What You Must Know About Bariatric Surgery

Bariatric surgery, also known as weight loss surgery, is a procedure through which obese people lose weight by reducing the stomach size with the help of a gastric band or by removing a portion of the stomach or by re-routing small intestines to a small stomach pouch.

Owing to the fad of being small-sized, people feel bariatric surgery is done only to lose weight. However, that’s not the case. It also helps in recovering from Type II diabetes and minimizing cardiovascular risks thereby reducing the mortality rate. As per the U.S National Institutes of Health, bariatric surgery should be performed for obese people with a Body Mass Index (BMI) of at last 40. But recent researches suggest that bariatric surgery can be performed on any patient whose BMI is higher than 30.

Bariatric Surgery Procedure

There are three procedures through which bariatric surgery is performed namely:

  1. Predominantly Malabsorptive Procedures: The success rate of this procedure is derived from creating a physiological condition of malabsorption.
  2. Predominantly Restrictive Procedures: As the name suggests, this procedure is based upon restrictive measures like reducing oral intake by limiting gastric volume. The risk of metabolic complications is reduced with this procedure.
  3. Mixed Procedures: In this, malabsorptive and restrictive procedures are combined.

Following are the bariatric surgery procedures commonly performed in India:

  • Gastric Bypass Surgery

In this procedure, the stomach is divided into two pouches. The upper one is made into a small sized pouch and the remaining part becomes the larger pouch. The upper part of the stomach is separated from rest of the stomach by stapling and the small intestines are rearranged to allow connection of both sections of the stomach. This results in lesser food intake. 

  • Lap-Band Surgery

This procedure is also known as Adjustable Gastric Band. In this procedure, the smaller pouch is created placing a silicon rubber on top of the stomach. It is performed laparoscopically. Lap-Band surgery is touted to be the safest procedure of bariatric surgery.

  • Gastric Sleeve Procedure

Also known as Sleeve Gastrectomy, in this process, a significant portion of the stomach is reduced by creating a major curve. This is a permanent/irreversible process unlike Lap-Band or Gastric Bypass. This process is also performed laparoscopically and is generally recommended for highly obese people. 

Postoperative Rehabilitation

After undergoing bariatric surgery patients are put on a clear liquid diet for a couple of days after which they are shifted to a liquid diet for two weeks. The patient follows this diet until the recovery of gastrointestinal tract. After complete recovery, the patient can shift to normal diet but since the intake of food reduces due to the reduction in the size of the stomach, doctors prescribe a diet rich in proteins and lower fats.

While bariatric surgery is not a magic bullet for weight loss, by following the right diet and lifestyle, most of the patients are able to maintain their weight after the surgery without any issues.

Need vs. Fad

The obsession of losing weight and reducing size has made bariatric surgery a fad. The body undergoes major altercations after undergoing the surgery. The post-surgery life isn’t as easy or simple to lead on. There are permanent dietary changes that the patient has to adhere to. If you fail to do so, the consequences can be serious. The surgery isn’t a permanent solution to weight issues. People feel that once they go under the knife, they can live the rest of their lives enjoying eating and no exercising. This is a myth. One needs to have a healthy and regular exercise routine else the weight is bound to return.

Being overweight or obese has serious health issues. People should opt for bariatric surgery for medical conditions rather than aesthetics. The health issues such people face range from hypertension to cardiac arrest and diabetes.

Take into consideration the overall factors before undergoing such a drastic step until and unless your doctor has suggested you to take this route due to your health concerns. Consult a reputed bariatric surgeon to help you know the needs and effects of the surgery on your body.

 

The Shifting Goalposts Of Popular Health Parameters And What Those Mean For Us

Here’s the irony we all seem to live with – while technology is giving us more and more opportunities to stay ahead of time, somewhere it is also making us too dependent on circumstances. The changing focus on health concerns rightly compliments this argument. While every person, irrespective of profession and gender, ideally needs to take care of health and stay fit, this is all the more true for working professionals who deal with long and stressful work hours. Consequently, diabetes, cholesterol, and thyroid top the list of most common health concerns faced by the working class.

