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August 2007 posts
Episode ...
08/26/2007
Just for documenting, because it just happened -
- Dinner 5-5:30pm. Beef ribs, probably 2-3 oz meat in total from four very small ribs and steamed broccoli, and honey mustard sauce (high sugar)
- Felt very hypoglycemic, 6:30, on: tripping, out of it, sweaty, shaking, disoriented - blood glucose 35. Ate a five sugar gram granola bar that my daughter brought me (I asked her to.)
obit
08/26/2007
Part two in a series, love letters from the internets.
08/26/2007
I wrote: "further contact is not advised."
Diana writes, to that:
I DON'T LIKE PEOPLE THAT THINK THEY DESERVE WHAT YOU FEEL YOU DO.
Thanks, ma'am, will do.
In the spirit of being somewhat helpful to someone who probably doesn't deserve it from me, I suggest that you start your own blog. Go to Google > search for "Free Blog Hosting." Then, start writing angry-toned posts about your issues IN! ALL! CAPS! and then, when you're feeling nervy, put a donation button up. Just Wait! Then, you'll get your own hate mail!
Because I'm all about being honest - you must know - that the various evolutions of a donation button on my blogs have probably made a total of $200 in three years.
What did it pay for? This Blog, first off. I paid for my blog. I. Paid. For. My. Blog. MY. BLOG. It costs to write here. Why would I pay to write? I don't know - I never claimed to have much brains.
Then, I traded
(ETA: Please note, I Said Ladies, because my readers are entirely all women - haven't seen a man in 'dees here parts in, forever. Please note, also, there was no inference of sexual harassment/innuendo inferred by such comment, I am referring to the business of "pimping" in which I would be paid for deeds done. Also, this comment was entirely sarcastic, in which I am. Very. Much. So.)
babies like cake.
08/25/2007
Weighty Matters. A Flickr Group.
08/25/2007
All things related to matters of weight. We all have a body. We all have issues.
Anything goes. Sharing photos of weight loss progression down to your goal, photos related to your weight loss journey, whatever path you choose.
Weight Loss Surgery Methods, Typical Diet & Exercise Plans, Lifestyle changes, or alternatively issues of the Eating Disordered. You are all welcome. Post.
Artistic and creative expression is encouraged.
So, join me at Flickr and share your photos. This group might be shared as part of a Flickr thingie soon (I talked with someone from the company - and she asked me if I'd chat about it.) So, please, let's fill it up with images of Weighty Matters.
Thank you!
baby buddha
08/24/2007
Time flies.
08/24/2007
One year ago today - our niece, baby E was born! Happy birthday Miss E!
She's growing.
08/24/2007
if baby ain't happy ain't nobody happy.
08/24/2007
Methinks somebody is not tolerating the moo-juice. She has been unpleasant.
The doc gave us the go ahead for whole milk at the babe's nine month appointment. We've been slowly swapping the milk out for the formula. The last week or so - it's been mostly milk. The diapers have exploded and she's not happy. Milk is for baby cows.
No comment.
08/24/2007
Remember the photos this woman posted on Obesity Help? (And, everyone freaked?) Well, she's confessed to why she is so very small + sick. She says she's anorexic, bulimic and bi-pol@r. Well, damn.
Do we understand why the pre-operative psychological testing should be much more thorough?
Hater mail. If I only had the noyve.
08/24/2007
"YOU HAVE A LOT OF NERVE" says [email protected]
HERE I LAY WITH A SPINE FRACTURED IN 5 PLACES, NEED DENTAL WORK SO BAD MY TEETH ACHE, BUT CAN'T WORK TO PAY FOR IT OR GET assISTANCE, AND YOU HAVE THE NERVE TO ASK PEOPLE TO HELP YOU LOSE YOUR BLUBBER. GET REAL CUPCAKE.
I guess I shouldn't complain, this is the first hate-mail I've received in two years.
I haven't got a love letter like this since I first started blogging.
A woman contacted me from her AOL blog - and wrote a nasty post about me, two years ago in July. She, also, had debilitating issues, and took it out on me.
To THAT woman, from two years ago? Honey, for all the "begging" I did, look how much plastic surgery I got so far. NONE! LMFAO! That was two years ago, and I'm still not any closer, but then again, whenever there's a spare dime, it goes to my family.
Should I do this? A page devoted to raising cash?
No. I blog, all the time. I am learning all I can, sharing all I can, and hoping to help others along the way while I make a few cents a day with my ad clicks. I finally opened a checking account in my own name - and I'm depositing my "earnings" there for what I can do to better myself, whether it will be plastic surgery or college, hopefully both. *sigh*
Do I have to explain this to you?! Do people really think I have ulterior motives? I thought I was transparent. Jesus!
