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Post by OLKoot on Jun 4, 2009 11:57:53 GMT 12.75
No scars: New obesity surgery goes through mouth AP
* By LINDSEY TANNER, AP Medical Writer Lindsey Tanner, Ap Medical Writer – 55 mins ago
CHICAGO – Doctors are testing a new kind of obesity surgery without any cuts through the abdomen, snaking a tube as thick as a garden hose down the throat to snap staples into the stomach. The experimental, scar-free procedure creates a narrow passage that slows the food as it moves from the upper stomach into the lower stomach, helping patients feel full more quickly and eat less.
Doctors say preliminary results from about 200 U.S. patients and 100 in Europe look promising.
After about 18 months, obese European patients have lost an average of about 45 percent of their body weight, said Dr. Gregg Nishi, a surgeon at Cedars-Sinai Medical Center in Los Angeles. He discussed the European and U.S. studies during a Chicago conference this week for digestive disease specialists.
The procedure is only being done in the studies, which recently ended enrollment. Makers of the device used in the operation plan to seek federal approval if the research continues to go as planned.
While the two studies are still under way and only brief details are being released, Nishi said results so far are slightly better than typical results from with conventional stomach stapling.
Risks include perforating the esophagus, as Nishi said happened to a patient at another center, but otherwise, he said, there have been no major complications.
Some study patients have lost weight after unknowingly undergoing fake procedures — sedation and the tube, but no stapling. Results comparing them with the real thing aren't yet available.
Liliana Gomez, an administrative coordinator at Cedars-Sinai, was among the first Americans to have the scarless obesity surgery last year, as a test case for the U.S. study. She had planned on more invasive conventional surgery until learning that doctors at her hospital were studying the scarless stapling technique.
"When I found out it was going to be oral, through your mouth, I was like, 'Wow, that's kind of different,'" she said.
Since her operation in August, Gomez has lost about 40 pounds and dropped from size 22 to size 16.
The 35-year-old mother of three has a long way to go — she's still obese according to body mass index standards. But Gomez says she has cut her meal portions by more than half and still feels full, and is optimistic she'll continue to lose weight.
The new method is part of a medical movement to perform surgery through body openings such as the nose, mouth and vagina instead of making cuts. The idea is to reduce chances of infection and pain, and speed recovery. With no scars, there are cosmetic advantages, too.
Gomez had considered a gastric bypass operation, a more complex kind of stomach stapling, but worried about risks from that surgery. It reduces the stomach to the size of a golf ball and reroutes the digestive tract.
Whether done through one large abdominal incision or several tiny ones, gastric bypass is far more invasive and increases chances for malnutrition because it repositions how the stomach attaches to the intestines to restrict calorie absorption.
Another popular weight-loss surgery option involves putting an adjustable band around the top part of the stomach to create a small pouch.
The experimental method Gomez had is the oral version of a different kind of stomach surgery, which reduces the size of the stomach with staples but doesn't reroute the digestive system.
Surgery is generally considered a last-resort treatment for obesity, which affects more than 15 million Americans. Still, demand is high. More than 200,000 Americans are expected to have conventional forms of obesity surgery this year, according to the American Society for Metabolic & Bariatric Surgery.
Dr. Scott Shikora, the society's president, called the oral procedure exciting and innovative, but said, "It is too early for us to say this is going to be a breakthrough."
Shikora said many U.S. obesity surgeons prefer the rerouting surgery or flexible bands, and that it remains to be seen whether the oral method has the same drawbacks as more outmoded stapling procedures.
The U.S. study is taking place at 10 centers. Patients will be followed for at least one year, with final results expected in 2010. They are randomly selected to undergo either the operation or a sham procedure.
Nishi said of 25 patients enrolled at his hospital, 17 got the real treatment, with no complications.
"I'm very impressed with it," Nishi said. So far, it looks like "a viable alternative," he said.
Satiety Inc., a California company that created the medical devices used in the technique, is paying for the research. Nishi said he has no financial ties to the company.
At Washington University School of Medicine in St. Louis, where the first U.S. procedure was done last summer, about 30 patients have undergone the treatment. Side effects have been minimal, including sore throats, nausea and some abdominal pain lasting less than a week, said Dr. J. Christopher Eagon. He said weight loss results from his center aren't yet available.
