This is not a good thing, folks.  And it scares me because the things I need to keep my vision, my bones, my blood clotting may go away.

Basically, this act will allow the FDA to pull all nutritional supplements.  And while the Centrums and NatureMades will be fine, what I worry about will be the 50,000 IU water-miscible D3′s that I take, or the 100mg K1′s, or any of the “dangerous” level meds.. or even the heme iron that I’ve FINALLY found that works for me.

So while I’ve always been political, have voted in every election that I have been able to vote in, have called my elected representatives for certain things — I have yet to write a single letter to any politicians.  The time has ended.

Senator John McCain
United States Senate
241 Russell Senate Office Building
Washington, D.C.  20510

Senator McCain:

I am not a constituent of yours.  Nor do I plan to be one in the future.  In fact, I live almost as far away from your Arizona as possible without actually living on a different continent.

However, the Dietary Supplement Safety Act that you are proposing could impact my life in ways you cannot possibly imagine.

Sir, I had Roux-en-Y gastric bypass surgery in 2004.  Like thousands of others who have battled morbid obesity, I have had a surgery that has altered my intestines in a way that severely limits my ability to absorb nutrition from food.  It is because of this fact that I survive daily from nutritional supplements — nutritional supplements that you are attempting to regulate.

I understand the need for regulation against unsafe chemicals that are being marketed and sold to our youth.  As a mother of young children, I can appreciate the desire to protect our children.  However, I see this Act as a way to limit my ability to maintain my health with these absolutely vital supplements.

I know that there are some supplements that are available in prescription form.  Unfortunately, not all of these are acceptable for patients such as myself and only over-the-counter supplementation will maintain my health.  For example, a common prescription to rectify a clinical deficiency of vitamin D is a 50,000 IU dose of vitamin D2 in an oil-suspension.  D2 has been found to be one-tenth the strength of D3 (which is available over-the-counter at your local pharmacy), and with my reconfigured intestinal design, I do not absorb the oil that the D2 is immersed in.  Therefore, what little of the vitamin I might absorb, much of it is lost in the body’s conversion to D3.  In many cases, a 50,000 IU dose of D2 would be equivalent to what I could pick up at CVS as a D3 supplement for anyone — and even worse for me with the fat malabsorption my surgery gave me.  Instead, I can take a 50,000 IU dose of D3 — something your Act would surely take away, relegating me to months of painful recovery as I suffer from osteomalacia or even osteoporosis at the tender age of 31.

While this is certainly an extreme case, it is something that thousands of us face daily.  Vitamin D is not the only vitamin I worry about with this act — high dose vitamin A allows me to keep my vision, vitamin K allows my blood to clot, B12 allows me to have neurological function, and high-dose iron allows my blood to move oxygen through my cells properly.  All of these are in higher-than-normal doses to counteract the surgical implications of my gastric bypass surgery — and it is something I will live with for the rest of my life.

I implore you to examine this issue very carefully as things are not exactly black and white.  I believe safety is needed in the supplement industry — especially as I take so many of them.  However, such strict regulation could seriously impact my ability to live a functional life versus a life of skinny sickness.

I had this surgery to be a healthier individual — this bit of regulation could seriously impair that goal.

Sincerely,
Andrea S. Ullberg
Wilson, NC  27896
andrea@ullberg.us

http://wlsvitagarten.com

Senator Kay Hagan
United States Senate
521 Dirksen Senate Office Building
Washington, D.C.  20510

Senator Hagan:

I am one of your constituents — one that is proud to say that voted for you.  I thank you for the hard work you’ve put forth in representing the people of North Carolina thus far.

I write to you today, however, to express grave concern about Senator McCain’s Dietary Supplement Safety Act.  This Act, if passed, could cause me and thousands more like me, great personal harm and impact my health and well-being in a way he has not considered.  Please take a moment to understand why.

I had Roux-en-Y gastric bypass surgery in 2004.  Like thousands of others who have battled morbid obesity, I have had a surgery that has altered my intestines in a way that severely limits my ability to absorb nutrition from food.  It is because of this fact that I survive daily from nutritional supplements — nutritional supplements that he is attempting to regulate.

