Once you have made the decision to get bariatric surgery, the next major step is choosing the right surgeon. There are many factors to consider in making this decision, and many ways to go about it. Here are some general tips and pointers about what to consider in making this key decision:
Know your options - Before deciding, check out who the bariatric surgeons in the Houston area are. Consider where they are located relative to you. Is it close by? Convenient? Also, consider whether they are covered under your insurance plan and if you have sufficient funds to pay their fees.
Visit their websites - Start looking at websites of weight loss surgery centers in the Houston area. Find out what services they offer and how they differentiate themselves from their competitors. Learn about the experience and expertise of the surgeons at the weight loss centers.
Ask a friend - There's a good chance you have a friend who has had gastric bypass or lap banding, or at least, a friend who knows someone who has had the procedure. Get in touch with this person and ask them about their experience. What did they like about their surgery and surgeon, and what did they dislike. This kind of firsthand experience is invaluable in making a final decision.
Call their office - Ultimately though, you have to decide for yourself. Make a list of questions that capture your concerns. Call up the surgery center that interests you and ask them your questions. Call up any other centers you are interested in, and elicit the same responses. Compare the responses and see what makes sense to you.
Make an appointment - The last major step is setting up an appointment with your potential surgeon. They should be happy to see you, explain your options in detail, and allay any concerns you may have. You can do all the research you want beforehand, but this meeting is key to see whether you feel comfortable with that particular surgeon performing this procedure on you. You have to be committed in this process, and you need a person you can depend on, as well as care team, that will help you achieve your goals.
Choosing a surgeon and bariatric center can make a significant difference in your overall outcome. Take your time, and you will feel much more comfortable with your decision! Good luck!
Monday, November 30, 2009
Friday, November 20, 2009
Gastric Bypass And Diabetes
Obesity is a very common disease. Diabetes is also a very common disease. It comes as no surprise that these two diseases occur together with a high frequency. While there is no clear causal link between obesity and diabetes, there is a fairly high correlation. If you are obese, you are at much higher risk of developing diabetes, and vice versa.
The link between two diseases raises the question: is gastric bypass surgery an option for diabetic obese patients? The question is intriguing. Diabetes is a disease in which the body has either a total lack of insulin, or decreased insulin production paired with decreased sensitivity to insulin in end organ tissues. The result of this is that blood sugar levels remain elevated, a state termed 'hyperglycemia.' Diabetes can lead to many debilitating problems, such as blindness, kidney problems, and even foot amputations. Diabetes also increases your risk for strokes and heart attacks. With such harmful effects a possibility, the question of whether gastric bypass surgery can be effective for diabetic patients is a valid one.
To address this question, the American Diabetes Association, or ADA, released in 2009 a Standard of Care statement addressing bariatric surgery specifically:
Given these results and this view from the ADA, if you are diabetic, obese, and living in the greater Houston area, you should consider asking your physician about gastric bypass surgery, or contacting a bariatric surgeon yourself. Ultimately, the person in charge of your obesity and your diabetes is *you*, so take charge today and make a difference in your life!
The link between two diseases raises the question: is gastric bypass surgery an option for diabetic obese patients? The question is intriguing. Diabetes is a disease in which the body has either a total lack of insulin, or decreased insulin production paired with decreased sensitivity to insulin in end organ tissues. The result of this is that blood sugar levels remain elevated, a state termed 'hyperglycemia.' Diabetes can lead to many debilitating problems, such as blindness, kidney problems, and even foot amputations. Diabetes also increases your risk for strokes and heart attacks. With such harmful effects a possibility, the question of whether gastric bypass surgery can be effective for diabetic patients is a valid one.
To address this question, the American Diabetes Association, or ADA, released in 2009 a Standard of Care statement addressing bariatric surgery specifically:
Gastric reduction surgery, either gastric banding or procedures that involve bypassing or transposing sections of the small intestine, when part of a comprehensive team approach, can be an effective weight loss treatment for severe obesity, and national guidelines support its consideration for people with type 2 diabetes who have BMI at or exceeding 35 kg/m2. Bariatric surgery has been shown to lead to near or complete normalization of glycemia in 55–95% of patients with type 2 diabetes, depending on the surgical procedure. A meta-analysis of studies of bariatric surgery reported that 78% of individuals with type 2 diabetes had complete “resolution” of diabetes (normalization of blood glucose levels in the absence of medications), and that the resolution rates were sustained in studies that had follow-up exceeding 2 years (96). Resolution rates are lowest with procedures that only constrict the stomach and higher with those that bypass portions of the small intestine. Additionally, there is increasing evidence that intestinal bypass procedures may have glycemic effects that are independent of, and additive to, their effects on weight.