Change in Health Parameters

Earlier the parameter set to identify if a person was diabetic, for example, was if the fasting blood sugar level was above 140 (i.e. 140 milligrams of glucose per decilitre of blood). However, in 1997, the Expert Committee on the Diagnosis and Classification of Diabetes Mellitus brought down the number to 126. This was probably more from a preventive point of view wherein; experts felt that sooner a condition was treated better the chances of a person from avoiding the dreaded health condition altogether. Unfortunately, this decision meant that all of a sudden almost 1.6 million people who were otherwise “healthy” (since their blood sugar level was in the previous good range of 126-140) suddenly were declared diabetic. The same goes for measuring cholesterol. While the cholesterol level earlier was considered a risk at 300, over the years as research progressed it came down to 240 and eventually has settled at 200, thus bringing in almost 42 million people in the category of high cholesterol patients.

The other health problem which is seen to greatly impact the population is thyroid. Thyroid, too, was always a concern but never with the same gravity that it demands now. Hypothyroidism affects about 4-5% of the people across the globe and in India, one in ten adults go through it. Statistics state that women are much more at a risk and need to take precautions from early on. Such numbers further promote research and force the medical fraternity to take the results even more seriously. However, the more focus the problems get, the more the number of people seem to “suffer” from it.

Change in the Treatment Outlook

As a result, the treatment patterns also have considerably undergone a change. Everyone now stresses on preventive measures vis-à-vis earlier times when a health problem was treated as and when it occurred. It could be because of the fact that since there is so less time to spare, people prefer taking extra cautions to stay healthy rather than later spend time making visits to a doctor. From the doctors’ perspective, they would prefer avoiding an unwarranted health scare by prescribing medicines to counter a possible situation than having to deal with it at a later stage. It also implies monetary profits for the healthcare business sector. That makes the increasingly lowered threshold levels slightly difficult to accept. But for the common man, the risk seems too great compared to money spent.

Resultant Situation

More importantly, what this situation has resulted in is an over-cautious generation. Lowered ideal health range levels may make people take cognisance of their eating habits, exercise routines, and so on. But they also forget the fact that excessively worrying about a certain health aspect will not take away the problem entirely; while cholesterol is the primary cause of a heart attack it can also occur due to unhealthy lifestyles, smoking, etc. Another example is of the BMI (Body Mass Index). In the beginning, BMI was essentially used as a measure for body weight, and, thus, to basically remain in the healthy bracket. It helped in predicting cardiovascular diseases or nutritional competencies. Now, as with other health parameters expanding their scope, so has this simple figure. Health specialists have lately arrived at a Waist-Hip Ratio (WHR) which when used along with the BMI apparently better predicts more serious disorders such as diabetes, lipid problems, atherosclerosis, and so on.

In some ways, this sounds greatly helpful. Yet, it is also important to remember that over-diagnosis can be problematic as well. Imagine the number of medicines one consumes these days. Somewhere it makes the body immune to certain strains of those medicines and hence when the real need arises, it is doubtful if that medicine will really have a positive effect. Many times, people even ignore the side effects of taking extra medications, just to ward off a future possible concern. The number of treatments available is endless as well. It is thus up to the educated us to decide whether we will allow ourselves to be supposedly called “unhealthy” and where to stop in this vicious circle.

 

Chronic Health Management with mHealth

According to a recent study conducted by the Public Health Foundation of India (PHFI), chronic diseases account for 60% of the deaths in India, annually killing more than five million people every year. These diseases include various ailments such as diabetes strokes, cardiovascular diseases, mental health illnesses, cancers, and chronic lung diseases which will cost the country around Rs. 280 trillion between 2012 and 2030 in terms of economic output. Why are these numbers so high? Is there something we can do to reduce them?

While there is no definite answer to these questions, mHealth is one technology that is actively helping in reducing these numbers. One of the major problems in chronic diseases is that they cannot be treated in one go. Patients need to monitor their health on an ongoing basis and also need to maintain a constant communication with their doctors so that the doctors are able to keep a check on the patients’ health and monitor the effects of medicines. The introduction of mHealth has been a major breakthrough in this area since it works on concepts such as consolidated data and encourages faster and easier communication between the patient and the doctor.