I understand the need for regulation against unsafe chemicals that are being marketed and sold to our youth.  As a mother of young children, I can appreciate the desire to protect them.  However, I see this Act as a way to limit my ability to maintain my health.  If I cannot maintain my health, I will not be able to protect or care for my children myself — which defeats the purpose of the bill.

I know that there are some supplements that are available in prescription form.  Unfortunately, not all of these are acceptable for patients such as myself and only over-the-counter supplementation will maintain my health.  For example, a common prescription to rectify a clinical deficiency of vitamin D is a 50,000 IU dose of vitamin D2 in an oil-suspension.  D2 has been found to be one-tenth the strength of D3 (which is available over-the-counter at your local pharmacy), and with my reconfigured intestinal design, I do not absorb the oil that the D2 is immersed in.  Therefore, what little of the vitamin I might absorb, much of it is lost in the body’s conversion to D3.  In many cases, a 50,000 IU dose of D2 would be equivalent to what I could pick up at CVS as a D3 supplement for anyone — and even worse for me with the fat malabsorption my surgery gave me.  Instead, I can take a 50,000 IU dose of D3 — something your Act would surely take away, relegating me to months of painful recovery as I suffer from osteomalacia or even osteoporosis at the tender age of 31.

While this is certainly an extreme case, it is something that thousands of us face daily.  Vitamin D is not the only vitamin I worry about with this act — high dose vitamin A allows me to keep my vision, vitamin K allows my blood to clot, B12 allows me to have neurological function, and high-dose iron allows my blood to move oxygen through my cells properly.  All of these are in higher-than-normal doses to counteract the surgical implications of my gastric bypass surgery — and it is something I will live with for the rest of my life.

I implore you to examine this issue very carefully as things are not exactly black and white.  I believe safety is needed in the supplement industry — especially as I take so many of them.  However, such strict regulation could seriously impact my ability to live a functional life versus a life of skinny sickness.

Please take the time to examine this issue very carefully.  Many of us depend on these supplements — not for simple well-being but for our actual lives.

Sincerely,

Andrea S. Ullberg
Wilson, NC  27896
andrea@ullberg.us

http://wlsvitagarten.com

Senator Richard Burr
United States Senate
217 Russell Senate Office Building
Washington, D.C.  20510

Senator Burr:

I thank you for the hard work you’ve put forth in representing the people of North Carolina.

I write to you today to express grave concern about Senator McCain’s Dietary Supplement Safety Act.  This Act, if passed, could cause me and thousands more like me, great personal harm and impact my health and well-being in a way he has not considered.  Please take a moment to understand why.

I had Roux-en-Y gastric bypass surgery in 2004.  Like thousands of others who have battled morbid obesity, I have had a surgery that has altered my intestines in a way that severely limits my ability to absorb nutrition from food.  It is because of this fact that I survive daily from nutritional supplements — nutritional supplements that he is attempting to regulate.

I understand the need for regulation against unsafe chemicals that are being marketed and sold to our youth.  As a mother of young children, I can appreciate the desire to protect them.  However, I see this Act as a way to limit my ability to maintain my health.  If I cannot maintain my health, I will not be able to protect or care for my children myself — which defeats the purpose of the bill.

I know that there are some supplements that are available in prescription form.  Unfortunately, not all of these are acceptable for patients such as myself and only over-the-counter supplementation will maintain my health.  For example, a common prescription to rectify a clinical deficiency of vitamin D is a 50,000 IU dose of vitamin D2 in an oil-suspension.  D2 has been found to be one-tenth the strength of D3 (which is available over-the-counter at your local pharmacy), and with my reconfigured intestinal design, I do not absorb the oil that the D2 is immersed in.  Therefore, what little of the vitamin I might absorb, much of it is lost in the body’s conversion to D3.  In many cases, a 50,000 IU dose of D2 would be equivalent to what I could pick up at CVS as a D3 supplement for anyone — and even worse for me with the fat malabsorption my surgery gave me.  Instead, I can take a 50,000 IU dose of D3 — something the Act would surely take away, relegating me to months of painful recovery as I suffer from osteomalacia or even osteoporosis at the tender age of 31.