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Post by Toby Benoit on Jun 4, 2009 13:36:01 GMT 12.75
Lord knows I have little or no self restraint when it comes to my diet, but I just haven't gotten brave enough for a surgical solution. I know a few folks that nearly died from the other types of surgeries and did extensive damage to their bodies. They were healthier fatter! It's a big crap shoot and I'm too big of a coward to gamble on the super-fast weight loss surgeries. I'm to prone to rolling snake-eyes (no offense Snake!) and this gamble won't cost only money, but my life. When the gastric bypass first became so popular, one in seven patients were dieing within the first two years. Losing the weight too fast shocked all their other organs. I'm fat. I live my life fat. I'll eventually die from my fat. But....while I'm here, I'm going to do my best to enjoy myself! Ya'll ever have real Cuban "Devil Crabs" ;D ;D ;D
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Post by OLKoot on Jun 4, 2009 14:44:50 GMT 12.75
Toby, I appreciate your position, and of course it would be your choice....My son is in the same boat and is trying to rush into a proceedure, but when I read this and found how non invasive a procedure it is, I thought I'd post it....Hey, I'm no light weight myself and I'm at the age where it could do me in too, alot faster then you... I also asked my son to wait a bit on his quick decisions too,just to see how this pans out.....He's looking at the regular cut, cut,cut....I dont want it that way, I've been cut enough to know myself....I thought the belt would be better and less invasive.....Now this comes along , and too me, things are looking up with technology....Dont fret my friend, and dont be so hard on yourself, your not alone......
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Post by Toby Benoit on Jun 5, 2009 11:47:17 GMT 12.75
My prayers are with him. Let us know if he makes a decision. The lap-band, was the one I have been most impressed with. The problem with that, was two fold. First, the band requires constant attention from the physician to inflate and deflate as your stomach shrinks or stretches and has to be repopsitioned a it slips up over the stomach curve. Lots of followup visits to the clinic...each one a paid office visit! Second concern was that in order to place the band, they asked me to fast and eat only jars of baby food for three weeks prior to placement in order to shrink my stomach to get a dood fit once the band was in place. If I can gather enough self restraint to eat only baby food for three whole weeks...what the fuq would I need the band for then??? There's no reasonable substitue for diet AND excersice. One without the other won't get it done. Another concern was the stretched out skin. Lose a hundred pounds and you'll build a gawdamned curtain of gut skin covering your pecker! Everytime you go to puiss, you'll have to have a curtain call!
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Post by Mars on Jun 5, 2009 14:09:38 GMT 12.75
I view procedures like mentioned as the same as treating a lung cancer patient that continues to smoke.
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Post by OLKoot on Jun 5, 2009 14:52:23 GMT 12.75
My prayers are with him. Let us know if he makes a decision. The lap-band, was the one I have been most impressed with. The problem with that, was two fold. First, the band requires constant attention from the physician to inflate and deflate as your stomach shrinks or stretches and has to be repopsitioned a it slips up over the stomach curve. Lots of followup visits to the clinic...each one a paid office visit! Second concern was that in order to place the band, they asked me to fast and eat only jars of baby food for three weeks prior to placement in order to shrink my stomach to get a dood fit once the band was in place. If I can gather enough self restraint to eat only baby food for three whole weeks...what the fuq would I need the band for then??? There's no reasonable substitue for diet AND excersice. One without the other won't get it done. Another concern was the stretched out skin. Lose a hundred pounds and you'll build a gawdamned curtain of gut skin covering your pecker! Everytime you go to puiss, you'll have to have a curtain call! Toby, I didnt realize what they want with that lap band proceedure and I see your point....I'll mention that to my son.....The only thing that I've seen work is what I did, and I still say it wokrs and I proved it......You eat normal portions and you dont get that sudden skin drop.....I'd like my son to try it, but I think alot also has to do with his mind.....Maybe its the same with you unless you have some form of illness that goes along with weight gain....He's just starting to get back to a doctor as he is unemployed and just qualified for a Connecticut Government Program.....They let him see doctors ,and since he' obese, he's also unemployable...Lord knows how many applications he's filled out over the last couple of years....I do blame it on the F'n liberals in this state issuing an edict that fat people are unemployable because the insurance industry says so....I'm waiting to hear a bit more ,like what diet do they need or how much excersize would be applicable......
