Tuesday, May 07, 2013
Thoughts on NJ Gov. Chris Christie's lap-band surgery?
How ironic that he chose to do this and now the nearly extinct TWINKIE is about to make a big comeback. Has the hallmark of a classic Twilight Zone, Burgess Meredith on the steps of that post-apocalyptic public library after having just broken his only pair of glasses with which he loved to read - It just isn't fair!
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I hope he does well but I think he's going to be sorry.
ReplyDeleteIn my opinion the lapband is the worst, least effective choice of the available surgeries.
Wow, I just had a very freakish moment.
ReplyDeleteI accidentally left out the 's' in 'blogspot' whilst typing the address to get here and came instead to this huge religious fanatic website.
Made me think that maybe Lista hijacked you or something.
So, he'll be a skinny guy with jowls?
ReplyDeleteI kinda like him how he is. Look how terrible Drew Carey looks, or Al Roker.
ReplyDeleteI like the big burly no bullshit Christie.
He might do well but he'll have to work hard. The lap band is such a worthless tool.
What Saty you don't have this place bookmarked yet? I've alot to say on this topic so we'll begin with it's my limited understanding that after a lapband if you eat too much you can die, kill yourself. Not that you would because you're full faster with smaller portions but I'm more old school where you lose the weight on your own and then you can risk overeating every now and then. I've just a whole philosophical problem with the lapband, picture Christie at his next big Thanksgiving and after a few minutes he pushes the plate away, the giblets and says he's had enough and no room for sweet potato pie afterwards! that's living? Resorting to the lapband for me means you didn't have the willpower. Much more to say,
ReplyDeleteI so agree that many people, celebs who've lost the weight actually look worse afterwards. Seen any pictures lately of former NYPD Commissioner Bernie Kerik? looks like a frail vegan and I know he's been through alot with his corruption trials but he looked better before and apparently didn't have a problem with the women. BB says Christie will look like a skinny guy with jowls now which means when you're really obese and lose all that poundage you then have to have further surgery to remove those annoying skinflaps. Now getting back to the TWINKIE for a minute I can picture Christie really debating the lapband with friends and then learns that his beloved Twinkie is gonna go extinct so he thinks one less snack to worry about, that tips the scales and he goes OK Let's Do It. Yeah man you made a mistake big guy.
ReplyDeleteYou won't die. You'll be uncomfortably full (think Thanksgiving), you'll probably puke, but you won't die barring any kind of freak accident.
ReplyDeleteAnd over time, the stomach will stretch.
Trust me.
He would have been better off with a surgery that included a metabolic component.
But if he can work it, more power to him.
I recall reading that somewhere, probably some urban legend. My point still stands though, after you have the lapband then overeating which is a natural human tendency becomes a problem and who doesn't overeat every now and then? Thanksgiving and Christmas I'll be damned if I'm not gonna eat normal like the rest of the guests so I think where I'm coming from on this is the lapband becomes a kind of joyless existence.
ReplyDeleteWhy don't you go over the rest of the surgeries and which is your favorite. I'm guessing now that insurance may not cover it since they'd probably deem it a form of elective surgery since you can simply diet and exercise to lose weight.
ReplyDeleteOh, insurance will cover, usually if there's a preexisting or comorbid condition... depends on the insurance.
ReplyDeleteIn broadest terms there are two types of procedure: restrictive and malabsorptive. The lap band is purely restrictive (makes the stomach smaller). Most surgeries are both restrictive and malabsorptive (smaller stomach plus you don't absorb the calories).
Okay, so I'm going to c/p some stuff on this so I know I'm accurate. So you have your gastric bypass:
Gastric bypass procedures (GBP) are any of a group of similar operations that first divides the stomach into a small upper pouch and a much larger lower "remnant" pouch and then re-arranges the small intestine to connect to both. Surgeons have developed several different ways to reconnect the intestine, thus leading to several different GBP names. Any GBP leads to a marked reduction in the functional volume of the stomach, accompanied by an altered physiological and physical response to food.
The gastric bypass procedure consists of:
Creation of a small, (15–30 mL/1–2 tbsp) thumb-sized pouch from the upper stomach, accompanied by bypass of the remaining stomach (about 400 mL and variable). This restricts the volume of food which can be eaten. The stomach may simply be partitioned (like a wall between two rooms in a house or two office cubicles next to each other with a partition wall in between them - and typically by the use of surgical staples), or it may be totally divided into two separate/separated parts (also with staples). Total division (separate/separated parts) is usually advocated to reduce the possibility that the two parts of the stomach will heal back together ("fistulize") and negate the operation.