While this is certainly an extreme case, it is something that thousands of us face daily.  Vitamin D is not the only vitamin I worry about with this act — high dose vitamin A allows me to keep my vision, vitamin K allows my blood to clot, B12 allows me to have neurological function, and high-dose iron allows my blood to move oxygen through my cells properly.  All of these are in higher-than-normal doses to counteract the surgical implications of my gastric bypass surgery — and it is something I will live with for the rest of my life.

I implore you to examine this issue very carefully as things are not exactly black and white.  I believe safety is needed in the supplement industry — especially as I take so many of them.  However, such strict regulation could seriously impact my ability to live a functional life versus a life of skinny sickness.

Please take the time to examine this issue very carefully.  Many of us depend on these supplements — not for simple well-being but for our actual lives.

Sincerely,

Andrea S. Ullberg
Wilson, NC  27896
andrea@ullberg.us

http://wlsvitagarten.com

Please.  Read more about this and do your part to protect yourselves.  This is important.  I’ve rarely taken action such as this and I think this is worth fighting for.

We NEED these supplements.  Don’t let them take them away from us.

Metabolic Surgery Statistics — 2008

On November 29, 2009, in Uncategorized, by Andrea

This morning, I came across this article by Buchwald and Oien (thanks Bonamy) outlining worldwide WLS statistics for 2008.  According to the authors, the last evaluation was done in 2003 and this evaluation was done by sending a survey to 39 nations or national groupings (of which 36 responded).  Given this was a survey, it will be somewhat biased based on the person answering the survey, as well as the fact that the numbers are worldwide — some procedures are done in other parts of the world that are not performed in the US routinely (such as Vertical Banded Gastroplasty {VBG}) or the Scopinaro Biliopancreatic procedure.  Of course, I am a numbers girl and wish that all numbers are exact figures, but let’s face it — it’s not realitySo given that, I have to concede that these are not going to be 100% exact.

Some direct quotes and figures from the report:

  • In 2008, 344, 221 bariatric surgery operations were performed by 4,680 bariatric surgeons, 220,000 of these operations were performed in USA/Canada by 1,625 surgeons
  • Seven other countries or national groupings with more than 100 bariatric surgeons: Australia/New Zealand (118), Brazil (700), Chile (100), France (310), Italy (300), Mexico (150), and Spain (400)
  • 91.4% of world bariatric surgery was performed laparoscopically
  • Considering all gastric bypasses together (distal and prox, open and lap), number of RNY exceeds AGB’s.
  • In Europe, relative percent of AGB decreased from 63.7% to 43.2% from 2003 to 2008, while RYGB increased from 11.1% to 39%.  In USA, AGB increased from 9% to 44% and RYGB decreased from 85% to 51%.  In both Europe and USA, VSG went from 0% in 2003 to 4%.
  • Most common type of procedures were purely restrictive (AGB, VSG, VBG) (48.6%), restrictive/malabsorptive (RNY) (49.0%), and primarily malabsorptive (BPD/DS) (2%).

Surgical types by breakdown (Lap and Open combined)

  1. Proximal RNY – 45.4%
  2. AGB – 42.4%
  3. VSG – 5.4%
  4. VBG – 1.1%
  5. BPD and DS procedures combined – 1.1%
  6. Other – 0.1%

The authors make a few conclusions about the numbers they received in this survey — some of which bother me.  There is quite a disenchantment of AGB in Europe, where there is quite a long history of it’s use there, and a growing trend towards VSG and RYGB there.  USA and Canada, where we want newer and better (and have marketing via TV commercials?  WTF?) is moving away RYGB (which we have a longer history) and are moving towards AGB and VSG.  In no cases are we moving closer to DS — which in many ways to ME seems to be an excellent choice and not given any credit or opportunity to shine.  The authors also clearly bring up the fact that many people would presumably want metabolic surgery if they could get their paws on it — would even, I dunnow, self-pay for it, or change jobs for it, or go work part-time at the Buxx for it?  For those of us in the community, we’ve seen and heard this time and time again so nice to see the professionals recognize it in a published article.  Additionally — patients are getting smarter, using the interwebz and understanding a bit more about what we are doing to our guts when we go and get chopped up — and it’s all for the betterment:

Further involved factors may be the predictable craving for something regionally newer, the imposition of payer mandates, media-derived prejudices and and biases, advertisement campaigns by the bariatric surgery industry, increased patient sophistication and use of websites, and, of course, relative regional economic advantages for bariatric surgeons.