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Post by eaglenest on Jun 6, 2009 8:32:26 GMT 12.75
I have had the surgery in 2006....I had the old fashion way where I have the scar....I had not pain afterwards and required no liquid pain medication or Morphine via a of the IV pump. I was sore. I have kept the weight off....I cannot tolerate rice and pasta. I love it, but I keep trying it and it seems to swell and I end up having to get rid of it. I try to eat 60 GM of protein and at least 60 oz. of fluid, but usually more per day. I would do it again in a heart beat. I feel better. I was walking with a cane and no more. I lost 85 pounds and the surgeon says that I am stabilized at my current weight of 150-155 lbs. There are so many terrible stories, however, I believe that if you want it bad enough...you have to do what the doc tells you and forget what others tell you. I have heard on TV that males seem to have more psychological problems, but again it is your attitude and the trust in your surgeon. I had no faith in the hospital where I had the surgery, but I trusted in my doc and I had a psychological checkup prior to the surgery as a requirement. I knew if I did not have the surgery that I would die sooner, I had had a heart attack and one stint. My cardiologist was OK with me having the surgery. And she always mentions when I see her how much weight that I had lost. Ones that I have known all my life doesn't recognize me at first and it takes time and they can not believe that it is ME!! Granted the surgery is not for everyone and now there are so many other ways of doing it...such as the band and etc. But this is my story. Sharon ;D ;D
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Post by Toby Benoit on Jun 6, 2009 10:05:49 GMT 12.75
;D God Bless You Sharon! ;D I'm plumb tickled it worked out for you!
Actually Steve, I do have a medical problem that contributes to my rediculous weight problem. I have very low testosterone. In fact, at one point it was so low, I was practically a chick! Normal I think they said was like four hundred and up, but mine was around 84!
I was so tired, didn't want to go anywhere...just leaving the house was an dreaded undertaking. I talked to a doctor about the depression, but after a simple blood test, he found my testosterone levels were the problem and not depression.
He had two months worth of samples of a cream called Testim, that he gave me. You rub it on your skin daily after your shower. In only a few days I felt the difference. I had more energy, I wanted to go out of the house and into the sun, and my "woodies" that had decreased to about once a week maybe, were back to daily. In fact, just the wiff of perfume at Wamart would get me harder that Chinese arithmatic!
I also lost about twenty pound during that two months without really trying.
Unfortunately, my insurance company flat refuses to pay for the prescription despite my doctors insistance and the meds are 275 a month...out of my reach right now.
There's a testosterone med, over the counter I saw advertised on TV the other day and am going to get some to try and see if it works or not.
Steve, before your son goes much farther, have him ask his doctor to check his testosterone levels. It might be a source of his weight retention.
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Post by eaglenest on Jun 6, 2009 11:47:15 GMT 12.75
Hi Toby, Having been a nurse try this for your medication. Go to "needymeds.com" It will ask your medication then print off a form and you fill out your part and take it to your doc and have him complete his part and also have him attach a letter stating that your Ins. will not pay for it and the drug company may send it to you for free....make sure that your doc writes a note. Have you tried Wal-Marts Formulary??? They do not have everything, but they may have something close to yours. Your doc should know this??? Some keep up with Wally's formulary and other do not. But, anyone with no Ins. can do this and they usually give a years supply like every three months at a time, that is needymeds.com It does not cover pain medications. I hope that may help!! Sharon
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Post by OLKoot on Jun 6, 2009 15:07:05 GMT 12.75
Toby, thanks for telling us something that is very private to you...My son also is a very tired person......Our problem is that years ago, he was one of the first diagnosed with Lymes Decease in NY state where I used to live and my other son also got hit with it....But over the years we have been under the impression that there was a relapse....Now that you mention testosterone, and the symptoms are similar, we will mention that to his doctor who he sees again shortly this month....
Eaglesnest, thanks for the website.....Its a shame how Pharmacuticals and insurance companies take such a stance on new medications as well as some of earlier issue that really helps ,but they insist on looking for others of less quality....Some costs are realyy prohibitive.....When my son had the Lymes , he had a "Q" port surgically placed under the skin at his breast bone, and had to take some exotic antibiotic at the cost of $5000 a month....What a fight his doctors had to keep him supplied for at least 6 months,which is what it took to knock the Lymes out of his system....I take Plavix for one and my insurance company wants $75 a month for it....It along with about 9 other meds makes cor a costly month for me, and since I'm retired and on Medicare, I fall into what they call a donut hole, or in other words, they aint paying for nothing until I spent "X" number of dollars out of pocket....Fortunately my doctors have been able to sample me till the end of the year.... My wife went through the original surgery, and has the scar that goes with it.......She is an asthmatic heavily into styroidal meds and she gained a huge amount of weight...Within a year or so she did lose over 200lbs.....