Re-construction of the GI tract to enable drainage of both segments of the stomach. The particular technique used for this reconstruction produces several variants of the operation, differing in the lengths of small intestine used, the degree to which food absorption is affected, and the likelihood of adverse nutritional effects. Usually, a segment of the small bowel (called the alimentary limb) is brought up to the proximal remains of the stomach.
_continued_
Biliopancreatic diversion/duodenal switch (BPD/DS) is the most complicated of the procedures and in my opinion absolutely the very best. It is the most malabsorptive, the most dramatic in terms of weight loss, the most effective in terms of how long and how much of that weight you keep off. It has several benefits that the regular gastric bypass doesn't have, most predominantly having a 'normal' (though reduced in size) stomach with a normal esophageal sphincter and pylorus (no dumping syndrome like is seen in a regular GB) and if the malabsorption becomes a problem that component of the surgery is actually reversible.
ReplyDeleteBiliopancreatic diversion
This complex operation is termed biliopancreatic diversion (BPD) or the Scopinaro procedure. The original form of this procedure is now rarely performed because of problems with malnourishment. It has been replaced with a modification known as duodenal switch (BPD/DS). Part of the stomach is resected, creating a smaller stomach (however the patient can eat a free diet as there is no restrictive component). The distal part of the small intestine is then connected to the pouch, bypassing the duodenum and jejunum.
In around 2% of patients there is severe malabsorption and nutritional deficiency that requires restoration of the normal absorption. The malabsorptive effect of BPD is so potent that those who undergo the procedure must take vitamin and dietary minerals above and beyond that of the normal population. Without these supplements, there is risk of serious deficiency diseases such as anemia and osteoporosis.
Restrictive procedures
Vertical banded gastroplasty
In the vertical banded gastroplasty, also called the Mason procedure or stomach stapling, a part of the stomach is permanently stapled to create a smaller pre-stomach pouch, which serves as the new stomach.
Adjustable gastric band
The restriction of the stomach also can be created using a silicone band, which can be adjusted by addition or removal of saline through a port placed just under the skin. This operation can be performed laparoscopically, and is commonly referred to as a "lap band". Weight loss is predominantly due to the restriction of nutrient intake that is created by the small gastric pouch and the narrow outlet. It is considered one of the safest procedures performed today with a mortality rate of 0.05%.
Sleeve gastrectomy
Sleeve gastrectomy, or gastric sleeve, is a surgical weight-loss procedure in which the stomach is reduced to about 15% of its original size, by surgical removal of a large portion of the stomach, following the major curve. The open edges are then attached together (typically with surgical staples, sutures, or both) to leave the stomach shaped more like a tube, or a sleeve, with a banana shape. The procedure permanently reduces the size of the stomach. The procedure is performed laparoscopically and is not reversible.
How's that for an overview? I should also point out that as of 2010 only about 50 doctors in the country were doing the BPD/DS. The cost at that time in Durham NC (this would vary across the country) was $49,845 and involved five days inpatient.
Another benefit of the BPD/DS is that it has a 98% cure rate for type 2 diabetes. In Europe it is being performed specifically for that reason even in the absence of obesity or other factors.
ReplyDeleteIn a way, stomach constriction methods resemble the hiatal hernia,
ReplyDeletewherein part of the stomach is above the diaphragm, part below.
From my experience, overeating with
that causes symptoms like being stuffed right into your throat and chest pains like a heart attack...
and leads to moderation at meals.
...then there's Diet & Exercise.
ReplyDeleteChristie exercise?
ReplyDeleteIndustrial strength treadmills are
expensive. (Of course he saves on
air travel by going as cargo freight)
Seems to me he's painting himself as some type of victim of forces beyond his control which for a conservative to do this...all he had to do was go on "Biggest Loser" or maybe one of them juice fasts. I wasn't big on colonoscopies and I sure am not keen on this stuff but something tells me as usual there's big bucks to be had.
ReplyDeleteI'm not sorry.
ReplyDeleteWonder if he has tried one of those expensive diets ?
ReplyDeleteI'm still not gonna vote for the guy. Anybody who calls himself a small-gov't conservative but then wants as many red-light cams in his state as possible, I had four of them in Yonkers a couple years ago at 50 bucks a pop and I don't care how svelte the guy looks in 016.
ReplyDeleteCurious- where does one find size
ReplyDeleteXXXXXXXL boxer shorts?
Not only that how exactly do they perform surgery on the obese? Think of all the layers of fat you have to cut through before you even hit muscle! The case could be made their operations should cost more.
ReplyDeleteGood point...I can hear the surgical team now: "Scalpel...
ReplyDeleteRetractor....clamp. Er, Holy Crap!
...ice cream scoop.