Proteingasm.
08/23/2007
Holy foodgasm Batman.
I just got a shipment of ISS Oh Yeah Protein Wafers (and some Whey Protein Powder sample packets, which I will make and review for you.)
Would you believe me if I said I screamed when I opened the box? I did. Why?
There was a flavor in the box that I never saw before - Vanilla. Plain vanilla creme. (They are in a blue box.) I adore the vanilla peanut butter flavor, but, straight vanilla - yumm-o! I didn't tear into them, if only because I just ate a chocolate one. (Because, I found a box in the cabinet on top of the baby food that I forgot I got from GNC during the B1G1 1/2 off thingie.)
Why have I not seen this flavor before? Hooray for vanilla protein bars! You don't know how excited I am to have one later.
I'll do a review. And, a YouTube, if my camera cooperates, and doesn't make me look like I'm dubbed over in pig-latin.
Here's a great price (the cheapest I've EVER seen) from a online store I have zero clue about:
Our Price: $11.50, 2 for $22.50, 4 for $43.99
Cost Per Serving: $1.28
Volume Discount: 4 or more at $11.00 each
Customer Review(s):
Response to anonymous commenter. Now, fat kids fat adults.
08/23/2007
Penises.
08/23/2007
A woman in Russia set her ex-hubby's pee pee on fire. Just 'cuz he was sitting on the couch, naked, having a little vodka. She's like, "Oh no, you ain't sittin on mah couch no more." And, then he's "burning like a torch." Ladies, if you think it's rough being single - HA!
That little tidbit made me giggle while I sip my coffee this morning, but, it gets worse, more penile humor here. A freak show performer inadvertantly glued his member to a vacuum.
Why do I mention this? Well, as I type, Bob is preparing to leave to go to the plastic surgeon to talk about his appeal for a panniculectomy. Power To The Penis. I am making a bet with my readers right now - that in the end - after all is said and done, he will get coverage due to the power of the penis.
Likewise, I will be denied coverage after a similar appeal with a slightly more creative letter (video, perhaps!) because I do not have said appendage. Then again, I can get boobies if we're self-paying, and he can't. Well, he could, but then I might be setting fire to them.
Weight Loss Surgery Saves Lives? (But we're more likely to commit suicide.) Studies published tomorrow in NEJM.
08/22/2007
We live longer, because we don't die from fat-related diseases, such as diabetes, cancer and heart disease. We are more likely to die of non-disease related issues now, such as accidents and suicide.
Just as a devil's advocate over here:
- I won't die of diabetes now (which I never had as a morbidly obese person) but, I might have a blood sugar low and crash my car and DIE due to the WLS.
- I wont have a heart attack due to my morbid obesity anymore, but my heart might stop beating if I get too anemic due to the WLS.
I see it as damned if you or don't.
Background
Although gastric bypass surgery accounts for 80% of bariatric surgery in the United States, only limited long-term data are available on mortality among patients who have undergone this procedure as compared with severely obese persons from a general population.
Conclusions
Long-term total mortality after gastric bypass surgery was significantly reduced, particularly deaths from diabetes, heart disease, and cancer. However, the rate of death from causes other than disease was higher in the surgery group than in the control group.
Weight loss surgery is known to help severely obese people shed pounds and lower their risk of diabetes, heart disease, and other obesity-related diseases. Now two landmark studies show that the surgery also saves lives.
In one study, deaths decreased by more than 90% from diabetes and 50% from heart disease in severely obese people who had weight loss surgery compared with those who did not.
In separate research, weight loss surgery was associated with a 29% reduction in deaths over an average follow-up of 10 years, compared to those who did not have weight loss surgery. Both studies are published in the Aug. 23 issue of The New England Journal of Medicine.
Longtime obesity researcher George Bray, MD, of Louisiana State University, tells WebMD that the new research provides the important "missing link" showing that weight loss surgery reduces mortality.
Weight loss surgery, says Bray, "is associated with a dramatic reduction in diabetes and other diseases associated with obesity, so it stands to reason that it would positively impact survival. But there has been some question about this, and a few studies have even suggested the opposite."
Weight Loss Surgery vs. No Surgery
In the larger of the two studies, roughly 8,000 gastric bypass patients and 8,000 people who did not have weight loss surgery matched for sex, age, and weight were followed for an average of seven years.
University of Utah School of Medicine researchers reported a 40% overall
reduction in deaths among the surgery patients compared to the patients who did
not have weight loss surgery.
Surgery patients' deaths decreased by 92% from diabetes, 56% from cardiovascular disease, and 60% from cancer.
Researcher Ted D. Adams, PhD, MPH, tells WebMD that the difference in cancer mortality was very surprising.