I have to say the thing I’m most concerned about is the complete lack of yeast in the DS numbers.  This is a wonderful surgery — doesn’t have many of the RNY pitfalls (and let me tell you, I know several of them first hand), doesn’t require all that much more work than far-out RNY patients (despite what some may tell you — it’s not all roses and rainbows and unicorns) and just isn’t getting the recognition or the opportunity to shine and show it’s stuff.  I wish more surgeons would learn how to perform it.  I wish more people would learn the stats.  I wish more people would stop spreading misinformation crap about it in hopes of making their own surgery look better.  And I wish many of the surgeons that don’t perform it would also stop this practice — it’s unprofessional as all hell and only perpetuates the problems as their patients then do the exact same thing and continues to spread the misinformation, fear, and, eventually, hatred, around.

Europe at least is performing the DS a bit more than we are -0-  they had a 58.7% increase of surgeries from 03 to 08 — but still that increase only comprised 4.9% of the total surgery population in 08 which is an actual decrease from 6.1% surgical population in 03.  Comparatively, the US went from 4.5% surgical population in 03 to 1%?!? in 08?  with a 52.5% decrease.  WHY? I don’t get it.  There is too much good in the DS for this statistic.  At least the US wasn’t as abysmal as Asia and the Pacific.. those numbers were too depressing to even type out.

So what does all of this mean?  WLS is on the rise, but not as much as it was in 03.  Considering how quickly the rate of obesity is climbing, this isn’t quite proportionate as some critics claim (including many private payers who don’t want to cover WLS as it would “cost too much”) — and given how diabetes costs are going to triple by 2023? This is a way to go to help avoid these ballooning costs.  Some surgeries are growing by leaps and bounds regionally — some are growing regardless (VSG, anyone?)  and some are still performed in areas while considered completely antiquated in others (VBG in the US).

Very interesting.  Somewhat sad.  But very interesting.

Bariatric surgery IS an ANSWER…

On November 18, 2009, in General Nutrition, by Andrea

So there’s a new report out yesterday that projects 103 million Americans will be obese by 2018 — that’s 43%  — up from 31% in 2008.  That’s quite an increase, and imagine the costs associated with the co-morbidities that are associated with obesity..

Mr. Thorpe concluded that the prevalence of obesity is growing faster than that of any other public health condition in the country’s history. Health care costs related to obesity — which is associated with conditions like hypertension and diabetes — would total $344 billion in 2018, or more than one in five dollars spent on health care, if the trends continue. If the obesity rate were held to its current level, the country would save nearly $200 billion a year by 2018, according to the study.

So while reading this little article — and thanks Eggface for linking it up — I remembered an article I read last year – this one right here that called Bariatric surgery “cost effective” !!  Heya, this might be an answer!

The cost of the most common type of weight-loss surgery, which typically runs between $17,000 and $26,000, is offset within two to four years by medical cost savings, according to a new study.

The findings, published in the September issue of the American Journal of Managed Care, may increase pressure on health-insurance companies to cover gastric bypass surgery. Some insurance plans specifically exclude weight-loss surgery, despite medical evidence of its effectiveness as a treatment not just for obesity, but also for related conditions including diabetes, high blood pressure and sleep apnea.

“The most cost-effective treatment for obesity is bariatric surgery. If you do that, within two to four years, you will get your money back,” said the study’s lead author, Pierre-Yves Crémieux, a health economist and principal at Analysis Group Inc., an economic consulting firm in Boston. “We have identified the break-even point for insurers,” he added.

So maybe, just maybe we can get people to listen?  Fixing obesity with a gut-rerouting can be a cost-effective solution.  I don’t advocate it for everyone — those who won’t take care of themselves, follow the vitamin regimen, etc. shouldn’t get sliced and diced.  I know, hard to weed out the crazies.  But here, here is a way to help cut health care costs that people are bitching about in the country.  Rather than tell those of us who have the surgery that we shouldn’t do this, doctors should help us and learn more about it, and hey, maybe even educate more patients about it to help save lives.

Well, a girl can dream, right?