Bariatric surgery requires bariatric equipment.
ReplyDeleteThere are, however, weight restrictions even in those circumstances. Durham Regional has a suite set up that can handle a patient up to 1000 pounds. This involves more than you think; everything has to be able to handle that kind of weight; they have a special lift built into the ceiling that runs from the bed to the toilet (which, also, has to be bariatric). It's impressive. When I went to Duke Metabolic I felt like, do you remember that comedienne Lily Tomlin who used to sit in the giant rocking chair? That's how I felt.
If Christie uses the missionary position on his wife can he be charged with attempted murder?
ReplyDeleteI got a cracked rib that way once. (No charges were filed.)
ReplyDeleteBack in the 60s, there was a packaged banana flip that was far better than
ReplyDeletethe Twinkie. Only three bakeries left, all in Ohio..Navarre, Lima and Martin's Ferry. They have a distribution center in Cleveland:
lucky Beth!
I was never overly into the Twinkie, I mean I'll eat them...
ReplyDeleteI like Devil Dogs better than Twinkies.
ReplyDeleteRight now I have to increase (yeah, I'm not kidding) the fat in my diet and also I'm not drinking enough water so I'm trying to do that. There's a fine line between how much fat is TOO much fat and I am trying to find exactly what that is... but it's clear I'm not getting enough. Did you know you really do need to have a certain amount of fat in your diet? Just like cholesterol. It's important. The problem is that it's easy to over do.
So I decided I am going to start easy, one tablespoon of olive oil with oregano, parsley, salt, pepper and a piece of nice bread. If that does what I want it to do then that's enough. Otherwise then maybe two tablespoons. But I decided if I am going to do this then I'm not going to be cheezy about it: it's going to be real butter (salted only please cause that's how I like it) and EVOO. I think those are generally healthier fats anyway.
And minimum 36 oz of water a day. I have really been slack on this lately and between that and the utter lack of fat in my diet my entire gastrointestinal system is currently painfully deranged.
It's so funny, Z, I wouldn't know you to see you in the street but I know lots about your gut.
Not only fat but you need a certain amount of salt in your diet too. Some customers I get it's like they want ZERO salt in everything and watch ten years from now they'll say salt ain't so bad. My friend and I were discussing bad guts and he goes since it's probably workstress related you really should be able to send the laundry bill to the Company when you have to get the skid marks out. I mean it's only right.
ReplyDeleteYou are absolutely right about the salt. The problem seems to be that we are an all or nothing kind of society, either it's horrible no-salt-added foods (they ALL taste horrible) or it's some report saying how some fast food place has 4300mg sodium in a single item. I just don't think we know how to moderate.
ReplyDeleteI would say about 50% of what I eat is raw vegetables. Some vegetables are higher in sodium like celery but really, I don't know for sure but probably I could eat 10 heads of celery and it's not as much sodium as a small fries. I don't worry about sodium per se but I try to be smart; like if I'm making a soup and I use some form of soy sauce or Maggi seasoning in the base then I wouldn't add any other salt to it. I like salt on my tomatoes and strangely enough on my oatmeal.
I'm the same way when I'm cooking, if some of the ingredients already have enough salt in them for taste I don't sprinkle any more loose salt on. Know a guy when he makes chicken pot pies and he already added the cream of chicken and then some chicken broth into the mixing bowl and then adds the chopped up chicken pieces and then he goes crazy with the salt and I'm like it has enough salt already, what are you doin'?!
ReplyDeleteI wonder how much of that obsession with salt is like a cultural taste, a thing you grow up with like how Indians love chilies or Italians love garlic. It's like whatever we're given as children, all the emotional things grow up around it and you become accustomed to a specific taste. Given that Americans eat so much processed food literally from birth and they are all uniformly crammed with sodium I wonder if it's not just a kind of reflex thing to want everything to be salty.
ReplyDeleteDid that make any sense?
That cultural thing is over-rated:
ReplyDeletethis Norwegian hates lutefisk!
Christie the other day said when people say just push the plate away at the table that it's not that simple. Actually it IS that simple.
ReplyDeletePicture Christie coming out of a Dunkin Donuts with coffee in one hand and cruller in the other and he says look it's not that simple. Ever know somebody who says they have to lose weight? we all do but then you watch them throughout the day and again it's a coffee and donut here, two McWraps over there for lunch, maybe a banana they had in their back pocket. The reason Christie chose the lapband is he doesn't have the Discipline.