"We did not anticipate such a large reduction in cancer deaths in such a short time, and we aren't really sure what to make of it," he says, adding that his research team is currently exploring the issue.
Death Rates From Causes Other Than Disease
There was yet another surprise in the findings. While surgery patients had a lower death rate from diabetes, cancer, and other diseases than nonsurgery patients, death rates from causes other than disease, such as accidents and suicide, were greater.
Patients who had weight loss surgery had death rates from nondisease causes that were 58% greater than people who did not have surgery.
The study offered few clues about the reason for this. But several previous studies have suggested a link between weight loss surgery and an increase in drug and alcohol abuse and other risk-taking behaviors. Adams says the findings highlight the need for better ways to identify psychological "red flags" in patients who are considering weight loss surgery and for assessing mental status after surgery.
08/22/2007
A rare complication of gastric bypass surgery leaves its victims virtually disabled, Mayo Clinic researchers reported.
- Inform
patients contemplating a weight-reduction operation that, although it
is a rare complication, nesidioblastosis is more frequent among
patients who have had Roux-en-Y gastric bypass than in the general
population.
- Note also that while the
cause of the nesidioblastosis remains unclear, a partial removal of the
pancreas appears to resolve the condition.
- Advise interested patients that the so-called "dumping syndrome," whose symptoms include flushing, dizziness, profuse sweating, and weakness, is commonly seen in gastric bypass patients; however, central nervous system glucose deficiency is not part of the dumping syndrome.
But others said the complication, called nesidioblastosis, a hyperfunction of insulin-producing beta cells, may also point the way to new treatments for diabetes.
The complication leads to a potentially life-threatening deficiency of sucrose in the central nervous system, says Fred Service, M.D., a Mayo endocrinologist and colleagues reported in the July 21 issue of the New England Journal of Medicine.
They described six patients who were referred to Mayo between 2000 and 2004 because of severe neurological symptoms -- including confusion and loss of consciousness -- after eating.
The symptoms were so severe, Dr. Service said in an interview, that patients couldn't drive or work, and "had to be babysat" for fear they could have a potentially deadly episode.
The diagnosis was hypoglycemia, caused by excess insulin production, leading to a severe deficiency of glucose in the central nervous system (i.e., neuroglycopenia).
One patient had insulin-producing pancreatic tumors that were surgically removed, but the rest had enlarged and overactive islets without cancer. The mean size was significantly larger than in obese controls (214 micrometers versus 151, p=0.001).
When the first patient was referred, the researchers considered the Roux-en-Y gastric bypass to be coincidental, especially because the patient also had insulin-producing pancreatic tumors. But "subsequent experienceâ¦led us to raise the possibility of a link between the islet hyperfunction and the bypass surgery," Dr. Service and colleagues wrote.
Over the same time period, nine people who had not had gastric bypass surgery were shown to have nesidioblastosis at the Mayo Clinic, meaning that the gastric bypass patients formed 40% of the total caseload.
However, only about a tenth of 1% of the U.S. population has had a gastric bypass.
The treatment was partial removal of the pancreas, Dr. Service said, which appeared to ameliorate the problem in all but one of the patients. That patient had a recurrence of symptoms, possibly because not enough of his pancreas was removed.
The cause of the nesidioblastosis is less clear, but it seems "possible that beta-trophic factors may be brought into play after bypass surgery," causing the growth of beta cells and islets, excess insulin production, and post-meal hypoglycemia, the authors argued.
"There is some scientific evidence that gut hormones could be mediating this," Dr. Service said.
If that's the case, said University of Washington endocrinologist David Cummings, M.D., in an accompanying editorial, it should spur research to identify the mediators "so that their physiological effects can be harnessed" against diabetes.
"On the face of it, the paper is a report of a novel adverse consequence of gastric bypass surgery," Dr. Cummings said in an interview, adding that the condition remains quite rare. "It's hardly a public health crisis."
One of the effects of gastric bypass surgery is to cure type 2 diabetes, he said, and it may be that "the same physiology is melting away the diabetes most of the time and occasionally goes too far."
He added, "I see this a hopeful finding that there's something about gastric bypass surgery that causes beta cells to regrow -- and rarely overgrow -- and if we can find that thing we have the potential of bottling it and using it treat diabetes."
Dr. Service said he's not entirely comfortable with that view: "I think Dr. Cummings may be looking at this through rose-colored glasses."
If there is an upside to the finding, he said, it's that surgeons who perform Roux-en-Y surgery will be alerted to the possibility of nesidioblastosis in their patients.
"The follow-up of (gastric bypass surgery) patients hasn't been as assiduous as it should have been," Dr. Service said.
He said the symptoms should not be mistaken for those of the so-called "dumping syndrome" -- flushing, dizziness, profuse sweating, and weakness -- that is commonly seen in gastric bypass patients.
