And so this is Christmas -

First of all I really need to apologize to each and all of you for my absence from the group. I have been very ill these last few months and between hospital stays, Dr visits and home nursing care I've just not had a lot of energy to post.
I have been reading the group though and I want you all to know that there isn't a day goes by that I don't think of you all and pray for peace for all of us.
Christmas can be so hard, can't it?
My sincere wish is that today, as all days you take a few moments to reflect on all that is good in your lives, the memories, the joyous times you had with loved ones gone.
Let the joy and the grief soothe your soul. Reach out if the pain is unbearable. Reach out if the joy overflows and you have some to spare.

Thank you all for looking after each other this past year. Welcome to the newest of us here.
You've found a place with people who have traveled a similar path, a group no one really wants to join. But, here we are.
Merry Christmas friends.
All my love to each of you.

aA
kesha.

I will vote in the next election now that it's legal ! ! !

Yesterday, November 21st, I was sworn in as an American Citizen!!!!!


yay me.

Another 'thing' to thank Canada for eh?

Just thought you'd like to know.

I've been quite ill lately and hopefully on a learning road to recovery but this was one thing I wasn't going to postpone.

aA
kesha

So, you say I took the easy way out. A surgeon's perspective on Bariatric Surgery.

Obesity has genetic components, well documented in the medical literature. There are socio-economic factors involved. Many of our patients have an abuse history, and sub-consciously shroud themselves from unwanted physical attention through their weight; hence, obesity has a psychological component. There are numerous metabolic issues at play, such as diabetes, hypo-thyroid issues, poly-cystic ovarian syndrome, and leptin insensitivity.

Now consider the thought process involved in undergoing surgery. Patients need to admit to themselves and their families that they have a disease that is so profound that they need to see a doctor to treat it. Then they have to see a mental health provider, to evaluate them for untreated mental illness and coping skills. Next they have to see a dietitian, and may need to undergo 6 months of medically supervised weight loss, depending on their insurance. Then they have to have a major surgical procedure. Granted, it’s typically performed laparoscopically, but they still need to undergo general anesthesia, and have someone operate on them in order to help fight this disease. They may incur significant expense, loss of time from work, and/or time away from school. Finally, they have to take vitamins for the rest of their lives, and they have to follow up with a mean surgeon (me) forever!

Does that sound like the easy way out? How do I explain to a woman at a party that, without surgical intervention, only 30% of my patients would live to see their 65th birthday? How do I explain the humiliation involved in asking for a seat belt extender on an airplane? To not be able to go to a movie, or an amusement park. To have to have a family member do your toilet care because you simply cannot reach? To not be able to run after your child when he or she is in danger? To have people judge you as lazy and slovenly before even shaking your hand? To be discriminated against when applying for a job, just because of the way you look?

Obese people are the last population that folks think of as socially acceptable to ridicule. Yet, over 30% of Americans are considered overweight. While I’m thrilled that the AMA has declared obesity a disease, how long until the rest of society recognizes that ruling and stops discriminating?

I didn't see it. But I'd like to address the types of surgery (wish I'd seen the episode)

If she indeed had a lap band, the stomach is NOT made smaller. A band is placed around the opening to the stomach and is restricted by injecting saline into the band, likewise the restriction can be lessened by removing or suctioning out the saline from the band.
Many people I know (yes many) have had no good luck at all with the lap band because they weren't disciplined and their doctors allowed them to have adjustments whenever they wanted to 'feast' ie: go to a wedding or a banquet, they could eat till their hearts content and then restrict intake at a later time.
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The Gastric Bypass operation, also known as the Roux-en-Y gastric bypass, is one of the most commonly performed weight loss surgical procedures. It involves creating a very small 2-3 ounce gastric pouch and connecting it to a limb of small bowel. The reduction in the size of the stomach is the most significant of all weight loss surgical procedures. It is, however, important to note that the smaller stomach pouch does not function in the same manner as the original intact stomach. When you compare the stomach of the Sleeve Gastrectomy or the Duodenal Switch operation, their function and physiology is very similar to the normal anatomy. This is, however, not the case in the Gastric Bypass operation. The remnant stomach that connects to the small bowel does not, physiologically or mechanically, function the same as a normal intact stomach. This ultimately results in a number of complications that are unique to the gastric bypass operation. Complications include marginal ulcers, dumping syndrome, stricture at the site of the gastrojejunostomy anastomosis (where the stomach is attached to the small bowel), and nutritional deficiencies including iron and B12.
Even though the short-term results of the gastric bypass operation may be acceptable when measured by excess weight loss, the outcome of its long-term maintained weight loss, along with the associated complications of the surgery, make it a procedure that a lot of surgeons no longer recommend.
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The Biliopancreatic Diversion with a Duodenal Switch is a hybrid surgical procedure that has two aspects that reduce weight.

The smaller stomach size limits the amount of food that can be taken in to about 120-150cc (1/2-3/4 Cup).

The small bowel is reattached in such a fashion as to keep the biliopancreatic juices away from the food until the last portion of the small bowel, limiting the absorption of the food that is eaten. The stomach is decreased in size by doing a Sleeve Gastrectomy, which uses proportional amounts of the stomach areas that make important enzymes and chemicals. The hallmark of the Duodenal Switch operation is the preservation of the pyloric valve. The pyloric valve is at the last portion of the stomach and acts as a gateway to the small bowel. The food needs to be of the right chemical and mechanical consistency before the pyloric valve allows it to progress into the small bowel. The appendix and the gallbladder are also removed.

Duodenal switch provides the best remedy for failed gastric bypass.

When necessary, the revision or reversal of the Duodenal Switch operation is technically the safest and easiest of all revisional surgical procedures.