Given these results and this view from the ADA, if you are diabetic, obese, and living in the greater Houston area, you should consider asking your physician about gastric bypass surgery, or contacting a bariatric surgeon yourself. Ultimately, the person in charge of your obesity and your diabetes is *you*, so take charge today and make a difference in your life!
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Saturday, November 7, 2009
How Bariatric Surgery Can Gain You Respect
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A recent study from Johns Hopkins showed that doctors treat obese patients with less respect as compared to their non-obese patients:
Clearly, getting bariatric surgery will not only help directly in terms of disease burden but will also improve how you are perceived by health professionals and society at large. Ideally, doctors should treat all of their patients equally, with dignity and respect. However, doctors for better or worse are human as well. They have their own perceptions and biases, which can affect how they provide care in a detrimental manner. As this report indicates, being overweight can cause doctors to hold certain beliefs about their patients, in terms of the patient's attitude or commitment to change, leading the doctors to unconsciously change how they treat those patients.
Bariatric surgery can help change those perceptions. By helping patients who are unable to lose weight on their own get over the hump of weight loss, bariatric surgery can change the external morphology, or body shape, of a patient in a quick and dramatic manner. This change may alter perceptions by healthcare physicians, who may then be better able to look past their patient's weight in order to address other health issues. Instead of weight being a perceptual roadblock, bariatric surgery can help the patient-physician team on the right path to lifelong health.
Should doctors discriminate or disrespect overweight and obese patients? Of course not, but the reality is that it occurs. While obese patients may have sadly come to expect such callousness from the public at large, no one should have to endure disrespectful or suboptimal care at the hands of someone they place their trust in. A morbidly obese patient should be motivated to consider any options available, including weight loss surgery, to take control of their lives and commit to living healthily. Whether you choose lap band or gastric bypass or some other procedure, the important thing is that you have taken the first step in taking charge of your health and your life.
Scientists reporting in the November issue of the Journal of General Internal Medicine say they found that the higher a patient’s body mass index (BMI), the less respect their doctors had for them.For more on this, Medscape: Doctors' Lack of Respect Weighs on the Obese.
Mary Margaret Huizinga, MD, MPH, of Johns Hopkins University School of Medicine and lead author of the study, says she came up with the idea for the research from her experiences working in a weight loss clinic.
She says that patients who'd visit would, by the time they left, “be in tears, saying 'no other physician talked with me like this before,'" and had failed to listen.
“Many patients felt like because they were overweight, they weren’t receiving the type of care other patients received,” she says in a news release.
She and colleagues looked at data on 238 patients and 40 physicians. The average BMI of the patients was 32.9.
A person with a BMI of 25 to 29.9 is considered overweight, and 30 or greater obese.
In the study, patients and physicians filled out questionnaires about a doctor’s visit. They were asked questions about their attitudes and perceptions of one another at the end of their encounter. Physicians were asked to rate the level of respect they had for each patient compared to “the average patient” on a 5-point scale.
The patients for whom doctors expressed low respect, on average, had a higher BMI than patients for whom the physicians had high respect, the researchers report. The researchers note that the findings don’t show a cause/effect relationship between BMI and physician respect. Their study also didn’t investigate patients’ health outcomes.
Clearly, getting bariatric surgery will not only help directly in terms of disease burden but will also improve how you are perceived by health professionals and society at large. Ideally, doctors should treat all of their patients equally, with dignity and respect. However, doctors for better or worse are human as well. They have their own perceptions and biases, which can affect how they provide care in a detrimental manner. As this report indicates, being overweight can cause doctors to hold certain beliefs about their patients, in terms of the patient's attitude or commitment to change, leading the doctors to unconsciously change how they treat those patients.
Bariatric surgery can help change those perceptions. By helping patients who are unable to lose weight on their own get over the hump of weight loss, bariatric surgery can change the external morphology, or body shape, of a patient in a quick and dramatic manner. This change may alter perceptions by healthcare physicians, who may then be better able to look past their patient's weight in order to address other health issues. Instead of weight being a perceptual roadblock, bariatric surgery can help the patient-physician team on the right path to lifelong health.
Should doctors discriminate or disrespect overweight and obese patients? Of course not, but the reality is that it occurs. While obese patients may have sadly come to expect such callousness from the public at large, no one should have to endure disrespectful or suboptimal care at the hands of someone they place their trust in. A morbidly obese patient should be motivated to consider any options available, including weight loss surgery, to take control of their lives and commit to living healthily. Whether you choose lap band or gastric bypass or some other procedure, the important thing is that you have taken the first step in taking charge of your health and your life.
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Sunday, November 1, 2009
Texas Bariatric Surgery Centers Of Excellence
Among the sites listed in the Houston Bariatric Surgery Directory and Houston Bariatric Surgery Directory Updated, some are Centers of Excellence. According to the Surgical Review Corporation, the following sites in Texas are Centers Of Excellence for Bariatric Surgery. Many centers are located in or near the Houston area:
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