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Post by Mars on Jun 6, 2009 15:14:36 GMT 12.75
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Post by Paws on Jun 7, 2009 0:07:00 GMT 12.75
Awww Steve, Toby ain't got no modesty. Besides even if he did get extra testosterone he would just waste it. Your boy sounds just like what Sue had. She never did get a diagnosis. I figured it was either Lymes or Toxoplasmosis. Too bad Dr House wasn't available.
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Post by OLKoot on Jun 7, 2009 5:14:30 GMT 12.75
MARS, theres a generic which would probably cut costs...This is what the insurance companies want......The Generic name is Valsartan
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Post by Toby Benoit on Jun 7, 2009 17:09:46 GMT 12.75
Thanks Sharon, but Wally-meds can't help with the testosterone creams. They'll cover viagra (No, I don't need it), but not the testim. Unfortunately, the viagra has no health benefits, but is a recreational med (covered), but the meds that'll actually give you a positive result physiologically, Nope! I'll be looking up about the freed meds website....Thanks! Steve, Paws is right. I ain't got no modesty; it'd only be wasted on me!
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Post by Snake Eyes on Jun 7, 2009 21:14:09 GMT 12.75
Awww Steve, Toby ain't got no modesty. Besides even if he did get extra testosterone he would just waste it. Your boy sounds just like what Sue had. She never did get a diagnosis. I figured it was either Lymes or Toxoplasmosis. Too bad Dr House wasn't available. Who needs Dr House when we have our very own Dr Phil. Toby, Back in the day I was considered a very heavy drinker and if I continued I would be dead by 50. I didn't but but cut way,way back. I went from drinking 2 fifths of Vodka a day to one a week. Currently one or two drinks a week. I do not know you personally, but I absolutely do know about addiction.Food is every bit as much as an addiction as alcohol or drugs. I know you love your family and your family loves you. When you make the choice to die your way,think again that it only effects you! Please think about your family,your friends and God and church. You owe it to the folks that love you to cut,way,way back on eating.Not quit eating,just eat what you usually eat in smaller portions.You can fill the gap of hunger with water, juices,veggies and fruits... I used tonic water to get me thru my drinking....Had professional folks tell me I had to quite completely or....... I may very well die of drinking,I don't think so,but I guess I have seen things that I would not have seen had I of died at 50. Toby, You owe it to the world to be a part of it as long as God decides,not you ! snake-eyes
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Post by Mars on Jun 8, 2009 4:50:26 GMT 12.75
I discussed going back to atenanol with my MD as it is way cheaper but the fact that I had "chest pains" with it that required the stress test ruled that out and the other generics all had additional unwanted potential side effects. The Together RX program keeps it cheap enough for us to afford at this time but if nothing else my MD agreed to provide samples each month of which he gave us each 2 months at our last visit 4 months ago. We actualy get closer to a 75% discount instead of the 65% because of an additional discount by having them filled at Wally World. If you call them they will help you locate the "cheaper" pharmacy if they can. I was surprised by Wally World. They sure beat the Medicine Shop where I was getting our RX. They are open more hours on more days and have yet to give me a shortage because of lack of supply like the Medicine Shop did.
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Post by OLKoot on Jun 8, 2009 5:24:48 GMT 12.75
MARS, understood!!!....I had a problem with two of my meds which were pretty high on the formulary schedule that each insurance company has as well as Wal-Mart or any other discount chain selling meds has....What can be done and what I asked my doctor to do, was to contact the insurance company and ask for a formulary exemption and they will probably lower your cost to the next lower tier....My Plavix was costing me $75 and now it costs me $35...PLavix did come out in a generic several years ago, and it cost me nothing....It was dropped from production several months later as it was found to do nothing, so I had to go back to the higher priced Plavix......I wonder what old honest Obama's new med plan will provide??? I hope its not suicide or assisted suicide for us old timers!!!!
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Post by Mars on Jun 8, 2009 10:16:16 GMT 12.75
Obamas new plan dictates that everybody must have medical insurance or be fined for not doing so. So by his "law" I'll be forced to pay the $1,200. a month premium which is more then I can draw on unemployment.
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Post by OLKoot on Jun 8, 2009 10:59:47 GMT 12.75
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Post by Mars on Jun 8, 2009 13:06:43 GMT 12.75
His "change" was never to make everybody wealthy or even middle class but to make everybody poor and dependant on scraps from the government. His medical "insurance" will be the doom of many.
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