ReplyDelete(it really isn't that simple)
ReplyDeleteWell it's simpler than Christie makes it and I only partly agree with you since things like your metabolism do slow down as you get older. Two comments here and when you actually deconstruct the problem of losing weight which everyone over-mystifies it begins to make some sense. FOOD, food is a great paradox - you need food but it also makes you fat. Starting with this foundational observation IF Christie put less food in his mouth over the years he may not be svelte today but he'd have gone a great way in at least simplifying his problem to some degree. He'd be overweight but less so, maybe husky but not obese. Now on to stray cats......
ReplyDeleteI've always felt you can learn alot from animals. Have you ever fed stray cats? I know technically you're not supposed to but just to illustrate a point - in my experience the most homeless stray cats that I've fed come by no more than twice a day. Sure I've given them extra amounts at each meal but that's eat, on their own choice they prefer TWO MAIN MEALS A DAY! (usually in their case morning and late afternoon). Animals seem to know that's enough, more than enough but what do we do? we've somehow been brought up on you need 3 SQUARE MEALS a day and in Christie's case it was probably 5 square meals a day. It's the third meal that's doing us in.
ReplyDeleteGiven that Christie is no feline,
ReplyDeletewe note that cat metabolism is somewhat different. While they
have burst of high energy (pursue and kill that moth), they also spend an inordinate amount of time
sleeping. There is the unusual house cat that grows to Christie
girth, but all the house cats we have had stayed, well...slimmer than the owner.
Differences between cat and human metabolism notwithstanding I'm sticking with my cat analogy. Strays only come around and eat when they're hungry, humans on the other hand often eat just 'cause there's food around. Also BB are most people's metabolisms and lifestyle geared towards burning off that third meal? Cats and humans, I also know some people who sleep 'til noon:)
ReplyDeleteJust because you feed them twice a day doesn't mean that they're eating only twice a day. If a cat gets nibbly he goes and kills something tasty. You don't have to be in on that process loop. So, apart from that analogy being burst....
ReplyDeleteI understand the President is going back to NJ to tour the coast with Christie. More lovin from the oven on the way I guess, maybe this will be the trip that forces the Republicans to officially disown him.
I read your comment on my mobile and, well more likely re my cat analogy you don't want to give me credit for the occasional creative insight. Felines the strays anyway only eat when they're hungry but I've known a cat or two who leave dead mice lying around without really eating it, must be the sport of it all. Now what do dogs and cats do when they first get up in the morning? they stretch and there's another lesson. Maybe if we all did that we wouldn't have the occasional groin pull or strained back, just sayin'.
ReplyDeleteRe Christie I think there's a misunderstanding on the part of liberals re the whole Sandy/Obama/Christie thing. Nobody's saying don't be civil, don't say thank you etc. but to me at least it seemed like he forgot who he was campaigning for and imo that tilted the balance...I mean the effusion might've been hard for some to take.
ReplyDeleteIf you stretched in the morning like a cat, you would be able to
ReplyDeletetwist your body in mid air and land
on all four paws.
So take up yoga.
ReplyDelete(I'm detecting a slight anti-cat bias here)...
ReplyDeleteWe used to have two cats, they were half brothers in the same litter. They were both enormous. Brother Spanky (that was his name) was a Maine Coon and weighed 21 pounds, was 46" nose to tail. Brother Clem was a plain old American Shorthair, white with some tortoise spots, and he was 19 pounds. They both had very sweet personalities. Of course they were just given to us out of someone's litter; we have a very strict no-buying-animals policy.
ReplyDeleteOnce they were gone we decided no more cats. And probably once the Breegirl is gone no more dogs either. I might get a pet rock.
Over here on Long Island there's been a spate of small 'gator or croc sightings here and there. Seems people get them as pets when they're small, get 'em online and then release them when they start growing and the owners get a little nervous.
ReplyDeleteWe don't have gators here but when we lived in Wilmington they were everywhere. On the Battleship there is a big sign that says PLEASE DO NOT FEED THE ALLIGATORS because dumb people do that. It's like a well known thing too with the golf... if your ball goes in the deep rough you might just wanna take a drop. And a couple times a year one will fall asleep sunbathing in the middle of the road (asphalt gets toasty) and then they have to stop traffic and all that to get the big boy out the way.
ReplyDeleteI like gators cause they're so damn prehistoric. And they have maternal instincts.
OH I almost forgot. In Greenfield Lake (in the middle of Wilm) there are gators and signs everywhere saying don't go swimming, there's gators. So this guy gets drunk with his friends and he goes in the water and they're yelling, look, the gator, and he thinks they're playin cause they're all half drunk, and the gator got him. It didn't kill him (they hardly ever do really) but it did gnaw on him a bit. I bet he sticks to the kiddy pool now. This is an absolutely true story because I can't make up such stupid shit.
ReplyDelete