So what exactly is mHealth? The use of mobile phones and other wireless technology in medical care can be termed as mHealth. This includes the use of Short Messaging Service (SMS), getting a consultation from your doctor/physician over the phone and the use of apps that are built for health management of the patients.

Health Record Management

Mobile apps make it easy to measure, track, and keep a record of various statistics related to chronic diseases such as blood glucose, weight, diet, and exercise. Instead of maintaining a record of these vitals on paper, patients can maintain their health records right on their phones for access from anywhere, anytime. This recorded data can then be easily shared with doctors, clinics, hospitals and laboratories without having to carry loads of paper reports.

Doctor-Patient Communication

Mobile has made the doctor-patient communication very easy and effective. Patients can communicate with their doctors through messaging apps, share their reports through apps and also maintain a history of their conversation. Patients also have the option to share their health data with the doctors and receive feedback and advice related to their health.

Health Management

Mobile apps have made health management very convenient. For chronic health diseases, patients need to be extremely cautious and regular with regards to their medication.  There are a few apps which intimate you with reminders to take your medicines at a particular time of the day and monitor the time when the medicine was actually taken – making the adherence to medication easier.

People suffering from chronic diseases need to keep a check on things like what they eat, how much they exercise, their heart rate, hemoglobin levels, etc. because excessively high or low numbers can have serious effects on their health. Mobile apps help them maintain a record of this data. With real-time access to data about their health, they can engage in personalised health management and know what is going on in their body. The meaningful insights offered by the data accumulated over a time helps patients is being more aware, responsible and proactive when it comes to maintaining their health issues.

Rural Healthcare

Another major trend in mHealth is Interactive Voice Response (IVR). This is especially helpful in the rural parts of the country where the masses do not have access to the latest technologies or basic health care. IVR provides distant training to health workers with the use of a simple cell phone with text and talk capabilities. This provides the possibility for remote education, disease tracking, monitoring, data collection, diagnostic and treatment support, communication, and training. An evaluation of these activities showed that most of the users had a great experience and would like to see more such initiatives.

It is evident that twenty-first-century health care will be driven by mobile technologies rather than location-based diagnostics which can be carried out only in hospitals and clinics. We will be able to undertake treatments anytime and anywhere, making them as mobile as we are and ultimately change the face of how the healthcare industry has been functioning.

Fight diabetes

Diabetes is a lifelong disease that develops when pancreas stop making insulin. It is one of the most common diseases found among all age groups of people. Diabetes does not have an immediate effect on the human body but slowly and gradually, it affects each part. That is the reason it is also called as “The Silent Killer”. Unfortunately, people neglect watching out for diabetes thinking that it comes with age, but the fact being that Diabetes has no age to strike. According to a recent survey by a leading news channel of India, 16-20% of children in India, are suffering from diabetes.

Maintaining control of blood glucose (blood sugar) is a fact of life for people with diabetes. Uncontrolled blood glucose levels can cause serious health complications that affect nearly every system and organ in the human body. Regular blood sugar tests can help maintain safe blood glucose levels and lower the risk for a host of diabetes complications. Continue reading Fight diabetes

Indian medics find way to ‘fix’ insulin without needles

Indian researchers create breakthrough method of delivering the  insulin pill. The days of injections seem truly numbered now
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Insulin Pills Image Courtesy: israel21c.org
Insulin Pills
Image Courtesy: israel21c.org

This is probably the sweetest bit of news for diabetics around the world, and it is coming from India.

A report in the Medical News Today says that Indian researchers have figured out a way to ‘fix’ the insulin pill in the body.

Till now, one of the biggest obstacles was in delivering the insulin pill to the gut in a way that it can be absorbed by the body. A team of researchers at the National Institute of Pharmaceutical Education and Research have found a method to do this: wrap insulin in little sacs of liposomes, which are made of the same material as cell membranes. Continue reading Indian medics find way to ‘fix’ insulin without needles