath sample will be collected and tested for the presence of hydrogen. To obtain the sample, you will be asked to blow up a balloon-type bag. Normally, very little hydrogen is detected in the breath. You will then be given a lactose, fructose, or lactulose solution to drink. Breath samples are collected every 15 minutes for 2 hours to detect any increase in hydrogen in the breath as the solution is digested. Increased hydrogen breath levels indicate improper digestion. The testing procedure lasts about 3 hours.

Super-fun, but likely the easiest of the tests because nothing goes inside me.  See? 

Next, is the capsule endoscopy. Then, the colonscopy for the holiday. 

Dear Santa, I thought I'd been good…


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On the first day of …

Something….the gastroenterologist gave to me… three Super Fun diagnostic tests that I probably needed done 11 months ago.  Okay, so I'll never write songs.  Shut up.

"Why would you ask for this kind of torture?"  (Well, because like one of my favorite commenters haters says, "Melting Mama Has Munchhausen's Syndrome."  Take THAT, keywords.)

Because, at this point? Any. answer. will. do.

Like I told the doctor today: I have forgotten what it feels like to feel good.

I go to bed with this discomfort — and it wakes me up. Every day. Every stinking day.  Even on the best days where I walk all day long and can "forget about it" for a while, it comes back when I am sitting, stopped or in bed.

Even if we get through the testing to find out, you know, it really WAS just a hernia (which has already been confirmed, I have a small hernia near my bellybutton) and/or a bacterial overgrowth problem, or even celiac… Crohn's — something — GOOD!

At least I have an answer instead of THIS. Constant dull pain — constant discomfort — constant reactions to food — that I cannot predict. I can't tell if one stab is related to the digestive distress, I just have no idea. I only know that it hurts every day, and I am quite sick of it. 11 months.

Colonscopy – check.  Capsule endoscopy – check.  Bacterial overgrowth breath test – check.  PS.  Biopsies for extra fun.

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"Yay."  Testing starts in two weeks.

Increased Alcoholism Rates Seen in Gastric Bypass Patients

Something (another article with a "DUH!?" factor) that comes as zero surprise to a post operative gastric bypass patient, who reads about other gastric bypss patients, and talks to hundreds of them.  <insert heavy dramatic sigh>


European researchers have found gastric bypass patients have an increased risk for postoperative alcohol dependence. Based on a retrospective cohort of bariatric surgery patients, the investigators are calling for clinicians to examine gastric bypass patients for postoperative alcohol-related diagnoses.

“The results of this study clearly indicate the need for physicians to screen for alcohol abuse as part of the workup prior to bariatric surgery and to follow patients who undergo this operation carefully for signs of alcohol abuse,” said Craig Fisher, MD, MPH, associate professor in the Department of Surgery, Weill Cornell Medical College of Cornell University, in New York City, who was not involved in the study.

According to investigator Magdalena östlund, MD, a researcher in the Department of Molecular Medicine and Surgery, Karolinska Institute, Stockholm, patients’ increased risk for acute alcohol intoxication, dependence, and weight gain after gastric bypass surgery may come from greater alcohol absorption in the small intestine and a more immediate spike in blood alcohol levels.

In light of previous research that showed substance abuse and mental illnesses were more common among obese patients, Dr. östlund’s team set out to investigate whether bariatric surgery might reduce the frequency of these illnesses. She and her colleagues examined data from 12,277 Swedish gastric bypass and restrictive surgery patients treated between 1980 and 2006 and followed for a mean of 8.9 years postoperatively. The researchers compared data between these patients and 122,770 age- and gender-matched controls who did not undergo bariatric surgery; they did not control for obesity in the matched group.

Compared with controls, bariatric surgery patients had significantly higher rates of psychosis, depression, attempted suicide and alcohol-related diagnoses, such as acute alcohol intoxication, and alcohol dependence before surgery. Preoperative rates of these illnesses were similar among patients undergoing restrictive and gastric bypass procedures; however, patients undergoing gastric bypass were 2.3 times more likely than those receiving banding procedures to get inpatient treatment for alcohol-related diagnoses postoperatively (odds ratio, 2.3 for bypass vs. banding). The only other diagnosis that changed in frequency after surgery was psychosis, which decreased in both groups.

“Patients need to be warned of the risks of alcohol consumption following gastric bypass,” Dr. östlund said at the 2011 Digestive Diseases Week (abstract 266).

Dr. Fisher said the strengths of the study’s design make the findings exceptionally reliable. “These data are unique in that they capture a population with very complete follow-up information,” said Dr. Fisher. “In the U.S., researchers often find it difficult to follow patients continuously, since they sometimes receive initial treatment at one center but go elsewhere for follow-up care. As there are a limited number of bariatric surgery centers in Sweden, the researchers were able to track all of the patients who underwent surgery.”


Drs. Fisher and Ostlund had no relevant information to disclose.

Source – General Surgery News