Related articles:
- Bariatric Surgery, a Growth Market, Quadruples in Five Years
- Experience Counts for Laparoscopic Gastric Bypass Surgery
Additional Pancreatic Diseases Coverage
Primary source: New England Journal of Medicine
Source reference:
Service, GJ et al. Hyperinsulinemic Hypoglycemia with Nesidioblastosis after Gastric-Bypass Surgery. N Engl J Med 2005;353:249-54.
View this abstract.
Additional source: New England Journal of Medicine
Source reference:
Cummings, DE et al. Gastric Bypass and Nesidioblastosis -- Too Much of a Good Thing for Islets? N Engl J Med 2005; 353:300-1.
View this extract.
Argh. Med complications? Updated.
08/22/2007
I finally got the RX for the Glyset, that took days! I came home and looked it up as a potential risk with the Trileptal I have been taking. It came up as a:
Moderate Interaction - assess the risk to the patient and take action as needed.
HYPOGLYCEMICS; INSULIN/BUPROPION - Additive side effects from both drugs
I just spent ten minutes on the phone with the pharmacist, and will call the endo, too... but... throwing it out there for any experience? Trileptal can cause hypo (and hyper) glycemia as well. Something I didn't pick up in my reading.
This is fantastic, because, now I sort of have to dig up that couple hundred bucks and go back to the pdocs office to get off of the meds?
PS. While I am on the topic - the pharmacy tech asked me, "You just have a discount card, no insurance, right?" I'm all, "That's not insurance?"
She says that the Medco card is a discount, that I'm paying for the medication, not co-pays. NO WONDER! ARGH.
I swear - who let this man choose the health insurance plan coverage?!
*Update: I spoke with the endo. No obvious issues with taking both meds. He also reassured me that the Glyset would not trigger hypoglycemia.
The best description of the altered digestion. For reference.
08/22/2007
From Diabetes.org:
"Gastric bypass divides the stomach into a small proximal pouch measuring
30 ml and a separate large distal defunctionalized remnant. The upper pouch is joined to the jejunum through a narrow gastro-jejunal anastomosis (Fig. 2). The proximal divided jejunum is reattached to the jejunum 75â150 cm below the gastro-jejunal anastomosis, creating a Roux-en-Y limb. Thus, storage capacity of the stomach is reduced to
5% of its normal volume, and ingested food bypasses
95% of the stomach, the entire duodenum, and a small portion (15â20 cm) of the proximal jejunum. Initially, the operation relies on gastric restriction much like gastroplasty (6â18 months).
Subsequently, when the pouch and stoma have stretched, other mechanisms take effect to maintain the loss, accounting for the superior weight loss maintenance compared with purely restrictive operations. The appetitive mechanisms of the diversionary component of GBP are achieved through the absence of a pyloric "meter" or "brake," allowing rapid transit via the gastrojejunostomy, and maldigestion caused by the absence of acid and pepsin and the grinding-mixing forces of the stomach. Thus, undigested food rapidly shunted into the small bowel can cause nimiety via mechanoreceptors and possibly satiety via chemoreceptors (17) or neurohumoral mechanisms."
How To Feel Really Super Extra DENIED?
08/22/2007
When you open your mailbox and find not one, not two, but THREE, yes, THREE Denial Letters From your health insurance provider regarding your begging for pannilectomy surgery.
- For Me,
- For Bob.
- For His Mother!
She doesn't live here. I guess they wanted me to feel guilty about saying that they approved her surgery, and sent me her denial instead. I do not know why her letter came here, but apparently she was initially denied for a few reasons, and they sent it back to the insurance and it was approved. But, whatever, that's over with, she's panni-free as of right this moment.
Now, for us - we were both given a standard letter with THIS as the reason for denial:
"The photographs provided for review did not demonstrate a pannus that extends below the pubis AND there is no supporting documentation indication difficulty with ambulation."
Does your pannus hang low, does it wobble to and fro? Can you tie it in a knot? Can you tie it in a bow? Can you throw it over your shoulder like a continental soldier? Does your pannus hang low?
Yes, Blue Cross, it hangs very low. In fact - each sides mudflap hangs to or beyond the pubis if you must know, for both of us.
As for AMBULATING? Will I have to make a video demonstrating said difficulty with ambulation? Do I really have to share that?
You do realize that Bob is going BACK to the plastic surgeon tomorrow to resubmit his claim with new photos - and he's using the "I have to lift my big pannus to find my penis" as the reasoning.
The doc is cool with this.
Power to the penis.
If he gets coverage NOW, by whining about his penis, I will maim someone.
Beth needs a creative yet not pornographic way to prove my necessity for the lopping of the mud flaps.